Naturalistic conversation improves daytime motorway driving performance under a benzodiazepine: A randomised,crossover, double-blind,placebo-controlled study

The adverse effects of benzodiazepines on driving are widely recognised. The aims of this study were both to determine the impact of naturalistic conversation on the driving ability of drivers under a benzodiazepine, and to measure the accuracy of drivers’ assessments of the joint effects of the benzodiazepine and conversation. Sixteen healthy male participants (29.69 ± 3.30 years) underwent a randomised, crossover, double-blind, placebo-controlled study with the benzodiazepine lorazepam (2 mg). They drove 200 km (125 miles) on a motorway in the morning. We measured two driving ability-related variables (i.e., lane-keeping performance), and collected a set of self-assessed variables (i.e., self-assessment of driving performance) during two 10-min sequences of interest (no conversation vs. conversation). An analysis of variance revealed an interaction whereby lane-keeping performance under lorazepam was worse in the no-conversation condition than in the conversation condition. No such difference was detected under placebo. Pearson's correlation coefficients revealed that self-assessments were (i) not at all predictive of lane-keeping when performed before the drive, but (ii) moderately predictive of lane-keeping performance when performed during or after the drive. We conclude that conversation with a passenger may contribute to safer lane-keeping when driving under a benzodiazepine. Moreover, a degree of awareness may be attained after some experience of driving under the influence of this type of medication.     

Development and evaluation of a Driving Observation Schedule (DOS) to study everyday driving performance of older drivers

This paper describes the development and evaluation of an on-road procedure, the Driving Observation Schedule (DOS), for monitoring individual driving behavior. DOS was developed for use in the Candrive/Ozcandrive five-year prospective study of older drivers. Key features included observations in drivers’ own vehicles, in familiar environments chosen by the driver, with start/end points at their own homes. Participants were 33 drivers aged 75+ years, who drove their selected route with observations recorded during intersection negotiation, lane-changing, merging, low speed maneuvers and maneuver-free driving. Driving behaviors were scored by a specialist occupational therapy driving assessor and another trained observer. Drivers also completed a post-drive survey about the acceptability of DOS. Vehicle position, speed, distance and specific roadways traveled were recorded by an in-vehicle device installed in the participant's vehicle; this device was also used to monitor participants’ driving over several months, allowing comparison of DOS trips with their everyday driving. Inter-rater reliability and DOS feasibility, acceptability and ecological validity are reported here. On average, drivers completed the DOS trip in 30.48 min (SD = 7.99). Inter-rater reliability measures indicated strong agreement between the trained and the expert observers: intra-class correlations (ICC) = 0.905, CI 95% 0.747–0.965, p < 0.0001; Pearson product correlation, r (18) = .83, p < 0.05. Standard error of the measurement (SEM), method error (ME) and coefficient of variation (CV) measures were consistently small (3.0, 2.9 & 3.3%, respectively). Most participants reported being ‘completely at ease’ (82%) with the driving task and ‘highly familiar with the route’ (97%). Vehicle data showed that DOS trips were similar to participants’ everyday driving trips in roads used, roadway speed limits, drivers’ average speed and speed limit compliance. In summary, preliminary findings suggest that DOS can be scored reliably, is of feasible duration, is acceptable to drivers and representative of everyday driving. Pending further research with a larger sample and other observers, DOS holds promise as a means of quantifying and monitoring changes in older drivers’ performance in environments typical of their everyday driving.     

The sensitivity of laboratory tests assessing driving related skills to dose-related impairment of alcohol: A literature review

Laboratory tests assessing driving related skills can be useful as initial screening tools to assess potential drug induced impairment as part of a standardized behavioural assessment. Unfortunately, consensus about which laboratory tests should be included to reliably assess drug induced impairment has not yet been reached. The aim of the present review was to evaluate the sensitivity of laboratory tests to the dose dependent effects of alcohol, as a benchmark, on performance parameters. In total, 179 experimental studies were included. Results show that a cued go/no-go task and a divided attention test with primary tracking and secondary visual search were consistently sensitive to the impairing effects at medium and high blood alcohol concentrations. Driving performance assessed in a simulator was less sensitive to the effects of alcohol as compared to naturalistic, on-the-road driving. In conclusion, replicating results of several potentially useful tests and their predictive validity of actual driving impairment should deserve further research. In addition, driving simulators should be validated and compared head to head to naturalistic driving in order to increase construct validity.     

