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1.

Objective

The aim of this study was to examine different socio-demographic, health and safety-related factors, and psychoactive substance use among fatally injured drivers in road traffic accidents in Finland during 2006–2008.

Methods

An accident information register maintained by the Traffic Safety Committee of Insurance Companies (VALT) of the Finnish Motor Insurers’ Centre was used as basic data, and the basic data were complemented with further toxicological analytical information retrieved from autopsy reports from the Department of Forensic Medicine, Helsinki University. The data included all the drivers (n = 556) who were driving a motor vehicle and who died in a road traffic accident in Finland during 2006–2008.

Results

Of all the 556 fatally injured drivers 43% (n = 238) had psychoactive substance findings. 51% (n = 121) of substance positive drivers had a finding for alcohol only, the rest had a finding for one or more illicit/medicinal drugs impairing driving ability, and possibly also alcohol. Fatally injured drivers with alcohol findings were significantly younger (mean age 34 years) than sober drivers (mean age 44 years) or drivers with findings for drugs (mean age 45 years). Socio-demographic background did not differ substantially among drunken/drugged and sober drivers, although drivers with alcohol findings had a slightly lower education and socioeconomic position. Previous substance abuse problems were highly prevalent among drivers with substance findings and mental or both mental and physical health problems were more common among drivers with drug findings. The non-use of safety equipment and driving at a high speed were more common among fatally injured drivers with substance findings.

Conclusions

Substance abuse and mental health problems, as well as reckless driving behavior were more pronounced among fatally injured drivers with substance findings when compared to sober drivers. Thus, prevention and early intervention concerning substance abuse, mental health problems and DUI are essential. Improved traffic safety cannot be achieved by means of traffic policy only, but integration with other policies, such as health and social policy should be strengthened.  相似文献   

2.
3.

Aim

The aim of this study was to identify demographic and behavioural factors associated with pre-licensed driving.

Method

A cohort comprising 3526 newly licensed drivers aged 15–24 years old from throughout New Zealand completed a questionnaire which sought information on pre-licensed driving behaviour and factors thought to be related to this.

Results

Almost half of the participants had driven on-road prior to passing their learner license theory test; 14% had driven more than 20 times; and 7.5% had driven more than 200 km. Multivariate logistic regression showed the results differed depending on the outcome examined. In general pre-licensed driving was significantly higher among males, among Māori, those living in a rural area, and those living in an area of high deprivation. Furthermore, those who drove pre-licensed were more likely to engage in other risky behaviours such as hazardous drinking and cannabis use, and have medium to high scores for sensation seeking and aggression/hostility.

Conclusion

The young people who were pre-licensed drivers displayed a range of demographic and behavioural characteristics that indicate they may be at higher crash risk than their peers who did not drive before licensing. Identifying those who drive before licensing and targeting road safety interventions towards this group may help reduce the high crash risk among novice drivers.  相似文献   

4.
5.

Background

Examination of teen driver compliance with graduated driver licensing (GDL) laws could be instrumental in identifying factors associated with persistently high motor vehicle mortality rates.

Methods

Fatality analysis reporting system (FARS) data from the years 2006 to 2009 were used in this nation-wide cross-sectional study of drivers covered by a state nighttime GDL law (n = 3492). A new definition of weekend, based on the school night in relation to the teenage social landscape, redefined Friday night as a weekend night and Sunday night as a weekday/school night and compared it to previous weekend definitions. Multiple logistic regression was used to examine independent effects of demographic, behavioral, environmental, contextual, and other factors on compliance with nighttime GDL laws. All analyses were performed in Stata version 11.

Results

Given coverage under nighttime GDL laws, drivers aged 15–17 years were non-compliant in 14.9% of the fatal MVCs in which they were involved, and nearly one-fifth (18.8%) of all fatalities aged 15–17 years were associated with non-compliance. Mortality risk was 10% higher using a revised social (school night) versus traditional (Sat–Sun) weekend definitions. In multivariable analysis, drivers non-compliant with nighttime GDL laws were more likely to be drinking (OR = 4.97, 3.85–6.40), unbelted (OR = 1.58, 1.25–1.99), driving on the weekend (OR = 1.82, 1.47–2.24), and killed (OR = 1.31, 1.04–1.65).

