“They’re lunatics on the road”: Exploring the normative influences of parents,friends, and police on young novices’ risky driving decisions

PurposeYoung novice drivers experience significantly greater risk of being injured or killed in car crashes than older more experienced drivers. This research utilised a qualitative approach guided by the framework of Akers’ social learning theory. It explored young novice drivers’ perspectives on risky driving including rewards and punishments expected from and administered by parents, friends, and police, imitation of parents’ and friends’ driving, and advantages and disadvantages of risky driving.MethodsTwenty-one young drivers (12 females, 9 males) aged 16–25 years (M = 17.71 years, SD = 2.15) with a Learner (n = 11) or Provisional (n = 10) driver licence participated in individual or small group interviews.Findings and conclusionsContent analysis supported four themes: (1) rewards and (2) punishments for risky driving, and the influence of (3) parents and (4) friends. The young novice drivers differed in their vulnerability to the negative influences of friends and parents, with some novices advising they were able to resist risky normative influences whilst others felt they could not. The authority of the police as enforcers of road rules was either accepted and respected or seen as being used to persecute young novices. These findings suggest that road safety interventions should consider the normative influence of parents and friends on the risky and safe behaviour of young novices. Police were also seen as influential upon behaviour. Future research should explore the complicated relationship between parents, friends, the police, young novices, and their risky driving behaviour.     

Evaluation of an in-vehicle monitoring system (IVMS) to reduce risky driving behaviors in commercial drivers: Comparison of in-cab warning lights and supervisory coaching with videos of driving behavior

ProblemRoadway incidents are the leading cause of work-related death in the United States.MethodsThe objective of this research was to evaluate whether two types of feedback from a commercially available in-vehicle monitoring system (IVMS) would reduce the incidence of risky driving behaviors in drivers from two companies. IVMS were installed in 315 vehicles representing the industries of local truck transportation and oil and gas support operations, and data were collected over an approximate two-year period in intervention and control groups. In one period, intervention group drivers were given feedback from in-cab warning lights from an IVMS that indicated occurrence of harsh vehicle maneuvers. In another period, intervention group drivers viewed video recordings of their risky driving behaviors with supervisors, and were coached by supervisors on safe driving practices.ResultsRisky driving behaviors declined significantly more during the period with coaching plus instant feedback with lights in comparison to the period with lights-only feedback (ORadj = 0.61 95% CI 0.43–0.86; Holm-adjusted p = 0.035) and the control group (ORadj = 0.52 95% CI 0.33–0.82; Holm-adjusted p = 0.032). Lights-only feedback was not found to be significantly different than the control group's decline from baseline (ORadj = 0.86 95% CI 0.51–1.43; Holm-adjusted p > 0.05).ConclusionsThe largest decline in the rate of risky driving behaviors occurred when feedback included both supervisory coaching and lights.Practical applicationsSupervisory coaching is an effective form of feedback to improve driving habits in the workplace. The potential advantages and limitations of this IVMS-based intervention program are discussed.     

Effects of lead time of verbal collision warning messages on driving behavior in connected vehicle settings

IntroductionUnder the connected vehicle environment, vehicles will be able to exchange traffic information with roadway infrastructure and other vehicles. With such information, collision warning systems (CWSs) will be able to warn drivers with potentially hazardous situations within or out of sight and reduce collision accidents. The lead time of warning messages is a crucial factor in determining the effectiveness of CWSs in the prevention of traffic accidents. Accordingly, it is necessary to understand the effects of lead time on driving behaviors and explore the optimal lead time in various collision scenarios.MethodsThe present driving simulator experiment studied the effects of controlled lead time at 16 levels (predetermined time headway from the subject vehicle to the collision location when the warning message broadcasted to a driver) on driving behaviors in various collision scenarios.ResultsMaximum effectiveness of warning messages was achieved when the controlled lead time was within the range of 5 s to 8 s. Specifically, the controlled lead time ranging from 4 s to 8 s led to the optimal safety benefit; and the controlled lead time ranging from 5 s to 8 s led to more gradual braking and shorter reaction time. Furthermore, a trapezoidal distribution of warning effectiveness was found by building a statistic model using curve estimation considering lead time, lifetime driving experience, and driving speed.ConclusionsThe results indicated that the controlled lead time significantly affected driver performance.Practical applicationsThe findings have implications for the design of collision warning systems.     

