Effects of in-vehicle monitoring on the driving behavior of teenagers

Objectives

The objective was to determine if teenage driving behavior improves when a monitoring and feedback device is installed in the teen's vehicle.

Methods

Vehicles of 85 teenage drivers were fit with a device that detected all instances of sudden braking/acceleration, speeding, and nonuse of seat belts. Drivers were assigned randomly to one of four research groups, differing in whether or not an alert sounded in the vehicle and whether or not parents were given access to websites containing notification records. Time trends in event rates per mile traveled were compared using Poisson regression.

Results

Seat belt use improved when violations were reported to the parent websites, and improved even more when in-vehicle alerts were activated. Consistent reductions in speeding were achieved only when teenagers received alerts about their speeding behavior, believed their speeding behavior would not be reported to parents if corrected, and when parents were being notified of such behavior by report cards.

Conclusions

Electronic monitoring of teenage drivers can reduce the incidence of risky behavior, especially seat belt nonuse. More complicated behavior is more difficult to change, however.

Impact on Industry

Parent participation is key to successful behavioral modification, but it is yet to be determined how best to encourage such participation.     

Implied-consent laws: A review of the literature and examination of current problems and related statutes

Problem

A substantial proportion of drivers arrested for DUI refuse the BAC test, thereby reducing the likelihood that they will be convicted and potentially increasing the number of high-risk multiple offenders contributing to alcohol-related crashes.

Method

This paper reviews the information on the current status of implied-consent laws (which impose a sanction on offenders who refuse the BAC test) in the 50 states and the other relevant traffic safety laws and policies that may influence state refusal rates.

Results

Although there appears to be only a weak relationship between state refusal rates and crash rates, there is strong evidence that BAC test refusals significantly compromise the arrest, prosecution, and sentencing of DUI suspects and the overall enforcement of DUI laws in the United States.

Discussion

Laws and policies that may reduce the number of refusals are discussed.

Impact on industry

Alcohol-related crash injuries are an important cost problem for U.S. industry because of property damage from crashes, crash injuries to employees that raise health costs, or the reduction of time on the job resulting from a highway injury.     

What kinds of injuries do OSHA inspections prevent?

Objective

OSHA's enforcement program is one of the major public efforts to protect American workers. We examine both the scope of injury prevention that inspections can contribute and the types of standards that contribute the most.

Methods

We linked Pennsylvania Department of Labor and Industry files for lost-time injuries and employment to calculate injury rates for 1998-2005 for all single-establishment manufacturing firms. We linked these to OSHA inspection records.

Results

Inspections with penalties did affect injury types unrelated to standards as well as those related. We also found again that citations for violations of the standard requiring personal protective equipment had the largest impact on preventing injuries.

Impact on Industry

Programs requiring protective equipment use deserve added attention from consultants and inspectors. In addition, some inspections spur managers to undertake safety measures that go beyond compliance with standards.     

The Long Beach/Fort Lauderdale relative risk study

Problem

The role of alcohol as a major factor in traffic crash causation has been firmly established. However, controversy remains as to the precise shape of the relative risk function and the BAC at which crash risk begins to increase.

Methods

This study used a case-control design in two locations: Long Beach, California, and Fort Lauderdale, Florida. Data were collected on 2,871 crashes of all severities and a matched control group of drivers selected from the same time, location, and direction of travel as the crash drivers. Of the 14,985 sample drivers, 81.3% of the crash drivers and 97.9% of the controls provided a valid BAC specimen.

Results

When adjusted for covariates and nonparticipation bias, increases in relative risk were observed at BACs of .04-.05, and the elevations in risk became very pronounced when BACs exceeded .10.

Discussion

The results provide strong support for .08 per se laws and for state policies that increase sanctions for BACs in excess of .15.

Impact on Industry

This study provides further precision on the deleterious effects of alcohol on driving and, by implication, on other complex tasks.     

