{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T14:15:36Z","timestamp":1793888136819,"version":"4.8.0"},"reference-count":23,"publisher":"BMJ","issue":"7346","license":[{"start":{"date-parts":[[2002,5,11]],"date-time":"2002-05-11T00:00:00Z","timestamp":1021075200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"accepted":{"date-parts":[[2002,1,29]]},"published-print":{"date-parts":[[2002,5,11]]},"abstract":"Abstract<\/jats:title>\n \n Objectives:<\/jats:bold>\n To estimate the contribution of driver sleepiness to the causes of car crash injuries.\n <\/jats:p>\n \n Design:<\/jats:bold>\n Population based case control study.\n <\/jats:p>\n \n Setting:<\/jats:bold>\n Auckland region of New Zealand, April 1998 to July 1999.\n <\/jats:p>\n \n Participants:<\/jats:bold>\n 571 car drivers involved in crashes where at least one occupant was admitted to hospital or killed (\u201cinjury crash\u201d); 588 car drivers recruited while driving on public roads (controls), representative of all time spent driving in the study region during the study period.\n <\/jats:p>\n \n Main outcome measures:<\/jats:bold>\n Relative risk for injury crash associated with driver characteristics related to sleep, and the population attributable risk for driver sleepiness.\n <\/jats:p>\n \n Results:<\/jats:bold>\n There was a strong association between measures of acute sleepiness and the risk of an injury crash. After adjustment for major confounders significantly increased risk was associated with drivers who identified themselves as sleepy (Stanford sleepiness score 4-7\n v<\/jats:italic>\n 1-3; odds ratio 8.2, 95% confidence interval 3.4 to 19.7); with drivers who reported five hours or less of sleep in the previous 24 hours compared with more than five hours (2.7, 1.4 to 5.4); and with driving between 2 am and 5 am compared with other times of day (5.6, 1.4 to 22.7). No increase in risk was associated with measures of chronic sleepiness. The population attributable risk for driving with one or more of the acute sleepiness risk factors was 19% (15% to 25%).\n <\/jats:p>\n \n Conclusions:<\/jats:bold>\n Acute sleepiness in car drivers significantly increases the risk of a crash in which a car occupant is injured or killed. Reductions in road traffic injuries may be achieved if fewer people drive when they are sleepy or have been deprived of sleep or drive between 2 am and 5 am.\n <\/jats:p>\n \n \n \n What is already known on this topic<\/jats:title>\n Driver sleepiness is considered a potentially important risk factor for car crashes and related injuries but the association has not been reliably quantified<\/jats:p>\n Published estimates of the proportion of car crashes attributable to driver sleepiness vary from about 3% to 30%<\/jats:p>\n <\/jats:sec>\n \n What this study adds<\/jats:title>\n Driving while feeling sleepy, driving after five hours or less of sleep, and driving between 2 am and 5 am were associated with a substantial increase in the risk of a car crash resulting in serious injury or death<\/jats:p>\n Reduction in the prevalence of these three behaviours may reduce the incidence of injury crashes by up to 19%<\/jats:p>\n <\/jats:sec>\n <\/jats:boxed-text>\n <\/jats:p>","DOI":"10.1136\/bmj.324.7346.1125","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T06:45:35Z","timestamp":1027752335000},"page":"1125.1","source":"Crossref","is-referenced-by-count":562,"title":["Driver sleepiness and risk of serious injury to car occupants: population based case control study"],"prefix":"10.1136","volume":"324","author":[{"given":"Jennie","family":"Connor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Norton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanthi","family":"Ameratunga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Civil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Dunn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Bailey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rod","family":"Jackson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2002,5,11]]},"reference":[{"key":"2025122121504488000_324.7346.1125.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.23.1908"},{"key":"2025122121504488000_324.7346.1125.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7290.829"},{"key":"2025122121504488000_324.7346.1125.3","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1111\/j.1445-5994.1999.tb01613.x","article-title":"Driver sleepiness: occupational screening and the physician's role","volume":"29","author":"Pierce","year":"1999","journal-title":"Aust N Z J Med"},{"key":"2025122121504488000_324.7346.1125.4","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1093\/sleep\/22.4.475","article-title":"Long distance driving and self-induced sleep deprivation among automobile drivers","volume":"22","author":"Philip","year":"1999","journal-title":"Sleep"},{"key":"2025122121504488000_324.7346.1125.