Acceptance of drinking and driving and alcohol-involved driving crashes in California

BackgroundAlcohol-impaired driving accounts for substantial proportion of traffic-related fatalities in the U.S. Risk perceptions for drinking and driving have been associated with various measures of drinking and driving behavior. In an effort to understand how to intervene and to better understand how risk perceptions may be shaped, this study explored whether an objective environmental-level measure (proportion of alcohol-involved driving crashes in one’s residential city) were related to individual-level perceptions and behavior.MethodsUsing data from a 2012 cross-sectional roadside survey of 1147 weekend nighttime drivers in California, individual-level self-reported acceptance of drinking and driving and past-year drinking and driving were merged with traffic crash data using respondent ZIP codes. Population average logistic regression modeling was conducted for the odds of acceptance of drinking and driving and self-reported, past-year drinking and driving.ResultsA non-linear relationship between city-level alcohol-involved traffic crashes and individual-level acceptance of drinking and driving was found. Acceptance of drinking and driving did not mediate the relationship between the proportion of alcohol-involved traffic crashes and self-reported drinking and driving behavior. However, it was directly related to behavior among those most likely to drink outside the home.DiscussionThe present study surveys a particularly relevant population and is one of few drinking and driving studies to evaluate the relationship between an objective environmental-level crash risk measure and individual-level risk perceptions. In communities with both low and high proportions of alcohol-involved traffic crashes there was low acceptance of drinking and driving. This may mean that in communities with low proportions of crashes, citizens have less permissive norms around drinking and driving, whereas in communities with a high proportion of crashes, the incidence of these crashes may serve as an environmental cue which informs drinking and driving perceptions. Perceptual information on traffic safety can be used to identify places where people may be at greater risk for drinking and driving. Community-level traffic fatalities may be a salient cue for tailoring risk communication.     

Validity of surrogate measures of alcohol involvement when applied to nonfatal crashes

Since the 1970s, nighttime fatal crashes have been used as a surrogate measure for alcohol-related fatalities for crashes for which more direct measures were absent. The validity of this approach was confirmed in 1985 but has not been re-evaluated since. Although this measure has also been applied to identify alcohol involvement in nonfatal crashes, its validity when applied to nonfatal cases has never been determined.The objective of this study was to evaluate the appropriateness of using nighttime crashes as surrogate measures for alcohol impairment when applied to fatal and nonfatal injury and property damage only (PDO) crashes. To do so, we used data from a crash-control design study collected at the roadside in two U.S. states between 1997 and 1999, as well as from the 1997-1999 and 2004-2006 Fatality Analysis Reporting System.The outcome of this study confirms the validity of using nighttime crashes as a surrogate measure for alcohol-related fatalities and supports the use of after-midnight crashes for measuring alcohol involvement in nonfatal and PDO crashes when the number of late-night crashes permits.     

Effects of osteoporosis on AIS 3+ injury risk in motor-vehicle crashes

Older occupants in motor-vehicle crashes are more likely to experience injury than younger occupants. One possible reason for this is that increasing age is associated with increased prevalence of osteoporosis, which decreases bone strength.Crash-injury data were used with Bayes’ Theorem to estimate the conditional probability of AIS 3+ skeletal injury given that an occupant is osteoporotic for the injury to the head, spine, thorax, lower extremities, and upper extremities. This requires the conditional probabilities of osteoporosis given AIS 3+ injury for each of the body regions, which were determined from analysis of the Crash Injury Research and Engineering Network database. It also requires information on probability of osteoporosis in the crash-involved population and the probabilities of AIS 3+ skeletal injury to different body regions in crashes. The latter probabilities were obtained from the National Automotive Sampling System-Crashworthiness Data System (NASS-CDS) database. The former was obtained by modeling the probability of osteoporosis in the US populations using data from the 2006 National Health Examination Nutrition Survey and applying this model to the estimate of the crash-involved population in NASS-CDS. To attempt to account for the effects of age on injury outcome that are independent of osteoporosis, only data from occupants who were 60 years of age or older were used in all analyses.Results indicate that the only body region that experiences a statistically significant change in fracture injury risk with osteoporosis is the spine, for which osteoporosis increases the risk of AIS 3+ fracture by 3.28 times, or from 0.41% to 1.34% (p < 0.0001). This finding suggests that the increase in AIS 3+ injury risk with age for non-spine injuries is likely influenced by factors other than osteoporosis.     