Conclusion

GDL non-compliance contributes to teen motor vehicle mortality. Legislative and enforcement efforts targeting non-school night driving, seatbelt nonuse and alcohol have potential to further reduce teen driving mortality.  相似文献   

6.

Introduction

Self-reports by novice teen drivers in California and elsewhere suggest that many violate graduated driver licensing (GDL) nighttime and passenger restrictions, and to a lesser extent, drive on learner permits without being supervised. Is this corroborated by their traffic conviction records?

Method

We examined historical aggregated conviction rates for GDL-related violations before and after GDL, and Poisson regressions of conviction rates over time among 16–17-year-old California novices.

Results

During the year before they received their provisional licenses, <1% of 16-year-old novices and <2% of 17-year-old novices were convicted of driving unlicensed or unsupervised on their learner permits. Statewide historical conviction rates for these offenses were not higher after GDL was implemented, despite the longer holding period. Convictions for violating GDL nighttime or passenger restrictions were highest almost immediately after provisional licensure, though only about 3% of 16-year-old novices and 2% of 17-year-old novices were ever convicted of violating either restriction.

Discussion

California 16–17-year-old novice drivers were very rarely convicted of GDL-related violations. The contradictive, large differences between the current findings and self-report surveys are likely due in part to the fact that most self-reports assessed only whether teens had ever violated a GDL-related requirement, which exaggerates prevalence. Our conviction findings are more similar to estimates of non-compliance with GDL-related requirements from naturalistic driving studies that monitor actual driving behavior and take exposure into account, but are lower likely due to issues related to detection, enforcement, and adjudication of violations, as well as limitations of existing naturalistic studies.  相似文献   

7.

Background

The growing proportion of older adults in Australia is predicted to comprise 23% of the population by 2030. Accordingly, an increasing number of older drivers and fatal crashes of these drivers could also be expected. While the cognitive and physiological limitations of ageing and their road safety implications have been widely documented, research has generally considered older drivers as a homogeneous group. Knowledge of age-related crash trends within the older driver group itself is currently limited.

Objective

The aim of this research was to identify age-related differences in serious road crashes of older drivers. This was achieved by comparing crash characteristics between older and younger drivers and between sub-groups of older drivers. Particular attention was paid to serious crashes (crashes resulting in hospitalisation and fatalities) as they place the greatest burden on the Australian health system.

Method

Using Queensland Crash data, a total of 191,709 crashes of all-aged drivers (17–80+) over a 9-year period were analysed. Crash patterns of drivers’ aged 17–24, 25–39, 40–49, 50–59, 60–69, 70–79 and 80+ were compared in terms of crash severity (e.g., fatal), at fault levels, traffic control measures (e.g., stop signs) and road features (e.g., intersections). Crashes of older driver sub-groups (60–69, 70–79, 80+) were also compared to those of middle-aged drivers (40–49 and 50–59 combined, who were identified as the safest driving cohort) with respect to crash-related traffic control features and other factors (e.g., speed). Confounding factors including speed and crash nature (e.g., sideswipe) were controlled for.

Results and discussion

Results indicated that patterns of serious crashes, as a function of crash severity, at-fault levels, road conditions and traffic control measures, differed significantly between age groups. As a group, older drivers (60+) represented the greatest proportion of crashes resulting in fatalities and hospitalisation, as well as those involving uncontrolled intersections and failure to give way. The opposite was found for middle-aged drivers, although they had the highest proportion of alcohol and speed-related crashes when compared to older drivers. Among all older drivers, those aged 60–69 were least likely to be involved in or the cause of crashes, but most likely to crash at interchanges and as a result of driving while fatigued or after consuming alcohol. Drivers aged 70–79 represented a mid-range level of crash involvement and culpability, and were most likely to crash at stop and give way signs. Drivers aged 80 years and beyond were most likely to be seriously injured or killed in, and at-fault for, crashes, and had the greatest number of crashes at both conventional and circular intersections. Overall, our findings highlight the heterogeneity of older drivers’ crash patterns and suggest that age-related differences must be considered in measures designed to improve older driver safety.  相似文献   

8.