Validity and reliability of the on-road driving assessment with senior drivers

The on-road driving assessment is widely regarded as the criterion measure for driving performance despite a paucity of evidence concerning its psychometric properties. The purpose of this study was 2-fold. First, we examined the psychometric properties of an on-road driving assessment with 100 senior drivers between 60 and 86 years (80 healthy volunteers and 20 with specific vision deficits) using Rasch modeling. Second, we compared the outcome of the gestalt decision made by trained professionals with that based on weighted error scores from the standardized assessment. Rasch analysis provided good evidence for construct validity and inter-rater reliability of the on-road assessment and some evidence for internal reliability. Goodness of fit statistics for all items were within an acceptable range and the item hierarchy was logical. The test had a moderate reliability index (0.67). The best cut off score yielded sensitivity of 81% and specificity of 95% compared with the gestalt decision. Further research is required with less competent drivers to more fully examine reliability. Healthy senior drivers failed to check blind spots when changing lanes and made errors when asked to report road markings and traffic signs as they drove. In addition unsafe drivers had difficulty negotiating intersections and lane changes.     

Age and inconsistency in driving performance

Research in cognitive neuropsychology suggests that investigation of the within-person variability, or inconsistency, of cognitive performance may provide valuable insights into ageing mental processes. It is rare though, for this interest in intraindividual variability to extend to everyday activities. As this may provide important information about driving behaviour, we therefore assessed age differences in driving inconsistency in younger (n = 24, M age = 21.29 years) and older (n = 21, M age = 71.24 years) persons who drove in residential, urban and motorway conditions in a fully immersive driving simulator. In measures of headway (maintaining a safe distance to a preceding vehicle) and lateral lane position, older drivers exhibited significantly greater performance inconsistency, and this was particularly marked in the faster motorway condition. Older drivers also recorded greater perceived mental demands associated with driving, and greater within-person variability across a range of cognitive measures. The findings suggest that age-related deficits in attentional and executive control may affect the consistency of driving performance in older persons. Discussion considers interventions to introduce in-vehicle systems to help maintain attention in older drivers, and to intervene when safety-critical boundaries are exceeded.     

Assessing the driving performance of older adult drivers: on-road versus simulated driving

To validate a laboratory-based driving simulator in measuring on-road driving performance, 129 older adult drivers were assessed with both the simulator and an on-road test. The driving performance of the participants was gauged by appropriate and reliable age-specific assessment criteria, which were found to be negatively correlated with age. Using principal component analysis, two performance indices were developed from the criteria to represent the overall performance in simulated driving and the on-road assessment. There was significant positive association between the two indices, with the simulated driving performance index explaining over two-thirds of the variability of the on-road driving performance index, after adjustment for age and gender of the drivers. The results supported the validity of the driving simulator and it is a safer and more economical method than the on-road testing to assess the driving performance of older adult drivers.     

Effect of different breath alcohol concentrations on driving performance in horizontal curves

Driving under the influence of alcohol on curved roadway segments has a higher risk than driving on straight segments. To explore the effect of different breath alcohol concentration (BrAC) levels on driving performance in roadway curves, a driving simulation experiment was designed to collect 25 participants’ driving performance parameters (i.e., speed and lane position) under the influence of 4 BrAC levels (0.00%, 0.03%, 0.06% and 0.09%) on 6 types of roadway curves (3 radii × 2 turning directions). Driving performance data for 22 participants were collected successfully. Then the average and standard deviation of the two parameters were analyzed, considering the entire curve and different sections of the curve, respectively.     

