Attitudes associated with behavioral predictors of serious road traffic crashes: results from the GAZEL cohort.

International audienceOBJECTIVES: To test the hypothesis that behavioral predictors of serious road traffic crashes (RTC) are correlated with unfavorable attitudes towards traffic safety. DESIGN: Prospective and cross-sectional cohort study. SETTING: France PARTICIPANTS: 13,447 of the 19,894 living members of the GAZEL cohort, workers and recent retirees of a French national utility company followed up since 1989. MAIN OUTCOMES MEASURES: Driving behavior and attitudes towards traffic safety in 2001 by questionnaire. Serious RTCs were recorded over the subsequent 3 years using the cohort annual questionnaire. Behavioral predictors of serious RTCs were assessed using generalized linear Poisson regression models with time-dependent covariates. Factor scores extracted from the first four attitudinal factors of principal component analysis were saved and then regressed on behavioral predictors as independent variables. RESULTS: After controlling for potential confounders, the best predictors of serious RTCs were: "exceeding speed limits on rural roads", "risky use of cellular phone", and "sleepy driving". The adjusted rate ratio ranged from 1.47 to 2.16. Predictors of contravention of the highway code (the first two predictors) were found to be strongly associated with negative attitudes towards "enforcement" and "speed limitations" with an adjusted odds ratio ranging from 1.31 to 2.02. CONCLUSION: Our study supports the view that individuals with a high propensity for driving behaviors associated with an increased risk of RTCs were more likely to have negative attitudes towards traffic safety. Changing drivers' negative or distorted opinions of traffic "enforcement" as well as "speed limitations" and "alcohol prohibition on roads" could improve their compliance with road traffic rules