Visual Assessment of Commercial Drivers in the South West Region of Cameroon

Abstract

Background: Driving is a visually intensive task. In Cameroon where the burden of road traffic deaths is high, visual assessment is not universally performed before the issuance of driver’s licenses. This study assesses the visual status of commercial drivers (CDs) in the Southwest Region of Cameroon.Methods: This was a cross-sectional community-based study on CDs in Limbe and Buea. Questionnaires were used to assess socio-demographic parameters, the incidence of road traffic crashes (RTCs), and self-reported visual status. Visual acuity (VA) was measured using a standard Snellen chart at 6 meters. Statistical analysis was done using descriptive methods; frequencies, paired Student’s t-test, and Chi-square test.Results: 207 CDs were enrolled. All were male, with a mean age of 41.8 ± 12.1 years. 15.0% had undergone an eye exam prior to licensure, and 3.4% within the past 10 years. VA in the better-seeing eye was less than 6/9 and 6/12 in 14.1%, and 10.6% of CDs, respectively. 75% of CDs with self-reported poor vision and 95% of CDs with VA < 0.5 had a history of an RTC compared to 55.8% of CDs with self-reported good vision and 55.7% of CDs with VA ≥ 0.5 (p<0.05). Injuries from RTCs were more common in CDs with self-reported poor vision (81.1%) and in those with VA<0.5 (90.5%) compared to CDs who self-reported good vision (55.8%) and those with VA ≥ 0.5 (55.7%) p<0.05.Conclusion: A large proportion of CDs did not have a visual assessment before the issuance or renewal of their driver’s licenses. A considerable number had poor vision in their better-seeing eye and suffered more from RTCs and related injuries. The concerned authorities should consider making vision tests a necessary requirement for the obtention of driver’s licenses.

Vision impairment and traffic safety outcomes in LMICs

“…In high-income countries, specific regulations that are inspired by apparently objective and frequently updated criteria are developed and implemented to guide the assessment of fitness to drive as a holistic and legal concept. 1-3 However, the proportion of drivers in many low-income and middle-income countries (LMICs), including those drivers involved in transportation of the public in large numbers, who are still able to secure a driving licence without ever having their vision assessed might seem shocking 4,5 and reveals challenges in law implementation. Paradoxically, it is observed that these shortcomings do not necessarily translate into a higher proportion of drivers with visual defects and the methods to assess visual function of drivers needs to be revisited.…”

“…Several studies have attempted to estimate the proportion of drivers with visual defects in all settings and some often attempt to associate the presence of such defects with the risk of occurrence of road traffic crashes. [4][5][6] The Article by Prabhath Piyasena and colleagues in The Lancet Global Health is an interesting overview of the problem, specifically in LMICs, with a focus on the prevalence of visual defects, adherence to visual parameters included in driving licensure requirements, and the possible association with the risk of poor driving outcomes. 7 The systematic review and meta-analysis of 15 7 Assessment of vision as a component of fitness to drive is historically based on perceptual parameters ranging from the most basic-ie, visual acuity, colour vision, and visual fields-to more specific ones such as stereopsis (the ability to appreciate depth), contrast sensitivity, and peripheral vision.…”