Martín-Cantera et al. BMC Public Health 2010, 10:136 http://www.biomedcentral.com/1471-2458/10/136 Page 3 of 9 Table 2 ICADTS classification of drugs in terms of driving effects CATEGORY DESCRIPTION I II III Presumed safe or unlikely effect Likely minor or moderate effect Likely severe effect or presumed dangerous BAC: Blood Alcohol Concentration (g/l) equivalence. Some ongoing studies are currently studying the effect that diverse long-term conditions and age, elements that usually go together, can have on the incidence of RTIs [27]. The Catalan Accident Statistics Annual Report (2003) indicates that in 7.6% of the collisions with victims, dri- vers suffered from the sudden appearance of an illness [28]. This same observation has been suggested at an international level [29]. According to data obtained from diverse review papers [30-33], a risk table has been pub- lished for different health problems and their adjusted risk, if the correct treatment was carried out. The fol- lowing findings should be noted: the relative risk of a driver with a chronic health condition of suffering a traffic injury is 1.33 (IC95% 1.28-1.37); the most highly associated illnesses are: Sleep Apnea Syndrome [RR 3.71 (IC95% 2.14-6.4)], neurological conditions [RR 1.75 (IC95% 1.61-1.89)], arthritis/joint limitations [RR 1.17 (IC95% 1.004-1.36)], cardio-vascular illnesses [RR 1.23 (IC95% 1.09-1.38)], diabetes mellitus [RR 1.56 (IC95% 1.31-1.86)], mental disorders [RR 1.72 (IC95% 1.48- 1.99)], visual impairments [RR 1.09 (IC95% 1.04-1.15)], hearing impairments [RR 1.19 (IC95% 1.02-1.4)] and high alcohol consumption [RR 2.00 (IC95% 1.89-2.12)] [30].; and the risks for the population with chronic health problems diminish in general if they are being treated and adequately controlled, with the exception of some chronic health problems where the risk can increase through the use of different types of medication (e.g. benzodiazepines) [31,34]. The situation in Primary Care In our country, few articles have been published on RTI and their impact in Primary Health care. Most of them, written during the 1990’s have consisted of descriptive epidemiological studies on the impact of road traffic injuries on the number of emergency consultations, its prevalence according to age groups and gender and stu- dies on time, place and gravity of the RTI. If sum- marised, they show that the frequency of RTI is approximately 8 per 1,000 inhabitants [35,36] making up 4.1% of all consultations in a primary health care centre [37]. Of all collision accidents of any kind, those on a public road are the second most frequent, after domestic accidents, road traffic injuries making up between 8.3% and 8.6% of all kinds [37-39]. BAC (g/l) < 0,5 0,5 - 0,8 > 0,8 ADVISE TO THE PATIENT Read the patient information leaflet before driving. Do not drive without consulting a health professional. Do not drive while you are taking this medicine. The most serious RTI happen on the road, and affect male drivers more (approximately 70%), with an average age of 27 ± 3 years [35-37], with a large peak in the group around 20 ± 5 years of age (42.8% of cases) [36]. The impact makes up 1% of the total of patients attended in an emergency centre [40]. Diverse authors warn of the high occurrence of RTI in children (245 per 1,000 inhabitants) [38], and the impor- tance of the use of child protection methods in vehicles. 20.75% of child accidents correspond to the RTI that affect those aged 12 ± 2 years [41,42]. The Theory of Change model and risk of RTI There are different theoretical explanations which try to predict the change in the prevention behaviour of popu- lations. Of all the analysed theories [43], the so called Health Belief Model shows that the most important ele- ments are: risk perceptions (personal susceptibility to suffer an injury), capacity to carry out effective activities and their economic costs. Several studies have aimed at describing the risk per- ception in relation to risky driving behaviours [44], cul- tural differences [45], the use of mobile phones while driving [46], the position of hands when driving [47]. Diverse population groups have also been studied such as young drivers compared to older drivers [48]. Others have examined differences in the perception of traffic risks for older and younger adults [49]. Also, the percep- tion of risk has been studied in relation to training [50], age and driving expertise [51]. These have been particu- larly assessed amongst drivers under the effects of alco- hol [52,53]. Just a few studies have established the existing relationship between health conditions and risk perception; amongst them, we found some papers on risk perception in diabetic patients during hypoglycae- mic stages [54,55], and in epileptic subjects [56]. Available publications show several methods to mea- sure the risk perception for an RTI. Likert scales with closed questions and a scale between complete disagree- ment to complete agreement have been used in some cases [47], as well as multiple-choice questionnaires (measuring probability of traffic accidents, consequences of traffic accidents, risk sensitivity and risk willingness with Likert scales) [45]. In some studies, the risk asso- ciated to particular traffic conditions and driving beha- viours was assessed [50] and in others it was analysed