Effects of enforcement intensity on alcohol impaired driving crashes

Background

Research measuring levels of enforcement has investigated whether increases in police activities (e.g., checkpoints, driving-while-intoxicated [DWI] special patrols) above some baseline level are associated with reduced crashes and fatalities. Little research, however, has attempted to quantitatively measure enforcement efforts and relate different enforcement levels to specific levels of the prevalence of alcohol-impaired driving.

Objective

The objective of this study was to investigate the effects of law-enforcement intensity in a sample of communities on the rate of crashes involving a drinking driver. We analyzed the influence of different enforcement strategies and measures: (1) specific deterrence – annual number of driving-under-the-influence (DUI) arrests per capita; (2) general deterrence – frequency of sobriety checkpoint operations; (3) highly visible traffic enforcement – annual number of traffic stops per capita; (4) enforcement presence – number of sworn officers per capita; and (5) overall traffic enforcement – the number of other traffic enforcement citations per capita (i.e., seat belt citations, speeding tickets, and other moving violations and warnings) in each community.

Methods

We took advantage of nationwide data on the local prevalence of impaired driving from the 2007 National Roadside Survey (NRS), measures of DUI enforcement activity provided by the police departments that participated in the 2007 NRS, and crashes from the General Estimates System (GES) in the same locations as the 2007 NRS. We analyzed the relationship between the intensity of enforcement and the prevalence of impaired driving crashes in 22–26 communities with complete data. Log-linear regressions were used throughout the study.

Results

A higher number of DUI arrests per 10,000 driving-aged population was associated with a lower ratio of drinking-driver crashes to non-drinking-driver crashes (p = 0.035) when controlling for the percentage of legally intoxicated drivers on the roads surveyed in the community from the 2007 NRS. Results indicate that a 10% increase in the DUI arrest rate is associated with a 1% reduction in the drinking driver crash rate. Similar results were obtained for an increase in the number of sworn officers per 10,000 driving-age population.

Discussion

While a higher DUI arrest rate was associated with a lower drinking-driver crash rate, sobriety checkpoints did not have a significant relationship to drinking-driver crashes. This appeared to be due to the fact that only 3% of the on-the-road drivers were exposed to frequent sobriety checkpoints (only 1 of 36 police agencies where we received enforcement data conducted checkpoints weekly). This low-use strategy is symptomatic of the general decline in checkpoint use in the U.S. since the 1980s and 1990s when the greatest declines in alcohol-impaired-driving fatal crashes occurred. The overall findings in this study may help law enforcement agencies around the country adjust their traffic enforcement intensity in order to reduce impaired driving in their community.     

The relationship of underage drinking laws to reductions in drinking drivers in fatal crashes in the United States

This study reports on an effort to evaluate and interrelate the existence and strength of two core laws and 14 expanded laws designed to (a) control the sales of alcohol, (b) prevent possession and consumption of alcohol, and (c) prevent alcohol impaired driving by youth aged 20 and younger. Our first analysis determined if the enactment of the possession and purchase laws (the two core minimum legal drinking age laws) was associated with a reduction in the ratio of drinking to nondrinking drivers aged 20 and younger who were involved in fatal crashes controlling for as many variables as possible. The ANOVA results suggest that in the presence of numerous covariates, the possession and purchase laws account for an 11.2% (p=0.041) reduction in the ratio measure. Our second analysis determined whether the existence and strength of any of the 16 underage drinking laws was associated with a reduction in the percentage of drivers aged 20 and younger involved in fatal crashes who were drinking. In the regression analyses, making it illegal to use a false identification to purchase alcohol was significant. From state to state, a unit difference (increase) in the strength of the False ID Use law was associated with a 7.3% smaller outcome measure (p=0.034).     

