Programme no. 409-SY
Public Health
The role of the GP in Traffic Medicine Issues in the Nordic countries
Lars Englund*1, Henrik L Hansen*2, Nils Moe*3, Timo Tervo*4
1Road and Rail Department,Swedish Transport Agency,Borlänge,Sweden, 2,Department of Danish Health and Medicines Authority,Copenhagen,Denmark, 3Norwegian Directorate of Health,Oslo,Norway, 4Professor of Traffic Medicine, Helsinki University Eye Hospital and Uusimaa traffic accident inspection board,Helsinki University ,Helsinki,Finland
* = Presenting author
Symposium
Objectives: What does practice among GPs in the Nordic countries look like when it comes to finding medically unfit car drivers? What is working well and what difficulties do the rules and regulations in the different countries give GPs? What role do the GPs play in rehabilitation and medical controls after a conviction of drunk driving?
Background: Background: Traffic medicine could be defined as the contribution that the medical profession can give to traffic safety. It contains considerations pre crash, at crash and post crash, involving both the vehicle and the road, but most of all the driver.

The percentage of all holders of a drivers license that are older than 65 is increasing in all Western countries. As persons in this age also have been car drivers for all their life they will continue to drive which also means that a higher percentage of elderly persons are active drivers. Especially the percentage of older female drivers will rise steeply.

Many of the older drivers are very fit but we will see an increasing number of persons with age-related diseases that can affect their fitness to drive. Thus there is a need to ensure that persons with diseases that make them dangerous in traffic will be sorted out. In this process society needs the help of doctors and in many cases this doctor will be the local GP. The role of the GP differs in the Nordic countries where some has an obligation for the GP to report to the authorities when a patient is unfit to drive while in other countries there are periodic medical examinations or obligations for the drivers themselves to report.

The diseases that are most prominent in elderly persons are the ones that affect cognitive functioning as in dementia and with sequelae after a stroke. The dangers in traffic makes these persons at increased risk in accidents in complicated traffic at intersections and when not yielding for traffic on a road with more heavy traffic. Problems with visual field defects after a stroke could also affect the ability to notice a pedestrian or bicyclist in time.

Apart from this there is also the role of the GP when it comes to persons (of all ages) with a diagnosis of dependency or abuse of alcohol. In most Nordic countries a person who had his license revoked after a drunk driving conviction has to prove that he is sober enough to get his license back by giving blood samples and by meeting the GP over a period of time. Alcohol interlock is used in some countries.

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Other considerations: Points for discussion: What are the advantages and draw-backs of the different systems as far as the GP is concerned? What can GP:s from each country learn from the other countries?