Comparison of driving simulator performance with real driving after alcohol intake: A randomised,single blind,placebo-controlled,cross-over trial

The purpose of this study was to establish and validate a driving simulator method for assessing drug effects on driving. To achieve this, we used ethanol as a positive control, and examined whether ethanol affects driving performance in the simulator, and whether these effects are consistent with performance during real driving on a test track, also under the influence of ethanol. Twenty healthy male volunteers underwent a total of six driving trials of 1 h duration; three in an instrumented vehicle on a closed-circuit test track that closely resembled rural Norwegian road conditions, and three in the simulator with a driving scenario modelled after the test track. Test subjects were either sober or titrated to blood alcohol concentration (BAC) levels of 0.5 g/L and 0.9 g/L. The study was conducted in a randomised, cross-over, single-blind fashion, using placebo drinks and placebo pills as confounders. The primary outcome measure was standard deviation of lateral position (SDLP; “weaving”). Eighteen test subjects completed all six driving trials, and complete data were acquired from 18 subjects in the simulator and 10 subjects on the test track, respectively. There was a positive dose–response relationship between higher ethanol concentrations and increases in SDLP in both the simulator and on the test track (p < 0.001 for both). In the simulator, this dose–response was evident already after 15 min of driving. SDLP values were higher and showed a larger inter-individual variability in the simulator than on the test track. Most subjects displayed a similar relationship between BAC and SDLP in the simulator and on the test track; however, a few subjects showed striking dissimilarities, with very high SDLP values in the simulator. This may reflect the lack of perceived danger in the simulator, causing reckless driving in a few test subjects. Overall, the results suggest that SDLP in the driving simulator is a sensitive measure of ethanol impaired driving. The comparison with real driving implies relative external validity of the simulator.     

The role of parental alcohol consumption on driving under the influence of alcohol: results from a longitudinal, nationally representative sample

Purpose

Many studies have examined the role of peer and parental alcohol use on drinking behaviors among adolescents. Few studies, however, have examined parental influences on driving under the influence (DUI) of alcohol. The current study uses data from a longitudinal study to examine the role of parental alcohol use during adolescence on the risk for DUI among young adult men and women.

Methods

Data were derived from 9559 adolescents and young adults who participated in the National Longitudinal Study of Adolescent Health (Add Health) Waves I and III. Survey logistic regression was used to examine the relationship between multilevel risk and protective factors and self-reported DUI. Analyses were stratified by gender and frequency of parental alcohol consumption to understand the role of parental alcohol use on risk for DUI among their youth.

Results

Risk and protective factors for DUI were very similar among men and women. Parental alcohol use significantly predicted DUI among women (OR = 1.39, p < 0.01) and men (OR = 1.33, p < 0.05). When parents did not report alcohol use, peer alcohol use significantly increased risk for DUI for both women (OR = 1.26, p < 0.05) and men (OR = 1.31, p < 0.001). When parents reported alcohol use, however, peer alcohol use was not a significant independent predictor.

Conclusions

Findings suggest remarkable similarities in risk and protective factors for DUI across gender groups. For men and women, parental alcohol consumption was a risk factor for DUI. Peers’ alcohol use predicted DUI only when parents did not use alcohol.     

Young drivers who obtained their licence after an intensive driving course report more incidents than drivers with a traditional driver education

This paper studies the effectiveness of intensive driving courses; both in driving test success and safe driving after passing the driving test. The so-called intensive driving course (IDC) consists of a limited number of consecutive days in which the learner driver takes driving lessons all day long; and is different from traditional training in which lessons are spread out over several months and in which learners take one or two driving lessons of approximately 1 h each per week. Our study indicates that – in the first two years of their driving career – IDC drivers (n = 35) reported an incident significantly more often (43%) than 351 drivers who obtained their driving licence after traditional training (26%). Our study also indicates that the IDC drivers underwent almost the same number of training hours as the drivers who had traditional training, although spacing of these hours was different. There was no difference in the number of attempts to pass the driving test. We did not find any evidence that a self-selection bias was responsible for the difference in reported number of incidents.     

The effects of texting on driving performance in a driving simulator: The influence of driver age