Identifying compensatory driving behavior among older adults using the situational avoidance questionnaire

IntroductionDriving self-regulation is considered a means through which older drivers can compensate for perceived declines in driving skill or more general feelings of discomfort on the road. One form of driving self-regulation is situational avoidance, the purposeful avoidance of situations perceived as challenging or potentially hazardous. This study aimed to validate the Situational Avoidance Questionnaire (SAQ, Davis, Conlon, Ownsworth, & Morrissey, 2016) and identify the point on the scale at which drivers practicing compensatory avoidance behavior could be distinguished from those whose driving is unrestricted, or who are avoiding situations for other, non-compensatory reasons (e.g., time or convenience).MethodSeventy-nine Australian drivers (M_age = 71.48, SD = 7.16, range: 55 to 86 years) completed the SAQ and were classified as a compensatory-restricted or a non-restricted driver based on a semi-structured interview designed to assess the motivations underlying avoidance behavior reported on the SAQ.ResultsUsing receiver-operator characteristic (ROC) analysis, the SAQ was found to have high diagnostic accuracy (sensitivity: 85%, specificity: 82%) in correctly classifying the driver groups. Group comparisons confirmed that compensatory-restricted drivers were self-regulating their driving behavior to reduce the perceived demands of the driving task. This group had, on average, slower hazard perception reaction times, and reported greater difficulty with driving, more discomfort when driving due to difficulty with hazard perception skills, and greater changes in cognition over the past five years.ConclusionsThe SAQ is a psychometrically sound measure of situational avoidance for drivers in baby boomer and older adult generations.Practical applicationsUse of validated measures of driving self-regulation that distinguish between compensatory and non-compensatory behavior, such as the SAQ, will advance our understanding of the driving self-regulation construct and its potential safety benefits for older road users.     

Distracting behaviors among teenagers and young,middle-aged,and older adult drivers when driving without and with warnings from an integrated vehicle safety system

IntroductionNegative reinforcement from crash warnings may reduce the likelihood that drivers engage in distracted driving. Alternatively, drivers may compensate for the perceived safety benefit of crash warnings by engaging in distractions more frequently, especially at higher speeds. The purpose of this study was to examine whether warning feedback from an integrated vehicle-based safety system affected the likelihood that various secondary behaviors were present among drivers ages 16–17, 20–30, 40–50, and 60–70.MethodParticipants drove an instrumented sedan with various collision warning systems for an extended period. Ten 5-second video clips were randomly sampled from driving periods at speeds above 25 mph and below 5 mph each week for each driver and coded for the presence of 11 secondary behaviors.ResultsAt least one secondary behavior was present in 46% of video clips; conversing with a passenger (17%), personal grooming (9%), and cellphone conversation (6%) were the most common. The likelihood that at least one secondary behavior was present was not significantly different during periods when drivers received warnings relative to periods without warnings. At least one secondary behavior was 21% more likely to be present at speeds below 5 mph relative to speeds above 25 mph; however, the effect of vehicle speed was not significantly affected by warning presence. Separate models for each of the five most common secondary behaviors also indicated that warnings had no significant effect on the likelihood that each behavior was present.ConclusionsCollision warnings were not associated with significant increases or decreases in the overall likelihood that teen and adult drivers engaged in secondary behaviors or the likelihood of the behaviors at speeds above 25 mph or below 5 mph.Practical applicationsThere was no evidence that forward collision warning and other technologies like those in this study will increase or decrease distracted driving.     

Driver speed selection and crash risk: Insights from the naturalistic driving study

IntroductionThis study investigates how speed limits affect driver speed selection, as well as the related crash risk, while controlling for various confounding factors such as traffic volumes and roadway geometry. Data from a naturalistic driving study are used to examine how driver speed selection varies among freeways with different posted speed limits, as well as how the likelihood of crash/near-crash events change with respect to mean speed and standard deviation.MethodRegression models are estimated to assess three measures of interest: the average speed of vehicles during the time preceding crash/near-crash and baseline (i.e., normal) driving events; the variation in travel speeds leading up to each event as quantified by the standard deviation in speeds over this period; and the probability of a specific event resulting in a crash/near-crash based on speed selection and other factors.ResultsSpeeds were relatively stable across levels-of-service A and B, within a range of 1.5 mph on average. Speeds were marginally lower (3.3 mph) on freeways posted at 65 mph versus 70 mph. In comparison, speeds were approximately 10.2 to 13.4 mph lower on facilities posted at 55 mph or 60 mph. Speeds were shown to be 2.5 mph lower in rainy weather and 11 mph lower under snow or sleet.ConclusionsSignificant correlation was observed with respect to speed selection behavior among the same individuals. Mean speeds are shown to increase with speed limits. However, these increases are less pronounced at higher speed limits. Drivers tend to reduce their travel speeds in presence of junctions and work zones, under adverse weather conditions, and particularly under heavy congestion. Crash risk increased with the standard deviation in speed, as well as on vertical curves and ramp junctions, and among the youngest and oldest age groups of drivers.     

