Declines in fatal crashes of older drivers: changes in crash risk and survivability

Objectives

Previous research has found that older driver fatal crash involvement rates per licensed driver declined substantially in the United States during 1997–2006 and declined much faster than the rate for middle-age drivers. The current study examined whether the larger-than-expected decline for older drivers extended to nonfatal crashes and whether the decline in fatal crash risk reflects lower likelihood of crashing or an improvement in survivability of the crashes that occur.

Methods

Trends in the rates of passenger vehicle crash involvements per 100,000 licensed drivers for drivers 70 and older (older drivers) were compared with trends for drivers ages 35–54 (middle-age drivers). Fatal crash information was obtained from the Fatality Analysis Reporting System for years 1997–2008, and nonfatal crash information was obtained from 13 states with good reporting information for years 1997–2005. Analysis of covariance models compared trends in annual crash rates for older drivers relative to rates for middle-age drivers. Differences in crash survivability were measured in terms of the odds of fatality given a crash each year, and the historical trends for older versus middle-age drivers were compared.

Results

Fatal crash involvement rates declined for older and middle-age drivers during 1997–2008 (1997–2005 for the 13 state subsample), but the decline for drivers 70 and older far exceeded the decline for drivers ages 35–54 (37 versus 23 percent, nationally; 22 versus 1 percent, 13 states). Nonfatal injury crash involvement rates showed similarly larger-than-expected declines for older drivers in the 13 state subsample, but the differences were smaller and not statistically significant (27 percent reduction for older drivers versus 16 percent for middle-age drivers). Property-damage-only crash involvement rates declined for older drivers (10 percent) but increased for middle-age drivers (1 percent). In 1997, older drivers were 3.5 times more likely than middle-age drivers to die in police-reported crashes (6.2 versus 1.8 deaths per 1000 crashes), but this difference was reduced during the 9-year study period to 2.9 times, as the rate of older drivers dying in a crash declined (5.5 deaths per 1000 crashes in 2005) and the death risk remained relatively stable for middle-age drivers.

Conclusions

Contrary to expectations based on increased licensure and travel by older drivers, their fatal crash risk has declined during the past decade and has declined at a faster rate than for middle-age drivers. The decreased risk for older drivers appears to extend not only to nonfatal injury crashes but also to property-damage-only crashes, at least as reported to police in the 13 states included in the nonfatal injury analysis. Although insurance collision data suggest that overall crash risk of older drivers may not be changing relative to middle-age drivers, the current analysis indicates that the reduced fatality risk of older drivers reflects both less likelihood of being involved in a police-reported crash and greater likelihood that they will survive when they do crash.     

Older drivers, medical condition, medical impairment and crash risk

New evidence has appeared to support the fact that the over-involvement of older drivers in traffic accidents disappears when the low mileage bias is taken into account. As a group, older drivers are as safe as or safer than other age groups, and only low mileage older drivers have a high crash rate. Furthermore, the role of the medical condition of older drivers in traffic accidents, as well as the fitness to drive evaluation, are objects of controversy. We examined all this with a cohort of 4316 drivers attending Medical Driving Test Centres for a mandatory fitness to drive evaluation. Our data shows that older drivers (> or =75) have a lower crash rate. Medical conditions that impair fitness to drive, as a tendency, increased with advanced age and with lower mileage group. The multivariate analysis of variance showed that there is an effect (p<0.0001) of age-range and mileage on the annual crash rate per million kilometres driven, while a medical restriction ("fit to drive with restriction") has no effect (p>0.05). Our data suggests that health status is not associated with increased crash risk for the low mileage group, although further studies are needed.     