Age and pedestrian injury severity in motor-vehicle crashes: a heteroskedastic logit analysis

This research explores the injury severity of pedestrians in motor-vehicle crashes. It is hypothesized that the variance of unobserved pedestrian characteristics increases with age. In response, a heteroskedastic generalized extreme value model is used. The analysis links explanatory factors with four injury outcomes: fatal, incapacitating, non-incapacitating, and possible or no injury. Police-reported crash data between 1997 and 2000 from North Carolina, USA, are used. The results show that pedestrian age induces heteroskedasticity which affects the probability of fatal injury. The effect grows more pronounced with increasing age past 65. The heteroskedastic model provides a better fit than the multinomial logit model. Notable factors increasing the probability of fatal pedestrian injury: increasing pedestrian age, male driver, intoxicated driver (2.7 times greater probability of fatality), traffic sign, commercial area, darkness with or without streetlights (2-4 times greater probability of fatality), sport-utility vehicle, truck, freeway, two-way divided roadway, speeding-involved, off roadway, motorist turning or backing, both driver and pedestrian at fault, and pedestrian only at fault. Conversely, the probability of a fatal injury decreased: with increasing driver age, during the PM traffic peak, with traffic signal control, in inclement weather, on a curved roadway, at a crosswalk, and when walking along roadway.     

Personality subtypes of young moped drivers, their relationship to risk-taking behavior and involvement in road crashes in an Austrian sample

Objective

This study aimed to identify subtypes of young moped drivers and analyze how these subtypes are involved in risk preferences and road crashes.

Design

A group of Austrian teenage moped drivers (213, 28% girls) completed an online questionnaire about moped usage, injuries, driving style, inattention, impulsivity, and personality according to the Five-Factor Model of Personality and Cloninger's model of personality.

Results

A cluster analysis yielded four types of moped drivers. One type was characterized by a high level of neuroticism, the second type was characterized by a risky personality and a risky driving style, the third type had a more cautious driving style, and the fourth type was characterized by a risky personality and high levels on inattention and impulsivity.

Conclusions

Our conclusions suggest that young moped drivers should not be perceived as a homogenous group, according to measures of injury prevention and intervention.     

Identifying factors that increase the likelihood of driving after drinking among college students

Driving after drinking (DAD) is a serious public health concern found to be more common among college students than those of other age groups or same-aged non-college peers. The current study examined potential predictors of DAD among a dual-site sample of 3753 (65% female, 58% Caucasian) college students. Results showed that 19.1% of respondents had driven after 3 or more drinks and 8.6% had driven after 5 or more drinks in the past 3 months. A logistic regression model showed that male status, fraternity or sorority affiliation, family history of alcohol abuse, medium or heavy drinking (as compared to light drinking), more approving self-attitudes toward DAD, and alcohol expectancies for sexual enhancement and risk/aggression were independently associated with driving after drinking over and above covariates. These results extend the current understanding of this high risk drinking behavior in collegiate populations and provide implications for preventive strategies. Findings indicate that in addition to targeting at-risk subgroups, valuable directions for DAD-related interventions may include focusing on lowering both self-approval of DAD and alcohol-related expectancies, particularly those associated with risk/aggression and sexuality.     

Pedestrian crashes in Washington,DC and Baltimore

Police crash reports were obtained for pedestrian-motor vehicle crashes in Washington, DC (N = 852) and Baltimore (N = 1234) for the year 1998. Reports were coded using procedures developed and applied in these two cities during the 1970s, including the determination of pedestrian crash type, primary precipitating factor, and culpability. Results indicated substantial differences between crash patterns observed during the 1970s and those observed during 1998. Midblock dart-dash crashes, which typically involve a precipitating factor or critical error by a child pedestrian, decreased (from 37% to 15% in Washington). Across all crashes in both cities, the number of drivers who made a critical error leading to the crash was nearly equivalent to the number of pedestrians who made a critical error. Overall, pedestrians were slightly more likely to be judged culpable (50% vs. 39%). Turning vehicle crashes, which typically involve a driver's failure to grant a pedestrian the right of way at a signalized intersection, increased (from 9% to 25% in Washington). Countermeasures to reduce the number of pedestrians hit by turning vehicles are discussed.     

