Working conditions and sleepiness while driving among truck drivers

Objective: The objective of this study is to identify the role of working conditions as predictors of sleepiness while driving among truck drivers.

Methods: This was a cross-sectional study carried out among truck drivers who transported grains to Paranaguá Port, Paraná, Brazil. The truck drivers were interviewed and completed a self-administered questionnaire to collect data on sociodemographic and behavioral variables, working conditions, consumption of illicit psychoactive substances, and sleep patterns. Drivers were considered to be sleepy while driving if they reported a medium or high probability of napping while driving at night, during the daytime, or while stopped in traffic. The statistical analysis used logistic regression models progressively adjusted for age, behavioral variables, sleep duration, and other working conditions.

Results: In total, 670 male drivers, with a mean age of 41.9 (±11.1) years, were enrolled. The prevalence of sleepiness while driving was 31.5%. After model adjustments, the following working conditions were associated with sleepiness while driving: Distance from the last shipment of more than 1,000?km (odds ratio [OR]?=?1.54; 95% confidence interval [CI], 1.07–2.23) and a formal labor contract with a productivity-based salary (OR = 2.65; 95% CI, 1.86–3.78). Consumption of illicit psychoactive substances (OR = 1.99; 95% CI, 1.14–3.47) was also associated with sleepiness while driving.

Conclusions: Distance traveled and a formal labor contract with productivity-based earnings were the working conditions associated with sleepiness while driving, regardless of other working or behavioral characteristics, age, consumption of illicit psychoactive substances, and sleep duration.     

Body Mass Index (BMI) as a first-line screening criterion for detection of excessive daytime sleepiness among professional drivers

OBJECTIVES: Obstructive sleep apnea (OSA) is the main predisposing factor of excessive daytime sleepiness (EDS), and, therefore, increases the risk of road crashes. However, it is difficult to rely on medical intake for OSA or fatigue since drivers' symptoms reports are not reliable. On the other hand, direct measurement of EDS among large numbers of drivers carries serious practical drawbacks. Obstructive sleep apnea, in turn, is strongly related to obesity, and elevated body mass index (BMI) is considered one of the major risk factors for OSA. Thus, it could be postulated that BMI may carry predictive value for EDS proneness. METHODS: The present study examined the interrelation between BMI, degree of OSA, as measured with Respiratory Distress Index (RDI), and the degree of EDS, as measured with the mean sleep onset latency in the Multiple Sleep Latency Test (MSLT) among obese (BMI = 32) professional drivers. The drivers went through polysomnography followed by the five sessions of MSLT in the next day. RESULTS: In accordance with prior studies, we have found strong correlation between BMI and the degree of OSA on the one hand, and between the degree of OSA and EDS on the other hand. OSA was detected among 77.7% of the drivers, 47.1% were sleepy, 19% had severe sleepiness [mean sleep latency [MSL < or = 5 min.], 28.1% had moderate sleepiness [MSL < or = 10 min.]. None of the drivers complained about any sleep problem, including snoring, and all reported that they do not experience excessive daytime sleepiness. Thus, there was no correlation between their subjective report and objective findings. CONCLUSIONS: Obese drivers with BMI above 32 are highly prone to be sleepy during the day. Their subjective reports of OSA or fatigue symptoms are not reliable. Therefore it is highly recommended to screen them easily by weight and height measure for further sleep study and decision about their driving abilities.     

Safe driving practices and factors associated with motor-vehicle collisions among people with insulin-treated diabetes mellitus: Results from the Diabetes and Driving (DAD) study