Motor-vehicle crash history and licensing outcomes for older drivers reported as medically impaired in Missouri

The identification and evaluation of medically impaired drivers is an important safety issue. Medical fitness to drive is applicable to all ages but is particularly salient for older adults. Voluntary procedures, whereby various professionals and family members may report medical fitness concerns to State driver license bureaus, are common in the United States. This paper examines traffic crashes of drivers reported during 2001-2005 under the State of Missouri's voluntary reporting law (House Bill HB-1536) and the resulting licensing outcomes.Missouri's law is non-specific as to age, but the mean age of reported drivers was 80. Reports were submitted by police officers (30%), license office staff (27%), physicians (20%), family members (16%), and others (7%). The most common medical condition was dementia/cognitive (45%). Crash history for reported drivers was higher than that of controls, dating back to 1993, reaching a peak in 2001 when the crash involvement of reported drivers was 9.3% vs. 2.2% for controls—a fourfold difference. The crash involvement of reported drivers decreased rapidly after, indicating the impact of HB-1536 reporting with subsequent license revocation and to a lesser degree, mortality. Of the 4,100 reported individuals, 144 (3.5%) retained a driver's license after the process.     

Trends in older driver crash involvement rates and survivability in the United States: An update

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.     

Characteristics of traffic crashes in Maryland (1996-1998): differences among the youngest drivers

Motor vehicle crashes (MVCs) are the leading cause of death among teenagers in the US. The present study examines how crash rates and crash characteristics differed among drivers aged 16-21 in the state of Maryland from 1996 to 1998. The results show that, based on police reports. the youngest drivers have the highest rate of MVCs per licensed driver and per annual miles driven. Furthermore, crash characteristics suggest that inexperience rather than risky driving may account for the differing rates. Drivers closer to the age of 16 had their crashes under the safest conditions: during the day in clear weather while drinking less.     

The effect of distractions on the crash types of teenage drivers

Teenage drivers are overrepresented in crashes when compared to middle-aged drivers. Driver distraction is becoming a greater concern among this group as in-vehicle devices, opportunities for distractions, and teenage drivers' willingness to engage in these activities increase. The objective of this study was to determine how different distraction factors impact the crash types that are common among teenage drivers. A multinomial logit model was developed to predict the likelihood that a driver will be involved in one of three common crash types: an angular collision with a moving vehicle, a rear-end collision with a moving lead vehicle, and a collision with a fixed object. These crashes were evaluated in terms of four driver distraction categories: cognitive, cell phone related, in-vehicle, and passenger-related distractions. Different driver distractions have varying effects on teenage drivers' crash involvement. Teenage drivers that were distracted at an intersection by passengers or cognitively were more likely to be involved in rear-end and angular collisions when compared to fixed-object collisions. In-vehicle distractions resulted in a greater likelihood of a collision with a fixed object when compared to angular collisions. Cell phone distractions resulted in a higher likelihood of rear-end collision. The results from this study need to be evaluated with caution due to the limited number of distraction related cases available in the U.S. GES crash database. Implications for identifying and improving the reporting of driver distraction related factors are therefore discussed.     

Findings from the Candrive/Ozcandrive study: Low mileage older drivers,crash risk and reduced fitness to drive

Previous research has found that only older drivers with low annual driving mileages had a heightened crash risk relative to other age groups. These drivers tend to drive mainly in urban areas, where the prevalence of complex traffic situations increases crash risk. However it might also be that some drivers may have reduced their driving due to perceived or actual declines in driving fitness.     

The association between sudden illness and motor vehicle crash mortality and injury among older drivers in NSW, Australia

This exploratory study aims to investigate the associations between sudden illness and the risk of motor vehicle crash-related mortalities and injuries among older drivers aged 60 or above. Information utilised in the study was obtained from police reports of all road traffic accidents that occurred on the roads between 1996 and 2000 in New South Wales, Australia. There were 409 older drivers involved in crashes after becoming ill suddenly. Among these the majority (62.1%) of crashes led to at least one occupant in the vehicle being killed or injured. There is a significant association between sudden illness and crash-related mortality and injury after adjusting for other risk factors. The risk of injury and death is increased by nearly six times (OR = 5.58, 95% CI = 4.54-6.85) for those who suffered a sudden illness while driving when compared to those non-sufferers. These results are discussed in the light of possible preventive strategies and the provision of risk assessment and safety counselling for older people.     

Driving errors of learner teens: Frequency,nature and their association with practice

Background

Despite demonstrating basic vehicle operations skills sufficient to pass a state licensing test, novice teen drivers demonstrate several deficits in tactical driving skills during the first several months of independent driving. Improving our knowledge of the types of errors made by teen permit holders early in the learning process would assist in the development of novel approaches to driver training and resources for parent supervision.

