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.     

Driver's lane keeping ability with eyes off road: Insights from a naturalistic study

Many studies have shown that driver inattention can influence lane-keeping ability. The majority of studies on lane keeping have been conducted in controlled on-road networks or in simulated environments. However, few studies have examined lane-keeping ability in naturalistic settings for the same purpose. In this current study, the relationship between driver inattention and lane keeping ability was examined using naturalistic data for 24 drivers. Driver inattention was placed into two categories based on whether drivers were looking forward toward the roadway (inattention with eyes-on-road) or not looking forward (inattention with eyes-off-road) while engaged in a secondary task. Repeated measures regression models were used to account for within-subject correlations. The results showed that, after accounting for driving speed and lane width, the eyes-off-road significantly increased the standard deviation of lane position (SDLP). The findings from this study are consistent with other studies that show that the amount of time drivers spend looking away from the road can impact drivers’ ability to maintain their lane position. Additionally, this paper demonstrates how driver inattention can be examined with real world data while accounting for the roadway, environment, and driver behavior.     

Driving simulator sickness: Impact on driving performance,influence of blood alcohol concentration,and effect of repeated simulator exposures

Simulator sickness is a major obstacle to the use of driving simulators for research, training and driver assessment purposes. The purpose of the present study was to investigate the possible influence of simulator sickness on driving performance measures such as standard deviation of lateral position (SDLP), and the effect of alcohol or repeated simulator exposure on the degree of simulator sickness. Twenty healthy male volunteers underwent three simulated driving trials of 1 h’s duration with a curvy rural road scenario, and rated their degree of simulator sickness after each trial. Subjects drove sober and with blood alcohol concentrations (BAC) of approx. 0.5 g/L and 0.9 g/L in a randomized order. Simulator sickness score (SSS) did not influence the primary outcome measure SDLP. Higher SSS significantly predicted lower average speed and frequency of steering wheel reversals. These effects seemed to be mitigated by alcohol. Higher BAC significantly predicted lower SSS, suggesting that alcohol inebriation alleviates simulator sickness. The negative relation between the number of previous exposures to the simulator and SSS was not statistically significant, but is consistent with habituation to the sickness-inducing effects, as shown in other studies. Overall, the results suggest no influence of simulator sickness on SDLP or several other driving performance measures. However, simulator sickness seems to cause test subjects to drive more carefully, with lower average speed and fewer steering wheel reversals, hampering the interpretation of these outcomes as measures of driving impairment and safety. BAC and repeated simulator exposures may act as confounding variables by influencing the degree of simulator sickness in experimental studies.     

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 prevalence and nature of stopped on-the-road driving tests and the relationship with objective performance impairment

Introduction and objectives

The on-the-road driving test in normal traffic is applied to examine the impact of drugs on driving performance. Although participants are accompanied by a licensed driving instructor, under Dutch law, the driver is primarily responsible for safe driving and is not permitted to continue driving when it is judged that the drug compromises safety. This review examined the prevalence and nature of stopped driving tests, and the relationship with Standard Deviation of Lateral Position (SDLP), i.e. the “weaving of the car”.

Materials and methods

A literature search was conducted to gather all publications on clinical trials that applied the on-the-road driving test, examining the effects of Central Nervous System (CNS)-drugs such as anxiolytics, antidepressants, antihistamines, analgesics, and hypnotics.

Results

47 papers reported on 50 Dutch clinical trials in which 1059 subjects participated (903 healthy volunteers and 156 patients). A total of 7232 driving tests were performed; 5050 after drug treatment and 2042 after placebo. 3.1% of all driving tests were terminated before completion: 4.1% after drug treatment, and 0.7% after placebo. The decision to stop a driving test was 3–4 times more often made by the driving instructor than the subject. The most common reasons for stopping were the driver feeling tired or sleepy, or the driving instructor noticing signs of drowsiness and performance impairment. Although SDLP values of stopped driving tests are sometimes high, there is no clear relationship between SDLP (changes from placebo) and the decision to stop a driving test. Based on 8 studies that reported exact data, 39.6% of stopped drivers had a lower and 60.4% had a higher SDLP than 35 cm, i.e. the cut-off point of safe driving. This confirms that perception of the driver as well as judgment by the instructor of driving to be ‘unsafe’ differs between individuals.

