Is Toxoplasma gondii a potential risk for traffic accidents in Turkey?

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Abstract

In Turkey, traffic accidents are the major causes of mortality and morbidity. According to the statistics made by Turkish Security Headquarters in the year 2000, 7500 people are killed in the traffic accidents every year. Drivers are mostly blamed for the traffic accidents. Tired, weary, sleepy and absentminded driving are common reasons for traffic accidents due to many reasons. Among these reasons mental and reflex conditions of drivers are significant. Toxoplasmosis is one of the most common zoonoses throughout the world. In immunocomponent adults, toxoplasmosis has no clinical signs or symptoms and infection in such people can only be detected by serological examinations. This kind of latent or dormant toxoplasmosis can be located in neural or muscular tissues and cause prolonged reaction times of the muscles. Extended reaction times also lead to deceleration of the reflexes which could be a major cause of the traffic accidents. By the light of this situation, the incidence of Toxoplasma gondii is investigated among the population who were involved in a traffic accident while driving. A total of 185 people (100 men and 85 women), aged between 21 and 40 years, living in Izmir and Manisa cities, were enrolled in the study group (SG) during a period of 6 months time. Their informed consents were taken initially and the laboratory tests of all these individuals related to blood alcohol levels after the accidents were found negative. The control group (CG) were also consisted 185 people (95 men and 90 women), residents of the same region, in same age group. The people in CG had no clinical signs or symptoms concerning toxoplasmosis. All collected sera were examined using a commercial IgG and IgM ELISA kit. According to the results of serological tests of the SG, 45 (24.32%) sera were IgG positive, six (3.24%) were IgM positive and 10 (5.40%) were both IgG and IgM positive. On the other hand in CG, 12 (6.48%) people found IgG positive, one (0.54%) found IgM positive and three (1.62%) found both IgG and IgM positive. This data was considered as statistically significant by Yates corrected χ2-test. (p < 0.05). In conclusion, there is an increased risk for traffic accidents for drivers owing to these high seroprevalence of latent toxoplasmosis. Prospective studies are still necessary on this subject but latent toxoplasmosis of drivers should be taken into account while developing strategies to prevent traffic accidents in Turkey.

Introduction

Accidents are defined as bad, unusual events in an unplanned and unforeseen time span causing life and/or property loss [1]. Generally, accidents can be categorized into four groups: (i) traffic accidents, (ii) home accidents (in developing countries the definition of home accidents should also include a special category for home-based work accidents. There is often no distinction between home and work especially in rural areas.), (iii) occupational accidents and (iv) sports accidents [2]. According to the WHO reports, traffic accidents are among the main reasons for public health damage; in the fifth place in undeveloped countries and in the 10th place in developed countries [3]. Traffic accidents are the major cause of mortality and morbidity in Turkey, as well. According to the statistics made by Turkish Security Headquarters, 4,586,082 traffic accidents occurred between 1984 and 2002, where 106,488 people were killed and 1,748,565 people were injured [4]. With these data, Turkey is in the first place in Europe and seventh worldwide. In Turkey, drivers are mostly responsible for the traffic accidents. Tired, weary, sleepy and absent-minded driving are the most frequent causes (19.4%) of traffic accidents due to many reasons. Among these, deterioration of the drivers’ mental state and the decrease of psychomotor performance are significant [4].

Toxoplasmosis is one of the most common zoonoses throughout the world. The seroprevalence of antibodies to Toxoplasma gondii in human populations in Europe, US and Turkey are 30%, 15.8% and 29%, consecutively [5], [6], [7]. In immunocompetent adults, toxoplasmosis has no clinical signs or symptoms and infection can only be detected by serological examinations [8]. This kind of latent or dormant toxoplasmosis can be located in neural or muscular tissues and cause prolonged reaction times of the muscles [9]. Extended reaction times also lead to deceleration of the reflexes, which could be a major cause of accidents; especially traffic accidents.

The aim of this study was to investigate the incidence of T. gondii among a population of drivers involved in a traffic accident.

Section snippets

Materials and methods

A total of 185 people (100 men and 85 women) involved in a traffic accident as drivers, were selected in the study group (SG) for a period of 6 months time during 2002–2003. The SG was chosen from people living in Izmir and Manisa cities of Turkey, aged between 21 and 40 years having driving license more than a year. Blood alcohol concentration (BAC) was measured at the emergency room and all were found to be lower than 11 mmol/l (the legal limit in Turkey). None reported taking any medication

Results

According to the results of serological tests of the SG, 45 (24.32%) sera were IgG positive, six (3.24%) were IgM positive and 10 (5.40%) were both IgG and IgM positive. On the other hand in CG, 12 (6.48%) people were found to be IgG positive, one (0.54%) was found to be IgM positive and three (1.62%) were found to be both IgG and IgM positive. The seroprevalence of latent toxoplasmosis in SG and CG was compared by Fischer exact test in Table 1.

To check the integrity of our results we repeated

Discussion

Many studies were made to investigate the seroprevalence of active or latent toxoplasmosis among populations. Joshi et al. examined 60 healthy adults for toxoplasmosis in India and reported the overall seropositivity was 17.2% [5]. In the first serological examination on toxoplasmosis in Turkey, the overall seropositivity was found between 12.8% and 29.4% [7].

There is inadequate data about the effects of asymptomatic toxoplasmosis on psychomotor system in humans, but the decline in psychomotor

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This paper was presented in IX European Multicolloquium of Parasitology, 18–23 July 2004, Valencia, Spain.

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