Estimating the risk of fatal traffic accidents posed by drivers with epilepsy in Japan: A comparison with traffic accidents caused by sudden death of occupational drivers

Abstract

Purpose: Pr oper judgement of the aptitude of people with epilepsy (PWE) for dr iving is a cr itical issue, both medically and socially. One thus far reported approach is a quantitative comparison of the risk of fatal traffic accidents caused by PWE drivers and that by subgroups of drivers in the general population. We propose a new approach that compares the risk posed by PWE drivers and that by sudden death of occupational drivers, and the maximum driving time for PWE based on that comparison. Method: The r isk of fatal tr affic accidents was estimated using four var iables. The value assigned to each variable was determined using reports and statistics. Results: The r isk of fatal tr affic accidents caused by sudden death of occupational dr iver s was estimated to be 7.6×10 -5 /year, 4.9×10 -5 /year, and 1.7×10 -5 /year for large-sized, mid-sized and normalsized vehicles. The risk of fatal traffic accidents caused by PWE drivers was estimated to be 5.3×10 -5 / year and 3.2×10 -5 /year for PWE with seizure-free periods of 1 year and 2 years, respectively. The maximum acceptable driving time for PWE having a 2-year seizure-free period at the equivalent risk caused by sudden death of occupational drivers of mid-sized vehicles was estimated to be 304 min/week. Conclusion: The r isk of fatal tr affic accidents caused by PWE dr iver s can be evaluated by comparing to that caused by sudden death of occupational drivers. Such risk posed by PWE drivers having a 2-year seizure-free period was less than that caused by sudden death of occupational drivers of midsized vehicles. Assuming that the society accepts the latter risk, PWE may be permitted to drive for an estimated maximum time at the equivalent risk of causing a fatal accident.

Risks of seizure with fatal traffic crash at wheel in people with epilepsy

“…Beyond such variability by region, the estimated risks would be unreliable in PWE whose driving time or probability of seizure causing a fatality deviates largely from the mean values. To overcome these issues, instead of drawing a line based solely on a seizure-free period, to limit driving time according to a seizure-free period and probability of seizure causing a fatality for each PWE may be considered a novel approach for driving aptitude [14]. Some American states have adopted a shorter seizure-free period combined with individual evaluation by a medical advisory board (MAB), according to the U.S. consensus guideline [9,15].…”