IntroductionThe aim of this study was to assess the prevalence of people with insulin-treated diabetes mellitus (ITDM) who have discussed issues related to diabetes and driving with their health care providers (HCPs). We also sought to determine the safe driving practices that are currently employed by this group. Finally, we investigated the factors that might increase the risk of motor-vehicle collisions (MVCs) among this group in Saudi Arabia.MethodThis cross-sectional study surveyed a representative sample of 429 current male drivers with ITDM using a structured questionnaire in Saudi Arabia.ResultsMost of the participants (76.5%) never discussed topics regarding diabetes and driving with their HCPs. The majority of the participants (61.8%) reported at least never doing one of the following: (a) carrying a blood glucose testing kit while driving, (b) testing their blood glucose level before driving or during a journey, or (c) having thought of a specific threshold of blood glucose level that would preclude driving. Three factors were associated with a higher risk of MVCs among participants with ITDM: (a) being on a basal/boluses regimen, (b) never having a discussion regarding diabetes and driving with their HCPs, and (c) having experienced hypoglycemia during driving.ConclusionsThe majority of people with ITDM had not had a discussion regarding diabetes and driving with their HCPs, which was reflected by a lack of safe driving practices. People with ITDM should be encouraged to take precautions while driving in order to prevent future MVCs.Practical applicationsThis research highlights the importance of investing more effort in educating drivers who have diabetes about safe driving practices by their health care providers. Also, it will attracts the attention of policymakers for an urgent need to establish clear policies and procedures for dealing with drivers who have diabetes.     

The on-road experiences and awareness of sleepiness in a sample of Australian highway drivers: A roadside driver sleepiness study

Objective: Driver sleepiness contributes substantially to road crash incidents. Simulator and on-road studies clearly reveal an impairing effect from sleepiness on driving ability. However, the degree to which drivers appreciate the dangerousness of driving while sleepy is somewhat unclear. This study sought to determine drivers' on-road experiences of sleepiness, their prior sleep habits, and personal awareness of the signs of sleepiness.

Methods: Participants were a random selection of 92 drivers traveling on a major highway in the state of Queensland, Australia, who were stopped by police as part of routine drink driving operations. Participants completed a brief questionnaire that included demographic information, sleepy driving experiences (signs of sleepiness and on-road experiences of sleepiness), and prior sleep habits. A modified version of the Karolinska Sleepiness Scale (KSS) was used to assess subjective sleepiness in the 15 min prior to being stopped by police.

Results: Participants' ratings of subjective sleepiness were quite low, with 90% reporting being alert to extremely alert on the KSS. Participants were reasonably aware of the signs of sleepiness, with many signs of sleepiness associated with on-road experiences of sleepiness. Additionally, the number of hours spent driving was positively correlated with the drivers' level of sleep debt.

Conclusions: The results suggest that participants had moderate experiences of driving while sleepy and many were aware of the signs of sleepiness. The relationship between driving long distances and increased sleep debt is a concern for road safety. Increased education regarding the dangers of sleepy driving seems warranted.     

Crash risk perception of sleepy driving and its comparisons with drink driving and speeding: Which behavior is perceived as the riskiest?

Objective: Driver sleepiness is a major crash risk factor but may be underrecognized as a risky driving behavior. Sleepy driving is usually rated as less of a road safety issue than more well-known risky driving behaviors, such as drink driving and speeding. The objective of this study was to compare perception of crash risk of sleepy driving, drink driving, and speeding.

Methods: Three hundred Australian drivers completed a questionnaire that assessed crash risk perceptions for sleepy driving, drink driving, and speeding. Additionally, the participants' perceptions of crash risk were assessed for 5 different contextual scenarios that included different levels of sleepiness (low, high), driving duration (short, long), and time of day/circadian influences (afternoon, nighttime) of driving.

Results: The analysis confirmed that sleepy driving was considered a risky driving behavior but not as risky as high levels of speeding (P < .05). Yet, the risk of crashing at 4 a.m. was considered as equally risky as low levels of speeding (10 km over the limit). The comparisons of the contextual scenarios revealed driving scenarios that would arguably be perceived as quite risky because time of day/circadian influences were not reported as high risk.

Conclusions: The results suggest a lack of awareness or appreciation of circadian rhythm functioning, particularly the descending phase of circadian rhythm that promotes increased sleepiness in the afternoon and during the early hours of the morning. Yet, the results suggested an appreciation of the danger associated with long-distance driving and driver sleepiness. Further efforts are required to improve the community's awareness of the impairing effects from sleepiness and, in particular, knowledge regarding the human circadian rhythm and the increased sleep propensity during the circadian nadir.     

