Citation

Williams JR, Tregear SJ. Proc. Int. Driv. Symp. Hum. Factors Driv. Assess. Train. Veh. Des. 2009; 5: 147-153.

Copyright

(Copyright © 2009, University of Iowa Public Policy Center)

DOI

unavailable

PMID

unavailable

Abstract

Cardiovascular disease (CVD) is the leading cause of death in the United States. With America’s workforce rapidly aging, more attention is being placed on CVD and its treatment among employees in safety sensitive occupations, such as the transportation industry. Implantable cardioverter defibrillators (ICDs) are increasingly being used to treat certain cardiovascular conditions, but despite the fact that they are effective in preventing sudden death from cardiac arrhythmia, there is concern about allowing individuals with an ICD to drive. A systematic review and meta-analysis was conducted to examine the health and safety impacts ICDs on driving. We considered data pertaining to four outcomes among individuals with an ICD: crash rate, the occurrence of sudden death while driving, the occurrence of syncope while driving, and the occurrence of at least one shock from their ICD while driving. Currently, the impact of an ICD on driver safety cannot be determined. Our assessments of the evidence pertaining to crash rates and sudden incapacitation while driving were inconclusive. Our results do indicate, however, that some individuals with an ICD will experience an inappropriate ICD discharge while driving (Strength of Evidence Rating: Strong). Experiencing such a discharge while driving is a potential hazard to driver safety. Quantitative assessment of the available data suggests that approximately 6.3% (95% CI: 4.7%-8.4%) of all individuals with an ICD who drive will experience a discharge while driving. These findings have potential implications for regulatory agencies with responsibility for road safety; particularly those agencies that regulate safety sensitive industries.