Conclusion

Driving tests are sometimes stopped after drug treatment or placebo. The decision to stop driving is not a good correlate of objective performance.     

Vigilance decrement during the on-the-road driving tests: The importance of time-on-task in psychopharmacological research

Time dependent decrements in performance are characteristic of activities that are monotonous and require focused attention for an extended period of time. A vigilance task is a task that participants can perform without difficulty for a short period of time, but with time their performance becomes impaired. A real world example of such a vigilance task is prolonged highway driving. The on-the-road driving test in normal traffic was specifically designed to measure the effects of vigilance decrement associated with driving. The primary parameter of this test is the Standard Deviation of Lateral Position (SDLP), i.e. the weaving of the car. This methodological paper explains the typical vigilance decrement seen in the on-the-road driving test and discusses the importance of sufficient time-on-task to elucidate potential adverse drug effects on driving. Performance decrements (SDLP increment) as a function of time are seen after both drug and placebo treatment, following a similar pattern over distance/time traveled. However, whereas for some drugs SDLP differences between drug and placebo are constant, other drugs produce additional performance decrement that increases over distance traveled. It is concluded that driving tests of short duration (e.g. less than half an hour) may fail to detect drug-related impairment, because participants are capable of, at least in part, counteracting the impairment by increased effort and motivation to perform the test.     

Does attention capacity moderate the effect of driver distraction in older drivers?

With age, a decline in attention capacity may occur and this may impact driving performance especially while distracted. Although the effect of distraction on driving performance of older drivers has been investigated, the moderating effect of attention capacity on driving performance during distraction has not been investigated yet. Therefore, the aim was to investigate whether attention capacity has a moderating effect on older drivers’ driving performance during visual distraction (experiment 1) and cognitive distraction (experiment 2). In a fixed-based driving simulator, older drivers completed a driving task without and with visual distraction (experiment 1, N = 17, mean age 78 years) or cognitive distraction (experiment 2, N = 35, mean age 76 years). Several specific driving measures of varying complexity (i.e., speed, lane keeping, following distance, braking behavior, and crashes) were investigated. In addition to these objective driving measures, subjective measures of workload and driving performance were also included. In experiment 1, crash occurrence increased with visual distraction and was negatively related to attention capacity. In experiment 2, complete stops at stop signs decreased, initiation of braking at pedestrian crossings was later, and crash occurrence increased with cognitive distraction. Interestingly, for a measure of lane keeping (i.e., standard deviation of lateral lane position (SDLP)), effects of both types of distraction were moderated by attention capacity. Despite the decrease of driving performance with distraction, participants estimated their driving performance during distraction as good. These results imply that attention capacity is important for driving. Driver assessment and training programs might therefore focus on attention capacity. Nonetheless, it is crucial to eliminate driver distraction as much as possible given the deterioration of performance on several driving measures in those with low and high attention capacity.     

Are bad drivers more impaired by alcohol? Sober driving precision predicts impairment from alcohol in a simulated driving task

The contribution of driver experience to risk for alcohol-related crashes is based on the tacit assumption that driver experience contributes to driver skill which could mediate the impairing effects of alcohol on driving performance. Surprisingly, few studies of alcohol effects on simulated driving performance have examined the role of driver skill as a mediator of the intensity of alcohol impairment. The present study examined the degree to which individual differences in driving skill mediated the intensity of impairment produced by a moderate dose of alcohol in a group of young adult drivers. Twenty-eight participants were familiarized with a simulated driving road test. After determining their baseline skill level, participants' driving performance was re-tested under either an active dose of alcohol (0.65 g/kg) or a placebo. Results showed that alcohol reduced driving precision, as evident by the increased within-lane deviation observed under the drug. Moreover, those individuals with poorer baseline skill levels showed the greater impairments in response to alcohol. The results highlight the importance of understanding interactions between driver skill level and the effects of alcohol and possibly other drugs.     

How do prolonged wakefulness and alcohol compare in the decrements they produce on a simulated driving task?