The effects of minimum legal drinking age 21 laws on alcohol-related driving in the United States

Objective

To examine trends in alcohol consumption and alcohol-related crashes among people younger than 21 in the United States and to review evidence on the effects of minimum legal drinking age (MLDA) laws.

Methods

Trends in alcohol-related crashes and alcohol consumption among young people were examined, and studies on the effects of lowering and raising the drinking age were reviewed.

Results

MLDA laws underwent many changes during the 20th century in the United States. Since July 1988, the MLDA has been 21 in all 50 states and the District of Columbia. Surveys tracking alcohol consumption among high school students and young adults found that drinking declined since the late 1970 s, and most of the decline occurred by the early 1990 s. These were the years when states were establishing, or reinstating, a MLDA-21. Among fatally injured drivers ages 16-20, the percentage with positive BACs declined from 61% in 1982 to 31% in 1995, a bigger decline than for older age groups; declines occurred among the ages directly affected by raising MLDAs (ages 18-20) and among young teenagers not directly affected (ages 16-17). Almost all studies designed specifically to gauge the effects of drinking age changes show MLDAs of 21 reduce drinking, problematic drinking, drinking and driving, and alcohol-related crashes among young people. Yet many underage people still drink, many drink and drive, and alcohol remains an important risk factor in serious crashes of young drivers, especially as they progress through the teenage years. Stepped-up enforcement of MLDA and drinking and driving laws can reduce underage drinking. Recent efforts to lower MLDAs to 18 and issue licenses to drink upon completion of alcohol education have gained local and national media attention. There is no evidence that alcohol education can even partially replace the effect of MLDA-21.

Conclusions

The cause and effect relationship between MLDAs of 21 and reductions in highway crashes is clear. Initiatives to lower the drinking age to 18 ignore the demonstrated public health benefits of MLDAs of 21.

Impact on Industry

Lowering the drinking age to 18 will increase highway crash deaths among young people.     

Assessing motivation for work environment improvements: Internal consistency, reliability and factorial structure

Problem

Workers' motivation to actively take part in improvements to the work environment is assumed to be important for the efficiency of investments for that purpose. That gives rise to the need for a tool to measure this motivation.

Method

A questionnaire to measure motivation for improvements to the work environment has been designed. Internal consistency and test-retest reliability of the domains of the questionnaire have been measured, and the factorial structure has been explored, from the answers of 113 employees.

Results

The internal consistency is high (0.94), as well as the correlation for the total score (0.84). Three factors are identified accounting for 61.6% of the total variance.

Discussion

The questionnaire can be a useful tool in improving intervention methods.

Impact on Industry

The expectation is that the tool can be useful, particularly with the aim of improving efficiency of companies' investments for work environment improvements.     

Case-control and cross-sectional methods for estimating crash modification factors: comparisons from roadway lighting and lane and shoulder width safety effect studies

Problem

While observational before-after studies are considered the industry standard for developing crash modification factors (CMFs), there are practical limitations that may preclude their use in highway safety analysis. There is a need to explore alternative methods for estimating CMFs.

Method

This paper employs case-control and cross-sectional analyses to estimate CMFs for fixed roadway lighting and the allocation of lane and shoulder widths.

Results

Based on the case-control method, the CMF for intersection lighting is 0.886, while the cross-sectional study indicates a CMF of 0.881. The CMFs developed for lane and shoulder widths are also similar when comparing the two methods.

Conclusions

This paper suggests that case-control and cross-sectional studies produce consistent results if care is taken in the study design and model development.

Impact on industry

Case-control and cross-sectional studies may provide a viable alternative to estimate CMFs when a before-after study is impractical due to data restrictions.     

The effect of work hours on adverse events and errors in health care

Introduction

We studied the relationship between registered nurses' extended work duration with adverse events and errors, including needlestick injuries, work-related injuries, patient falls with injury, nosocomial infections, and medication errors.

Method

Using bivariate and multivariate logistic regression, this secondary analysis of 11,516 registered nurses examined nurse characteristics, work hours, and adverse events and errors.