Identifying factors that predict persistent driving after drinking,unsafe driving after drinking,and driving after using cannabis among young adults

The main aim of this study was to identify adolescent/young adulthood factors that predicted persistent driving after drinking, persistent unsafe driving after drinking, and persistent cannabis use and driving among young adults. It was a longitudinal study of a birth cohort (n=933, 474 males and 459 females) and was based on data collected at ages 15, 18, 21 and 26 years. At each of these ages members of the cohort attended the research unit for a personal interview by a trained interviewer, using a standardised questionnaire. For this study, the data for the outcome measures (persistent driving after drinking, persistent unsafe driving after drinking, and persistent driving after using cannabis) were obtained at ages 21 and 26 years. The main explanatory measures were collected at ages 15, 18, 21 years and included demographic factors (academic qualifications, employment, parenting); personality measures; mental health measures (substance use, cannabis dependence, alcohol dependence, depression); anti-social behaviour (juvenile arrest, aggressive behaviour, court convictions); early driving behaviour and experiences (car and motorcycle licences, traffic crashes).The analyses were conducted by gender. The results showed that females who persisted in driving after drinking (13%, n=61) were more likely than the others to have a motorcycle licence at 18. The males who persisted in driving after drinking (28%, n=135) were more likely than the other males to have some school academic qualifications and to be employed at age 26. Compared to the other males, those who persisted in unsafe driving after drinking (4%, n=17) were more likely to be aggressive at 18 and alcohol dependent at 21. Only six (1%) females persisted in unsafe driving after drinking so regression analyses were not conducted for this group. For persistent driving after using cannabis, the univariate analyses showed that females who persisted with this behaviour tended to have high substance use at 18, cannabis dependence at 21, police contact as a juvenile, and to be a parent at 21. For this group, because of the small numbers (3%, n=13) multivariate analyses were not appropriate. For the males who persisted in driving after using cannabis (14%, n=68) a wide range of variables were significant at the univariate stage. The multivariate analysis showed that the most important factors were dependence on cannabis at 21, at least one traffic conviction before 21, a non traffic conviction before 18, and low constraint at 18. CONCLUSION: These results show different characteristics were associated with persistence in each of these outcome behaviours. This indicates that different approaches would be required if intervention programmes were to be developed to target these behaviours.     

Factors affecting the severity of work related traffic crashes in drivers receiving a worker's compensation claim

Aim

To examine factors that contribute to the severity of work related crashes in New South Wales, Australia.

Methods

Workers’ Compensation data was linked to police crash records for the period 1998-2002. Multivariate analysis was carried out to assess the relationship between relevant risk factors and the severity of injury (permanent disability or death) in drivers who had received a claim for a work related crash.

Results

Age, gender, occupation, duty status, vehicle type, licence status, fatigue, speeding and location of the crash were independently associated with the severity of the crash. Drivers aged 65 years and older were nearly twice (OR: 1.824, 95% CI: 1.106-3.007) as likely to be permanently injured or die as a result of a work related crash compared to the younger age group (15-24 years old). The risk to older drivers was even higher in crashes occurring while on duty. Drivers involved in traffic crashes while commuting were more likely to be severely injured (OR: 1.28, CI: 1.15-1.42) than those on duty. Compared to car drivers, taxi drivers were more than twice (OR: 2.38, CI: 1.726-3.296) as likely to be severely injured.

Conclusions

The findings contribute to bridging the gap in knowledge in the area of work related crashes and highlight the higher risk of permanent disability and death in older drivers, taxi drivers and commuters.     

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.     

Prevalence and characteristics of red light running crashes in the United States

About 40% of motor vehicle crashes occur at intersections. In recent years, the number of crashes at traffic signals has increased considerably. A major cause of such crashes is drivers disregarding traffic signals. Despite concerns about the frequent occurrence of red light violations and the significant crash consequences, relatively little is known about the overall prevalence and characteristics of red light running crashes. The present study examines the prevalence of red light running crashes on a national basis and identifies the characteristics of such crashes and the drivers involved. Cities with especially high rates of fatal red light running crashes are identified. Countermeasures to reduce red light running crashes based on collision patterns and characteristics of drivers involved are discussed. It was estimated that about 260 000 red light running crashes occur annually in the United States, of which approximately 750 result in fatalities. Comparisons were made between red light running drivers and drivers deemed not to have run red lights in these same crashes. As a group, red light runners were more likely than other drivers to be younger than age 30, male, have prior moving violations and convictions for driving while intoxicated, have invalid driver’s licenses, and have consumed alcohol prior to the crash. Comparisons also were made between characteristics of red light runners involved in daytime and nighttime crashes. Nighttime red light runners were more likely than daytime runners to be young, male, and have more deviant characteristics, 53% having high blood alcohol concentrations.     