Dropout during a driving simulator study: A survival analysis

IntroductionSimulator sickness is the occurrence of motion-sickness like symptoms that can occur during use of simulators and virtual reality technologies. This study investigated individual factors that contributed to simulator sickness and dropout while using a desktop driving simulator.MethodEighty-eight older adult drivers (mean age 72.82 ± 5.42 years) attempted a practice drive and two test drives. Participants also completed a battery of cognitive and visual assessments, provided information on their health and driving habits, and reported their experience of simulator sickness symptoms throughout the study.ResultsFifty-two participants dropped out before completing the driving tasks. A time-dependent Cox Proportional Hazards model showed that female gender (HR = 2.02), prior motion sickness history (HR = 2.22), and Mini-SSQ score (HR = 1.55) were associated with dropout. There were no differences between dropouts and completers on any of the cognitive abilities tests.ConclusionsOlder adults are a high-risk group for simulator sickness. Within this group, female gender and prior motion sickness history are related to simulator dropout. Higher reported experience of symptoms of simulator sickness increased rates of dropout.Practical applicationsThe results highlight the importance of screening and monitoring of participants in driving simulation studies. Older adults, females, and those with a prior history of motion sickness may be especially at risk.     

Participation in driver education/training courses during graduated driver licensing,and the effect of a time-discount on subsequent traffic offenses: Findings from the New Zealand Drivers Study

IntroductionThe New Zealand GDL includes a time-discount at the restricted license stage, for attendance at an approved driver education course. This is despite international evidence showing that earlier licensure associated with a time-discount can increase risk for newly licensed drivers.ObjectiveTo examine participation in driver education courses and especially those that qualify for a time-discount; compare the profiles of course participants with non-participants; examine reasons for participation; and examine the association between a time-discount and traffic offenses once fully licensed.MethodThis study was based on the New Zealand Drivers Study (NZDS), a prospective cohort study of newly licensed drivers. Data on driver education courses were obtained at the full license interview (n = 1763), driver license and traffic offense data from the NZ Driver Licence Registry, and other data at the NZDS interviews.Results94% had heard of and 49% (n = 868) participated in a defensive driving course (DDC). No other course had more than 1% participation. Compared with the others, the DDC group were young, non-Māori, and from an area of relatively low deprivation. Through GDL, the DDC group were relatively more compliant with the conditions, and less likely to crash or receive a traffic offense notice. The groups did not differ on personality, alcohol and drug use. The reason most (85%) attended a DDC was to get their full license sooner; 86% (n = 748) received a time-discount. The time-discount group were 40% more likely to receive a traffic offense notice on their full license; this reduced to 10% after controlling for other factors.Conclusion and practical implicationsThe results of this study, when viewed in conjunction with other NZ crash evidence, indicate that a time-discount should not be given for completing a DDC or Street Talk course.     

Protective factors associated with young passenger intervening in risky driving situations

IntroductionWhile the negative influence of passengers on driving is usually studied, young passengers may protect against young drivers' crash involvement by speaking out and trying to stop unsafe driving behavior. This study sought to examine psychosocial constructs of young passengers who are likely to intervene in their friends' risky driving.MethodUniversity students aged 17 to 25 years who were single (n = 123) or in a romantic relationship (n = 130) completed an online survey measuring protective factors.ResultsThe combination of individual, friend and (for participants in a relationship) romantic partner protective factors predicted self-reported passenger intervening intentions.Impact on IndustrySince peer passengers often increase young drivers' crash risk, research on passenger intervening has significant implications for road safety strategies. The findings provide support for the operationalization of protective factors in strategies that target passenger intervening behavior.     

