Suicide by crashing into a heavy vehicle: Focus on professional drivers using in-depth crash data

Objective: Road traffic suicides typically involve a passenger car driver crashing his or her vehicle into a heavy vehicle, because death is almost certain due to the large mass difference between these vehicles. For the same reason, heavy-vehicle drivers typically suffer minor injuries, if any, and have thus received little attention in the research literature. In this study, we focused on heavy-vehicle drivers who were involved as the second party in road suicides in Finland.

Methods: We analyzed 138 road suicides (2011–2016) involving a passenger car crashing into a heavy vehicle. We used in-depth road crash investigation data from the Finnish Crash Data Institute.

Results: The results showed that all but 2 crashes were head-on collisions. Almost 30% of truck drivers were injured, but only a few suffered serious injuries. More than a quarter reported sick leave following their crash. Injury insurance compensation to heavy-vehicle drivers was just above €9,000 on average. Material damage to heavy vehicles was significant, with average insurance compensation paid being €70,500. Three out of 4 truck drivers reported that drivers committing suicide acted abruptly and left them little opportunity for preventive action.

Conclusions: Suicides by crashing into heavy vehicles can have an impact on drivers’ well-being; however, it is difficult to see how heavy-vehicle drivers could avoid a suicide attempt involving their vehicle.     

Improving pedestrian safety using combined HOG and Haar partial detection in mobile systems

Objective: The objective of this study is to develop a novel algorithm on a mobile system that can warn drivers about the possibility of a collision with a pedestrian. The constraints of the algorithm are near-real-time detection speed and a good detection rate.

Method: Histogram of gradients (HOG)-based detection is widely used in pedestrian safety applications; however, it has low detection speed for real-time systems. Hence, it has no direct usage for mobile systems. In order to achieve near-real-time detection speed, partial Haar transform predetections are applied to an image before HOG detection. The partial and HOG detections are merged and a score-based confidence level is defined for the final detection phase. In this way, the outcome is prioritized and different warning levels can be issued to warn the driver before a possible pedestrian collision.

Results: The proposed algorithm provides an increase in detection speed (from 46 to 76 fps) and detection rate (from 80 to 91%) with respect to HOG-based pedestrian detection. It also improves confidence of the results by multidetection merging and score assignment to detections.

Conclusions: Performance improvement of the algorithm is compared with respect to state-of-the-art detectors/algorithms. Based on the detection rate and detection speed performance, it can be concluded that the proposed algorithm is suitable to be used for mobile systems to warn drivers about the possibility of collision with a pedestrian.     

Driving difficulties as reported by older drivers with mild cognitive impairment and without neurological impairment

Objective: Considerable evidence indicates that medical conditions prevalent among older individuals lead to impairments in visual, cognitive, or psychomotor functions needed to drive safely. The purpose of this study was to explore the factors determining driving difficulties as seen from the viewpoint of 30 older drivers with mild cognitive impairment (MCI) and 30 age-matched controls without cognitive impairment.

Methods: Perceptions of driving difficulties from both groups were examined using data from an extensive questionnaire. Samples of drivers diagnosed with MCI and age-matched controls were asked to report the frequency with which they experienced driving difficulties due to functional deficits and knowledge of new traffic rules and traffic signs.

Results: The analysis revealed that 2 factors underlie MCI perceptions of driving difficulties, representing (1) difficulties associated with late detection combined with slowed response to relevant targets in the peripheral field of view and (2) difficulties associated with divided attention between tasks requiring switching from automatic to conscious processing particularly of long duration. The analysis for healthy controls revealed 3 factors representing (1) difficulties in estimating speed and distance of approaching vehicles in complex (attention-dividing) high-information-load conditions; (2) difficulties in moving head, neck, and feet; and (3) difficulties in switching from automatic responses to needing to use cognitive processing in new or unexpected situations.

Conclusions: Though both group analyses show difficulties with switching from automatic to decision making, the difficulties are different. For the control group, the difficulty in switching involves switching in new or unexpected situations associated with high-information-load conditions, whereas this switching difficulty for the MCI group is associated with divided attention between easier tasks requiring switching. These findings underline the ability of older drivers (with MCI and without cognitive impairment) to indicate probable impairments in various driving skills. The patterns of difficulties perceived by the MCI group and the age-matched healthy control group are indicative of demanding driving situations that may merit special attention for road designers and road safety engineers. They may also be considered in the design of older drivers’ fitness to drive evaluations, training programs, and/or vehicle technologies that provide for older driver assistance.     

