Visual Impairment and Risk of Self-Reported Road Traffic Crashes Among Bus Drivers in Bangladesh.

PURPOSE: This study assesses the prevalence and the causes of visual impairment among bus drivers undergoing screening in Bangladesh and associations with self-reported crashes. METHODS: Eye health screenings including refraction and questionnaires were conducted at 10 bus terminals in 7 districts of Bangladesh from June through August 2019. Presenting near and distance visual impairment and self-reported road traffic crashes were recorded. RESULTS: Among 700 participants, nearly 1 in 5 (n = 126, 18.0%) had presented visual acuity (VA) in the better-seeing eye ≤6/9, not meeting the vision standard of Bangladesh for bus drivers. A majority of drivers (n = 492, 70.3%) had near or distance refractive error, and most who failed to reach the driving standard (88.1%, n = 111) could be improved with readily available treatment, either glasses or cataract surgery. A history of 1 or more road traffic crashes while driving a bus or minibus was reported by 62 (8.97%) participants. In multivariable models, factors significantly associated with near or distance visual impairment included older age [odds ratio (OR) per year 1.15, 95% confidence interval (CI): 1.12-1.18, P < 0.0001] and having no driver's license (OR 1.80, 95% CI: 1.04-3.13, P = 0.037). Self-reported history of a motor vehicle crash was associated with near or distance visual impairment (OR 2.45, 95% CI: 1.09-5.49, P = 0.030), even when adjusting for other factors such as age and weekly miles are driven. CONCLUSIONS: Ensuring that bus drivers are screened to meet the required visual standards for driving while referring those who do not for treatment, can contribute to safer roads in this high-risk setting.