Distracted driving is a significant contributor to motor vehicle accidents and fatalities, and texting is a particularly significant form of driver distraction that continues to be on the rise. The present study examined the influence of driver age (18–59 years old) and other factors on the disruptive effects of texting on simulated driving behavior. While ‘driving’ the simulator, subjects were engaged in a series of brief text conversations with a member of the research team. The primary dependent variable was the occurrence of Lane Excursions (defined as any time the center of the vehicle moved outside the directed driving lane, e.g., into the lane for oncoming traffic or onto the shoulder of the road), measured as (1) the percent of subjects that exhibited Lane Excursions, (2) the number of Lane Excursions occurring and (3) the percent of the texting time in Lane Excursions. Multiple Regression analyses were used to assess the influence of several factors on driving performance while texting, including text task duration, texting skill level (subject-reported), texting history (#texts/week), driver gender and driver age. Lane Excursions were not observed in the absence of texting, but 66% of subjects overall exhibited Lane Excursions while texting. Multiple Regression analysis for all subjects (N = 50) revealed that text task duration was significantly correlated with the number of Lane Excursions, and texting skill level and driver age were significantly correlated with the percent of subjects exhibiting Lane Excursions. Driver gender was not significantly correlated with Lane Excursions during texting. Multiple Regression analysis of only highly skilled texters (N = 27) revealed that driver age was significantly correlated with the number of Lane Excursions, the percent of subjects exhibiting Lane Excursions and the percent of texting time in Lane Excursions. In contrast, Multiple Regression analysis of those drivers who self-identified as not highly skilled texters (N = 23) revealed that text task duration was significantly correlated with the number of Lane Excursions. The present studies confirm past reports that texting impairs driving simulator performance. Moreover, the present study demonstrates that for highly skilled texters, the effects of texting on driving are actually worse for older drivers. Given the increasing frequency of texting while driving within virtually all age groups, these data suggest that ‘no texting while driving’ education and public service messages need to be continued, and they should be expanded to target older drivers as well.     

Combined effects of alcohol and distraction on driving performance

Although alcohol and distraction are often cited as significant risk factors for traffic crashes, most research has considered them in isolation. It is therefore necessary to consider the interactions between alcohol and distraction impairment sources, especially when examining the relationship between behavior and crash risk. In a driving simulator, the primary goal was to maintain a safe headway to a lead vehicle and the secondary goal was to maintain stable lane position. All participants engaged in distractions that represented different levels of resource competition and half of the participants consumed alcohol (target BAC 0.08 g/dl). Specific comparisons were made between sober driving while distracted and driving intoxicated without distraction. Distraction tasks produced more changes in driving behavior than did alcohol for both longitudinal (primary) and lateral (secondary) driving goals. Alcohol impairment was evident only in relation to lateral driving performance, however there was an amplification of impairment when alcohol and distraction conditions were combined. Distraction resulted in a general level of impairment across all driving goals, whereas participants with alcohol appeared to shed secondary driving goals to “protect” primary driving goals. Drivers’ strategies to cope with alcohol (and distraction) may not be sufficient to offset the increased crash risk.     

Reliability of simulator driving tool for evaluation of sleepiness,fatigue and driving performance

Study objective

To compare the impact of extended wakefulness (i.e., sleepiness) and prolonged driving (i.e., fatigue) at the wheel in simulated versus real-life driving conditions.

Design

Participants drove on an INRETS-MSIS SIM2 simulator in a research laboratory or an open French highway during 3 nocturnal driving sessions. A dose–response design of duration of nocturnal driving was used: a 2 h short driving session (3–5 AM), a 4 h intermediate driving session (1–5 AM) and an 8 h long driving session (9 PM–5 AM).

Participants

Two groups of healthy male drivers (20 for simulated driving and 14 drivers for real driving; mean age ± SD = 22.3 ± 1.6 years), free of sleep disorders.

Measurements

Number of inappropriate line crossings, self-rated fatigue and sleepiness were recorded in the last hour of driving sessions to control the effects of prior waking time and time of day.

Results

Compared to the daytime reference session, both simulated and real driving performance were affected by a short nocturnal driving session (P < .05 and P < .001, respectively). Extension of nocturnal driving duration affected simulated performance nonlinearly and more severely than that of real driving (P < .001).Compared to the daytime reference session, short nocturnal simulated and real driving sessions increased self-perceived fatigue and sleepiness. Real and simulated driving conditions had an identical impact on fatigue and sleepiness during extended periods of nocturnal driving.

Conclusions

In healthy subjects, the INRETS-MSIS SIM2 simulator appropriately measures driving impairment in terms of inappropriate line crossings related to extended wakefulness but has limitations to measure the impact of extended driving on drivers’ performance.     