A simulator study of driving behavior and mental workload in mixed-use arterial road environments

Objectives: Mixed-use urban environments, such as arterial roads with adjacent commercial land uses, represent crash locations with the highest risk. These locations are often characterized by high volumes of motor vehicle traffic, on-street parking, and interactions with multiple road user groups such as pedestrians, cyclists, and public transportation. The objective of this study was to investigate previously identified crash risk factors for mixed-use urban environments and assess how parking occupancy, center medians, and cyclist volume influence performance and workload in a driving simulator study.

Methods: Thirty participants were recruited for the study. Participants completed 6 drives that presented different combinations of cyclist volume, median condition, and parking occupancy. Incorporated into the simulator drives was a secondary peripheral detection task (PDT) designed to measure mental workload. Participants provided subjective assessments of workload using the Rating Scale Mental Effort (RSME).

Results: Mean lateral lane position was found to significantly vary across the 3 independent variables of parking occupancy, cyclist volume, and median conditions. No significant changes were identified for mean speed across the conditions. Subjective and objective measures of workload identified changes due to the presence of cyclists with slower reaction times for the PDT task when cyclists were present.

Conclusion: The findings provide insight into the interaction of road design elements in mixed-use urban road environments and demonstrate that increasingly complex environments increase driver demand. This has important road design implications for mixed-use arterial roads, which are often characterized by complex interactions between multiple road user groups.     

Spatial analysis of mortality rate of pedestrian accidents in Iran during 2012–2013

Objectives: Considering the high mortality rate of pedestrians in traffic accidents in Iran, the present study aimed to determine the high-risk and low-risk areas of accidents resulting in pedestrian deaths and the spatial analysis of their mortality rates.

Methods: This cross-sectional study included 4,371 deceased pedestrians reported by the Legal Medicine Organization in Iran from March 2012 to March 2013. For spatial analysis, the collected data were entered into ArcGIS software version 10.2 and a spatial map of the mortality rate was drawn according to the distribution of data in the provinces. Using this software, high-risk and low-risk areas were identified by calculating the spatial autocorrelation of the data. The Moran’s index of road accident patterns was surveyed and high-risk and low-risk points were identified using the local Getis index.

Results: The age-standardized incidence rate was 6.8 per 100,000. After analyzing the data using ArcGIS software, the local Moran’s index showed a cluster pattern with a high mortality rate in 3 provinces of Mazandaran, Gilan, and Qazvin. In identifying high-risk and low-risk points, the local Getis index showed 3 hot spots with a confidence interval of 99% in Qom, Qazvin, and Mazandaran and 5 hot spots with a 95% confidence interval in Markazi, Tehran, Zanjan, Gilan, and Golestan provinces.

Conclusions: According to the cluster pattern of accidents in the 3 provinces and the presence of hot spots in 9 provinces, it is necessary to identify factors that increase the risk of death in the study provinces in order to reduce the mortality rate among pedestrians due to traffic accidents. Therefore, to reduce the pedestrian mortality rate, especially in high-risk provinces, some studies need to be conducted to determine the risk factors in pedestrian mortality.     

Trends and patterns in fatal US motorcycle crashes, 2000–2016

Objective: To investigate trends of motorcyclist fatalities and identify at-risk populations by motorcyclist demographics and crash characteristics.

Methods: We used the Fatality Analysis Reporting System (FARS) database (2000–2016) to track fatality rate trends, which were quantified by using Poisson mixed-effects regression models comparing 2000–2001 and 2007–2008, as well as 2009–2010 and 2015–2016.

Results: The overall fatality rate per 100,000 population increased from 2000 to 2016, defined by two trend lines—before and after the economic recession in 2008–2009. The overall fatality rate ratio between 2000–2001 and 2007–2008 was 1.60 [95% Confidence Interval (CI): 1.51–1.70], and between 2009–2010 and 2015–2016 was 1.09 (95% CI: 1.02–1.18). Fatality rates increased among all age groups, particularly for motorcyclists aged 60 and older. Those aged 18–29 had the highest fatality rates overall. Age-and-sex standardized state fatality rates were consistently highest in Wyoming, South Dakota, and South Carolina and lowest in Massachusetts, New York and New Jersey.

