Car drivers with dementia: Different complications due to different etiologies?

Objective: Older drivers with dementia are an at-risk group for unsafe driving. However, dementia refers to various etiologies and the question is whether dementias of different etiology have similar effects on driving ability.

Methods: The literature on the effects of dementia of various etiologies on driving ability is reviewed. Studies addressing dementia etiologies and driving were identified through PubMed, PsychINFO, and Google Scholar.

Results and Conclusions: Early symptoms and prognoses differ between dementias of different etiology. Therefore, different etiologies may represent different likelihoods with regard to fitness to drive. Moreover, dementia etiologies could indicate the type of driving problems that can be expected to occur. However, there is a great lack of data and knowledge about the effects of almost all etiologies of dementia on driving. One could hypothesize that patients with Alzheimer's disease may well suffer from strategic difficulties such as finding a route, whereas patients with frontotemporal dementia are more inclined to make tactical-level errors because of impaired hazard perception. Patients with other dementia etiologies involving motor symptoms may suffer from problems on the operational level. Still, the effects of various etiologies of dementias on driving have thus far not been studied thoroughly. For the detection of driving difficulties in patients with dementia, structured interviews with patients but also their family members appear crucial. Neuropsychological assessment could support the identification of cognitive impairments. The impact of such impairments on driving could also be investigated in a driving simulator. In a driving simulator, strengths and weaknesses in driving behavior can be observed. With this knowledge, patients can be advised appropriately about their fitness to drive and options for support in driving (e.g., compensation techniques, car adaptations). However, as long as no valid, reliable, and widely accepted test battery is available for the assessment of fitness to drive, costly on-road test rides are inevitable. The development of a fitness-to-drive test battery for patients with dementia could provide an alternative for these on-road test rides, on condition that differences between dementia etiologies are taken into consideration.     

Characteristics and risks of drivers with low annual distance driven

OBJECTIVES: It has been noted by several authors that risk (defined only in terms of total expected numbers of crash involvements per total distance driven) paints a misleading picture of crash liability, particularly for the young and the old, as their high risk is associated with risky driving patterns typical of people who drive low annual kms. This article sets out to analyze these driving patterns of low-km drivers and to evaluate the risk of these patterns. As licensing programs tend to focus on young and old drivers, who tend to drive lower annual distances, income and employment data are also analyzed for low-km drivers. This is to provide a better picture for policy makers of the sort of people and the sorts of transportation requirements that their policies may affect. METHODS: Crash data and travel data were disaggregated by driver characteristics and by driving conditions (road type, day and night, weekend and weekday) and combined to form estimates of risk for typical driving patterns of driver groups. Characteristics of driving patterns and of the drivers themselves were derived for groups defined by age and by the amount of annual driving undertaken. RESULTS: Older drivers who drive less tend to have higher risk per km mainly due to their predominantly urban trips. Nevertheless, because older drivers on average manage to reduce their risk per distance driven by choosing driving patterns that are safer than the driving patterns of other age groups, the risk of older drivers as a group is not overestimated. CONCLUSION: Despite being quite different from one another, the low- and high-km driving patterns of younger drivers were found to impose identical risks.     

特长隧道环境下驾驶人注视转移特性研究

为了研究不同经验驾驶人在高速公路特长隧道环境下的注视转移特性,在高速公路特长隧道中开展实车实验,利用 iView X HED型眼动仪采集了32名不同经验驾驶人的眼动数据。运用动态聚类方法,对驾驶人注视区域进行划分,分析了职业与非职业驾驶员在高速公路隧道不同段与普通路段的注视转移规律与注意力分配特性。结果表明:相较于非职业驾驶人,职业驾驶员具有较强的注视前瞻性,且在隧道的不同段主要注视的区域因行车环境不同变化较小;驾驶人对同一目标需要重复注视才能提取足够的信息,且当行车环境复杂度增加或驾驶员驾驶经验不足时,重复注视概率增加;驾驶人在不同路段行车时,主要通过注视中间区域获取信息;行车环境与驾驶经验对驾驶人在中间近处、左侧区域及内后视镜区域的注视平稳分布存在显著的交互作用。     

Hardcore drinking drivers and other contributors to the alcohol-impaired driving problem: need for a comprehensive approach

