Risks of the road are no reason to stay at home

If family car vacations evoke pleasant thoughts of stress-free drives up the coast, to the mountains or through the countryside to Grandma’s house, you may want to take a look at some new studies that suggest otherwise.

In June, researchers reported that certain people who take road trips increase their risk of heart attack, that drivers who rely on air bags and don’t use their seat belts are begging for trouble and that distracted drivers are lousy drivers, especially when they are engaged in complex mental activity such as currency calculation.

Americans are planning to take 275 million leisure trips this summer, according to the Travel Industry Assn. of America, and 70% of those will include driving.

The research, while sobering, needs to be put in perspective, says Willem J. Kop, an assistant professor of medical and clinical psychology at the Uniformed Services University of the Health Sciences in Bethesda, Md. Kop conducted the study of heart attacks on the road published last month in the journal Psychosomatic Medicine.

“It’s like any risk factor,” he says. “It’s not that everyone who drives on vacation will suddenly be at an increased risk for a heart attack.”

Kop and his colleagues from the Netherlands, where he previously worked, looked at 92 men and women who had heart attacks during their vacations abroad and compared them with two other groups: 67 people who were on vacation but didn’t have heart problems and 30 people who had heart attacks while they were not on vacation.

When they looked more closely, they found that those who suffered heart attacks on vacation were more than twice as likely to have traveled by car than by plane or other transportation mode.

“What surprised me,” Kop says, “is that we also asked people how stressed they were. And self-reported stress was no different on average among the groups,” including those who did and did not have heart attacks.

Researchers did not know exactly what was happening at the time of the attack, so it was impossible to know whether stressful situations played a role. But those in the group that had heart attacks, either at home or away, had more risk factors for heart disease than those who didn’t suffer an attack.

The study also found that the less luxurious the vacationers’ accommodations, the more likely a heart attack. Kop speculates that may be because of a lack of privacy in tents and mobile homes.

“You should realize when you go on vacation that any novel environment or novel exposure to food, behavior or activity -- and also driving in a country you are not used to -- can act as a strong trigger to heart attack if you are at risk,” he says.

This research isn’t meant to dissuade anyone from taking vacation, he adds. But being aware of the risks if you are heart-attack prone (such factors as high blood pressure or previous attacks) is wise, he says.

Another expert familiar with Kop’s study agrees that the study is no reason to avoid a road trip. “The focus should be on managing risk factors [for heart disease], not on the mode of travel,” says Dr. Bruce Brundage, president of the Pulmonary Hypertension Assn. and medical director of the Heart Institute of the Cascades in Bend, Ore. Brundage notes that controlling risk factors for heart disease, such as keeping blood pressure and cholesterol within normal ranges, is more important than stressing out over a study -- and a small study at that. A larger study might not replicate Kop’s findings, he says.

It pays to take maximum precautions when you’re riding in a car equipped with air bags, according to research at the University of Alabama at Birmingham by Gerald McGwin, who works at the university’s center for injury sciences. He found that riding in the front seat of a vehicle equipped with air bags and not using a seat belt puts you at greater risk for a broken leg if you have an accident, especially in a frontal or head-on crash.

Using U.S. government data, McGwin and researchers evaluated frontal collisions involving more than 15 million front-seat occupants of motor vehicles from 1995 to 2000. Those who didn’t wear seat belts but who were in a seat near an air bag had a 50% increased risk of lower extremity injury, McGwin says.

It makes sense, he says. Without a seat belt, during a frontal crash, he says, you tend to be thrust forward. In his study, in the June issue of the Journal of Trauma, he found that the legs bear the brunt of that movement.

McGwin finds that many occupants think an air bag is sufficient to protect them, so they don’t buckle up. As a result, they’re actually increasing their risk of injury, he says.

Drivers who don’t pay attention also are at increased risk of injury, according to another study. Previous research has shown that external distractions such as cell phones can reduce drivers’ performance, but a new study has found that drivers who focus on complicated mental tasks -- say, figuring out how to change American currency into the currency at their destination -- also drive poorly.

Researchers from Madrid studied 12 adults in their 20s as they drove for about four hours on the highway north of the city. When the drivers were asked to do complex mental gymnastics, such as currency conversions, their performance at detecting targets -- for the study, a flashing spotlight -- declined, says Luis Miguel Nunes Gonzalez, a coauthor of the study published in the June issue of the Journal of Experimental Psychology: Applied, a publication of the American Psychological Assn.

While drivers were doing some of the assigned tasks, their ability to detect the spotlights declined by 30% compared with the control group. That could be an accident waiting to happen, Nunes says, because the spotlight used in the study was similar to, say, a flashing turn signal on the car ahead.

When they looked at the effect of subjects who responded to cell phone calls while driving, they found that uncomplicated phone conversations had no more effect on driving performance than live conversation with other passengers, if the phone calls were hands-free and voice-activated.

His conclusion: “Complex mental tasks produce distractions while driving. If you do tasks that are demanding, such as mental calculations, you are incapacitated.” The same results would have occurred with middle-aged or older drivers, Nunes says.

Before you steer your car out of the driveway, know that the news isn’t all bad. Summer months aren’t the highest for motor vehicle traffic deaths, according to the National Safety Council. In 2001, the safety council says, December had the greatest number of fatal accidents and February the fewest.

Healthy Traveler appears twice a month. Kathleen Doheny can be reached at kathleendoheny@ earthlink.net.