Results

All of the adverse event and error variables were significantly related to working more than 40 hours in the average week. Medication errors and needlestick injuries had the strongest and most consistent relationships with the work hour and voluntary overtime variables.

Discussion

This study confirms prior findings that increased work hours raise the likelihood of adverse events and errors in healthcare, and further found the same relationship with voluntary overtime.

Impact on Industry

Legislation has focused on mandatory overtime; however, this study demonstrated that voluntary overtime could also negatively impact nurse and patient safety.     

Bicycle helmet use among children in the United States: The effects of legislation, personal and household factors

Introduction

Children ages 5-14 years have the highest rate of bicycle-related injuries in the country. Bicycle helmets can prevent head and brain injuries, which represent the most serious type of bicycle-related injury.

Objectives

This paper compares children's bicycle helmet use to that estimated from an earlier study, and explores regional differences in helmet use by existing helmet legislation.

Methods

This study was a cross-sectional, list-assisted random-digit-dial telephone survey. Interviews were completed by 9,684 respondents during 2001-2003. The subset with at least one child in the household age 5-14 years (2,409 respondents) answered questions about bicycle helmet use for a randomly selected child in their household.

Results

Almost half (48%) of the children always wore their helmet, 23% sometimes wore their helmet, and 29% never wore their helmet. Helmet wearing was significantly associated with race, ethnicity, and child age but was not associated with the sex of the child. Other significant predictors of use included household income, household education, census region, and bicycle helmet law status. Statewide laws were more effective than laws covering smaller areas. The proportion of children who always wore a helmet increased from 25% in 1994 to 48% in 2001-2002. Significant increases in helmet use from 20% to 26% were seen among both sexes, younger (5-9 years) and older (10-14 years) children, and in all four regions of the country.

Conclusions

While there has been substantial progress in the number of children who always wear their helmets, more than half do not. Further progress will require using a combination of methods that have been shown to successfully promote consistent helmet use. Impact on industry: minimal.     

Falls from height during the floor slab formwork of buildings: Current situation in Spain

Problem

One of the phases with the highest risk of falls from a height in the construction of a building is during the floor slab formwork stage. This paper analyzes this particular risk, as well as the most frequently used fall-protection systems.

Method

A survey was carried out to define the current situation in Spain with regard to falls from a height during floor slab formwork and the fall-protection systems used to prevent such a risk.

Results

The results of the survey clarified the current situation in Spain with regard to this risk, and made it clear that there is considerable risk of falling from a height during the floor slab formwork stage.

Discussion

All the safety systems analyzed presented a series of weak points that should be studied in detail before they can be used on building sites.

Impact on industry

The risk of falling associated with floor slab formwork and the most frequently used protection systems are analyzed. As no research had been carried out to date on this type of risk, we consider the research presented in this article to be a pioneer in the field.     

Risks older drivers pose to themselves and to other road users

Problem

Studies have shown that older drivers have high death rates and lower rates of involvement in crashes that kill others; but most studies have not considered drivers' responsibility for their crashes, and many have considered only one particular measure of risk.

Method

This study examines risks that drivers of various ages pose to themselves and to others on per-driver, per-trip, and per-mile bases, taking responsibility for crashes into account, using United States fatal crash data from 1999 through 2003 and travel estimates from 2001.

Results

Relative to other age groups, drivers aged 85 and older face the highest risk of their own death, whereas teens pose the greatest risk to passengers, occupants of other vehicles, and non-motorists.

Discussion

The oldest drivers pose more risk to other road users than middle-aged drivers do; the degree of their excess risk depends strongly upon how risk is measured.

Impact on industry

These results demonstrate the importance of keeping clear the meaning and implications of various risk measures.     

What is the potential of trauma registry data to be used for road traffic injury surveillance and informing road safety policy?

Introduction

Information from hospital trauma registries is increasingly being used to support injury surveillance efforts. This research examines the potential of using trauma registry data for road traffic injury surveillance for different types of road users in terms of both the information collected and how representative trauma data are compared to two population-based road traffic injury data collections.

