Type A behavior pattern, risky driving behaviors, and serious road traffic accidents: a prospective study of the GAZEL cohort.

The type A behavior pattern (TABP), characterized by impatience, time urgency, and hostility, was originally developed in relation to coronary heart disease. Since 1986, there has been a debate on whether the TABP is also associated with risky driving behaviors leading to increased risks in road traffic accidents (RTAs). The authors examined prospectively the relation among risky driving behaviors, serious RTAs, and the TABP in a cohort of 20,000 French employees of Electricité de France-Gaz de France who were aged 39-54 years in 1993. A total of 11,965 participants were included in this study. The TABP was assessed in 1993 using the French version of the Bortner Rating Scale. Driving behaviors and serious RTAs were recorded in 2001. Sociodemographic and alcohol consumption data were available from the cohort's annual follow-up. The impact of the TABP on the risk of serious RTAs was assessed using the Cox proportional hazards regression model with time-dependent covariates. After adjustment for potential confounders, the risk for serious RTAs increased proportionally with TABP scores: hazard ratios were 1.29 (95% confidence interval: 1.03, 1.63) for intermediate-level scores and 1.48 (95% confidence interval: 1.16, 1.90) for high-level scores relative to low TABP scores. The authors concluded that type A drivers had an increased risk of RTAs. Implications of this finding for traffic safety are discussed.