Context

Authorizing powered two-wheeler drivers to drive in lanes reserved to buses is a measure that is sometimes mentioned to improve mobility conditions for these users. But what effect would this measure have on the safety of these users and on the safety of the other users with whom they share the traffic space?

Objective

The objective of this study is to contribute elements to help answer this question. More precisely, the objective is to estimate the risk of having an accident per kilometer driven by powered two-wheeler drivers who drive in bus lanes and to compare this risk with that of powered two-wheeler drivers who drive in general traffic lanes.

Method

Using the bodily injury accidents recorded by the police over two years on 13 roads in the city of Marseille and a campaign of periodical observations of powered two-wheeler traffic, we estimated the risk per kilometer driven by powered two-wheeler drivers who drive in bus lanes and compared it with that of drivers who do not drive in them.

Results

The results show that the risk for powered two-wheeler drivers who drive in bus lanes of being involved in a bodily injury accident is significantly higher than the risk run by drivers who drive in general traffic lanes. For the 13 roads studied, it is on average 3.25 times higher (95% CI: 2.03; 5.21).

Conclusion

In the current situation, powered two-wheeler drivers who drive in bus lanes are less safe than those who drive in general traffic lanes. The analysis of police reports suggests that part of this increased risk comes from collisions between automobile drivers turning right and powered two-wheelers driving in the bus lane who continue straight ahead.  相似文献   

9.

Background

A training method known as Episodic training has shown promise in reducing speeding behavior in young drivers (Prabhakharan and Molesworth, 2011). The present study aimed to investigate how cognitive resources are utilized to implement this behavioral change.

Method

60 participants were randomly divided into four groups and completed a simulated training drive in Week 1 followed by a 10 km simulated test drive in Week 2. As part of the test drive, two groups were asked to complete a secondary task (mental arithmetic task) in addition to the test drive.

Results

The results indicated that implementing a speed management strategy elicited by Episodic training was successful in isolation, but came at a cognitive trade-off when performed in conjunction with a secondary task.

Conclusion

From an applied perspective, these results suggest driver training programmes should compartmentalize driver training in order to reduce the cognitive load experienced by trainee drivers, and hence facilitate in driver skill acquisition.  相似文献   

10.

Background

Low seat belt use and higher crash rates contribute to persistence of motor vehicle crashes as the leading cause of teenage death. Service-learning has been identified as an important component of public health interventions to improve health behavior.

Methodology

A service-learning intervention was conducted in eleven selected high schools across the United States in the 2011–2012 school year. Direct morning and afternoon observations of seat belt use were used to obtain baseline observations during the fall semester and post-intervention observations in the spring. The Mann–Whitney U test for 2 independent samples was used to evaluate if the intervention was associated with a statistically significant change in seat belt use. We identified factors associated with seat belt use post-intervention using multivariable logistic regression.

Results

Overall seat belt use rate increased by 12.8%, from 70.4% at baseline to 83.2% post-intervention (p < 0.0001). A statistically significant increase in seat belt use was noted among white, black, and Hispanic teen drivers. However, black and Hispanic drivers were still less likely to use seat belts while driving compared to white drivers. Female drivers and drivers who had passengers in their vehicle had increased odds of seat belt use.

Conclusion

A high school service-learning intervention was associated with improved seat belt use regardless of race, ethnicity, or gender, but did not eliminate disparities adversely affecting minority youth. Continuous incorporation of service-learning in high school curricula could benefit quality improvement evaluations aimed at disparities elimination and might improve the safety behavior of emerging youth cohorts.  相似文献   

11.

Objectives

Identify the possibility that alcohol consumption represents an incremental factor in healthcare costs of patients involved in traffic accidents.

Methods

Data of people admitted into three major health institutions from an intermediate city in Colombia was collected. Socio-demographic characteristics, health care costs and alcohol consumption levels by breath alcohol concentration (BrAC) methodology were identified. Generalized linear models were applied to investigate whether alcohol consumption acts as an incremental factor for healthcare costs.