Assessment of patients' medical fitness to drive by primary care physicians: A cross-sectional study

Objectives: Motor vehicle collisions (MVCs) are a significant health burden in Saudi Arabia. The literature has consistently indicated that chronic medical conditions, such as diabetes, heart disease, stroke, obstructive sleep apnea, and neurodevelopmental disorders, increase the risk of MVCs. Therefore, assessment of driver fitness by primary care physicians (PCPs) remains a major health intervention that might reduce MVCs. We studied the practices of PCPs in assessing medical fitness to drive in at-risk patients.

Methods: We conducted a cross-sectional study of all 88 government-funded primary care centers in the city of Riyadh, Saudi Arabia. We administered a self-reported questionnaire to PCPs that inquired about their driving risk assessment for specific medical conditions.

Results: Among all PCPs and centers, 189 PCPs (63%) from 74 centers (84%) participated in our survey. The mean age of the PCPs was 40 ± 10 years, and 108 (57%) were men. The average clinical experience of the group was 13 ± 9 years. Fewer than half of PCPs considered diabetes mellitus (45%) and obstructive sleep apnea (46%) as potential risks for MVCs. Approximately 45% of PCPs did not notify any authority or relatives of potential driving issues that they noticed in their patients. Only 15% of the participants believed that PCPs were responsible for alerting authorities about their fitness to drive.

Conclusions: PCPs did not adequately assess their patients' driving history and eligibility. Efforts are needed to improve awareness among PCPs regarding the effects of chronic medical conditions on driving.     

Medical investigation after a motorcoach strikes the rear of a tractor semitrailer parked on the highway; 13 fatal

Abstract

Objective: The objective of this study was to examine the medical conditions of 2 commercial drivers and the effects of physical barriers to occupant egress in a crash involving a tractor trailer and a motorcoach in order to assess and identify the factors that caused the crash and had a significant effect on occupant extrication.

Methods: Physical evidence from the scene, video evidence, commercial driver information, phone records, toxicology findings, autopsy results, and personal medical information were reviewed.

Results: On October 23, 2016, at 5:16 a.m., a motorcoach carrying a driver and 42 passengers struck the rear of a stopped semitrailer occupied by its driver in the center-right lane of Interstate 10 at highway speed outside Palm Springs, California. The motorcoach driver and 12 passengers died; 11 passengers were seriously injured.

All traffic had been stopped on I-10 early that morning to allow electrical lines to be strung over the highway. Security camera footage showed that the truck arrived at the end of a traffic queue 2?min before traffic flow resumed. Physical evidence indicated that the truck’s parking brake was still engaged at the time of the collision about 2?min later. The truck driver had a body mass index (BMI) between 45.6 and 50?kg/m², which placed him at very high risk of moderate to severe obstructive sleep apnea; he also inaccurately recalled that he had been stopped for 20–25?min and had placed the vehicle in gear just before the collision.

The motorcoach driver was on the return leg of an overnight trip to a casino. Based on his phone records, known driving time, and security camera footage, at the time of the collision he had had 4?h of sleep opportunity in the preceding 35?h. There was no evidence that the motorcoach driver attempted any evasive action before the collision. In addition, postmortem testing revealed a hemoglobin A1C of 11.4%, indicating poorly controlled diabetes; this was apparently undiagnosed prior to the crash.

The motorcoach was equipped with a single loading door at the front of the vehicle; it was rendered inoperable by the collision. Emergency egress was initially carried out through the emergency exit windows, but they repeatedly swung shut, impeding passengers’ efforts to exit. Emergency responders eventually cut open the bus wall to create a larger means of egress. Overall, it took almost 3?h to extricate the occupants from the vehicle.

Conclusions: The National Transportation Safety Board (NTSB) determined that the probable cause of the accident was the truck driver’s falling asleep, most likely due to undiagnosed moderate-to-severe obstructive sleep apnea, and the motorcoach driver’s failure to identify the stopped truck as a hazard requiring evasive action, most likely as the result of fatigue. Additional easy-to-use emergency exits would have decreased the time to extricate the occupants.     