Methods

The purpose of the current analysis was to describe driving performance errors made by teens during the permit period, and to determine if there were differences in the frequency and type of errors made by teens: (1) in comparison to licensed, safe, and experienced adult drivers; (2) by teen and parent-supervisor characteristics; and (3) by teen-reported quantity of practice driving. Data for this analysis were combined from two studies: (1) the control group of teens in a randomized clinical trial evaluating an intervention to improve parent-supervised practice driving (n = 89 parent-teen dyads) and (2) a sample of 37 adult drivers (mean age 44.2 years), recruited and screened as an experienced and competent reference standard in a validation study of an on-road driving assessment for teens (tODA). Three measures of performance: drive termination (i.e., the assessment was discontinued for safety reasons), safety-relevant critical errors, and vehicle operation errors were evaluated at the approximate mid-point (12 weeks) and end (24 weeks) of the learner phase. Differences in driver performance were compared using the Wilcoxon rank sum test for continuous variables and Pearson's Chi-square test for categorical variables.

Results

10.4% of teens had their early assessment terminated for safety reasons and 15.4% had their late assessment terminated, compared to no adults. These teens reported substantially fewer behind the wheel practice hours compared with teens that did not have their assessments terminated: tODA_early (9.0 vs. 20.0, p < 0.001) and tODA_late (19.0 vs. 58.3, p < 0.001). With respect to critical driving errors, 55% of teens committed a total of 85 critical errors (range of 1–5 errors per driver) on the early tODA; by comparison, only one adult committed a critical error (p < 0.001). On the late tODA, 54% of teens committed 67 critical errors (range of 1–8 errors per driver) compared with only one adult (p < 0.001). No differences in teen or parent gender, parent/teen relationship type or parent prior experience teaching a teen to drive were observed between teens who committed a critical error on either route and teens that committed no critical errors. A borderline association between median teen-reported practice quantity and critical error commission was observed for the late tODA. The overall median proportion of vehicle operation errors for teens was higher than that of adults on both assessments, though median error proportions were less than 10% for both teens and adults.

Conclusion

In comparison to a group of experienced adult drivers, a substantially higher proportion of learner teens committed safety-relevant critical driving errors at both time points of assessment. These findings, as well as the associations between practice quantity and the driving performance outcomes studied suggest that further research is needed to better understand how teens might effectively learn skills necessary for safe independent driving while they are still under supervised conditions.     

A population based estimation of the driver protection provided by passenger cars: France 1996–2005

The technology used in cars to protect occupants is constantly developing. Demonstrating the beneficial effects in the field is complex as the most recent vehicles are generally used by drivers who differ from other drivers and who drive in different traffic conditions. This paper presents an overall estimation of the consequences of changes in the secondary safety of cars, taking account of most of these factors.The data come from information collected about injury road traffic crashes by the police in France between 1996 and 2005. The risk of the driver being killed has been evaluated for the 144,034 drivers involved in two-car crashes and for the 63,621 drivers involved in single-car crashes.The study shows that when a recent car is in collision with an older car the driver of the former is better protected than the driver of the latter. These improvements in secondary safety are not observed in the case of single-car crashes, very probably because of higher impact speeds. Our findings also confirm the need for protection systems to be better adapted to the specific characteristics of users and for an improvement in the crash compatibility of vehicles, in particular to overcome the consequences of differences between the masses of vehicles.     

The stability of driver acceleration behavior, and a replication of its relation to bus accidents

The reliability over time of a method for measuring driver acceleration behavior was tested on bus drivers in regular traffic. Also, a replication of an earlier finding of a correlation between driver acceleration behavior and accident frequency for the individual drivers was made. It was found that the split-half correlation is probably around 0.50 for the mean (of accelerations) of a 30-min drive, and similar for the test-retest of 2.5h measured about a month apart. With such reliability, the sample was probably too small to reliably determine any association with accidents, but some significant correlations were found. Some ways of holding constant the differences in exposure and driving environment were tried with mixed success. Alternate ways of analyzing the data and several methodological problems were briefly discussed. It was concluded that the measurements of acceleration behavior, for bus drivers, are fairly reliable over at least a few months. However, some strange discrepancies between samples make all interpretations concerning the link to accidents tentative.     