Young drivers' perceptions of culpability of sleep-deprived versus drinking drivers

Introduction: Sleep-deprived driving can be as dangerous as alcohol-impaired driving, however, little is known about attitudes toward sleep-deprived drivers. This study examined the extent to which young drivers regard sleep-deprived compared to drinking drivers as culpable for a crash, and how their perceptions of driving while in these conditions differ. Method: University student participants (N = 295; M = 20.4 years, SD = 1.3; 81% women) were randomly assigned to read one of five fatal motor-vehicle crash scenarios, which differed by aspects of the driver's condition. Culpability ratings for the drinking driver were higher than those for the sleep-deprived driver. Results: Qualitative findings revealed that driving while sleep-deprived was viewed as understandable, and driving after drinking was viewed as definitely wrong. The dangers of sleep-deprived driving remain under-recognized.     

Better effect of the use of a needle safety device in combination with an interactive workshop to prevent needle stick injuries

ObjectivesThis study compares the effectiveness of two types of interventions with no intervention on the prevention of needle stick injuries (NSIs).MethodsHealth care workers, who were at risk for NSIs, were eligible for this three-armed cluster randomized controlled trial. In total, 23 hospital wards were randomly assigned to 1 of 2 intervention groups, which were given either a needle safety device and a workshop (NW; 7 wards, n = 267) or a workshop only (W; 8 wards, n = 263), or to a control group (C; 8 wards, n = 266). The primary outcome was the half-year incidence of NSIs, which was measured through questionnaires and official notification at the occupational health service at baseline (T0), 6 months (T1) and 12 months (T2) after baseline. Analysis were done by intention to treat. This study is registered as a prospective randomized trial, number NTR1207.ResultsA statistically significant difference was found between the groups for the half-year incidence of NSIs (p = 0.046) on the basis of questionnaire data with ORs for reported NSIs for the NW group compared with the control group of 0.34 (95% CI: 0.13–0.91) and 0.45 (95% CI: 0.19–1.06) for the W group compared with the control group. The officially registered NSIs during the study period showed no statistical differences between the groups.ConclusionsThe combined intervention of the introduction of needle safety devices and an interactive workshop led to the highest reduction in the number of self-reported NSIs compared to a workshop alone or no intervention.     

Drivers' visual behavior when using handheld and hands-free cell phones

ObjectiveThis study investigated driver distraction and how the use of handheld (HH), portable hands-free (PHF), and integrated hands-free (IHF) cell phones affected the visual behavior of motor vehicle drivers.MethodA naturalistic driving study recorded 204 participating drivers using video cameras and vehicle sensors for an average of 31 days. A total of 1564 cell phone calls made and 844 text messages sent while driving were sampled and underwent a video review. Baselines were established by recording epochs prior to the cell phone interactions. Total eyes-off-road time (TEORT) was examined to assess the visual demands of cell phone subtasks while driving. Percent TEORT was reported and compared against the baseline.ResultsVisual-manual subtasks performed on HH, PHF, and IHF cell phones were found to significantly increase drivers' mean percent TEORT. In contrast, conversing on an HH cell phone was found to significantly decrease drivers' mean percent TEORT, indicating that drivers looked at the forward roadway more often. No significant differences in percent TEORT were found for drivers conversing using PHF or IHF cell phones. The mean TEORT durations for visual-manual subtasks performed on an HH cell phone were significantly longer than the mean TEORT durations on either IHF or PHF cell phones.Practical applicationsThis research helps to further reinforce the distinction made between handheld and hands-free cell phone use in transportation distraction policy.     

How do older adult drivers self-regulate? Characteristics of self-regulation classes defined by latent class analysis

ProblemMotor-vehicle crashes were the second leading cause of injury death for adults aged 65–84 years in 2014. Some older drivers choose to self-regulate their driving to maintain mobility while reducing driving risk, yet the process remains poorly understood.MethodsData from 729 older adults (aged ≥ 60 years) who joined an older adult ride service program between April 1, 2010 and November 8, 2013 were analyzed to define and describe classes of driving self-regulation. Latent class analysis was employed to characterize older adult driving self-regulation classes using driving frequency and avoidance of seven driving situations. Logistic regression was used to explore associations between characteristics affecting mobility and self-regulation class.ResultsThree classes were identified (low, medium, and high self-regulation). High self-regulating participants reported the highest proportion of always avoiding seven risky driving situations and the lowest driving frequency followed by medium and low self-regulators. Those who were female, aged 80 years or older, visually impaired, assistive device users, and those with special health needs were more likely to be high self-regulating compared with low self-regulating.Conclusions and practical applicationsAvoidance of certain driving situations and weekly driving frequency are valid indicators for describing driving self-regulation classes in older adults. Understanding the unique characteristics and mobility limitations of each class can guide optimal transportation strategies for older adults.     

