RESUMO
OBJECTIVE: To investigate the association between popular football games played in Europe and the incidence of traffic accidents in Asia. DESIGN: Study based on 41 538 traffic accidents involving taxis in Singapore and 1 814 320 traffic accidents in Taiwan, combined with 12 788 European club football games over a seven year period. SETTING: Singapore and Taiwan. PARTICIPANTS: The largest taxi company in Singapore, with fine grained traffic accident records in a three year span; all traffic accident records in Taiwan in a six year span. EXPOSURE: Days when high profile football games were played or not played. MAIN OUTCOME MEASURE: Number of traffic accidents. RESULTS: Regression based and time series models suggest that days with high profile European football matches were more positively associated with traffic accidents than days with less popular European football matches. For an approximate 134.74m (£120.25m; $159.76m) increase in average market value for matches played on a given day, approximately one extra accident would occur among Singapore taxi drivers, and for an approximate 7.99m increase in average market value of matches, approximately one extra accident would occur among all drivers in Taiwan. This association remained after control for weather conditions, time of the year, weekend versus weekday effects, driver demographics, and underlying temporal trends. It was also stronger for daytime traffic accidents than for night time traffic accidents, suggesting that the association between high profile football matches and traffic accidents cannot be attributed to night time celebration or attention deficits while watching and driving. Annually, this increased rate of traffic accidents may translate to approximately 371 accidents among taxi drivers in Singapore and approximately 41 079 accidents among the Taiwanese public, as well as economic losses of approximately 821 448 among Singapore taxi drivers and approximately 13 994 409 among Taiwanese drivers and insurers. The total health and economic impact of this finding is likely to be much higher because GMT+8 is the most populous time zone, encompassing 24% of the world's population. CONCLUSIONS: Days featuring high profile football matches in Europe were associated with more traffic accidents in Taiwan and Singapore than were days with lower profile football matches. A potential causal mechanism may be Asian drivers losing sleep by watching high profile European matches, which are often played in the middle of the night in Asia.