Determining the validity of the AMA guide: A historical cohort analysis of the Assessment of Driving Related Skills and crash rate among older drivers

Background

Chronic health conditions associated with ageing can lead to changes in driving ability. The Canadian Driving Research Initiative for Vehicular Safety in the Elderly (Candrive II) is a 5-year prospective study funded by the Canadian Institutes of Health Research aiming to develop an in-office screening tool that will help clinicians identify potentially at-risk older drivers. Currently, no tools exist to directly predict the risk of motor vehicle collision (MVC) in this population. The American Medical Association (AMA), in collaboration with the National Highway Traffic Safety Association, has designed an opinion-based guide for assessing medical fitness to drive in older adults and recommends that physicians use the Assessment of Driving Related Skills (ADReS) as a test battery to measure vision, cognition and motor/somatosensory functions related to driving. The ADReS consists of the Snellen visual acuity test, visual fields by confrontation test, Trail Making Test part B, clock drawing test, Rapid Pace Walk, and manual tests of range of motion and motor strength. We used baseline data from the Candrive/Ozcandrive common cohort of older drivers to evaluate the validity of the ADReS subtests. We hypothesized that participants who crashed in the 2 years before the baseline assessment would have poorer scores on the ADReS subtests than participants who had not crashed.

Methods

In the Candrive/Ozcandrive study, 1230 participants aged 70 years or older were recruited from 7 Canadian cities, 1 Australian city and 1 New Zealand city, all of whom completed a comprehensive clinical assessment at study entry. The assessment included all tests selected as part of the ADReS. For this historical cohort study, data on all crashes (at-fault and non-at-fault) that occurred within 2 years preceding the baseline assessment were obtained from the respective licensing jurisdictions. Those who crashed were compared to those who had not crashed on their ADReS subtest scores using Pearson's chi-squared test and Student's t-test.

Results

Sixty-three of the 1230 participants (5.1%) were involved in an MVC within the 2 years preceding the baseline assessment. Contrary to our hypothesis, there were no statistically significant associations between abnormal performance on the tests constituting the ADReS and history of crash in the previous 2 years (p > 0.01).

Discussion

We found that a history of crash in the previous 2 years was not associated with abnormalities on the subtests comprising the ADReS. This suggests the need for prospective analyses of risk factors over time to establish sensitive, valid predictors of crash that can be incorporated in clinical practice guidelines.     

An examination of the environmental,driver and vehicle factors associated with the serious and fatal crashes of older rural drivers

Motor vehicle crashes involving rural drivers aged 75 years and over are more than twice as likely to result in a serious or fatal injury as those involving their urban counterparts. The current study examined some of the reasons for this using a database of police-reported crashes (2004–2008) to identify the environmental (lighting, road and weather conditions, road layout, road surface, speed limit), driver (driver error, crash type), and vehicle (vehicle age) factors that are associated with the crashes of older rural drivers. It also determined whether these same factors are associated with an increased likelihood of serious or fatal injury in younger drivers for whom frailty does not contribute to the resulting injury severity. A number of environmental (i.e., undivided, unsealed, curved and inclined roads, and areas with a speed limit of 100 km/h or greater) and driver (i.e., collision with a fixed object and rolling over) factors were more frequent in the crashes of older rural drivers and additionally associated with increased injury severity in younger drivers. Moreover, when these environmental factors were entered into a logistic regression model to predict whether older drivers who were involved in crashes did or did not sustain a serious or fatal injury, it was found that each factor independently increased the likelihood of a serious or fatal injury. Changes, such as the provision of divided and sealed roads, greater protection from fixed roadside objects, and reduced speed limits, appear to be indicated in order to improve the safety of the rural driving environment for drivers of all ages. Additionally, older rural drivers should be encouraged to reduce their exposure to these risky circumstances.     

