The general practitioners of the territorial professional health community (CPTS) of Greater Narbonne are involved in an approach intended to raise awareness and adapt the system dedicated to medical fitness to drive. In Aude, a few figures make it possible to identify the importance of potential unfitness factors.
Seniors over-represented in road deaths
In its monthly departmental road safety barometer for November 2024, the Aude prefecture reported, at the end of November, 39 deaths on the roads, compared to 29 at the end of November 2023. An increase of 34.5% in victims for which seniors have paid a heavy price: in October 2024, two of the users killed were 75 years old and over; “since the beginning of the year, specifies the document, there are eight users aged 75 and over who have died on the roads of Aude compared to 4 in 2023 and 2022.. A raw figure, which however says nothing about the responsibility of these victims (four drivers, three passengers, one pedestrian) in these accidents.
Also read:
“Having the reflex to wonder if my patient is compatible with driving”: Narbonnais general practitioners at the forefront of a “taboo” subject
To be taken with caution, therefore, so as not to stigmatize an age group, even though seniors, with age helping, are necessarily susceptible to sensory disorders affecting driving. Besides, the barometer continued, “users aged 18 to 24 nevertheless remain the most involved in fatal accidents with nine killed since the start of the year”. Proof by example that statistics should be taken with a pinch of salt. The fact remains that with eight of the 39 victims recorded, those over 75 in Aude represented 20.5% of the deaths, when, on 1is January 2024, the 46,757 Audois in the same age category represented 12.4% of the population.
Numerous disabling pathologies
Cardiovascular or neurological pathologies, pain, diabetes or disabilities, ophthalmic or ENT pathologies, cognitive disorders, epilepsy, diabetes with risk of feeling unwell, etc. The list of pathologies that can lead to partial or total incapacity to drive is long. But it is impossible today to know exactly how many Audois are affected by such pathologies, and whether the impact of these illnesses is sufficient to justify a driving ban or the authorization restrictions that the procedure allows (no night driving , on the motorway, vehicle fittings, etc.). However, one indicator shows that the number of Aude drivers potentially affected is vast. The table of people supported by Social Security for long-term illness (ALD), for the 30 ALD recognized by decree, allows us to know that 3,100 Audois were affected in 2023 by a disabling stroke, when 9,480 benefited from an ALD for serious heart failure, serious arrhythmia, serious valvular heart disease or serious congenital heart disease, 21,240 for type 1 or 2, or 2,590 for Alzheimer’s disease and 1,020 for Parkinson’s disease.
Medications: the great unknown
Each box of medications that could potentially affect driving is decorated with a pictogram, with three color codes defining three levels of risk: level 1 (yellow) means a low risk because it depends above all on how the person tolerates more or less the medicine is good; level 2 (orange) means a real risk, linked to the mode of action of the medication, and therefore requires that the doctor or pharmacist examines on a case-by-case basis whether taking the medication is compatible with driving; Level 3 (red) means that driving is strictly discouraged. According to Health Insurance, 5% of medications are classified as level 3 risk.
But just as with pathologies and their potential effect on driving, it is impossible to provide a definitive figure on the number of Audois concerned: “Hypnotics and anxiolytics (particularly benzodiazepines) are the substances most frequently found in blood tests of road accident victims”specifies Social Security; but other families can have effects, such as medications for motion sickness, antihistamines, antidiabetics, antivertigo drugs, or even pain treatments. A single piece of data is enough to raise the scale of the question: in 2017-2019, 23.2% of Audois had received at least 3 deliveries of psychotropic drugs (11.2% for anxiolytics). Between 2005 and 2008, the National Institute of Health and Medical Research (Inserm) looked at more than 70,000 drivers involved in an injury accident. Result : “The risk of accident would increase by 14% with taking a single medication, by 30% with two and by 86% with three.” And to evaluate “the proportion of road accidents which are attributable to medicines is approximately 3%”.
