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1.

Objective

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

Methods

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

Results

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

Conclusions

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

2.
Fatigue is a major cause of road traffic accidents. However, due to the blurred concept of fatigue and the lack of reliable testing devices (cf. the breath analyzer for alcohol levels), it is extremely difficult to incorporate fatigue in operationalized terms into either traffic or criminal law. Even though the Finnish Road Traffic Act explicitly forbids driving while tired, it is done only on a general level among other factors (sickness, etc.) that impair a driver's fitness to drive (Article 63). The present study was done to investigate the circumstances of fatigue driving offenses. From the Finnish Vehicle Administration driver record database we extracted all drivers (N = 768) punished under Article 63 from 2004-2005. Of these drivers, 90.4% committed a fatigue-related traffic offense. Accidents, predominantly single vehicle, were the most common (92.5%) consequence of fatigued driving. Although fatigue-related accidents are thought to be serious, our data shows that most of the accidents (81.6%) did not involve personal injuries. Almost every twentieth driver was punished because his vehicle was drifting on the road. The presence of alcohol or drugs was noted in 13% of the cases. Only 3.1% of the punished drivers officially denied being tired or falling asleep. Young men (≤35 yrs) represented 50% of all punished drivers. Time of day and seasonal effects were clear in this data. This study shows that even without a reliable fatigue detector and unambiguous criteria for recognizing the contribution of fatigue to accident causation, Finnish police and the courts punish a significant number of drivers every year on the basis of fatigue.  相似文献   

3.
It is well known that driving under the influence of alcohol increases the risk of traffic accidents. Alcohol-dependent patients are responsible for two-thirds of motor vehicle crashes involving alcohol. Studies carried out on the general population have shown a relation between alcohol dependence and traffic accidents. The aim of the study is to analyse the effect on traffic accidents of treatment of patients with alcohol-related problems. To do so, the prevalence of traffic problems in a sample of patients with a diagnosed dependence on alcohol was assessed for three periods: during their lifetime, in the year preceding the start of treatment and over the year of treatment. A prospective study was carried out of 176 patients (147 males, 29 females; mean age 42.9 years) diagnosed as alcohol dependent according to the DSM-IV criteria in three alcoholic treatment centres in Castilla y León, Spain. 36.9% of the alcohol-dependent patients had had some kind of traffic problem during their life and 8.5% in the year prior to starting treatment. The most frequent problem was positive breath tests, followed by accidents with damage to the vehicle. Sixty-nine of the 176 patients were still receiving treatment after a year. The prevalence of traffic problems among those patients who followed treatment for 1 year (4.3%) was lower than in the year before treatment (15.9%). The study showed that the treatment is also effective in reducing traffic problems.  相似文献   

4.
A case–control study was conducted on 204 drivers fatally injured in road traffic accidents in south-eastern Norway during the period 2003–2008. Cases from single vehicle accidents (N = 68) were assessed separately. As controls, 10 540 drivers selected in a roadside survey in the same geographical area during 2005–2006 were used. Blood samples were collected from the cases and oral fluid (saliva) samples from the controls. Samples were analysed for alcohol, amphetamines, cannabis, cocaine, opioid analgesics, hypnotics, sedatives and a muscle relaxant; altogether 22 psychoactive substances. Equivalent cutoff concentrations for blood and oral fluid were used. The risk for fatal injury in a road traffic accident was estimated using logistic regression adjusting for gender, age, season of the year, and time of the week. The odds for involvement in fatal road traffic accidents for different substances or combination of substances were in increasing order: single drug < multiple drugs < alcohol only < alcohol + drugs. For single substance use: medicinal drug or THC < amphetamine/methamphetamine < alcohol. For most substances, higher ORs were found when studying drivers involved in single vehicle accidents than for those involved in multiple vehicle accidents, but confidence intervals were wider.  相似文献   

5.
6.
Driving with alcohol and other psychoactive substances imposes an increased risk of severe injury accidents. In a population-based case–control design, the relative risks of severe driver injury (MAIS ≥ 2) by driving with ten substance groups were approximated by odds ratios (alcohol, amphetamines, benzoylecgonine, cocaine, cannabis, illicit opiates, benzodiazepines and Z-drugs, i.e. zolpidem and zopiclone, medicinal opioids, alcohol–drug combinations and drug–drug combinations). Data from six countries were included in the study: Belgium, Denmark, Finland, Italy, Lithuania and the Netherlands. Case samples (N = 2490) were collected from severely injured drivers of passenger cars or vans in selected hospitals in various regions of the countries. Control samples (N = 15,832) were sampled in a uniform sampling scheme stratified according to country, time, road type and season. Relative risks were approximated by odds ratios and calculated by logistic regression. The estimates were adjusted for age, gender and country.  相似文献   