Conclusion: Motorcycle fatality rates increased overall and across all age groups between 2000 and 2016. Fatalities for the oldest riders showed the steadiest increasing trends. Results highlight the continued public health burden of motorcyclist fatalities and, by extension, the importance of improving motorcycle safety.     

Reliability and validity of the Multidimensional Driving Style Inventory in Chinese drivers

Objective: The Multidimensional Driving Style Inventory (MDSI) has been widely used in assessing the associations between driving styles and traffic violations and accidents in different cultural contexts. Due to the lack of a valid instrument to assess driving style, studies concerning driving style and its influence factors are limited in China. Thus, this study aimed to adapt and validate a Chinese version of the MDSI.

Methods: Seven hundred and sixty drivers aged from 19 to 60 years old were asked to complete the MDSI and a personality scale (trait anger, sensation seeking, altruism, and normlessness). Exploratory factory analysis (EFA) and confirmatory factor analysis (CFA) were used to obtain the factorial structure of the MDSI. The external validity of the MDSI was then evaluated by examining the associations between driving styles and personality traits, demographic variables, and traffic violations and crashes.

Results: EFA revealed a 6-factor structure of the MDSI (i.e., risky, anxious, angry, distress reduction, careful, and dissociative driving styles). CFA confirmed that the model fit of the MDSI was acceptable. The MDSI factors were moderately or weakly correlated with trait anger, sensation seeking, altruism, and normlessness. Significant gender and age differences in driving styles were found. Moreover, drivers who had traffic violations or crashes in the past year scored higher on risky and angry driving styles and lower on careful driving style than those who had not have traffic violations or crashes.

Conclusions: The Chinese version of the MDSI proved to be a reliable, valid, and highly useful instrument. It could be used to assess Chinese drivers who are at risk due to their maladaptive driving styles.     

Driving anger expression in Germany—Validation of the Driving Anger Expression Inventory for German drivers

Objective: The main objective of this article is to examine whether the Driving Anger Expression Inventory (DAX) applies to German drivers because this scale has previously been given to drivers in many different countries.

Methods: We applied German versions of the DAX, the Driving Anger Scale (DAS), and the State-Trait Anger Expression Inventory (STAXI) to a sample of 501 German drivers. We computed confirmatory factor analysis and principal axis factoring (PAF) analysis to examine the structure of driving anger expression in Germany. Finally, we related the drivers’ anger exp ression scores to their driving anger experiences and their general anger propensities to assess the validity of the DAX for German drivers.

Results: Results indicated that the DAX’s original factor structure does not apply to German drivers because the confirmatory factor analysis did not show a good model fit. An item analysis revealed that many DAX items had no meaningful variability. They were excluded from further analysis. The subsequent PAF analysis indicated that German drivers do not use personal physical aggression to express their driving anger. Instead, they reported unique preventive anger expression management behavior. In addition, their driving anger expressions were significantly related to their driving anger experiences and their general anger propensities indicated the validity of the refined DAX for German drivers.

Conclusions: We conclude that German drivers do not use strong behaviors to express their driving anger. Many statements of Deffenbacher et al.’s (Behav Res Ther. 40:717–737, 2002) original American questionnaire were not applicable for our sample of German drivers. These findings are in line with several other studies showing discrepancies in driving anger expression in various countries. Future investigations should examine the reasons for discrepancies in driving anger expression.     

Epidemiology of alcohol and drug screening among pedestrian fatalities in the United States, 2014–2016

Objective: U.S. pedestrian fatalities increased by 25% between 2010 and 2015. Risk factors include distractions, the built environment, urbanization, economic variables, and weather conditions. Of interest is the role of alcohol and drugs in premature death among pedestrians. This study sought to explore the prevalence of substance use screenings among pedestrian fatalities in the United States between 2014 and 2016.

Methods: Data were collected from the Fatality Analysis Reporting System provided by the NHTSA. Pedestrian crash variables included demographics as well as information regarding alcohol or drug testing status. Frequency and cross-tabulation tables were constructed to assess the prevalence of screening by person, place, and time. Log-linear analyses were completed to explore age, race, and sex differences. A 3-year examination period was used to control for yearly fluctuations and to incorporate an increasing trend in cases.