Results

The average cost of healthcare was 878 USD. In general, there are differences between health care costs for patients with positive blood alcohol level compared with those who had negative levels. Univariate analysis shows that the average cost of care can be 2.26 times higher (95% CI: 1.20–4.23), and after controlling for patient characteristics, alcohol consumption represents an incremental factor of almost 1.66 times (95% CI: 1.05–2.62).

Conclusions

Alcohol is identified as a possible factor associated with the increased use of direct health care resources. The estimates show the need to implement and enhance prevention programs against alcohol consumption among citizens, in order to mitigate the impact that traffic accidents have on their health status. The law enforcement to help reduce driving under the influence of alcoholic beverages could help to diminish the economic and social impacts of this problem.  相似文献   

12.

Aim

To show the usefulness of joinpoint trend analysis for assessing changes in traffic safety policies.

Methods

Trends in driver death rates from traffic injury stratified by alcohol involvement in Spain during 2001–2011 were characterized with joinpoint regression to observe how changes in these rates match in time with the implementation of traffic regulations and interventions.

Results

Both alcohol-related (blood alcohol concentration >0.3 g/l) and non-alcohol-related rates decreased similarly (10–11% annually) during 2001–2011, although the former showed an earlier (2003 joinpoint) acceleration of the downward trend than the latter (2006 joinpoint); both joinpoints matched in time with relevant road safety interventions.

Conclusions

These results, which are consistent with results from previous analytical studies, show that joinpoint trend analysis, although not valid for causal inference, is useful for assessing changes in traffic safety policies. This methodology can be easily extended to other risk factors, such as excessive speeding or not wearing a seat belt.  相似文献   

13.

Objective

The purpose of this study was to conduct a process and outcome evaluation of the deterrent impact of Ontario's street racing and stunt driving legislation which came into effect on September 30, 2007, on collision casualties defined as injuries and fatalities. It was hypothesized that because males, especially young ones, are much more likely to engage in speeding, street racing and stunt driving, the new law would have more impact in reducing speeding-related collision casualties in males when compared to females.

Methods

Interrupted time series analysis with ARIMA modelling was applied to the monthly speeding-related collision casualties in Ontario for the period of January 1, 2002 to December 31, 2010, separately for young male drivers 16–25 years of age (primary intervention group), mature male drivers 26–65 years of age (secondary intervention group), young female drivers 16–25 years of age (primary comparison group) and mature female drivers 26–65 years of age (secondary comparison group). A covariate adjustment using non-speeding casualties was included.

Results

A significant intervention effect was found for young male drivers with, on average, 58 fewer collision casualties per month, but not for mature male drivers, when non-speeding casualties were controlled for. No corresponding effect was observed in either comparison (females) group.

Conclusion

These findings indicate a reduction in speeding-related casualties among young males of 58 fewer casualties per month subsequent to the introduction of Ontario's street racing and stunt driving legislation and suggest the presence of a general deterrent effect.  相似文献   

14.

Objective

Previous research has shown that fatal crash involvement rates per licensed driver aged 70 and older declined significantly more per year in the United States than rates for middle-aged drivers aged 35–54 during 1997–2008, and per vehicle mile traveled from 1995–1996 to 2001–2002. Analyses of police-reported crash data during 1997–2005 indicated that the greater declines for older drivers were due to decreases in crash involvement and in the risk of dying in the crashes that occurred. The current study examined if trends in crash rates, crash involvements, and survivability persisted into more recent years.

Methods

Trends for drivers 70 and older were compared with trends for drivers aged 35–54 for U.S. national fatal passenger vehicle crash involvements per 100,000 licensed drivers during 1997–2012 and for U.S. national fatal passenger vehicle crash involvements per vehicle miles traveled in 1995–1996, 2001–2002, and 2008. Using police-reported crash data during 1997–2008 from 20 U.S. states, trends in involvement rates in non-fatal crashes of various severities per 100,000 licensed drivers and changes in the odds of death and the odds of death or serious injury in a crash were compared between older and middle-aged drivers.