The prevalence of seatbelt and mobile phone use among drivers in Riyadh,Saudi Arabia: An observational study

IntroductionRoad traffic injuries (RTIs) are the third leading cause of death in Saudi Arabia. Numerous factors may increase the likelihood of RTIs. The prevalence of risk factors associated with RTIs may vary due to several reasons. Because little is known about these risk factors locally, we examined the prevalence of mobile phone and seatbelt use and their association with spatial locations.MethodsThis is an observational study conducted at major highways and inner intersections throughout Riyadh, the country's capital. Two observers captured seatbelt and mobile phone use among drivers. Logistic regression models were constructed to examine the association between real estate prices and mobile phone or seatbelt use. Observations were categorized as taken place in an affluent neighborhood if the average price per square meter was above 2500 Saudi Riyal.ResultsA total of 1700 drivers were observed in 13 sites citywide. 13.8% of drivers were seen using mobile while driving and only a third of drivers (34%) were wearing seatbelts. Being at an affluent neighborhood was associated with close to three times higher odds of wearing seatbelts (OR = 2.7, 95% CI = 1.9–3.7) and also associated with 42% lower odds of mobile phone use among drivers (OR = 0.58, 95% CI = 0.36–0.92).DiscussionThis study found a high prevalence of traffic violations among drivers in Riyadh. Based on our estimate, 660,000 drivers are roaming the street during daytime while using their phones and they are less likely to wear seatbelts. Unfortunately, this estimate might contribute to increasing RTIs. Despite existing regulations, seatbelt use among drivers is significantly lower than in developed countries (i.e. USA 94%).ConclusionOur study found a high prevalence of traffic violations represented by lack of compliance with seatbelt and mobile phone use laws. These findings provide a basis for their underlying prevalence in SA. Practical applications: Public health prevention programs may use these findings to facilitate support to increasing investment in awareness campaigns and further enforcement by the traffic police to reduce RITs and improve population health.     

A pre/post evaluation of fatigue,stress and vigilance amongst commercially licensed truck drivers performing a prolonged driving task

Purpose. The main purpose of this research study was to evaluate changes in fatigue, stress and vigilance amongst commercially licensed truck drivers involved in a prolonged driving task. The secondary purpose was to determine whether a new ergonomic seat could help reduce both physical and cognitive fatigue during a prolonged driving task. Two different truck seats were evaluated: an industrial standard seat and a new truck seat prototype. Methods. Twenty male truck drivers were recruited to attend two testing sessions, on two separate days, with each session randomized for seat design. During each session, participants performed two 10-min simulated driving tasks. Between simulated sessions, participants drove a long-haul truck for 90 min. Fatigue and stress were quantified using a series of questionnaires whereas vigilance was measured using a standardized computer test. Results. Seat interactions had a significant effect on fatigue patterns. Conclusion. The new ergonomic seat design holds potential in improving road safety and vehicle accidents due to fatigue-related accidents.     

Child passengers and driver culpability in fatal crashes by driver gender

Objective: Studies based on accident statistics generally suggest that the presence of a passenger reduces adult drivers' accident risk. However, passengers have been reported to be a source of distraction in a remarkable portion of distraction-related crashes. Although the effect of passengers on driving performance has been studied extensively, few studies have focused on how a child passenger affects the driver.

?A child in a car is a potential distractor for parents, especially for mothers of small children, who often suffer from sleep deficit. The aim of this study was to examine how the presence of child passengers of different ages is associated with a higher driver culpability, which was expected due to child-related distraction and fatigue.

Methods: The analysis was based on the comprehensive data of fatal crashes studied in-depth by multidisciplinary road accident investigation teams in Finland during 1988–2012. Teams determine the primary party who had the most crucial effect on the origin of the event. We define the primary party as culpable and the others involved as nonculpable drivers. The culpability rate was defined as the percentage of culpable drivers and rates were compared for drivers with a child/teen passenger aged 0–17 years (N = 348), with an adult passenger without children (N = 324), and when driving alone (N = 579), grouped by child age and driver gender.

?Drivers with specific risk-related behavior (substantial speeding, driving when intoxicated, unbelted, or without a license) were excluded from the analyses, in order to make the drivers with and without children comparable. Only drivers 26–47 years old were included, representing parents with children 0–9 years of age.