Results: Pedestrian fatalities accounted for 84% of all deaths among vulnerable road users during the examination period. Those most at risk were white males between the ages of 45 and 64. Over all states, 74.7% of fatalities were tested for alcohol and 67.1% were tested for drugs; further, 66.5% of cases were tested for both alcohol and drugs and 24.8% were tested for neither substance. Cases screened for both alcohol and drugs ranged from 2.9% in North Carolina to 95.7% in Nevada and those testing for neither substance ranged from a high of 68.9% in Indiana to a low of 1.1% in Maryland. Log-linear regression revealed significant differences in alcohol screening by age and race but not by sex. Differences in drug screening were not identified for any demographic variable. Fatalities tested for alcohol were significantly more likely to be tested for drugs; only 8.2% were screened solely for alcohol and 0.05% were screened for drugs alone.

Conclusions: Preventive strategies become more important as pedestrian crashes and fatalities increase. Risk reduction in the form of policy change, alterations to the built environment, or interdisciplinary approaches to injury prevention is dependent upon best evidence supported in part by more deliberate and consistent screening.     

Automobile injury trends in the contemporary fleet: Belted occupants in frontal collisions

Objective: As vehicle safety technologies and evaluation procedures advance, it is pertinent to periodically evaluate injury trends to identify continuing and emerging priorities for intervention. This study examined detailed injury distributions and injury risk trends in belted occupants in frontal automobile collisions (10 o’clock to 2 o’clock) using NASS-CDS (1998–2015).

Methods: Injury distributions were examined by occupant age and vehicle model year (stratified at pre- and post-2009). Logistic regression models were developed to examine the effects of various factors on injury risk (by body region), controlling for delta-V, sex, age, height, body mass index (BMI), vehicle model year (again stratified at 2009).

Results: Among other observations, these analyses indicate that newer model year vehicles (model year [MY] 2009 and later) carry less risk of Abbreviated Injury Scale (AIS) 2+ and AIS 3+ injury compared to older model year vehicles, with odds ratios of 0.69 (AIS 2+) and 0.45 (AIS 3+). The largest reductions in risk between newer model year vehicles and older model year vehicles occur in the lower extremities and in the risk of skull fracture. There is no statistically significant change in risk of AIS 3+ rib fracture or sternum injury between model year categories. Females are at greater risk of AIS 2+ and AIS 3+ injury compared to males, with increased risk across most injury types.

Conclusions: For belted occupants in frontal collisions, substantial reductions in injury risk have been realized in many body regions in recent years. Risk reduction in the thorax has lagged other body regions, resulting in increasing prevalence among skeletal injuries in newer model year vehicles (especially in the elderly). Injuries also remain common in the arm and hand/wrist for all age ranges studied. These results provide insight into where advances in the field have made gains in occupant protection and what injury types remain to be addressed.     

Implications of head and neck restraint test repeatability for specification improvement

Objective: Since 2005, National Association for Stock Car Auto Racing, Incorporated (NASCAR) drivers have been required to use a head and neck restraint system (HNR) that complies with SFI Foundation, Inc. (SFI) 38.1. The primary purpose of the HNR is to control and limit injurious neck loads and head kinematics during frontal and frontal oblique impacts. The SFI 38.1 performance specification was implemented to establish a uniform test procedure and minimum standard for the evaluation of HNRs using dynamic sled testing. The purpose of this study was to evaluate the repeatability of the current SFI 38.1 test setup and explore the effects of a polyester seat belt restraint system.

Method: Eight sled tests were conducted using the SFI 38.1 sled test protocol with additional test setup constraints. Four 0° frontal tests and 4 30° right frontal (RF) oblique tests were conducted. The first 3 tests of each principal direction of force (PDOF) used nylon SFI 16.1 seat belt restraint assemblies. The fourth test of each PDOF used polyester SFI 16.6 seat belt restraint assemblies. A secondary data set (Lab B Data) was also supplied by the HNR manufacturer for further comparisons. The International Organization for Standardization (ISO) 18571 objective comparison method was used to quantify the repeatability of the anthropomorphic test device (ATD) resultant head, chest, and pelvis acceleration and upper neck axial force and flexion extension bending moment time histories across multiple tests.

Results: Two data sets generated using the SFI 38.1 test protocol exhibited large variations in mean ISO scores of ATD channels. The 8 tests conducted with additional setup constraints had significantly lower mean ISO score coefficients of variation (CVs). The Lab B tests conducted within the current specification but without the additional test setup constraints had larger mean ISO score standard deviation and CV for all comparisons. Specifically, tests with the additional setup constraints had average CVs of 3.3 and 2.9% for the 0° and 30° RF orientations, respectively. Lab B tests had average CVs of 22.9 and 24.5%, respectively. Polyester seat belt comparisons had CVs of 5.3 and 6.2% for the 0° and 30° RF orientations, respectively.