7.
Speed is one of the main risk factors in traffic safety, as it increases both the chances and the severity of a crash. In order to achieve improved traffic safety by influencing the speed of travel, road authorities may decide to lower the legally imposed speed limits. In 2001 the Flemish government decided to lower speed limits from 90 km/h to 70 km/h on a considerable number of highways. The present study examines the effectiveness of this measure using a comparison group before- and after study to account for general trend effects in road safety. Sixty-one road sections with a total length of 116 km were included. The speed limits for those locations were restricted in 2001 and 2002. The comparison group consisted of 19 road sections with a total length of 53 km and an unchanged speed limit of 90 km/h throughout the research period. Taking trend into account, the analyses showed a 5% decrease [0.88; 1.03] in the crash rates after the speed limit restriction. A greater effect was identified in the case of crashes involving serious injuries and fatalities, which showed a decrease of 33% [0.57; 0.79]. Separate analyses between crashes at intersections and at road sections showed a higher effectiveness at road sections. It can be concluded from this study that speed limit restrictions do have a favorable effect on traffic safety, especially on severe crashes. Future research should examine the cause for the difference in the effect between road sections and intersections that was identified, taking vehicle speeds into account.  相似文献   

8.
Excessive speed is currently one of the primary contributory factors in traffic accidents within roadwork sites around the world. The present study evaluated two novel interventions designed to control traffic speed within an open road, roadwork site in New Zealand where drivers were required to decrease their speed from 100 to 50 km/h. Two different interventions were placed at the entrance to the work site and required drivers to pass between a 3.5 m wide passage of either evenly or decreasingly spaced cones. A multi-element baseline design was utilised. Both interventions were highly effective at reducing vehicle speed, with the greatest initial decrease in speed to 9.47 km/h below baseline for the uneven arrangement. Additionally, both arrangements more than halved the proportion of ‘dangerous’ speeders travelling faster than 20 km/h over the speed limit. The findings indicate that both arrangements of cones are effective, convenient, cost-effective strategies. It is concluded that, although both arrangements are highly effective, the use of unevenly-spaced cones is likely to most markedly reduce the number of speed-related accidents within open road roadwork zones. The findings are discussed in relation to the perceptual mechanisms by which transverse and peripheral stimuli influence speed perception and driver behaviour.  相似文献   

9.
This paper uses data from an observational study, conducted at access points in straight sections of primary roads in Malaysia in 2012, to investigate the effects of motorcyclists’ behavior and road environment attributes on the occurrence of serious traffic conflicts involving motorcyclists entering primary roads via access points. In order to handle the unobserved heterogeneity in the small sample data size, this study applies mixed effects logistic regression with multilevel bootstrapping. Two statistically significant models (Model 2 and Model 3) are produced, with 2 levels of random effect parameters, i.e. motorcyclists’ attributes and behavior at Level 1, and road environment attributes at Level 2. Among all the road environment attributes tested, the traffic volume and the speed limit are found to be statistically significant, only contributing to 26–29% of the variations affecting the traffic conflict outcome. The implication is that 71–74% of the unmeasured or undescribed attributes and behavior of motorcyclists still have an importance in predicting the outcome: a serious traffic conflict. As for the fixed effect parameters, both models show that the risk of motorcyclists being involved in a serious traffic conflict is 2–4 times more likely if they accept a shorter gap to a single approaching vehicle (time lag <4 s) and in between two vehicles (time gap <4 s) when entering the primary road from the access point. A road environment factor, such as a narrow lane (seen in Model 2), and a behavioral factor, such as stopping at the stop line (seen in Model 3), also influence the occurrence of a serious traffic conflict compared to those entering into a wider lane road and without stopping at the stop line, respectively. A discussion of the possible reasons for this seemingly strange result, including a recommendation for further research, concludes the paper.  相似文献   

10.
The objective of this study was to determine the relationship between alcohol use, psychoactive drug use and road traffic injury (RTI). A case-control study was conducted among drivers in Bangkok, Thailand. Two hundred cases and 849 controls were enrolled between February and November 2006. Cases who sustained a RTI were matched with four controls recruited from petrol stations within a 1-km radius of the reported crash site of the case.A positive alcohol breath test (≥50 mg/dl), and positive tests for the presence of illicit (amphetamine, cocaine, marijuana) and non-illicit psychoactive drugs (antihistamine, benzodiazepine, antidepressants), using gas chromatography/mass spectrometry (GC/MS) were documented as primary measures.There were significantly higher odds of an alcohol breath test ≥50 mg/dl (adjusted odds ratio (OR) 63.6 (95% CI: 25.5-158.9)), illicit psychoactive drugs (adjusted OR 3.4 (95% CI: 1.7-6.6)) and non-illicit psychoactive drug (adjusted OR 3.1 (95% CI: 1.5-6.3)) among cases than controls.Even though driving under the influence of psychoactive drugs has been significantly linked to RTI, its contribution to road safety is much lower than driving under the influence of alcohol. With limited resources, the priority for RTI prevention should be given to control of driving under the influence of alcohol.  相似文献   