Results: Male drivers were less often culpable with 0- to 17-year-old passengers in the car than alone or with adults. This was not the case with female drivers. The gender difference in culpability was most marked with small children age 0–4 years. Female drivers' culpability rate with a 0- to 4-year-old child passenger was higher and male drivers' culpability rate was lower compared to drivers without passengers or with only adult passengers.

Conclusion: The results indicate that female drivers are at higher risk of crashes than male drivers when driving with small children. Further research is needed to replicate this finding and to determine causal mechanisms.     

Perceived stress,mental health,organizational factors,and self-reported risky driving behaviors among truck drivers circulating in France

Introduction: The growth of the European market for road-freight transport has recently led to important changes. The growing number of foreign pavilion drivers transiting in France, which plays a bridging role among European countries, has influenced the lives of truck drivers by increasing competition, pressure on day-to-day activities, and constraints related to delivery deadlines. Adding this new pressure to those inherent in the road-freight transport sector has raised concerns, especially ones linked to levels of perceived stress by truck drivers. Method: With safety concerns in mind, we devised a questionnaire aimed at understanding how French truck drivers and non-French truck drivers, passing through four highway rest areas in France perceive stress, organizational factors, mental health, and risky driving behaviors. A sample of 515 truck drivers took part in the survey (260 French nationals), 97.9% of whom were male. Results: The results of a structural equation model indicated that perceived stress can increase self-reported risky driving behaviors among truck drivers. Furthermore, organizational factors and mental health were closely linked to perceived stress. Finally, some differences were found between French and non-French truck drivers with respect to mind-wandering and mental health, and to perceive driving difficulties to overcome and driving skills. Practical Applications: Several recommendations based on the findings are provided to policymakers and organizations.     

Marijuana use and driving in Washington State: Risk perceptions and behaviors before and after implementation of retail sales

Objective: Washington is among the first states to legalize recreational use of marijuana. This study examined marijuana use and risk perceptions before and after retail sales of recreational marijuana began in July 2014, the relationship between risk perceptions and marijuana use, and the relationship between self-reported marijuana use and drug test results.

Methods: Roadside surveys were conducted in 3 waves: June 2014, the month before retail sales of marijuana began; 5–6 months later (November–December 2014); and 1 year later (June 2015). A total of 2,355 drivers completed a marijuana questionnaire about their past and current marijuana use and perceived risks associated with driving after using marijuana. Data collection also included biological specimens (oral fluid and/or blood for marijuana testing and breath for alcohol testing). Drivers who tested positive for delta-9-tetrahydrocannabinol or 11-hydroxy-delta-9-tetrahydrocannabinol in oral fluid or blood were defined as THC-positive.

Results: The proportion of drivers who reported recent marijuana use was similar across the 3 surveys. However, the proportion of THC-positive daytime drivers increased from 8% before retail sales to 23% 6 months after retail sales; this proportion did not change among nighttime drivers (19 and 20%). Drivers’ perceived risk of impairment by marijuana and perceived risk of being arrested for marijuana-impaired driving were similar before and after retail sales. The odds of being THC-positive were 40% lower among drivers who perceived that marijuana was very likely to impair driving, compared to other drivers. Drivers’ perceived risk of being arrested for marijuana-impaired driving was not predictive of THC-positive driving.

Conclusions: The prevalence of daytime THC-positive drivers increased substantially a few months after retail sales of marijuana were legal. Daytime and nighttime prevalence of THC-positive drivers was similar after retail sales. This pattern differs from that typically found for alcohol use, which is consistently higher among drivers at nighttime, compared to daytime. Reports of marijuana use were not always consistent with drug test results, which suggests that comparisons of self-reported marijuana use before and after legalization could be biased. This study examined marijuana use and risk perceptions over the course of 1 year. However, law changes may influence cultural norms gradually over a longer period of time. Future studies should continue to monitor marijuana use over time, as well as identify ways to determine whether drivers are impaired by marijuana.     

Slow eyelid closure as a measure of driver drowsiness and its relationship to performance

Objective: Slow eyelid closure is recognized as an indicator of sleepiness in sleep-deprived individuals, although automated ocular devices are not well validated. This study aimed to determine whether changes in eyelid closure are evident following acute sleep deprivation as assessed by an automated device and how ocular parameters relate to performance after sleep deprivation.

