Marijuana and the Risk of Fatal Car Crashes: What Can We Learn from FARS and NRS Data?
Marijuana and the Risk of Fatal Car Crashes: What Can We Learn from FARS and NRS Data?
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DOI：
10.1007/s10935-017-0478-3
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发表时间：
2017-06-01
影响因子：
1.7
通讯作者：
Lacey, John H.
中科院分区：
文献类型：
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作者：
Romano, Eduardo;Torres-Saavedra, Pedro;Lacey, John H.
实验室研究表明，大麻会严重损害驾驶技能。然而，关于大麻使用对撞车风险的贡献，流行病学研究一直没有定论。在美国，基于可比车祸死亡分析报告系统(FARS)和非车祸国家路边调查(NRS)数据的病例对照研究已被应用于评估药物对车祸风险的贡献，但这些研究得出了令人困惑的甚至相互矛盾的结果。我们假设，这种结果的差异源于这些研究中使用的数据库的限制，特别是FARS的数据库。这项工作的目标是检验这一假设，并在这样做的过程中，阐明使用这些数据库进行药物驾驶研究的利弊。我们利用了最近的两项大麻碰撞风险研究，尽管使用了类似的数据库(FARS和NRS)，并遵循了类似的总体方法，但得出了相反的结果(Li，Brady&Chen，2013；Romano，Torres-Saavedra，Voas和Lacey，2014)。通过确定这些努力在方法上的相似和差异，我们评估了FARS和NRS数据库的局限性如何导致相互矛盾和有偏见的结果。由于其局限性，我们建议FARS数据库既不应用于审查药物使用趋势，也不应用于获得准确的风险估计。然而，在某些条件下(例如，根据定期检测药物的司法管辖区的数据，检测程序的差异尽可能小)，FARS数据库可用于评估相对于酒精等其他风险来源，药物对致命撞车风险的贡献。
Lab studies have shown that marijuana can severely impair driving skills. Epidemiological studies, however, have been inconclusive regarding the contribution of marijuana use to crash risk. In the United States, case-control studies based on the merging of comparable crash Fatality Analysis Reporting System (FARS) and non-crash National Roadside Survey (NRS) data have been applied to assess the contribution of drugs to crash risk, but these studies have yielded confusing, even contradictory results. We hypothesize that such a divergence of results emanates from limitations in the databases used in these studies, in particular that of the FARS. The goal of this effort is to examine this hypothesis, and in doing so, illuminate the pros and cons of using these databases for drugged-driving research efforts. We took advantage of two relatively recent cannabis crash risk studies that, despite using similar databases (the FARS and the NRS) and following similar overall approaches, yielded opposite results (Li, Brady, & Chen, 2013; Romano, Torres-Saavedra, Voas, & Lacey, 2014). By identifying methodological similarities and differences between these efforts, we assessed how the limitations of the FARS and NRS databases contributed to contradictory and biased results. Because of its limitations, we suggest that the FARS database should neither be used to examine trends in drug use nor to obtain precise risk estimates. However, under certain conditions (e.g., based on data from jurisdictions that routinely test for drugs, with as little variation in testing procedures as possible), the FARS database could be used to assess the contribution of drugs to fatal crash risk relative to other sources of risk such as alcohol.