11.
The number of deaths in road traffic accidents in Spain exceeds three thousand people each year. Public authorities have implemented some policies with the aim to reducing this number. Among them, the improvement of road quality standards and some legal changes encouraging careful driving behavior. However, less attention has been focused on one of the issues that may be critical to reducing the number of fatalities caused by traffic accidents: a quick emergency medical care. In this paper, we use a sample of more than 1400 accidents occurred on Spanish roads in May 2004. Our objective is to analyze to which extent a reduction of the time interval between the crash and the arrival of the emergency services to the crash scene is related to a lower probability of death. Our results suggest that a 10 min reduction of the medical response time can be statistically associated with an average decrease of the probability of death by one third, both on motorways and conventional roads.  相似文献   

12.
This paper presents a re-analysis of the Power Model of the relationship between the mean speed of traffic and road safety. Past evaluations of the model, most recently in 2009, have broadly speaking supported it. However, the most recent evaluation of the model indicated that the relationship between speed and road safety depends not only on the relative change in speed, as suggested by the Power Model, but also on initial speed. This implies that the exponent describing, for example, a 25% reduction in speed will not be the same when speed changes from 100 km/h to 75 km/h as it will when speed changes from 20 km/h to 15 km/h. This paper reports an analysis leading to a re-parameterisation of the Power Model in terms of continuously varying exponents which depend on initial speed. The re-parameterisation was accomplished by fitting exponential functions to data points in which changes in speed and accidents were sorted in groups of 10 km/h according to initial speed, starting with data points referring to the highest initial speeds. The exponential functions fitted the data extremely well and imply that the effect on accidents of a given relative change in speed is largest when initial speed is highest.  相似文献   

13.
In 2006, we carried out a cross-sectional study in the urban area of Pelotas, Southern Brazil, with the aim of outlining the profile of bicycle commuters, analyzing their use of safety equipment and risk behaviors and the association between these variables and involvement in traffic accidents in the previous 12 months. This study was based on the baseline survey carried out prior to an educational intervention aimed at reducing accidents among cyclists. The sample included 1133 male subjects aged 20 years or more, and who used a bicycle for commuting. Crude and adjusted analyses were carried out using Poisson regression. We recorded a total of 152 reported traffic accidents in the 12 months preceding the interview, involving 10.8% of subjects. Most risk behaviors studied and the use of safety equipment showed no significant association with accidents. Only commuting by bicycle seven days per week, as opposed to five or six, and a combination of extremely imprudent behaviors such as zigzagging through traffic, riding after ingesting alcohol, and high-speed riding were found to be risk factors for accidents. Our findings suggest that in the context where the study was done (poor road signaling, limited policing, aggressive driving) changing cyclist behavior may not have substantial impact in terms of accident reduction before other road traffic interventions are implemented.  相似文献   

14.
ObjectivePedestrians, bicyclists and motorcyclists can suffer serious injury in road traffic crashes. To date, no studies examine the injury severity within this vulnerable cohort following collisions with reversing cars.Material and methodsOur institution prospectively maintains a database including medical and technical information regarding traffic accidents in our area, including urban and suburban regions. In a retrospective review of this database, the authors describe the injury severity of pedestrians, bicyclists and motorcyclists following traffic crashes involving reversing cars. Injury severity was described using the abbreviated injury scale (AIS) as well as the maximum abbreviated injury scale (MAIS).ResultsThis study included 234 crashes occurring between 1999 and 2012. The lower extremity was injured most often while also suffering more severe injuries with a median AIS of 1 compared to 0 in all other documented body regions. The upper extremity was injured second most often. AIS ranging from 4 to 6 were infrequent. AIS 3 however, was documented for the legs in 4.3% of patients. MAIS 0, 1, 2, 3, 5 and 9 were found in 1, 164, 46, 14, 1, and 8 patients in the study cohort, respectively. Pedestrians and motorcyclists were seriously injured in 9.1% and 9.6% of cases, respectively. In contrast, no bicyclists suffered serious injuries. As to the zone of impact, most collisions occurred at the rear center of the vehicle (35%) followed by rear left (26%), rear right (20%), side rear (11%), side center (4%) and side front (3%). 204 (87.2%) collisions occurred during the day, 19 (8.1%) at night and 11 (4.7%) at twilight. Speed was similar in crashes involving pedestrians, bicyclists and motorcyclists, being as high as 7.0 ± 3.6, 7.0 ± 4.0 and 7.9 ± 4.2 km/h respectively.ConclusionsThis is the first study that analyzes injury severity among these vulnerable road users following collisions with reversing vehicles. The majority of collisions occur at low impact speed during the day. Most injuries resulting from these collisions are not serious, however pedestrians are at greatest risk of severe injury to any body region. The lower extremities suffer the most serious and frequent injuries within this cohort.  相似文献   