Methods

The three data collections were assessed against recommended variables to be collected for injury surveillance purposes and the representativeness of the distribution of road traffic-related injury data from the trauma registry was compared to hospital admission and road traffic authority data collections.

Results

Data from the trauma registry was largely not representative of the distribution of age groups or activities compared to the two population-based collections, but was representative for gender for some road user groups to at least one population-based data collection.

Conclusions

Trauma data could be used to supplement information from population-based data collections to inform road safety efforts.

Impact on Industry

Road safety policy makers should be aware of the potential and the limitations of using trauma registry data for road traffic injury surveillance.     

Re-education of young driving offenders; Effects on self-reports of driver behavior

Introduction

Offending drivers are often re-educated, but these courses have seldom been shown to have any safety effects.

Method

An on-line improvement course for offending drivers below the age of 25 was evaluated with several driver inventories.

Results

The drivers reported higher levels of aggression, stress, sensation seeking, drunk driving, and driving violations, six months after the course than before. However, these levels were lower than those of controls, indicating that the initially low levels for the education group were due to socially desirable responding, as measured by a lie scale, an effect that waned after the course.

Discussion

The results can be interpreted as a positive effect of the education, although this conclusion is tentative and not in agreement with all effects in the data.

Impact on industry

The results are in disagreement with previous evaluation studies using the same or similar instruments, and show the need to include controls for social desirability in self-report studies.     

Predicting driver drowsiness using vehicle measures: Recent insights and future challenges

Introduction

Driver drowsiness is a significant contributing factor to road crashes. One approach to tackling this issue is to develop technological countermeasures for detecting driver drowsiness, so that a driver can be warned before a crash occurs.

Method

The goal of this review is to assess, given the current state of knowledge, whether vehicle measures can be used to reliably predict drowsiness in real time.

Results

Several behavioral experiments have shown that drowsiness can have a serious impact on driving performance in controlled, experimental settings. However, most of those studies have investigated simple functions of performance (such as standard deviation of lane position) and results are often reported as averages across drivers, and across time.

Conclusions

Further research is necessary to examine more complex functions, as well as individual differences between drivers.

Impact on Industry

A successful countermeasure for predicting driver drowsiness will probably require the setting of multiple criteria, and the use of multiple measures.     

A reporting guide for studies on individual differences in traffic safety

Problem

Studies on individual differences in traffic safety report differently on their methodologies, and use different statistics, and these are therefore difficult to compare and meta-analyze.

Method

Based upon a previous, extensive review and meta-analysis of the traffic safety literature, several recommendations are made about what features of the methodology of studies on individual differences (including evaluations) in safety need to be reported to facilitate interpretation and meta-analysis. Similarly, some basic types of statistical values are recommended.

Impact on Industry

The accumulation of knowledge about individual differences in traffic safety would be facilitated if scientific authors and journals adhered to these guidelines.     

Television news' coverage of motor-vehicle crashes

Problem

Traffic crashes are a major cause of injury and death. Although it has been argued that a skewed estimation of personal risks may be partly attributable to news representations of mortality causes, the manners in which traffic crashes are covered in the news have not received much attention in the literature.

Method

The current study used content analysis to examine the framing of traffic crashes in television news.

Results

The data indicated that Flemish television news does not report traffic crashes from a public health perspective and consequently it misses opportunities to inform the public on the causes and consequences of risk-taking in traffic.

Impact on industry

It is important that professionals are aware of these findings and stress contextual factors surrounding traffic crashes in their communication with journalists. This may lead to more accurate reports and a more accurate risk perception of viewers.     

Evaluation of a healthcare safety climate measurement tool

Problem

Psychometrically validated measurement tools are needed to evaluate an organization's safety climate. In 2000, Gershon and colleagues published a new healthcare safety climate measurement tool to determine its relationship to safe work behavior (Gershon, R., Karkashian, C., Grosch, J., Murphy, L., Escamilla-Cejudo, A., Flanagan, P., et al. (2000). Hospital safety climate and its relationship with safe work practices and workplace exposure incidents. American Journal of Infection Control, 28, 211-21). The present study evaluated the psychometric properties of the Gershon tool when modified to address respiratory rather than bloodborne pathogen exposures.