The influence of driver distraction on the severity of injuries sustained by teenage drivers and their passengers

Studies show that teenage drivers are at a higher risk for crashes. Opportunities to engage in technology and non-technology based distractions appear to be a particular concern among this age group. An ordered logit model was developed to predict the likelihood of a severe injury for these drivers and their passenger using a national crash database (the 2003, U.S. DOT-General Estimate System [GES]). As one would expect, speeding substantially increases the likelihood of severe injuries for teenage drivers and their passengers. The results of the analysis also reveal that teenage drivers have an increased likelihood of more severe injuries if distracted by a cell phone or by passengers than if the source of distraction was related to in-vehicle devices or if the driver was inattentive. Additionally, passengers of teenage drivers are more likely to sustain severe injuries when their driver is distracted by devices or passengers than with a non-distracted or inattentive driver. This supports the previous literature on teenage drivers and extends our understanding of injuries for this age group related to distraction-related crashes.     

An exploratory study of the relationship between road rage and crash experience in a representative sample of US drivers

The phenomenon of road rage has been frequently discussed but infrequently examined. Using a representative sample of 1382 US adult drivers, who were interviewed in a 1998 telephone survey, exploratory analyses examined the relationship between self-reported measures of road rage, generally hazardous driving behaviors, and crash experience. Regarding specific road rage behaviors, most respondents reported having engaged in verbal expressions of annoyance; however only 2.45% reported ever having been involved in direct confrontation with another car or driver. After controlling for gender, age. driving frequency, annual miles driven and verbal expression, an angry/threatening driving subscale of road rage was significantly associated with hazardous driving behaviors that included frequency of driving over the legal blood alcohol limit, receipt of tickets in the past year. and habitually exceeding the speed limit as well as crash experience. However, the verbal/frustration expression subscale was not associated with crash experience or hazardous driving indicators, except for number of tickets, after controlling for other crash-related factors such as gender and age. Direct confrontation by deliberately hitting another car or leaving the car to argue with and/or injure another driver was rarely reported. Results suggest that angry/threatening driving is related to crash involvement; however, after controlling for exposure and angry/threatening and hazardous driving the relationship of milder expressions of frustration while driving and crash involvement was not significant.     

On the training and testing of entry-level commercial motor vehicle drivers

This study examined the effectiveness of 3 different training types on commercial motor vehicle (CMV) drivers’ skill levels. The training types included a conventional 8-week certified course, a conventional 8-week certified course with approximately 60% of driving time spent in a CMV driving simulator, and a Commercial Driver's License (CDL) test focused short course. Participants’ scores on the Division of Motor Vehicles (DMV) road and range tests were assessed. In addition to their DMV scores, participants replicated DMV road and range driving tests in an instrumented vehicle and the CMV driving simulator. Results indicated no training group differences in DMV road tests. There were differences between training groups on DMV range tests and real truck and simulator versions of the DMV road and range tests; on these tests conventional- and simulator-trained participants generally scored higher than CDL-focused participants. However, all groups performed higher in the real truck than in the simulator for both road and range tests. These findings indicate the need for a minimum standard of entry-level CMV driver training as well as support of the use of a driving simulator for training entry-level drivers; however, testing using a simulator does not appear to be feasible with current technology.     

Road mobility and the risk of road traffic accident as a driver. The impact of medical conditions and life events

STUDY OBJECTIVE: We conducted a longitudinal investigation of the impact of self-reported life events and medical conditions on changes in road mobility on the wheel between 2000 and 2002 in order to assess whether these changes would affect the risk of road traffic accident (RTA). METHODS: Data are from a cohort of workers and retirees from the French national gas and electricity companies (the Gazel cohort). In the present study, 10,483 participants were included (7843 men aged 51-61 years and 2640 women aged 46-61 years, in 2000). The link between mobility and the risk of RTA was approximated using data on RTA number during lifetime and reported mobility in 2000. We then compared changes in road mobility between 2000 and 2002 resulting from life events and medical conditions reported to have occurred in the year 2001 or changed when compared to year 2000. We also compared road mobilities in 2000 in order to assess any pre-existing differences before life events and medical conditions. This led to estimation of the effect of road mobility changes on the risk of RTA. RESULTS: Changes in road mobility associated with life events and medical conditions were only found among men. These changes in road mobility were minimal. Ensuing changes in the risk of RTA were estimated to be small (odds-ratios ranged from 0.94 to 1.01). The only life events found to be associated with increased road mobility was an important purchase. Hospitalization, serious RTA, and retiring were associated with reduced road mobility. Concerning medical conditions, men who reported cataract, angina pectoris, diabetes, anxiety and stress, sleep disorder, and depression decreased their road mobility. CONCLUSION: We found no or moderate changes in road mobility resulting from life events and medical conditions, suggesting that results from previous published studies that assessed the impact of life events or medical conditions on RTA were not jeopardized by improper adjustment for road mobility.     