15.
Data concerning injury hazards among tourists are difficult to obtain because estimates of person–time denominators are rarely available. Existing sources are limited to enumeration of injured or killed persons by nationality and type of injury and the analysis can only rely on proportional indicators. Since 1995, the Regional Hospital in the tourist island of Kerkyra (Corfu) has been covering all types of accidents including road traffic injuries, in the context of the Emergency Department Injury Surveillance System (EDISS). The catchment area of this hospital practically coincides with the island population. About 15% of all accidents are traffic-related among either permanent residents or Greek tourists, but they represent 40% among tourists of foreign nationalities. This is suggestive, but far from conclusive evidence, that traffic injuries may be more common among foreign tourists. There are indications that accidents among foreign tourists overall are slightly more serious. Among Greek tourists, the ratio between peak and non-peak period is similar for non-traffic injuries (7.4) and traffic injuries (6.8), whereas among foreign tourists the corresponding ratio is 9.2 for non traffic injuries and 15.0 for traffic injuries. This pattern is difficult to explain in terms other than an excess risk of traffic injuries among foreign tourists.  相似文献   

16.

Objectives

(i) To estimate the rate ratio (RR) of use of alcohol alone, cocaine alone, and both substances simultaneously on acute injury or an aggressive incident, (ii) to compare the RRs for simultaneous use within 3 or 6 h of the event; and (iii) to compare the RRs of two measures of exposure, “hours of feeling effects” vs estimates based on self-reported quantity and frequency of use.

Methods

The study employed a case–crossover design with the frequency approach. Clients (N = 616) in substance abuse treatment for alcohol or cocaine issues from 2009 to 2012 completed a self-administered questionnaire on their substance use within 3 and 6 h before a recent injury or physically aggressive incident. Clients also reported detailed quantity and frequency information in relation to their typical substance use, as well as information on “feeling effects”. The RR of acute harms due to substance use was estimated using the Mantel–Haenszel estimator.

Results

In the 6-h window before the event, use of cocaine alone, alcohol alone and simultaneous alcohol and cocaine use were each significantly (P < 0.05) related to a recent injury and aggressive incident. Simultaneous use was not significantly greater than use of either drug alone. Estimates of RR based on simultaneous use for a 3-h window before the event were consistently larger than those based on a 6-h window, and comparisons were significant (P < 0.05) for an aggressive incident but not an injury. With reference to the two measures of exposure, three of eight comparisons of RRs were significantly larger for feeling the effects of the substance in comparison to quantity and frequency of substance use.

Conclusion

These findings are consistent with increased likelihood of harms related to the acute effects of alcohol alone, cocaine alone or simultaneous use. The results are suggestive that the acute effects of these drugs may be better measured within a 3-h time window than a 6-h window. Finally, we found that “hours of feeling effects” yielded higher estimates of RR than the quantity–frequency approach; however both measures support the overall findings.  相似文献   

17.
Drunk drivers are a menace to themselves and to other road users, as drunk driving significantly increases the risk of involvement in road accidents and the probability of severe or fatal injuries. Although injuries and fatalities related to road accidents have decreased in recent decades, the prevalence of drunk driving among drivers killed in road accidents has remained stable, at around 25% or more during the past 10 years. Understanding drunk driving, and in particular, recidivism, is essential for designing effective countermeasures, and accordingly, the present study aims at identifying the differences between non-drunk drivers, drunk driving non-recidivists and drunk driving recidivists with respect to their demographic and socio-economic characteristics, road accident involvement and other traffic and non-traffic-related law violations. This study is based on register-data from Statistics Denmark and includes information from 2008 to 2012 for the entire population, aged 18 or older, of Denmark. The results from univariate and multivariate statistical analyses reveal a five year prevalence of 17% for drunk driving recidivism, and a significant relation between recidivism and the drunk drivers’ gender, age, income, education, receipt of an early retirement pension, household type, and residential area. Moreover, recidivists are found to have a higher involvement in alcohol-related road accidents, as well as other traffic and, in particular, non-traffic-related offences. These findings indicate that drunk driving recidivism is more likely to occur among persons who are in situations of socio-economic disadvantage and marginalisation. Thus, to increase their effectiveness, preventive measures aiming to reduce drunk driving should also address issues related to the general life situations of the drunk driving recidivists that contribute to an increased risk of drunk driving recidivism.  相似文献   