Comprehensive analysis of single- and multi-vehicle large truck at-fault crashes on rural and urban roadways in Alabama

The research described in this paper analyzed injury severities at a disaggregate level for single-vehicle (SV) and multi-vehicle (MV) large truck at-fault accidents for rural and urban locations in Alabama. Given the occurrence of a crash, four separate random parameter logit models of injury severity (with possible outcomes of major, minor, and possible or no injury) were estimated. The models identified different sets of factors that can lead to effective policy decisions aimed at reducing large truck-at-fault accidents for respective locations. The results of the study clearly indicated that there are differences between the influences of a variety of variables on the injury severities resulting from urban vs. rural SV and MV large truck at-fault accidents. The results showed that some variables were significant only in one type of accident model (SV or MV) but not in the other accident model. Again, some variables were found to be significant in one location (rural or urban) but not in other locations. The study also identified important factors that significantly impact the injury severity resulting from SV and MV large truck at-fault accidents in urban and rural locations based on the estimated values of average direct pseudo-elasticity. A careful study of the results of this study will help policy makers and transportation agencies identify location specific recommendations to increase safety awareness related to large truck involved accidents and to improve overall highway safety.     

Less is more: the influence of traffic count on drinking and driving behaviour

Drinking and driving road checks are often organized with either a clear prevention or repression objective in mind. The objective of a prevention strategy is to make as many people as possible believe that police officers are enforcing drinking and driving laws and that drinking drivers will most likely be caught. As such, targeting high traffic count road sites with high-visibility road checks is a priority because it serves to increase awareness of the enforcement activity. An alternative to this prevention approach is the “repression” approach that involves targeting times and places where the highest number of drinking drivers are to be expected. Rather than attempting to affect the subjective chance of getting caught, this approach seeks to increase the objective likelihood of getting caught; the aim is to apprehend as many drinking drivers as possible. Regardless of the chosen strategy, there is a need to understand how traffic count influences drinking and driving behaviour as traffic count may play a role in a police officer's choice of sites for a road check. The objective of this paper is to shed some light on this relationship between drinking and driving behaviour and traffic count. In this paper, data from a roadside survey, carried out in British Columbia in 2003, are used. A two-level logistic regression analysis was carried out with data from 2627 drivers coming from 48 different road sites to replicate a model that was previously obtained with comparable data from a Belgian roadside survey, also carried out in 2003. The present study successfully replicated the findings of the Belgian model, substantiating that the probability for drivers to be drinking and driving significantly decreases with an increasing level of traffic count. This supports the suggestion that drinking drivers avoid high traffic count road sites. The relevance of these findings with respect to organizing preventive or repressive road checks and possible confounding variables are discussed at the end of this paper.     

Identifying social mechanisms for the prevention of adolescent drinking and driving

This study identifies social mechanisms that might help prevent youth from being involved in driving under the influence of alcohol (DUI) and riding with drinking drivers (RWDD). Data collected through telephone surveys with 1534 adolescents and young adults aged 15-20 years (mean=17.6, S.D.=1.6) in California, USA, were analyzed. Structural equation modeling analyses showed that DUI and RWDD were strongly related to drinking in unstructured situations, modeling of DUI by peers and parents, and perceived peer approval or disapproval of DUI. DUI outcome expectancies were indirectly related to DUI and RWDD through situational drinking. Parental monitoring and DUI law enforcement were also indirectly related to DUI and RWDD through DUI expectancies and other mechanisms. The findings, overall, suggest that parental influence remains important even through late adolescence. Parental monitoring, in particular, might help to reduce unstructured socializing with peers, drinking, and affiliation with peers who engage in DUI. Parental monitoring may also foster beliefs about the risks of DUI. Conversely, parents' own DUI behavior may normalize drinking and DUI behaviors, thus countering monitoring efforts.     