Event-related potentials and secondary task performance during simulated driving

Inattention and distraction account for a substantial number of traffic accidents. Therefore, we examined the impact of secondary task performance (an auditory oddball task) on a primary driving task (lane keeping). Twenty healthy participants performed two 20-min tests in the Divided Attention Steering Simulator (DASS). The visual secondary task of the DASS was replaced by an auditory oddball task to allow recording of brain activity. The driving task and the secondary (distracting) oddball task were presented in isolation and simultaneously, to assess their mutual interference. In addition to performance measures (lane keeping in the primary driving task and reaction speed in the secondary oddball task), brain activity, i.e. event-related potentials (ERPs), was recorded. Performance parameters on the driving test and the secondary oddball task did not differ between performance in isolation and simultaneous performance. However, when both tasks were performed simultaneously, reaction time variability increased in the secondary oddball task. Analysis of brain activity indicated that ERP amplitude (P3a amplitude) related to the secondary task, was significantly reduced when the task was performed simultaneously with the driving test. This study shows that when performing a simple secondary task during driving, performance of the driving task and this secondary task are both unaffected. However, analysis of brain activity shows reduced cortical processing of irrelevant, potentially distracting stimuli from the secondary task during driving.     

The contribution of alcohol to night time crash risk and other risks of night driving

Many studies show that driving at night is more risky in terms of crash involvements per distance travelled than driving during the day. The reasons for this include the more prevalent use of alcohol by drivers at night, the effects of fatigue on the driving task and the risk associated with reduced visibility. Although the consumption of alcohol prior to driving occurs most commonly at night, drink-driving is not inherently a night time risk factor. This study decomposes the New Zealand risk of driving at night into risk associated with alcohol and risk associated with inherently night time factors. The overall risk associated with alcohol use by drivers was shown to decrease with increasing age for the most risky situation analysed (male drivers on weekend nights). Given the levels of drinking and driving on weekend nights, the overall effect of alcohol was shown to contribute almost half of weekend night time risk for drivers aged under 40 on lower volume roads, but to contribute little to overall risk on higher-volume roads, consistent with other research showing that higher-volume roads are not favoured by drinking drivers. Risk at night relative to risk during the day (excluding risk associated with drinking and driving) was shown to decrease with age. Roads with illumination at night are less risky at night relative to during the day than roads without illumination. The risks estimated in this paper reflect the behaviour of the road users studied and their prevalence on the roads under the conditions analysed.     

Impact of alcohol checks and social norm on driving under the influence of alcohol (DUI)

This study investigated the influence of alcohol checks and social norm on self-reported driving under the influence of alcohol above the legal limit (DUI). The analysis was based on the responses of 12,507 car drivers from 19 European countries to the SARTRE-4 survey (2010). The data were analysed by means of a multiple logistic regression-model on two levels: (1) individual and (2) national level.     

Retail alcohol monopolies, underage drinking, and youth impaired driving deaths

OBJECTIVE: To explore associations of state retail alcohol monopolies with underage drinking and alcohol-impaired driving deaths. DATA: Surveys on youth who drank alcohol and binge-drank recently and their beverage choices; census of motor vehicle fatalities by driver blood alcohol level. METHODS: Regressions estimated associations of monopolies with under-21 drinking, binge drinking, alcohol-impaired driving deaths, and odds a driver under 21 who died was alcohol-positive. RESULTS: About 93.8% of those ages 12-20 who consumed alcohol in the past month drank some wine or spirits. In states with a retail monopoly over spirits or wine and spirits, an average of 14.5% fewer high school students reported drinking alcohol in the past 30 days and 16.7% fewer reported binge drinking in the past 30 days than high school students in non-monopoly states. Monopolies over both wine and spirits were associated with larger consumption reductions than monopolies over spirits only. Lower consumption rates in monopoly states, in turn, were associated with a 9.3% lower alcohol-impaired driving death rate under age 21 in monopoly states versus non-monopoly states. Alcohol monopolies may prevent 45 impaired driving deaths annually. CONCLUSIONS: Continuing existing retail alcohol monopolies should help control underage drinking and associated harms.     