The effects of alcohol ingestion were compared with those of prolonged wakefulness on a simulated driving task. Eighteen healthy, male subjects aged between 19 and 35 years drove for 30 min on a simulated driving task at blood alcohol concentrations of 0.00, 0.05 and 0.08%. Subjective sleepiness was assessed before and after the driving task. Driving performance was measured in terms of the mean and standard deviation (S.D.) of lane position (tracking); the mean and S.D. of speed deviation (the difference between the actual speed and the posted speed limit); and the number of off-road occurrences. Ratings of sleepiness increased with increasing blood alcohol concentration, and were higher following the driving task. With increasing blood alcohol concentration, tracking variability, speed variability, and off-road events increased, while speed deviation decreased, the result of subjects driving faster. The results were compared with a previous study examining simulated driving performance during one night of prolonged wakefulness [Arnedt, J.T., MacLean A.W., 1996. Effects of sleep loss on urban and motorway driving stimulation performance. Presented at the Drive Alert... Arrive Alive International Forum, Washington DC], using an approach adopted by Dawson and Reid [Dawson, D., Reid, K., 1997. Fatigue, alcohol and performance impairment. Nature 388, 23]. For mean tracking, tracking variability, and speed variability 18.5 and 21 h of wakefulness produced changes of the same magnitude as 0.05 and 0.08% blood alcohol concentration, respectively. Alcohol consumption produced changes in speed deviation and off-road occurrences of greater magnitude than the corresponding levels of prolonged wakefulness. While limited to situations in which there is no other traffic present, the findings suggest that impairments in simulated driving are evident even at relatively modest blood alcohol levels, and that wakefulness prolonged by as little as 3 h can produce decrements in the ability to maintain speed and road position as serious as those found at the legal limits of alcohol consumption.     

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.     

Driving performance impairments due to hypovigilance on monotonous roads

Drivers' ability to react to unpredictable events deteriorates when exposed to highly predictable and uneventful driving tasks. Highway design reduces the driving task mainly to a lane-keeping manoeuvre. Such a task is monotonous, providing little stimulation and this contributes to crashes due to inattention. Research has shown that driver's hypovigilance can be assessed with EEG measurements and that driving performance is impaired during prolonged monotonous driving tasks. This paper aims to show that two dimensions of monotony - namely road design and road side variability - decrease vigilance and impair driving performance. This is the first study correlating hypovigilance and driver performance in varied monotonous conditions, particularly on a short time scale (a few seconds). We induced vigilance decrement as assessed with an EEG during a monotonous driving simulator experiment. Road monotony was varied through both road design and road side variability. The driver's decrease in vigilance occurred due to both road design and road scenery monotony and almost independently of the driver's sensation seeking level. Such impairment was also correlated to observable measurements from the driver, the car and the environment. During periods of hypovigilance, the driving performance impairment affected lane positioning, time to lane crossing, blink frequency, heart rate variability and non-specific electrodermal response rates. This work lays the foundation for the development of an in-vehicle device preventing hypovigilance crashes on monotonous roads.     

Law enforcement and alcohol consumption policy as countermeasures against drunken driving: Possibilities and limitations

The potential effectiveness of the two following countermeasures against drunken driving is assessed in this paper: (1) manipulation of the risk of detection, and (2) changes of the opportunity structure, i.e. alcohol consumption and motoring. Empirical findings for Sweden in 1976 indicate that the first countermeasure seems to have no observable impact on the incidence of drunken driving, at least not in the short term. The clearest indication of the appropriate preventive measure is the strong relationship found between drunken driving and alcohol consumption: however, such a relationship was not found for motoring.     