Conclusion: With the addition of common test setup constraints, which do not violate the specification, the SFI 38.1 test protocol produced a repeatable test process for determining performance capabilities of HNRs within a single sled lab. A limited study using polyester webbing seat belt assemblies versus the nylon material called for in SFI 38.1 indicates that the material likely has less effects on ATD upper neck axial force and flexion extension bending moment time histories than the test setup freedom currently available within the specification. The additional test setup constraints are discussed and were shown to improve ATD response repeatability for a given HNR.     

Effect of alcohol use on accelerating and braking behaviors of drivers

Objective: The present study examines the accelerating and braking behaviors of drivers at different blood alcohol concentrations (BACs) in heterogeneous driving conditions using driving simulator experiments.

Methods: Eighty-two licensed drivers performed simulated driving in a rural road environment designed in the driving simulator at 4 BAC levels: 0.00, 0.03, 0.05, and 0.08%. Driving performance was analyzed using vehicle control variables such as mean acceleration and mean brake pedal force. Generalized linear mixed models were developed to quantify the effect of different alcohol levels and explanatory variables such as driver’s age, gender, and other factors on the driving performance indicators.

Results: Alcohol use was reported as a significant factor affecting the accelerating and braking performance of drivers. The acceleration model results indicated that drivers’ mean acceleration increased by 0.013, 0.026, and 0.027 m/s² for BAC levels of 0.03, 0.05, and 0.08%, respectively. Results of the brake pedal force model showed that drivers’ mean brake pedal force increased by 1.09, 1.32, and 1.44 N for BAC levels of 0.03, 0.05, and 0.08%, respectively. Age was a significant factor in both the models where a 1-year increase in driver age resulted in a 0.2% reduction in mean acceleration and a 19% reduction in mean brake pedal force. Driving experience could compensate for the negative effects of alcohol to some extent while driving.

Conclusions: The findings of the present study revealed that drivers tend to be more aggressive and impulsive under the influence of alcohol, which deteriorates their driving performance. Impairment in accelerating and braking behaviors of drivers under the influence of alcohol leads to increased crash probabilities. The conclusions may provide reference in making countermeasures against drinking and driving and contribute to traffic safety.     

Behavioral influences on driver crash risks in Ghana: A qualitative study of commercial passenger drivers

Objectives: Though there is a growing body of literature on crash risks in the developed world, little is known about how well these models apply to motoring in developing countries, the context in which the majority of road traffic fatalities occur. This qualitative study explores factors perceived to influence crash risks for commercial drivers in Ghana.

Method: Twenty commercial drivers of varied ages and experience were sampled from 7 major lorry terminals in 3 regions (Greater Accra, Ashanti, and Volta) of Ghana. Data were collected through semistructured interviews.

Results: The participants identified some issues that are shared with drivers in the developed world, though moderated by the Ghanaian context. These included work pressures (e.g., fatigued driving), speeding, distracted driving, and inadequate vehicle maintenance. Other factors identified by participants are less frequently considered in research addressing driving behavior in developed countries. These included aggressive competition over passengers and corruption (e.g., improper licensing practices), among others.

Conclusion: The findings have implications for building a research base to support the development of road safety policy and interventions in developing countries.     

Effect of the zero-tolerance drinking and driving law on mortality due to road traffic accidents according to the type of victim,sex, and age in Rio de Janeiro,Brazil: An interrupted time series study

Objective: The objective of this study was to estimate the effect of the Brazilian zero-tolerance drinking and driving law on mortality rates due to road traffic accidents according to the type of victim, sex, and age.

Methods: An interrupted time series design was used to compare yearly mortality rates due to road traffic accidents in Rio de Janeiro, Brazil, before and after the zero-tolerance drinking and driving law came into effect on June 19, 2008. Yearly mortality rates were compared according to the type of victim: pedestrian, cyclist, motorcyclist, and vehicle occupant. We used the Prais-Winsten procedure of autoregression in the analysis of time series; the outcome of this analysis was the annual percentage change in the rates. Overall and stratified analyses were conducted to investigate whether the zero-tolerance drinking and driving law may have had a distributional effect on mortality rates due to road traffic accidents depending on sex and age group; a significance level of P < .01 was accepted.