Occupational driver safety: Conceptualising a leadership-based intervention to improve safe driving performance

Occupational driving crashes are the most common cause of death and injury in the workplace. The physical and psychological outcomes following injury are also very costly to organizations. Thus, safe driving poses a managerial challenge. Some research has attempted to address this issue through modifying discrete and often simple target behaviours (e.g., driver training programs). However, current intervention approaches in the occupational driving field generally consider the role of organizational factors in workplace safety. This study adopts the A–B–C framework to identify the contingencies associated with an effective exchange of safety information within the occupational driving context. Utilizing a sample of occupational drivers and their supervisors, this multi-level study examines the contingencies associated with the exchange of safety information within the supervisor–driver relationship. Safety values are identified as an antecedent of the safety information exchange, and the quality of the leader–member exchange relationship and safe driving performance is identified as the behavioural consequences. We also examine the function of role overload as a factor influencing the relationship between safety values and the safety information exchange. Hierarchical linear modelling found that role overload moderated the relationship between supervisors’ perceptions of the value given to safety and the safety information exchange. A significant relationship was also found between the safety information exchange and the subsequent quality of the leader–member exchange relationship. Finally, the quality of the leader–member exchange relationship was found to be significantly associated with safe driving performance. Theoretical and practical implications of these results are discussed.     

Influences during adolescence on perceptions and behaviour related to alcohol use and unsafe driving as young adults

OBJECTIVE: To investigate whether aggression, parent and peer influences, and previous traffic-related experiences at ages 15 and 18 impacted on (a) differences between the perceived safe and estimated legal alcohol consumption limit, and (b) driving while impaired (DWI) behaviour at age 21. METHOD: The study population was a birth cohort involved in a longitudinal investigation of health and development. At the ages of 15 and 18, study members completed questionnaires assessing parent and peer attachment, experience travelling with an alcohol impaired adult or youth, aggression, and previous crash experience. At age 21, study members were questioned about how much alcohol they perceived they could drink and still drive safely, and whether they had driven after 'perhaps consuming too much alcohol'. For each participant their legal alcohol consumption limit was estimated using their height and weight. Path analysis was used to determine whether variables measured at ages 15 and 18 predicted differences between the perceived safe and estimated legal alcohol consumption limit and driving while impaired, both measured at age 21. RESULTS: Insufficient females drove while impaired at age 21, who also had complete data on all other variables, to conduct path analysis for this outcome. For males, aggression at ages 15 and 18, travelling with an impaired youth at age 18, and previous crash experience at age 18 predicted DWI behaviour at age 21. Only aggression at age 15 predicted the difference between perceived safe and estimated legal alcohol consumption limit for the males. For females, aggression at ages 15 and 18, and travelling with an impaired adult at age 15 predicted the difference between perceived safe and estimated legal alcohol consumption limit. CONCLUSION: The results show that aggressive behaviours and adult and/or youth modelling of drink driving behaviours in mid- to late-adolescence are related to differences between perceived safe and estimated legal alcohol consumption limit for both genders and driving while impaired for males.     

Effects of higher-order driving skill training on young, inexperienced drivers' on-road driving performance

The aim of the current study was to compare the effects of training in higher-order driving skills (e.g., perceptual, motivational, insight) and vehicle handling skill training in relation to on-road driving performance, hazard perception, attitudes to risky driving and driver confidence levels in young, inexperienced drivers. Thirty-six young drivers (23 males and 13 females, average age 16.3 years), mostly on a restricted NZ driver licence, participated in a Driver Training Research camp. Participants were randomly allocated to one of three equally sized groups according to the type of driving skill training (5 days) they received: higher-order, vehicle handling or control (no training). Professional driver assessors conducted a comprehensive driving assessment before (Baseline) and after the training (Post Training). At both time points, participants also carried out a computerised hazard perception task, and completed self-report questionnaires to assess attitudes to risky driving and driver confidence. In terms of on road driving, the participants who received higher-order driving skill training showed a statistically significant improvement in relation to visual search and the composite driving measure. This was accompanied by an improvement in hazard perception, safer attitudes to close following and to dangerous overtaking and a decrease in driving related confidence. The participants who received vehicle handling skill training showed significant improvements in relation to their on-road direction control, speed choice and the composite driving score. However, this group showed no improvement in hazard perception, attitudes to risky driving or driver confidence. The findings will be discussed in the context of driver training as a viable crash prevention intervention in regard to young, inexperienced drivers.