Driving performance impairments due to hypovigilance on monotonous roads

Drivers’ ability to react to unpredictable events deteriorates when exposed to highly predictable and uneventful driving tasks. Highway design reduces the driving task mainly to a lane-keeping manoeuvre. Such a task is monotonous, providing little stimulation and this contributes to crashes due to inattention. Research has shown that driver’s hypovigilance can be assessed with EEG measurements and that driving performance is impaired during prolonged monotonous driving tasks. This paper aims to show that two dimensions of monotony – namely road design and road side variability – decrease vigilance and impair driving performance. This is the first study correlating hypovigilance and driver performance in varied monotonous conditions, particularly on a short time scale (a few seconds). We induced vigilance decrement as assessed with an EEG during a monotonous driving simulator experiment. Road monotony was varied through both road design and road side variability. The driver’s decrease in vigilance occurred due to both road design and road scenery monotony and almost independently of the driver’s sensation seeking level. Such impairment was also correlated to observable measurements from the driver, the car and the environment. During periods of hypovigilance, the driving performance impairment affected lane positioning, time to lane crossing, blink frequency, heart rate variability and non-specific electrodermal response rates. This work lays the foundation for the development of an in-vehicle device preventing hypovigilance crashes on monotonous roads.     

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.     

轻音乐对驾驶疲劳的双向影响

目的本实验探索驾驶负荷累积与轻音乐对驾驶疲劳的影响。方法采用2(驾驶负荷累积)×2(音乐条件)×3(模拟驾驶阶段)混合设计,对32名驾驶员被试进行模拟驾驶实验,采集驾驶员驾驶速度和他们的垂直搜索广度与瞳孔直径。结果第45-60 min时,对于无驾驶负荷累积的被试,轻音乐组车速显著快于无音乐组,轻音乐组垂直搜索广度显著大于无音乐组;对于有驾驶负荷累积的被试,轻音乐组的瞳孔直径小于无音乐组(边缘显著),轻音乐组的车速慢于无音乐组。结论轻音乐对无累积疲劳的驾驶员具有唤醒作用,加快他们的车速,扩大垂直搜索广度,对驾驶绩效具有积极的影响;轻音乐对有累积疲劳的驾驶员会产生催眠作用,缩小瞳孔直径,车速减慢,对驾驶绩效具有消极的影响。     

Evaluation of Calibration Laboratories Performance

One of the main goals of interlaboratory comparisons (ILCs) is the evaluation of the laboratories performance for the routine calibrations they perform for the clients. In the frame of Accreditation of Laboratories, the national accreditation boards (NABs) in collaboration with the national metrology institutes (NMIs) organize the ILCs needed to comply with the requirements of the international accreditation organizations. In order that an ILC is a reliable tool for a laboratory to validate its best measurement capability (BMC), it is needed that the NMI (reference laboratory) provides a better traveling standard??in terms of accuracy class or uncertainty??than the laboratories BMCs. Although this is the general situation, there are cases where the NABs ask the NMIs to evaluate the performance of the accredited laboratories when calibrating industrial measuring instruments. The aim of this article is to discuss the existing approaches for the evaluation of ILCs and propose a basis for the validation of the laboratories measurement capabilities. An example is drafted with the evaluation of the results of mercury-in-glass thermometers ILC with 12 participant laboratories.     

Let them experience a ride under the influence of alcohol; a successful intervention program?

A considerable amount of all traffic accidents can be attributed to driving under the influence of alcohol. In particular the group of drivers aged 18–24 years is involved in many serious traffic accidents where alcohol turns out to be a major factor. In fact this age group shows about three times as many alcohol related traffic fatalities as all other categories of road users. The intervention program “Alcohol-free on the road” (Dutch: “Alcoholvrij op weg”) aims to enhance young people's awareness of the effects of alcohol by letting them personally experience the effect of alcohol on their driving abilities. To this end, young drivers were invited to a closed circuit and allowed to drive first sober and then intoxicated, guided and guarded by driving instructors. Based on several other studies it was thought that a realistic experience of the effects of alcohol on driving abilities may contribute to a better understanding of the impact of alcohol and may stimulate attitudes that are needed to support the conscious decision not to drive while intoxicated.After more than ten years of running and data collection, 1200 young drivers have participated in the intervention program. In a quasi-experimental study with a non-equivalent group design, the program is evaluated in order to assess its effectiveness both with respect to the attitudes of the participants and the actual relevant behaviour in the years after the alcohol experience intervention program they attended, i.e. the incidence of actually driving under the influence of alcohol. To do this, a questionnaire was sent to a subset (415) of the participants who have completed the program, along with a control group (450), to compare attitudes and actual behaviour. In addition, the Public Prosecutor checked the files of those who responded, for the occurrence of driving under the influence of alcohol. The group that participated in the alcohol intervention program showed more awareness about the dangers of driving while intoxicated than the control group, and this group reported improved alcohol law compliance. Furthermore, less participants in the intervention program than in the control group were present in the Public Prosecutor files, respectively 0.7% and 4.2%. Hence, the alcohol driving experience intervention program might turn out to be effective and successful in decreasing driving under the influence of alcohol. Although the results of the present study are no more than suggestive, they may be considered a first step towards demonstrating the effectiveness of this type of intervention. However, the intervention is unique and warrants a more robust evaluation. A large-sized randomized controlled trial should be conducted in the next phase to confirm the findings that the intervention program is a suitable educational tool to decrease driving under the influence of alcohol. The present paper serves to raise awareness of this intervention and its potential.     