Method

Medical practitioners, nurses, and nurse aides (n = 460) were surveyed using the modified Gershon tool. Data were analyzed by factor analysis and psychometric properties of the tool evaluated.

Results

Eight safety climate dimensions were extracted from 25 items (Cronbach's alpha range: 0.62 - 0.88). Factor extractions and psychometric properties were reasonably consistent with those of the Gershon tool.

Impact on Industry

The Gershon safety climate tool appears to have sufficient reliability and validity for use by healthcare decision makers as an indicator of employee perceptions of safety in their institution.     

Epidemiology of subway-related fatalities in New York City, 1990-2003

Problem

Subway transit is a relatively safe mode of transportation, yet compared to all other forms of mass transit in the United States (U.S.), subways have the highest fatality rate. The aim of this paper is to characterize subway-related fatalities in order to identify opportunities for risk reduction.

Method

Medical examiner records for all New York City (NYC) subway-related deaths (1990-2003) were reviewed. Data were abstracted on decedents' demographics and autopsy findings, including laboratory findings.

Results

There were 668 subway-related fatalities, of these, 10 (1.5%) were homicides, 343 (51.3%) were determined to be suicides, and 315 (47.2%) were accidental. Although decedent characteristics varied between fatality categories, they were not particularly informative with regard to prevention.

Conclusion

Prevention strategies that focus on structural controls are likely to be most efficacious in improving the overall safety of the NYC subway systems.

Impact on industry

These findings suggest that structural rather than individual-level interventions would be most successful in preventing subway fatalities.     

Is a hands-free phone safer than a handheld phone?

Introduction

Although it is becoming more and more accepted that driving while talking on a cell phone can be hazardous, most jurisdictions are making handheld phone use illegal while allowing hands-free phone use.

Methods

The scientific literature exploring the effects of these two types of cell phone use on driving and driving-related performance is reviewed here.

Results

Our review shows that talking on the phone, regardless of phone type, has negative impacts on performance especially in detecting and identifying events. Performance while using a hands-free phone was rarely found to be better than when using a handheld phone. Some studies found that drivers compensate for the deleterious effects of cell phone use when using a handheld phone but neglect to do so when using a hands-free phone.

Impact on Industry

Current research does not support the decision to allow hands-free phone use while driving.     

Adolescent, and their parents, attitudes towards graduated driver licensing and subsequent risky driving and crashes in young adulthood

Problem

Although Graduated Driver Licensing Systems (GDLS) have helped reduce young driver crash rates, they remain significantly over-represented in crash statistics. To be effective GDLS rely heavily on support for the legislation by those directly involved; parents to enforce the restrictions and adolescents to comply. There is some evidence that practices regarding GDLS restrictions influence adolescent driving outcomes in the early stage of licensure. However there has been no examination undertaken on the influence of parent and adolescent attitudes toward GDLS on adolescents’ driving behavior and crash experiences as they move into their young adult years. The aim of this research was to examine these relationships.

Method

This investigation was based on a longitudinal study of a birth cohort, and uses data collected when the cohort members were aged 15, 18, and 21 years. At age 15 both adolescent and their parent attitudes toward GDLS were measured. At age 18 adolescent GDLS attitudes were measured again. The association between these measures and self-reported risky driving behavior and crash involvement at age 21 were examined.

Results

Negative attitudes toward the learner supervisor restriction for males, and negative attitudes toward a GDLS for females were strongly associated with risky driving and crash involvement as young adults.

Impact on industry

Targeting interventions to improve adolescents and parents understanding of the reasons for graduated licensing and the specific restrictions may improve attitudes and views and thereby contribute to a reduction in risky driving behaviors and crash risk among young adults.