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-4575(00)00013-0"},{"key":"2025122121504488000_324.7346.1125.6","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1093\/sleep\/24.6.688","article-title":"Prevalence of driver sleepiness in a random population-based sample of car driving","volume":"24","author":"Connor","year":"2001","journal-title":"Sleep"},{"key":"2025122121504488000_324.7346.1125.7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.1995.tb00221.x"},{"key":"2025122121504488000_324.7346.1125.8","unstructured":"Dinges D Kribbs N .Performing while sleepy: effects of experimentally-induced sleepiness. In: Monk T , ed. Sleep, sleepiness and performance. New York:John Wiley,1991:98\u2013128."},{"key":"2025122121504488000_324.7346.1125.9","unstructured":"Expert Panel on Driver Fatigue and Sleepiness .Drowsy driving and automobile crashes. Washington, DC:National Center for Sleep Disorders Research\/National Highway Traffic Safety Authority,1997."},{"key":"2025122121504488000_324.7346.1125.10","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1093\/sleep\/19.4.318","article-title":"Effects of sleep deprivation on performance: a meta-analysis","volume":"19","author":"Pilcher","year":"1996","journal-title":"Sleep"},{"key":"2025122121504488000_324.7346.1125.11","unstructured":"Bonnet M .Sleep deprivation. In: Kryger M Roth T Dement W , eds. Principles and practice of sleep medicine. 3rd ed. Philadelphia, PA:WB Saunders,2000."},{"key":"2025122121504488000_324.7346.1125.12","unstructured":"Land Transport Safety Authority .Accident investigation system (AIS) 1993-1997. Wellington:LTSA,1998."},{"key":"2025122121504488000_324.7346.1125.13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8986.1973.tb00801.x"},{"key":"2025122121504488000_324.7346.1125.14","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1093\/sleep\/14.6.540","article-title":"A new method for measuring daytime sleepiness: the Epworth sleepiness scale","volume":"14","author":"Johns","year":"1991","journal-title":"Sleep"},{"key":"2025122121504488000_324.7346.1125.15","unstructured":"Roehrs T Carskadon M Dement W .Daytime sleepiness and alertness. In: Kryger M Roth T Dement W , eds. Principles and practice of sleep medicine. 3rd ed. Philadelphia, PA:WB Saunders,2000."},{"key":"2025122121504488000_324.7346.1125.16","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.79.3.340"},{"key":"2025122121504488000_324.7346.1125.17","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1002\/sim.4780101113","article-title":"Methods of adjustment for estimating the attributable risk in case-control studies: a review","volume":"10","author":"Benichou","year":"1991","journal-title":"Stat Med"},{"key":"2025122121504488000_324.7346.1125.18","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1093\/oxfordjournals.epirev.a036144","article-title":"Attributable risk estimation in case-control studies","volume":"16","author":"Coughlin","year":"1994","journal-title":"Epidemiol Rev"},{"key":"2025122121504488000_324.7346.1125.19","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1093\/sleep\/17.1.84","article-title":"The cost of sleep-related accidents: a report for the National Commission on Sleep Disorders Research","volume":"17","author":"Leger","year":"1994","journal-title":"Sleep"},{"key":"2025122121504488000_324.7346.1125.20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199903183401104"},{"key":"2025122121504488000_324.7346.1125.21","unstructured":"Maycock G .Driver sleepiness as a factor in car and HGV accidents. Crowthorne, Berkshire:Transport Research Laboratory,1995:39."},{"key":"2025122121504488000_324.7346.1125.22","unstructured":"Chervin R .Use of clinical tools and tests in sleep medicine. In: Kryger M Roth T Dement W , eds. Principles and practice of sleep medicine. 3rd ed. Philadelphia, PA:WB Saunders,2000."},{"key":"2025122121504488000_324.7346.1125.23","doi-asserted-by":"publisher","DOI":"10.1136\/ip.7.3.194"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.324.7346.1125","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.324.7346.1125","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T05:50:53Z","timestamp":1766382653000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.324.7346.1125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,5,11]]},"references-count":23,"journal-issue":{"issue":"7346","published-online":{"date-parts":[[2002,5,11]]},"published-print":{"date-parts":[[2002,5,11]]}},"alternative-id":["10.1136\/bmj.324.7346.1125"],"URL":"https:\/\/doi.org\/10.1136\/bmj.324.7346.1125","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"value":"0959-8138","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,5,11]]}}}