18.
The number of pedestrian–motor vehicle accidents and pedestrian deaths in China surged in recent years. However, a large scale empirical research on pedestrian traffic crashes in China is lacking. In this study, we identify significant risk factors associated with fault and severity in pedestrian–motor vehicle accidents. Risk factors in several different dimensions, including pedestrian, driver, vehicle, road and environmental factors, are considered. We analyze 6967 pedestrian traffic accident reports for the period 2006–2010 in Guangdong Province, China. These data, obtained from the Guangdong Provincial Security Department, are extracted from the Traffic Management Sector-Specific Incident Case Data Report. Pedestrian traffic crashes have a unique inevitability and particular high risk, due to pedestrians’ fragility, slow movement and lack of lighting equipment. The empirical analysis of the present study has the following policy implications. First, traffic crashes in which pedestrians are at fault are more likely to cause serious injuries or death, suggesting that relevant agencies should pay attention to measures that prevent pedestrians from violating traffic rules. Second, both the attention to elderly pedestrians, male and experienced drivers, the penalty to drunk driving, speeding, driving without a driver's license and other violation behaviors should be strengthened. Third, vehicle safety inspections and safety training sessions for truck drivers should be reinforced. Fourth, improving the road conditions and road lighting at night are important measures in reducing the probability of accident casualties. Fifth, specific road safety campaigns in rural areas, and education programs especially for young children and teens should be developed and promoted. Moreover, we reveal a country-specific factor, hukou, which has significant effect on the severity in pedestrian accidents due to the discrepancy in the level of social insurance/security, suggesting that equal social security level among urban and rural people should be set up. In addition, establishing a comprehensive liability distribution system for non-urban areas and roadways will be conducive to both pedestrians’ and drivers’ voluntary compliance with traffic rules.  相似文献   

19.
The aim of the study was to investigate the psychosocial consequences and coping strategies among accident victims in South Africa. Participants (138 drivers and 141 passengers) who had been involved in a road traffic accident were approached and interviewed in public places. In both groups the median age group was between 25 years and 34 years. In 34 accidents (12.2%) a family member was killed, in 68 accidents (24.4%) a non-family member was killed in the accident. In 272 accidents 197 (72.4%) persons (both drivers and passengers) were injured and 168 (61.7%) were hospitalized. Eighty-seven drivers (63%) did not perceive themselves at fault and 51 (37%) did. Following the road traffic accident both drivers and passengers showed a significant decline of their well-being. Drivers who perceived themselves to be at fault did not cope better than those not perceiving themselves at fault. Passengers related to the drivers showed more decline in their well-being than those not related. Path analysis for drivers found that holding oneself responsible had a direct, and mediated by self-blame, guilt and family distress, negative effect on personal well-being. In the passengers group, holding the driver or others responsible led, mediated by increased self-blame, feelings of guilt, and family distress, to lower psychological well-being (PWB). Findings have relevant implications for the development of coping strategies to aid victims of road traffic accidents in dealing with their trauma in this African context, which may differ to those in Western societies.  相似文献   

20.
Ungulate–vehicle collisions pose a serious traffic safety hazard in the North of Spain. The understanding of underlying temporal and spatial structure of these non-random events is imperative to develop appropriate mitigation measures. This study analyses the temporal, spatial and spatiotemporal patterns of car crashes involving wild boar and roe deer in the province of Lugo (NW Spain) in the period 2006–2010 using geographic information systems (GIS) and spatial statistics. The temporal analysis – conducted at three scales: daily, weekly and seasonal – revealed that accidents are related to specific animal's life cycles and to interactions with human activities. The localization of collision points with GIS discovered the sections of the autonomic road network where accidents with the two studied species concentrate. Besides, the spatial arrangement of significant hotspots was mapped through kernel density estimation over two time scales (daily and seasonal), distinguishing among 41 sets, sequentially arranged to facilitate clustering comparison and determination of spatiotemporal risky areas. This work is of valuable help for road managers to design the appropriate mitigation measures that will improve traffic safety and animal welfare.  相似文献   

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