Examining teen driver crashes and the prevalence of distraction: Recent trends, 2007–2015

IntroductionTeen drivers crash at a much higher rate than adult drivers, with distractions found as a factor in nearly 6 out of 10 moderate-to-severe teen crashes. As the driving environment continues to rapidly evolve, it is important to examine the effect these changes may be having on our youngest and most vulnerable drivers.MethodThe purpose of this study was to identify types of vehicle crashes teens are most frequently involved in, as well as the distracting activities being engaged in leading up to these crashes, with a focus on identifying changes or trends over time. We examined 2,229 naturalistic driving videos involving drivers ages 16–19. These videos captured crashes occurring between 2007 and 2015. The data of interest for this study included crash type, behaviors drivers engaged in leading up to the collision, total duration of time the driver's eyes were off the forward roadway, and duration of the longest glance away from forward.ResultsRear-end crashes increased significantly (annual % change = 3.23 [2.40–4.05]), corresponding with national data trends. Among cell phone related crashes, a significant shift occurred, from talking/listening to operating/looking (annual % change = 4.22 [1.15–7.29]). Among rear-end crashes, there was an increase in the time drivers' eyes were off the road (β = 0.1527, P = 0.0004) and durations of longest glances away (β = 0.1020, P = 0.0014).ConclusionsFindings suggest that shifts in the way cell phones are being used, from talking/listening to operating/looking, may be a cause of the increasing number of rear-end crashes for teen drivers.Practical applicationsUnderstanding the role that cell phone use plays in teen driver crashes is extremely important. Knowing how and when teens are engaging in this behavior is the only way effective technologies can be developed for mitigating these crashes.     

Conscientious personality and young drivers' crash risk

Introduction: Personality characteristics are associated with many risk behaviors. However, the relationship between personality traits, risky driving behavior, and crash risk is poorly understood. The purpose of this study was to examine the association between personality, risky driving behavior, and crashes and near-crashes, using naturalistic driving research methods. Method: Participants' driving exposure, kinematic risky driving (KRD), high-risk secondary task engagement, and the frequency of crashes and near-crashes (CNC) were assessed over the first 18 months of licensure using naturalistic driving methods. A personality survey (NEO-Five Factor Inventory) was administered at baseline. The association between personality characteristics, KRD rate, secondary task engagement rate, and CNC rate was estimated using a linear regression model. Mediation analysis was conducted to examine if participants' KRD rate or secondary task engagement rate mediated the relationship between personality and CNC. Data were collected as part of the Naturalistic Teen Driving Study. Results: Conscientiousness was marginally negatively associated with CNC (path c = − 0.034, p = .09) and both potential mediators KRD (path a = − 0.040, p = .09) and secondary task engagement while driving (path a = − 0.053, p = .03). KRD, but not secondary task engagement, was found to mediate (path b = 0.376, p = .02) the relationship between conscientiousness and CNC (path c′ = − 0.025, p = .20). Conclusions: Using objective measures of driving behavior and a widely used personality construct, these findings present a causal pathway through which personality and risky driving are associated with CNC. Specifically, more conscientious teenage drivers engaged in fewer risky driving maneuvers, and suffered fewer CNC. Practical Applications: Part of the variability in crash risk observed among newly licensed teenage drivers can be explained by personality. Parents and driving instructors may take teenage drivers' personality into account when providing guidance, and establishing norms and expectations about driving.     

Role of sensation seeking and attitudes as mediators between age of driver and risky driving of Powered Two Wheelers

IntroductionThis study examines the effect of age of driver on risky driving of Powered Two-Wheelers (PTW) employing sensation seeking and safety attitudes as mediators.MethodsA survey was conducted with 1299 PTW drivers (1089 males and 210 females) within the age of 18 and 63 years, living in the state of Kerala, India. The questionnaire consisted of 31 items to measure sensation seeking, safety attitude, and risky driving of the drivers.ResultsMediation models were examined using sensation seeking as mediator and secondly safety attitudes as mediators. The relationship between the driver's age and risky driving was fully mediated by all the three variables.Practical applicationsResults of this study suggest that safety strategies should be employed to reduce risky driving tendencies that could be achieved by shaping or adapting the mediators (reducing sensation seeking and enhancing safety attitudes). This goal could be reached by starting to educate children about this at an early stage when they are at school as well as by social learning and safety awareness campaigns.     