Drugs related to motor vehicle crashes in northern European countries: a study of fatally injured drivers

The aim of this study was to find which drugs and drug combinations were most common in drivers who died, in particular, in single vehicle crashes where the responsibility for the crash would be referred to the driver killed. The study included all available blood samples from drivers, who died within 24 h of the accident, in the years 2001 and 2002 in the five Nordic countries (total population about 24 million inhabitants). The samples were analysed for more than 200 different drugs in addition to alcohol, using a similar analytical programme and cut-off limits in all countries. In three countries (Finland, Norway and Sweden) blood samples were available for more than 70% of the drivers, allowing representative prevalence data to be collected. 60% of the drivers in single vehicle crashes had alcohol and/or drug in their blood samples, compared with 30% of drivers killed in collisions with other vehicles. In single vehicle accidents, 66% of the drivers under 30 years of age had alcohol and/or drugs in their blood (alcohol only – 40%; drugs only – 12%; alcohol and drugs – 14%). The drugs found were mostly illicit drugs and psychoactive medicinal drugs with warning labels (in 57% and 58% respectively of the drivers under 30 with drugs present). Similar findings were obtained for drivers 30–49 years of age (63% with alcohol and/or drugs). In drivers aged 50 years and above, killed in single vehicle crashes (48% with alcohol and/or drugs) illicit drugs were found in only one case, and psychoactive medicinal drugs were detected less frequently than in younger age groups. In 75% of single vehicle crashes, the driver was under 50 years. Thus, the majority of accidents where the drivers must be considered responsible, occurred with drivers who had recently used alcohol, or drugs, alone or in combination. The drugs involved were often illicit and/or psychoactive drugs with warning labels. Therefore a large proportion of single vehicle accidents appear to be preventable, if more effective measures against driving after intake of alcohol and drugs can be implemented.     

The effect of the new traffic law on drinking and driving in São Paulo,Brazil

Objective

To present data on drinking and driving in the city of São Paulo, Brazil, and the effects of the new traffic law (Law 11,705) introduced in 2008.

Methods

A cross-sectional study was performed using a questionnaire and passive breath test data to study the prevalence of drinking and driving and the association of drinking and driving with background characteristics and drinking patterns on two separate occasions. The data were gathered from 2007 to 2009 through roadside surveys conducted on busy public roads. Four thousand two-hundred thirty-four (4234) drivers were approached, before and after prohibition, from the south, north, east, and west regions of the city of São Paulo, located in southeastern Brazil, including cars, motorcycles, and utility vehicles. A total of 3854 (91%) consented to participate in the survey and answered the questionnaire. Out of this group, 3229 (84%) agreed to take the passive breathalyzer test.

Results

Logistic regression analyses controlling for gender and age was used to predict a positive breath test (above 0.2 g/l) and the impact of the new law. These analyses indicated that, after the passage of the new traffic law, there was a 45% decrease in driver behavior with positive breathalyzer results. Having a pattern of alcohol consumption of at least once a week and the habit of drinking and driving are risks for a positive breathalyzer.

Conclusions

Despite the decline in the frequency of motorists driving under the influence of alcohol, traffic-related injuries and deaths, after the new law, other measures for a public policy related to alcohol should be considered based on scientific evidence, consistency of action, clear goals, community support, and greater reliability in the laws.     

Analyzing the relationship between car generation and severity of motor-vehicle crashes in Denmark

While the number of fatalities on Danish roads has decreased in the last 40 years, research has not investigated the contribution of legislation changes, enforcement measures, technological enhancements, infrastructural improvements and human factors to this reduction. In the context of a Danish car market with remarkably high registration tax that causes potential buyers to hold longer onto old cars, the relationship between technological enhancements of vehicles and severity of crashes requires particular attention.     

Rear seat safer: seating position, restraint use and injuries in children in traffic crashes in Victoria, Australia

Car crashes are a major cause of death and serious injury to children but most analyses of risk are based on US data. The Australian context is different in at least three ways: (1) the proportion of passenger-side airbags, a potential risk to children in front seats, is much lower; (2) unlike in the US, Australian airbags are designed to work with restrained passengers; (3) restraint use for children 0-12 years is high (>90%). Official data drawn from Victorian crash records (n=30,631) were used to calculate relative risks of death or serious injury for children (0-3 years, 4-7 years; 8-12 years) traveling in passenger cars during 1993-1998 and 1999-2004. Over 90% were reportedly wearing a restraint, and 20% were traveling in the front seat. For children under 4 years traveling in the front seat, the relative risk of death was twice as great as when traveling in the rear, and that of serious injury was 60% greater. The relative risk of death whilst traveling in the front seat was almost four times greater for children aged under 1 year. We suggest that serious consideration should be given to mandating rear seating for children, particularly those aged 4 and under.