Pedestrian- and driver-related factors associated with the risk of causing collisions involving pedestrians in Spain

This study aimed to quantify the association between pedestrian- and driver-related factors and the risk of causing road crashes involving pedestrians in urban areas in Spain between 1993 and 2011. From the nationwide police-based registry of road crashes with victims in Spain, we analyzed all 63,205 pairs of pedestrians and drivers involved in crashes in urban areas in which only the pedestrian or only the driver was at fault. Logistic regression models were used to obtain adjusted odds ratios to assess the strength of association between each individual-related variable and the pedestrian’s odds of being at fault for the crash (and conversely, the driver’s odds of not being at fault).The subgroups of road users at high risk of causing a road crash with a pedestrian in urban areas were young and male pedestrians, pedestrians with psychophysical conditions or health problems, the youngest and the oldest drivers, and drivers with markers of high-risk behaviors (alcohol use, nonuse of safety devices, and driving without a valid license). These subgroups should be targeted by preventive strategies intended to decrease the rate of urban road crashes involving pedestrians in Spain.     

French validation of a new version of the Driver Behavior Questionnaire (DBQ) for drivers of all ages and level of experiences

The purpose of this study was to validate a new version of the Driver Behavior Questionnaire (DBQ) on a sample of French drivers in order to gain a better understanding of different driver behaviors, by differentiating two types of violations (aggressive and ordinary), three types of errors (dangerous, inattention and inexperience) and by taking positive behaviors into account. 525 drivers (205 men and 320 women), between 18 and 79 years of age, filled in a questionnaire on line including the 41 items in the new version of the DBQ and information relative to their mobility and their accident history. Exploratory factor analysis confirmed a six-factor structure: “dangerous errors”, “inattention errors”, “inexperience errors”, “ordinary violations”, “aggressive violations” and “positive behaviors”. A revised version with 23 items of the new version of the DBQ was produced by selecting the items that loaded most strongly on the six factors. The results also showed the link between demographic variables (age and gender), mobility (kilometers driven weekly), the DBQ scores and the involvement in an accident in the previous five years. This study permitted to validate a more detailed version of the “Driving Behavior Questionnaire” among French drivers of all age and all level of experience.     

An exposure based study of crash and injury rates in a cohort of transport and recreational cyclists in New South Wales,Australia

This paper examines self-reported prospectively collected data from 2038 adult transport and recreational cyclists from New South Wales (Australia) to determine exposure-based incident crash and injury rates. During 25,971 days of cycling, 198 crashes were reported, comprising approximately equal numbers of falls and collisions. The overall crash rate was 0.290 (95% CI, 0.264–0.319) per 1000 km or 6.06 (95% CI, 5.52–6.65) per 1000 h of travel. The rate of crashes causing any injury (self-treated, or medically attended without overnight hospital stay) was 0.148 (95% CI, 0.133–0.164) per 1000 km or 3.09 (95% CI, 2.79-3.43) per 1000 h of travel. The rate of crashes causing a medically attended injury (without overnight hospital stay) was 0.023 (95% CI, 0.020–0.027) per 1000 km or 0.49 (95% CI, 0.43-0.56) per 1000 h of travel. No injuries requiring an overnight stay in hospital were reported on days meeting the inclusion criteria. After adjustment for exposure in hours, or for the risks associated with different infrastructure utilisation, the rates of crashes and medically attended injuries were found to be greater for females than males, less experienced than more experienced cyclists, and for those who rode mainly for transport rather than mainly for recreation. Comparison of estimated crash and injury rates on different infrastructure types were limited by the small number of events, however findings suggest that the separation of cyclists from motorised traffic is by itself not sufficient to ensure safe cycling.