Methods: Twelve healthy professional drivers (45.58 ± 10.93 years) completed 2 randomized sessions: After a normal night of sleep and after 24 h of total sleep deprivation. Slow eye closure (PERCLOS) was measured while drivers performed a simulated driving task.

Results: Following sleep deprivation, drivers displayed significantly more eyelid closure (P < .05), greater variation in lane position (P < .01) and more attentional lapses (P < .05) compared to after normal sleep. PERCLOS was moderately associated with variability in both vigilance performance (r = 0.68, P < .05) and variation in lane position on the driving task (r = 0.61, P < .05).

Conclusions: Automated ocular measurement appears to be an effective means of detecting impairment due to sleep loss in the laboratory.     

The use and safety of medications known to affect driving in Jordan: A cross-sectional study

Objectives: The aim of this study was to estimate the main driving-impairing medications used by drivers in Jordan, the reported frequency of medication side effects, the frequency of motor vehicle crashes (MVCs) while using driving-impairing medicines, as well as factors associated with MVCs.

Methods: A cross-sectional study involving 1,049 individuals (age 18–75 years) who are actively driving vehicles and taking at least one medication known to affect driving (anxiolytics, antidepressants, hypnotics, antiepileptics, opioids, sedating antihistamines, hypoglycemic agents, antihypertensives, central nervous system [CNS] stimulants, and herbals with CNS-related effects) was conducted in Amman, Jordan, over a period of 8 months (September 2013–May 2014) using a structured validated questionnaire.

Results: Sixty-three percent of participants noticed a link between a medicine taken and feeling sleepy and 57% stated that they experience at least one adverse effect other than sleepiness from their medication. About 22% of the participants reported having a MVC while on medication. Multiple logistic regression analysis showed that among the participants who reported having a crash while taking a driving-impairing medication, the odds ratios were significantly higher for the use of inhalant substance (odds ratio [OR] = 2.787, P = .014), having chronic conditions (OR = 1.869, P = .001), and use of antiepileptic medications (OR = 2.348, P = .008) and significantly lower for the use of antihypertensives (OR = 0.533, P = .008).

Conclusion: The study results show high prevalence of adverse effects of medications with potential for driving impairment, including involvement in MVCs. Our findings highlight the types of patient-related and medication-related factors associated with MVCs in Jordan, such as inhalant use, presence of chronic conditions, and use of antiepileptics.     

Factors associated with driving under the influence of alcohol

Objective: This study examined the risk factors of driving under the influence of alcohol (DUI) among drivers of specific vehicle categories (DSC). On the basis of this research, the variables related to DUI and involvement in traffic crashes were defined. The analysis was conducted for car drivers, bicyclists, motorcyclists, bus drivers, and truck drivers.

Method: The research sample included drivers involved in traffic crashes on the territory of Serbia in 2016 (60,666). Two types of analyses were conducted in this study. Logistic regression established the correlation between DUI and DSC and the The Technique for Order of Preference by Similarity to Ideal Solution (Multi-criteria decision making) method was applied to consider the scoring and explore the potential for the prevalence of DUI on the basis of 2 data sets (DUI and non DUI).

Results: The study results showed that driver error and male drivers were the 2 most significant risk factors for DUI, with the highest scores and potential for prevalence. The nonuse of restraint systems, driver experience, and driver age are the factors with a significant prediction of involvement in an accident and an insignificant prediction of DUI.

Conclusions: Following the development of the logistic prediction models for DUI drivers, testing of the model was conducted for 3 control driver groups: Car, motorcycle, and bicycle. The prediction model with a probability greater than 50% showed that 77% of car drivers were under the influence of alcohol. Similarly, the prediction percentage for motorcyclists and bicyclists amounted to 71 and 67%, respectively. The recommendation of the study is that drivers whose DUI probability is above 50% should be potentially suspected of DUI. The results of this study can help to understand the problem of DUI among specific driver categories and detect DUI drivers, with the aim of creating successful traffic safety policy.     

Prevalence of alcohol-impaired driving and riding in northern Ghana

Objective: The objective of this study was to determine the roadside prevalence of alcohol-impaired driving among drivers and riders in northern Ghana. The study also verifies motorists' perceptions of their own alcohol use and knowledge of the legal blood alcohol concentration (BAC) limit in Ghana.