Results

During 2007–2012, declines in national fatal crash involvement rates per licensed driver were similar for drivers 70 and older and middle-aged drivers (18 percent each). However, when considering the entire study period, fatal crash involvement rates continued to reflect a substantially larger decline for drivers 70 and older than for middle-aged drivers (42 vs. 30 percent per licensed driver during 1997–2012, 39 vs. 26 percent per vehicle mile traveled from 1995–2006 to 2008). When analyses of police-reported crash data were extended through 2008, non-fatal injury crash involvement rates per licensed driver declined more for older than for middle-aged drivers (39 vs. 30 percent), and unlike in prior research, average annual declines were significantly larger for drivers 80 and older. Property damage-only crash involvement rates similarly declined significantly more for older than for middle-aged drivers (15 vs. 3 percent). Drivers 70 and older in 1997 were 3.5 times more likely than middle-aged drivers to die in a crash, and this ratio declined to 3.2 by 2008.

Conclusions

Although declines in fatal crash involvement rates in recent years have not differed between older and middle-aged drivers, this did not undo earlier gains for older drivers. The recent slowing in the relative magnitude of the decline for older drivers may be related to the differential effect of the U.S. recession on fatal crash involvements of drivers in these age groups. The decreased likelihood of being involved in a crash of any severity and increased survivability when a crash occurred held when examining data through 2008, and for drivers 80 and older, significant declines in crash involvement relative to middle-aged drivers extended to non-fatal injury crashes.  相似文献   

15.

Background

Use of cellular phones has been shown to be associated with crashes but many external distractions remain to be studied.

Objective

To assess the risk associated with diversion of attention due to unexpected events or secondary tasks at the wheel.

Design

Responsibility case–control study.

Setting

Adult emergency department of the Bordeaux University Hospital (France) from April 2010 to August 2011.

Participants

955 injured drivers presenting as a result of motor vehicle crash.

Main outcome measures

The main outcome variable was responsibility for the crash. Exposures were external distraction, alcohol use, psychotropic medicine use, and sleep deprivation. Potential confounders were sociodemographic and crash characteristics.

Results

Beyond classical risk factor found to be associated with responsibility, results showed that distracting events inside the vehicle (picking up an object), distraction due to driver activity (smoking) and distracting events occurring outside were associated with an increased probability of being at fault. These distraction-related factors accounted for 8% of injurious road crashes.

Limitations

Retrospective responsibility self-assessment.

Conclusions

Diverted attention may carry more risk than expected. Our results are supporting recent research efforts to detect periods of driving vulnerability related to inattention.  相似文献   

16.
17.

Background

Drink driving among women is a growing problem in many motorised countries. While research has shown that male and female drink drivers differ on a number of characteristics, few studies have addressed the circumstances surrounding women's drink driving offences specifically.

Aim

To add to previous research by comparing apprehension characteristics among men and women and to extend the understanding of the female drink driving problem by investigating the drink driving characteristics that are unique to women.

Results

The sample consisted of the 248,173 (21.5% women) drink drivers apprehended between 2000 and 2011 in Queensland, Australia. Gender comparisons showed that women were older, had lower levels of reoffending, and were more likely to be apprehended in Major Cities compared to men. Comparisons of age group and reoffending and non-reoffending among female drink drivers only revealed that higher BAC readings were more common among younger women. Moreover, a substantial minority (13.7%) of women aged 24 years or younger were apprehended with a BAC below0.05%, reflecting a breach of the zero tolerance BAC for provisional licence holders in Australia. Older women were more likely to be charged with a ‘failure to provide a test’ offence as a result of refusing to provide a breath or blood sample, indicating that drink driving is associated high levels of stigma for this group. Reoffending occurred among 16.2% of the female drink drivers and these drivers were more likely than non-reoffending drivers to record a mid to high range BAC, to be aged 30–39 or below 21years, and to be apprehended in Inner Regional or Remote locations.

Conclusion

Findings highlight the unique circumstances and divergent needs of female drink drivers compared to male drivers and for different groups of female drivers.  相似文献   

18.