Results: From 1999 to 2016, there were 15,629 deaths due to road traffic accidents in Rio de Janeiro. The effect of the zero-tolerance drinking and driving law on overall mortality rates due to road traffic accidents in Rio de Janeiro was not statistically significant. However, among cyclists and motorcyclists aged ≥60 years and among pedestrians of both sexes and aged ≥20 years, the effect of the zero-tolerance drinking and driving law was to decrease mortality due to road traffic accidents at a yearly rate.

Conclusion: There is evidence of reduced mortality rates due to road traffic accidents among cyclists and motorcyclists aged ≥60 years and among pedestrians of both sexes aged ≥20 years in the second major Brazilian capital 9 years after the zero-tolerance drinking and driving law was adopted.     

Fatally injured drivers in Norway 2005–2015—Trends in substance use and crash characteristics

Objective: Norway introduced a “Vision Zero” strategy in 2001, using multiple approaches, aiming toward a future in which no one will be killed or seriously injured in road traffic crashes (RTCs). Official statistics show that the number of fatally injured road users has declined substantially from 341 deaths in 2000 to 117 in 2015. In-depth crash investigations of all fatal RTCs started in Norway in 2005. The aim of this study was to investigate whether fatal crash characteristics, vehicle safety features, and prevalence of drugs and/or alcohol among fatally injured drivers and riders has changed during 2005–2015, accompanying the reduction in road fatalities.

Methods: Data on all car/van drivers and motorcycle/moped riders fatally injured in RTCs during 2005–2015 were extracted from Norwegian road traffic crash registries and combined with forensic toxicology data.

Results: The proportion of cars and motorcycles with antilock braking systems and cars with electronic stability control, increased significantly during the study period. The prevalence of nonuse of seat belts/helmets and speeding declined among both fatally injured drivers and riders. In addition, the prevalence of alcohol declined, though no significant change in the total prevalence of other substances was noted.

Conclusion: The observed changes toward more safety installations in cars and motorcycles and lower prevalence of driver-related risk factors like alcohol use, speeding, and nonuse of seat belts/helmets among fatally injured drivers/riders may have contributed to the decrease in road traffic deaths.     

Investigating factors influencing drivers' speed selection behavior under reduced visibility conditions

Objective: Driving speed is a major concern for driving safety under reduced visibility conditions. Many factors affect speed selection in low visibility, but few studies have been conducted examining drivers' characteristics, particularly in China. The present study aimed to investigate the correlation between drivers' demographic information, driving ability, and speed choice in low-visibility conditions using a sample of Chinese drivers.

Methods: A self-designed driving ability scale was used to assess driving ability in reduced visibility conditions. The reliability and validity of 306 gathered questionnaires were examined in this article, and a structural equation model (SEM) was built to explore the predictors of drivers' speed selection behavior under reduced visibility conditions and to measure the relationships between various factors.

Results: Age and driving experience have no direct relationship to speed selection behavior in reduced visibility, but the frequency of using expressways and annual mileage are significantly related to the speed on roads that have a speed restriction of 80 or 120 km/h. Under reduced visibility conditions, driving ability has a significant effect on speed selection behavior, and driving skill (DS) is the most influential on speed selection behavior on roads with a speed limit of 120 km/h; otherwise, the effect of risk perception (RP) does not differ by speed choice on 3 roads with different speed limits. Driving speed in good weather also has a positive influence on speed selection behavior in low visibility.

Conclusion: Driving ability is directly associated with speed selection in reduced visibility conditions, and some demographic data indirectly influence speed selection. This study provides useful recommendations for drivers' training programs to reduce casualties from accidents in low-visibility conditions.     

High blood alcohol concentration associated with traumatic brain injury among traffic injury patients during New Year festivals in Thailand

Objective: Road traffic injury (RTI) is one of the most significant public health problems in Thailand, especially during New Year and Songkran (Thai traditional New Year) holidays, which have the highest traffic density during the entire year. Drunk driving was reported to be one of the leading causes of RTI in Thailand. This study aimed to investigate the prevalence of patients with high blood alcohol concentration (BAC) and the association of BAC and specific organ injury during New Year and Songkran (Thai traditional New Year) holidays.

