Assessment of driving fitness among patients with alcohol-related visits to two hospitals in eastern Finland.

Objective: The aim of the present study was twofold. The first aim was to explore how frequently physicians evaluate driving fitness when a patient has a serious alcohol problem, which is accomplished by examining differences in physicians' compliance with their intervention/notification obligation among different alcohol-related ICD-10 diagnoses. The second aim was to explore how many heavy alcohol users have a valid driving license.

Methods: Data from all patients with an alcohol-related ICD-10 diagnosis code as a cause of a hospital visit were collected during a three-month period from Kuopio University Hospital and North Karelia Central Hospital.

Results: Eighty-one percent (81%) of patients with alcohol-related ICD-10 diagnoses were heavy alcohol users and had alcohol withdrawal syndrome, alcohol-related organ disease or multidrug abuse combined with alcohol abuse. The driving fitness of these patients was significantly reduced, and the health requirements of the driving license were not met. Physicians evaluated driving fitness for only 20% of alcohol-related hospital visits/hospitalisations. Moreover, fitness to drive was evaluated in only 24% of cases of a patient with a major alcohol problem and a valid driving license. Driving fitness was most frequently evaluated in cases with alcohol-related convulsions (74%). In total, 80% of patients with a major alcohol problem had a valid driving license even though the requirements of driving fitness were not met.

Conclusions: The obligation to evaluate the driving fitness of heavy alcohol users is often neglected, except in cases of alcohol-abuse-related convulsions. Physicians should play a greater role in monitoring road safety, or sanctions should be set for failures to obey the obligations. The driving fitness of a patient hospitalised due to alcohol use should be assessed more regularly. Cognition problems related to alcohol-related liver disease/alcohol-related dementia are probably often overlooked. Alcohol-abuse-related conditions are poorly recognised and remain unreported to the authorities.