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Awake gives a
dose of good sense |
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| Most responsible drivers
know the dangers of drink driving, but how many know about
the effects of simple medicines? |
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| “Over-thecounter medicines
contain substances that have a major impact on driver
performance” |
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Thirty years ago, it was commonplace to drive home after Friday
night drinks or a big night out at the pub. Drinking and driving
was not seen as an issue, to the point that drivers were encouraged
to have “one for the road”.
As a result of an intensive and concerted education campaign in
the form of annual, hard-hitting television advertisements, the
incidence of drink-driving has been drastically reduced and drinking
and driving is now widely frowned upon, particularly among younger
drivers.
Raising awareness
While the problem of drink driving has been reduced significantly,
the issue of driver tiredness remains largely unchecked. It is estimated
that driver tiredness contributes to approximately 20% of fatal
accidents on motorways and major UK roads and 10% of all accidents
are sleep-related: this equates to approximately 350 fatalities
each year.
To combat the problem of driver tiredness, the government has begun
to improve public awareness of the issue, with the launch of the
first TV campaign focusing on driver tiredness; radio adverts running
during holiday periods, when drivers are more likely to undertake
long-distance journeys; and motorway variable message signs displaying
the phrase “Don’t Drive Tired”.
The government’s advice to drivers is to plan the journey,
stop in a safe place if tired, drink a couple of cups of strong
coffee and while this is taking effect, to have a short nap of no
more than 15 minutes.
Professional drivers
This advice, based on the research carried out by Loughborough Sleep
Research Centre, is fine for non-professional drivers, but for those
who drive for a living, more long-term solutions are required. It
is not sufficient – or desirable – for professional
drivers to be relying on stimulants such as caffeine to keep them
awake behind the wheel.
Awake works with companies to provide effective long-term counter
measures, involving training to raise awareness of the dangers,
assessing the risk associated with different shift patterns, and
working with management, drivers and their families to come up with
solutions that work for all.
This work frequently involves interviewing drivers about their experiences
of driver tiredness. As part of these interviews, drivers are asked
about their medical history, including use of medications. This
work has highlighted an issue which, to date, has received very
little publicity, but which is almost certainly a contributory factor
in a proportion of sleep-related vehicle accidents: the use of over-the-counter
medicines that can cause daytime drowsiness.
Over-the-counter medicines (OTCs) are those products that can be
bought from a chemist without a doctor’s prescription. Many
of the products bought this way and used to treat colds, coughs,
hay-fever and travel sickness, contain substances that have a major
impact on driver performance, both in the immediate period after
they have been taken, as well as causing a significant “hangover”
effect the next day.
Make no mistake – these products can cause significant impairment:
in some cases greater than that caused by the legal blood alcohol
concentration limit for driving in the UK.
The over-the-counter medicines that have the greatest sedative side
effect are those that contain “first-generation antihistamines”,
a group of substances commonly found in hay-fever treatments. As
well as alleviating a runny nose, sneezing and allergies, antihistamines
can cause distinct drowsiness. The sedating effects of these products
is so pronounced that in different packaging many of these same
antihistamines are marketed and sold specifically as sleep aids.
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| “It can be difficult
to tell whether an OTC will make one drowsy because the labelling
can be confusing” |
The most common antihistamines liable to have sedating effects are:
chlorpheniramine, diphenhydramine, promethazine and triprolidine.
These products are cheap and effective and so are in widespread
use in OTCs. They are contained in over 50 OTC medicines, including
32 cough and decongestant preparations, nine anti-allergy treatments
and seven analgesics.
It can be difficult to tell whether an over-thecounter medicine
will make one drowsy because the labelling of these medicines can
be confusing and misleading. Part of the problem lies in the fact
that the labelling of OTCs is not governed like the labelling of
prescription drugs. The labelling suggested by the British National
Formulary is only a recommendation and is not always followed by
the manufacturers. Consequently, there is considerable variability
in packaging, with some products having no warning at all. Additionally,
while some medications come with a warning that “this medication
may cause drowsiness”, others containing the same sedating
substances come with no warning.
If a product contains one of these antihistamines you should always
assume that it will cause drowsiness and you should not drive while
using the medicine. You should also be aware of the hangover effects
caused by some products intended for use at bedtime.
Some medicines used to treat cold and cough symptoms are intended
for night-time use and advertised as helping to aid restful sleep.
As they usually contain one of the sedating antihistamines they
will certainly do this. But many people will wake up feeling drowsy
and below par for at least an hour after taking one of these medicines
the night before.
Safer alternatives There are alternative OTC medications that do
not have sedating effects. Professional drivers should always make
it clear to their GP or pharmacist that they drive for a living
and ask to be recommended an appropriate medicine that will not
cause drowsiness. Nonetheless, drivers need to be careful when taking
what are assumed to be “non-sedating” medicines because,
while these may not impair driving when taken as recommended, this
is not the case if the recommended dose is exceeded – a fact
rarely mentioned on packaging.
In order to protect against the sedating effects of OTC medicines,
driver and manager awareness of the issue needs to be improved.
Drivers and managers should be able to identify those medications
that have sedating effects, understand how these medications can
be taken responsibly and have knowledge of the non-sedating alternative
medications that are available.
Moreover, the responsible management of driver tiredness can only
be achieved if a “no-blame” culture is established within
a company. That is, if drivers feel they can inform management of
any tiredness they might be encountering and any medications they
are taking without being unduly penalised. The Awake organisation
helps companies tackle the problem of driver tiredness, including
the effective management of over-the-counter medicines.
Awake has developed a range of educational seminars and materials
aimed at improving awareness of these issues among management and
employees. A focus of the Awake training is the provision of practical
information and strategies that can be implemented at a personal
and company level to protect against tiredness.
For more information, please contact Dr Paul
Jackson on:
Tel: 020 7693 6166
Website: www.awakeltd.info |
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