Method: With the assistance of police, systematic random sampling was used to collect data at roadblocks using a cross-sectional study design. Breathalyzers were used to screen whether motorists had detectable alcohol in their breath and follow-up breath tests were conducted to measure the actual breath alcohol levels among positive participants.

Results: In all, 9.7% of the 789 participants had detectable alcohol, among whom 6% exceeded the legal BAC limit of 0.08%. The prevalence of alcohol-impaired driving/riding was highest among cyclists (10% of all cyclists breath-tested) followed by truck drivers (9%) and motorcyclists (7% of all motorcyclists breath-tested). The occurrence of a positive BAC among cyclists was about 8 times higher (odds ratio [OR] = 7.73; P < .001) and it was 2 times higher among motorcyclists (OR = 2.30; P = .039) compared to private car drivers. The likelihood for detecting a positive BAC among male motorists/riders was higher than that among females (OR = 1.67; P = .354). The odds for detecting a positive BAC among weekend motorists/riders was significantly higher than on weekdays (OR = 2.62; P = .001).

Conclusion: Alcohol-impaired driving/riding in Ghana is high by international standards. In order to attenuate the harmful effects of alcohol misuse such as alcohol-impaired driving/riding, there is the need to educate road users about how much alcohol they can consume and stay below the legal limit. The police should also initiate random breath testing to instill the deterrence of detection, certainty of apprehension and punishment, and severity and celerity of punishment among drink-driving motorists and riders.     

Risk factors associated with truck-involved fatal crash severity: Analyzing their impact for different groups of truck drivers

Introduction: Fatal crashes that include at least one fatality of an occupant within 30 days of the crash cause large numbers of injured persons and property losses, especially when a truck is involved. Method: To better understand the underlying effects of truck-driver-related characteristics in fatal crashes, a five-year (from 2012 to 2016) dataset from the Fatality Analysis Reporting System (FARS) was used for analysis. Based on demographic attributes, driving violation behavior, crash histories, and conviction records of truck drivers, a latent class clustering analysis was applied to classify truck drivers into three groups, namely, ‘‘middle-aged and elderly drivers with low risk of driving violations and high historical crash records,” ‘‘drivers with high risk of driving violations and high historical crash records,” and ‘‘middle-aged drivers with no driving violations and conviction records.” Next, equivalent fatalities were used to scale fatal crash severities into three levels. Subsequently, a partial proportional odds (PPO) model for each driver group was developed to identify the risk factors associated with the crash severity. Results' Conclusions: The model estimation results showed that the risk factors, as well as their impacts on different driver groups, were different. Adverse weather conditions, rural areas, curved alignments, tractor-trailer units, heavier weights and various collision manners were significantly associated with the crash severities in all driver groups, whereas driving violation behaviors such as driving under the influence of alcohol or drugs, fatigue, or carelessness were significantly associated with the high-risk group only, and fewer risk factors and minor marginal effects were identified for the low-risk groups. Practical Applications: Corresponding countermeasures for specific truck driver groups are proposed. And drivers with high risk of driving violations and high historical crash records should be more concerned.     

Aggressive driving behaviour in young drivers (aged 16 through 25) involved in fatal crashes

IntroductionWe wished to determine the extent to which number of passengers, driver age, and sex were associated with aggressive driving actions (ADAs) in young drivers involved in a fatal crash.MethodsWe used U.S. fatal-crash data from Fatality Analysis Reporting System (FARS), 1991 –2008. Proxy measures of aggressive driving included ADA presence and speed differential (posted speed limit minus estimated travel speed). We examined the odds of an ADA and speed differential in young drivers (aged 16 to 25) by passenger status.ResultsCompared to driving alone young drivers (aged 16) had increased odds of an ADA between 14% (OR: 1.14; 95% CI: 1.07; 1.22) and 95% (OR: 1.95; 95% CI: 1.40; 2.74) when accompanied by one and five passengers, respectively. Further, carrying a higher number of passengers was a stronger predictor of speeding in younger drivers.ConclusionsThis study supports the use of graduated licensing approaches. Specifically, developing interventions to reduce aggressive driving appear imperative.Impact on IndustryWhile the results of our study support the use of graduated licensing approaches there is room for improvement. Our study indicates that tackling impaired driving is not sufficient to drastically reduce aggressive driving among the youngest drivers. Further research on young drivers is required to understand the influence of peers and the role of gender on driving behavior. Strategies to reduce aggressive driving behaviors among the youngest drivers may not only prevent crashes during their early driving careers but may also translate into a reduced crash risk over their lifetime.     

