Madam, verbal abuse/threats or actual acts of physical harm by either a driver or passenger of one vehicle directed against the occupants of another vehicle or pedestrians entail road rage and could potentially lead to involvement in collisions, injuries, and death.^1-3 Road rage has also been associated with psychiatric illnesses in both the victims and the perpetrators.⁴ A previous study reported that the most common type of road rage experience of bus drivers was someone in another vehicle making rude gestures at them; reported by 156 (88.6%) of bus drivers in the twin cities of Islamabad and Rawalpindi in Pakistan.³ While another study reported 30% of university students having experienced being shouted, cursed or made rude gestures at while riding a vehicle, in the past three months; among a sample of 532 students.²
A cross-sectional survey with convenience sampling was conducted among taxi drivers in Islamabad and Rawalpindi at various frequently visited areas, popular destinations, and designated taxi stands; to understand their behaviour and experiences pertaining to road rage and its relationship to years of having driven taxi, from July to November 2008. An interviewer-administered, pre-tested, structured questionnaire with close-ended questions was used. Taxi drivers who had been driving for at least one year were interviewed by a trained interviewer, after obtaining verbal consent and ensuring confidentiality. Results were analyzed using STATA version 9, applying chi-square test.
Cumulatively, 496 taxi drivers were interviewed, however records on participation refusal were not kept but their number was less than 30. The mean age of taxi drivers was 38.9 ± 8.1 years. On average, respondents had been driving a taxi for 12.5 ± 7.9 years. Educational status was described by respondents as 71 (14.3%) with no formal education, 141 (28.4%) with 2 to 5 years of education, 252 (50.8%) with 6 to 10 years of education, and the rest with 11-12 years of education.

Table, lists the frequency of road rage behaviour and experiences of taxi drivers in the past three months disaggregated by ten or more years of having driven taxi, and statistically significant associations; using Pearson chi-square test of difference between two groups of drivers.
The most common types of reported road rage experience/behaviour in the past three months were, someone in another vehicle having made rude gestures, and respondents themselves having made rude gestures at someone in another vehicle while they were driving. Several statistically significant associations were found between taxi drives that had driven for ten years or less versus those drivers who had driven for more than ten years in terms of road rage experiences and behaviour. Taxi drivers who had driven for ten or less years had a mean age of 32.6 ± 4.2 years versus 44.8 ± 6.2 years for those who had driven for over ten years. Hence differences in the two groups are associated with the age of taxi drives.
The most disturbing findings of this study were the fact that 432 (87.1%) taxi drivers replied affirmatively to smoking cigarettes on a regular basis, and 86 (17.3%) reported regular use of illicit drugs/alcohol. There is a need for nationally represented surveys to study road age in commercial vehicle drivers, and to quantify cigarette smoking and use of drugs, so as to determine the need for, and plan health education programmes targeting this group; and to improve road safety in Pakistan.

Masood Ali Shaikh,1 Zulfiqar Siddiqui2
Apartment # 32, Building # 3, Group No. 71, Al Rehab, Cairo, Egypt,
1 268-B, Kamal Road, Cantt. Rawalpindi.2

1.Mann RE, Zhao J, Stoduto G, Adlaf EM, Smart RG, Donovan JE. Road rage and collision involvement. Am J Health Behav 2007; 31: 384-91.
2.Shaikh IA, Shaikh MA, Kamal A, Masood S. Road rage behavior: Experiences of university students. J Coll Physicians Surg Pak 2005; 15: 830-1.
3.Shaikh IA, Shaikh MA, Siddiqui Z. Road rage behavior and experiences of bus and wagon drivers in Islamabad and Rawalpindi. J Pak Med Assoc 2008; 58: 220-1.
4.Fong G, Frost D, Stansfeld S. Road rage: a psychiatric phenomenon? Soc Psychiatry Psychiatr Epidemiol 2001; 36: 277-86.