Methods: A cross-sectional study was performed to analyze the database from the Thai Governmental Road Safety Evaluation Project. Patient data on RTIs were collected from 26 main provincial hospitals during the New Year Festival 2003 and 2004 and Songkran Festival in 2003. Patient characteristics, type of organ injured, and BAC levels were mainly analyzed.

Results: During those long holidays, 2,642 RTI patients were identified, among whom 1,341 patients had high BAC levels. High BAC levels were associated with motorcycle users, male sex, middle age, teenagers, being riders or drivers, and not using protective devices. Moreover, high BAC levels were associated with brain injury.

Conclusion: Excessive alcohol consumption and RTIs occurred on New Year and Songkran Festival in Thailand. Legislation should be strictly used during these long holidays to control driving under the influence of alcohol, particularly among motorcyclists.     

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.     

Driving under the influence of alcohol and drugs in the eastern part of Denmark in 2015 and 2016: Abuse patterns and trends

Objectives: The objective of this study was to examine the frequency of psychoactive drugs and alcohol in drivers under suspicion of driving under the influence of drugs and alcohol in 2015 and 2016 in the eastern part of Denmark. The trends in the number of traffic cases sent for drug analysis since 2000 and alcohol analysis since 2011 are also discussed.

Methods: Blood samples from drivers suspected of being under the influence of alcohol and/or medication and/or illicit drugs in 2015 and 2016 were investigated as requested by the police. The blood samples were screened for alcohol and/or tetrahydrocannabinol (THC) alone, for other drugs (covering all drugs, except THC, listed in the Danish list of narcotic drugs), or for THC and other drugs. Age and gender were also recorded. The number of drug traffic cases since 2000 and the number of alcohol cases since 2011 were extracted from our Laboratory Information Management System (LIMS).

Results: In total, 11,493 traffic cases were investigated. Alcohol and/or drugs exceeded the legal limit in 9,657 (84%) cases. Men constituted 95% of the drivers investigated for drugs and 88% of the alcohol cases. The drivers investigated for drugs consisted primarily of young men, whereas drivers investigated for alcohol were older.

The frequency was higher for positive alcohol cases above the legal limit (87%) than for drug cases (76%) above the fixed concentration limit. THC (67–69%) was the most frequently detected drug above the legal limit, followed by cocaine (27–28.5%), amphetamine (17%), and clonazepam (6–7%) in both years. Morphine (5.4%), included among the 5 most frequent drugs in 2015, was replaced by methadone (4.6%) in 2016. Few new psychoactive drugs (NPS) were detected.

The number of traffic cases sent for drug analysis has increased more than 30-fold since 2000–2006, and the number of traffic cases submitted in 2016 for drug analysis was higher than the number for alcohol analysis; the latter has decreased since 2011.

Conclusion: Overall, alcohol was the most frequent compound detected above the legal limit in both years, followed by the well-known illicit drugs THC, cocaine, and amphetamine. NPS were seldom seen. One consequence of the increased focus on drugs in traffic has been an immense increase in drug traffic cases sent for analysis since 2006 in the eastern part of Denmark. Although this survey revealed only minimal changes compared to earlier investigations, surveys like this are invaluable for monitoring abuse patterns and trends in drugged and drunken driving.     

Gap acceptance behavior at unsignalized intersections: Effects of using a phone and a music player while driving

Objectives: The present study is an attempt to analyze and compare the distraction effects caused by the use of a phone and a music player at unsignalized intersections.

Method: Eighty-eight participants performed simulated driving experiments where they faced a sequence of gaps in the major road traffic at 2 unsignalized intersections. In this process, their driving behavior was evaluated in terms of gap acceptance probability, accepted lag, and maneuver completion time. These parameters were modeled with a generalized estimating equation (GEE) method by considering distraction, demographic factors, driving history, maneuver types, and driving attributes in the approach and completion zones as independent variables.

Results: The results showed that gap acceptance probability decreased by 46% during the conversation task, whereas it increased by 66% during the music player task. Lower gap acceptance could be a compensatory behavior adopted by drivers during the conversation task, whereas no such measure was adapted during the music player task. The results indicate that a higher approach speed during the music player task might have led to increased gap acceptance. Further, though the effect of distraction on the accepted lag was not evident, the completion time was reduced during the conversation task.

Conclusions: Overall, the results suggest that drivers are more likely to adopt a compensatory measure in complex driving situations only if they perceive a high risk. Hence, drivers are exposed to a greater risk while operating a music player, because this is not perceived as risky behavior.