The impact of Stereotype Threat on the simulated driving performance of older drivers

Older drivers are perceived as being dangerous and overly cautious by other drivers. We tested the hypothesis that this negative stereotype has a direct influence on the performance of older drivers. Based on the Stereotype Threat literature, we predicted that older driving performance would be altered after exposure to a Stereotype Threat. Sixty-one older drivers aged 65 and above completed a simulated driving assessment course. Prior to testing, half of the participants were told that the objective of the study was to investigate why older adults aged 65 and above were more implicated in on-road accidents (Stereotype Threat condition) and half were showed a neutral statement. Results confirmed that exposure to the threat significantly altered driving performance. Older adults in the Stereotype Threat condition made more driving mistakes than those in the control group. Interestingly, under a Stereotype Threat condition, older adults tended to commit more speeding infractions. We also observed that domain identification (whether driving is deemed important or not) moderated the impact of the threat. Taken together, these results support recent older drivers’ performance models suggesting that the interaction between individual and social factors need to be considered when examining older drivers’ performance.     

Viscoelastically prestressed polymeric matrix composites – Effects of test span and fibre volume fraction on Charpy impact characteristics

A viscoelastically prestressed polymeric matrix composite (VPPMC) is produced by subjecting polymeric fibres to tensile creep, the applied load being removed before moulding the fibres into a resin matrix. After matrix curing, the viscoelastically strained fibres impart compressive stresses to the surrounding matrix, thereby improving mechanical properties. This study investigated the mechanisms considered responsible for VPPMCs improving impact toughness by performing Charpy impact tests on unidirectional nylon 6,6 fibre–polyester resin samples over a range of span settings (24–60 mm) and fibre volume fractions (3.3–16.6%). Comparing VPPMC samples with control (unstressed) counterparts, the main findings were: (i) improved impact energy absorption (up to 40%) depends principally on shear stress-induced fibre–matrix debonding (delamination) and (ii) energy absorption improves slightly with increasing fibre volume fraction, but the relationship is statistically weak. The findings are discussed in relation to improving the impact performance of practical structures.     

The effects of cannabis and alcohol on simulated arterial driving: Influences of driving experience and task demand

This study compared the effects of three doses of cannabis and alcohol (placebo, low and high doses), both alone and in combination, on the driving performance of young, novice drivers and more experienced drivers. Alcohol was administered as ethanol (95%) mixed with orange juice in doses of approximately 0, 0.4 and 0.6 g/kg. Cannabis was administered by inhalation of smoke from pre-rolled cannabis cigarettes (supplied by the National Institute of Drug Abuse, USA). Active cigarettes contained 19 mg delta-9-THC. Using a counterbalanced design, the simulated driving performance of 25 experienced and 22 inexperienced drivers was tested under the nine different drug conditions in an arterial driving environment during which workload was varied through the drive characteristics as well as through the inclusion of a secondary task. High levels of cannabis generally induced greater impairment than lower levels, while alcohol at the doses used had few effects and did not produce synergistic effects when combined with cannabis. Both cannabis and alcohol were associated with increases in speed and lateral position variability, high dose cannabis was associated with decreased mean speed, increased mean and variability in headways, and longer reaction time, while in contrast alcohol was associated with a slight increase in mean speed. Given the limitations of the study, it is of great interest to further explore the qualitative impairments in driving performance associated with cannabis and alcohol separately and how these impairments may manifest in terms of crash characteristics.