Naturalistic teenage driving study: Findings and lessons learned

IntroductionThis paper summarizes the findings on novice teenage driving outcomes (e.g., crashes and risky driving behaviors) from the Naturalistic Teenage Driving Study.MethodSurvey and driving data from a data acquisition system (global positioning system, accelerometers, cameras) were collected from 42 newly licensed teenage drivers and their parents during the first 18 months of teenage licensure; stress responsivity was also measured in teenagers.ResultOverall teenage crash and near-crash (CNC) rates declined over time, but were > 4 times higher among teenagers than adults. Contributing factors to teenage CNC rates included secondary task engagement (e.g., distraction), kinematic risky driving, low stress responsivity, and risky social norms.ConclusionsThe data support the contention that the high novice teenage CNC risk is due both to inexperience and risky driving behavior, particularly kinematic risky driving and secondary task engagement.Practical ApplicationsGraduated driver licensing policy and other prevention efforts should focus on kinematic risky driving, secondary task engagement, and risky social norms.     

The impact of the 2007 graduated driver licensing law in Massachusetts on the rate of citations and licensing in teenage drivers

ObjectiveWe recently demonstrated that the 2007 Massachusetts Graduated Driving Licensing (GDL) law decreased the rate of motor vehicle crashes in teenage drivers. To better understand this decrease, we sought to examine the law's impact on the issuance of driving licenses and traffic citations to teenage drivers.MethodsCitation and license data were obtained from the Massachusetts Department of Transportation. Census data were obtained from the Census Data Center. Two study periods were defined: pre-GDL (2002–2006) and post-GDL (2007–2012). Two populations were defined: the study population (aged 16–17) and the control population (aged 25–29). The rates of licenses per population were compared pre- vs. post-GDL for the study group. The numbers of total, state, and local citations per population were compared pre- vs. post-GDL for both populations. A sensitivity analysis was performed for the rates of citations using licenses issued as a denominator.ResultsWhile licenses per population obtained by the study group decreased over the entire period, there was no change in the rate of decrease per year pre- vs. post-GDL (2.0% vs. 1.4%; p = 0.6392). In the study population, total, state, and local citations decreased post-GDL (17.8% vs. 8.1%, p < 0.0001; 3.7% vs. 2.2%, p < 0.0001; 14.1% vs. 5.8%, p < 0.0001, respectively). In the control group, total and state citations did not change (26.7% vs. 23.9%, p = 0.3606; 9.2% vs. 10.2%, p = 0.3404, respectively), and local citations decreased (17.5% vs. 13.7%, p = 0.0389). The rates of decrease per year for total, state, and local citations were significantly greater in the study population compared with control (p < 0.0001, p = 0.0002, p < 0.0001, respectively).ConclusionsThe 2007 GDL law in Massachusetts was associated with fewer traffic citations without a change in the rate of licenses issued to teenagers. These findings suggest that 2007 GDL may be improving driving habits as opposed to motivating teenagers to delay the issuing of licenses.     

Workers' compensation loss prevention representative contact and risk of lost-time injury in construction policyholders

IntroductionInsurance loss prevention (LP) representatives have access and contact with businesses and employees to provide targeted safety and health resources. Construction firms, especially those smaller in size, are a high-risk population. This research evaluated the association between LP rep contact and risk for lost-time injuries in construction policyholders.MethodsWorkers' compensation data were utilized to track LP rep contact with policyholders and incidence of lost-time injury over time. Survival analysis with repeated events modeling calculated hazard ratios (HR) and 95% confidence intervals (CI).ResultsCompared no LP contact, one contact was associated with a 27% reduction of risk (HR = 0.73, CI = 0.65–0.82), two with a 41% (HR = 0.59, CI = 0.51–0.68), and three or more contacts with a 28% reduction of risk (HR = 0.72, CI = 0.65–0.81).ConclusionsLP reps appear to be a valuable partner in efforts to reduce injury burden. Their presence or contact with policyholders is consistent with reduction in overall incidence of lost-time injuries.Practical applicationsReduction in lost-time injuries, resulting in reduced workers' compensation costs for policyholders and insurance companies, builds a business-case for safety and injury prevention. LP reps are often a low or no-cost benefit for insurance policyholders and may be an important injury prevention resource for small firms and/or those with lack of safety resources and staff.