Ticketing aggressive cars and trucks (TACT): How does it work on city streets?

Objective: The purpose of this study was to determine the feasibility of modifying the Ticking Aggressive Cars and Trucks (TACT) program, originally designed to work on state highways, within a metropolitan area to reduce unsafe interactions and their related crashes between drivers of large trucks and passenger vehicles.

Methods: Using crash data, the driving behaviors most commonly associated with large truck and passenger vehicle crashes were identified. A public awareness campaign using media messaging and increased law enforcement was created targeting these associated behaviors. The frequency of these behaviors both before and after the public awareness campaign was determined through observation of traffic at 3 specific locations within the city. Each location had a sufficient volume of large truck and passenger traffic to observe frequent interactions. Pre- and postintervention data were compared using negative binomial regression with generalized estimating equations to evaluate whether the campaign was associated with a reduction in the identified driving behaviors.

Results: A comparison between crash data from before, during, and after the campaign and crashes during the same time periods in previous years did not show a significant difference (P =.081). The number of large trucks observed in traffic remained the same during pre- and postintervention periods (P =.625). The rates of negative interactions per 100 large trucks decreased for both large trucks and passenger vehicles after the intervention, with calculated rate ratios of 0.58 (95% confidence interval [CI], 0.48, 0.70) and 0.31 (95% CI, 0.20, 0.47). The greatest reduction was seen in passenger vehicles following too close, with a rate ratio of 0.21 (95% CI, 0.15, 0.30).

Conclusions: Although designed for reducing crashes on highways, the TACT program can be an effective approach for improving driver behaviors on city streets.     

Classification of driving workload affected by highway alignment conditions based on classification and regression tree algorithm

Objective: Guaranteeing a safe and comfortable driving workload can contribute to reducing traffic injuries. In order to provide safe and comfortable threshold values, this study attempted to classify driving workload from the aspects of human factors mainly affected by highway geometric conditions and to determine the thresholds of different workload classifications. This article stated a hypothesis that the values of driver workload change within a certain range.

Methods: Driving workload scales were stated based on a comprehensive literature review. Through comparative analysis of different psychophysiological measures, heart rate variability (HRV) was chosen as the representative measure for quantifying driving workload by field experiments. Seventy-two participants (36 car drivers and 36 large truck drivers) and 6 highways with different geometric designs were selected to conduct field experiments. A wearable wireless dynamic multiparameter physiological detector (KF-2) was employed to detect physiological data that were simultaneously correlated to the speed changes recorded by a Global Positioning System (GPS) (testing time, driving speeds, running track, and distance). Through performing statistical analyses, including the distribution of HRV during the flat, straight segments and P-P plots of modified HRV, a driving workload calculation model was proposed. Integrating driving workload scales with values, the threshold of each scale of driving workload was determined by classification and regression tree (CART) algorithms.

Results: The driving workload calculation model was suitable for driving speeds in the range of 40 to 120 km/h. The experimental data of 72 participants revealed that driving workload had a significant effect on modified HRV, revealing a change in driving speed. When the driving speed was between 100 and 120 km/h, drivers showed an apparent increase in the corresponding modified HRV. The threshold value of the normal driving workload K was between ?0.0011 and 0.056 for a car driver and between ?0.00086 and 0.067 for a truck driver.

Conclusion: Heart rate variability was a direct and effective index for measuring driving workload despite being affected by multiple highway alignment elements. The driving workload model and the thresholds of driving workload classifications can be used to evaluate the quality of highway geometric design. A higher quality of highway geometric design could keep driving workload within a safer and more comfortable range. This study provided insight into reducing traffic injuries from the perspective of disciplinary integration of highway engineering and human factor engineering.