The occupational risk of motor vehicle collisions for emergency medicine residents

Objective: To determine the prevalence and risk factors associated with mot or vehicle collisions (MVCs) and near crashes as reported by emergency medi cine (EM) residents following various ED shifts. Methods: A survey was sent to all allopathic EM-2-EM-4 residents in May 1996 asking whether they had ever been involved in an MVC or near-crash while driving home after an ED s hift. The residents' night shift schedules, self-reported tolerance of nigh t work, ability to overcome drowsiness, sleep flexibility, and morningness/ eveningness tendencies also were collected. Results: Seventy-eight programs participated and 62% of 1,554 eligible residents returned usable surveys. Seventy-six (8%, 95% CI = 6% to 10%) residents reported having 96 crashes a nd 553 (58%, 95% CI = 55% to 61%) residents reported being involved in 1,44 6 near-crashes. Nearly three fourths of the MVCs and 80% of the near-crashe s followed the night shift. Stepwise logistic regression of all variables d emonstrated a cumulative association (R = 0.19, p = 0.0004) that accounted for 4% of the observed variability in MVCs and near-crashes. Univariate ana lysis showed that MVCs and near-crashes were inversely related to residents ' shiftwork tolerance (p = 0.019) and positively related to the number of n ight shifts worked per month (p = 0.035). Conclusions: Residents reported b eing involved in a higher number of MVCs and near-crashes while driving hom e after a night shift compared with other shifts. Driving home after a nigh t shift appears to be a significant occupational risk for EM residents.