Introduction

The purpose of this paper is to assess the impact of administrative sanctions introduced as part of a new law for drinking drivers in British Columbia, Canada. The new law, known as immediate roadside prohibitions (IRP), aimed to increase the efficiency of police and courts for processing drinking drivers, thereby increasing the certainty of their being apprehended and punished. However, in order to maintain these efficiencies, sanctions under this new law largely replaced laws under the Criminal Code of Canada for Driving While Impaired (DWI) by alcohol, which had more severe penalties but lower certainty of punishment. We examined whether the intervention was related to abrupt significant declines in three types of alcohol-related collisions (i.e. fatalities, injuries or property damage only) compared to the same type of collisions without alcohol involvement.

Methods

An interrupted time series design, with a non-equivalent control was used, testing for an intervention effect. Monthly rates of the three types of collisions with and without alcohol involvement were calculated for the 15-year period before and the 1-year period after implementation of the new law. ARIMA time series analysis was conducted controlling for trend effects, seasonality, autocorrelation, and collisions without alcohol.

Results

Significant average declines (p < 0.05) in alcohol-related collisions were found as follows: 40.4% for fatal collisions, 23.4% for injury collisions and 19.5% for property damage only collisions. No significant effects were found for any of the three comparable non-alcohol-related types of collisions.

Conclusions

These results suggest that provincial law of administrative sanctions for drinking drivers and associated publicity was more effective for minimizing alcohol-related collisions than laws under the Canadian Criminal Code.  相似文献   

19.

Objective

The current study evaluated part of the Multifactorial Model of Driving Safety to elucidate the relative importance of cognitive function and a limited range of standard measures of visual function in relation to the Capacity to Drive Safely. Capacity to Drive Safely was operationalized using three validated screening measures for older drivers. These included an adaptation of the well validated Useful Field of View (UFOV) and two newer measures, namely a Hazard Perception Test (HPT), and a Hazard Change Detection Task (HCDT).

Method

Community dwelling drivers (n = 297) aged 65–96 were assessed using a battery of measures of cognitive and visual function.

Results

Factor analysis of these predictor variables yielded factors including Executive/Speed, Vision (measured by visual acuity and contrast sensitivity), Spatial, Visual Closure, and Working Memory. Cognitive and Vision factors explained 83–95% of age-related variance in the Capacity to Drive Safely. Spatial and Working Memory were associated with UFOV, HPT and HCDT, Executive/Speed was associated with UFOV and HCDT and Vision was associated with HPT.

Conclusion

The Capacity to Drive Safely declines with chronological age, and this decline is associated with age-related declines in several higher order cognitive abilities involving manipulation and storage of visuospatial information under speeded conditions. There are also age-independent effects of cognitive function and vision that determine driving safety.  相似文献   

20.

Background

This study aimed to assess the association between cannabis use and unintended non-fatal injuries other than those caused by road crashes.

Methods

Cross-sectional data were collected from a nationwide sample of 27,934 subjects surveyed in 2005 in Spain: 14,699 persons aged 15–34 years and 13,235 aged 35–64 years. Logistic regression was used to obtain odds ratios (OR) between patterns of cannabis use and frequency of non-traffic injuries, adjusted for sociodemographic factors and for the use of alcohol, tobacco and other drugs.

Results

Cannabis use in the last 12 months was associated with a higher frequency of injuries (OR = 1.4; 95% CI: 1.2–1.7). The OR in older adults (35–64 year age group) was 1.8 and 1.3 in younger people (15–34 year age group). The strongest associations found were between weekly use of cannabis and injuries from knocks and bumps (OR = 5.1; 95% CI 2.9–8.9) and those occurring outside work (OR = 3.0; 95% CI 1.8–4.9) in the older adult population.

Conclusion

Although our analysis did not control for behavioural factors, cannabis use is independently associated with an increased frequency of non-traffic injuries, especially in the older adult population. These associations emphasise the need to carry out longitudinal studies addressing the causal links between cannabis use and unintended injuries.  相似文献   

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