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. 2017 Oct 16;12(10):e0185517.
doi: 10.1371/journal.pone.0185517. eCollection 2017.

The acute physiological stress response to driving: A systematic review

Michael Antoun  1 , Kate M Edwards  1   2 , Joanna Sweeting  3 , Ding Ding  2   4
Affiliations

The acute physiological stress response to driving: A systematic review

Michael Antoun et al. PLoS One. .

Abstract

Background: The experience of driving has been suggested to be detrimental to health. One hypothesis is that each exposure elicits an acute stress response, and that repeated exposures may act as a chronic stressor.

Objective: The aim of this review is to evaluate and synthesise the evidence on whether driving elicits an acute physiological stress response.

Methods: Electronic databases, including CINAHL, PsycINFO and Medline, were searched for original articles written in English from database inception until March 2016. The inclusion criteria of this review included a quantitative examination of an acute physiological stress response to driving, in either on-road or simulated settings, compared to a comparison or control condition. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting criteria.

Results: A total of 27,295 abstracts were screened and 28 full-text manuscripts retrieved. Of these, seven articles met the inclusion criteria including four simulator studies and three on-road studies. All suggested a significant change in at least one physiological outcome, but the strongest evidence was for increases in urine catecholamine and cortisol after driving for long hours on-road; results on other outcomes are limited by the small number of studies or inconsistent findings.

Conclusions: Overall, these studies provided moderate evidence to suggest that driving for long hours elicits a stress response over an extended period of time. There is insufficient evidence that driving for a shorter period of time elicits an acute stress response, especially in real, on-road tasks. However, the limited number of studies, small sample sizes, heterogeneity in study objectives, methodologies and physiological outcomes limit conclusions. Future studies could be improved by recruiting a larger sample, utilizing modern stress markers such as heart rate variability, and primarily focusing on the acute physiological stress response to on-road driving.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Acute stress response pathways.
Abbreviations: ACTH = Adrenocorticotropic hormone; BP = blood pressure; CRF = Corticotropin releasing factor; SNS = sympathetic nervous system; TPR = total peripheral resistance.
Fig 2
Fig 2. Consort diagram: Study selection.
See this image and copyright information in PMC

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