Disability related to road traffic crashes among adults in Spain.

BACKGROUND Road traffic accidents cause substantial morbidity and disease burden; few studies have examined their impact on disability. OBJECTIVE To estimate the magnitude and distribution of disability due to road traffic accidents according to socio-demographic variables, and its main socioeconomic and health determinants. METHODS A cross-sectional study was conducted in community-dwelling participants in the "2008 Spanish National Disability Survey", a representative sample of 91,846 households with 20,425 disabled persons older than 15 years; 443 had disability due to road traffic accidents. RESULTS The prevalence was 2.1 per 1000 inhabitants (95% CI:1.8-2.3), with no differences by sex. Risk was highest among persons aged 31 to 64 years, and onset of disability showed a sharp inflection point at age 16 years in both sexes. Odds ratios (ORs) were higher (OR=1.3; 95% CI:1.1- 1.7) for participants with secondary education than for those with the lowest educational levels and were lower (OR: 0.5; 95% CI:0.3-0.8) for participants with the highest household income levels than for those with lowest. Only 24% of disabled participants were gainfully employed. As compared to other sources of disability, traffic crashes caused greater disability in terms of mobility (OR=3.1;p<0.001), a greater need for health/social services (OR=1.5;p=0.003), and more problems with private transportation (OR=1.6;p<0.001), moving around outside the home (OR=1.6;p<0.001) and changes in economic activity (OR=2.4;p<0.001). CONCLUSIONS The prevalence of disability due to road traffic accidents in Spain is lower than in other developed countries, with middle-aged and socio-economically underprivileged persons being the most affected. Disability due to road traffic accidents is related to a greater demand for social/health care support, problems of accessibility/commuting, and major changes in economic activity.