OBJECTIVE: Understanding the hardcore drinking driver concept in the context of the alcohol-impaired driving problem. METHOD: Review of the relevant literature. RESULTS: As progress against alcohol-impaired driving slowed in the early 1990s, public and political attention turned to "hardcore" drinking drivers, and they have been a priority for the past 15 years. Though intuitive, the hardcore concept has been difficult to conceptualize. Its definition of hard-to-change chronic heavy drinking drivers focuses on a group that is not easily identifiable and ignores many who account for a large portion of alcohol-impaired driving crashes. These include drivers who drink heavily on occasion and drivers who drink at more moderate levels that elevate crash risk. Emphasis on the hardcore has focused attention on the small proportion of drinking drivers who have been detected and arrested, whereas the vast majority of drinking drivers go undetected. Some countermeasures aimed at the hardcore group have been effective in reducing recidivism, but attention and resources also need to be given to general deterrent initiatives (e.g., 0.08 g/dL, sobriety checkpoints, administrative license suspension). There has been no reduction in the overall alcohol-impaired driving problem since the mid-1990s. CONCLUSION: Reductions in the alcohol-impaired driving problem require that attention be focused on all relevant target groups. Some benefits could accrue by recognizing that countermeasures developed for hardcore drinking drivers, such as alcohol ignition interlocks and vehicle or plate impoundment, might also be effective with more numerous first-time offenders. However, such strategies are likely to be most effective against recidivism (specific deterrence). Greater gains could be achieved through general deterrent efforts (increasing the real and perceived risk of arrest and punishment to all drinking drivers), along with application of public health measures designed to reduce overall consumption. Additional ways need to be found to separate drinking and driving, either through cultural changes in drinking and/or driving behavior or, in the future, with the use of technology that can make vehicles inoperable by drivers with illegal blood alcohol concentrations.     

Cell phone users, reported crash risk, unsafe driving behaviors and dispositions: a survey of motorists in Maryland

INTRODUCTION: The purpose of this investigation was to identify risky driving behaviors and dispositions that distinguish drivers who use a cell phone while operating a motor vehicle from non-cell phone using drivers. METHOD: Annual telephone surveys were used to identify drivers who reported using a cell phone while driving in the last month (n=1803) and were compared to those who said they did not use cell phones while driving (n=1578). RESULTS: Cell phone using drivers were more likely to report driving while drowsy, going 20 mph over the speed limit, driving aggressively, running a stop sign or red light, and driving after having had several drinks. They were also more likely to have had a prior history of citation and crash involvement than non-cell phone using drivers. Cell phone using drivers also reported they were less careful and more in a hurry when they drive than non-cell phone using drivers. CONCLUSION: Cell phone using drivers report engaging in many behaviors that place them at risk for a traffic crash, independent of the specific driving impairments that cell phone usage may produce. Strategies that combine coordinated and sustained enforcement activities along with widespread public awareness campaigns hold promise as effective countermeasures for these drivers, who resemble aggressive drivers in many respects.     

Using a driving simulator to identify older drivers at inflated risk of motor vehicle crashes

PROBLEM: To develop appropriate assessment criteria to measure the performance of older drivers using an interactive PC-based driving simulator, and to determine which measures were associated with the occurrence of motor-vehicle crash. METHOD: One hundred and twenty-nine older drivers residing in a metropolitan city volunteered to participate in this retrospective cohort study. Using the driving simulator, appropriate driving tasks were devised to test the older drivers, whose performances were assessed by 10 reliable assessment criteria. Logistic regression analysis was then undertaken to determine those criteria that influence the self-reported crash outcome. RESULTS: As expected, driving skill of older drivers was found to decline with age. Over 60% of the sample participants reported having at least one motor-vehicle crash during the past year. Adjusting for age in a logistic regression analysis, the cognitive abilities associated with the crash occurrence were working memory, decision making under pressure of time, and confidence in driving at high speed. SUMMARY: The findings of this retrospective study indicated those individuals at inflated risk of vehicle crashes could be identified using the PC-based interactive driving simulator. Prospective studies need to be undertaken to determine whether the driving simulator can predict future crash events. IMPACT ON INDUSTRY: This study demonstrated an economical driving simulator approach to screen out problematic or unsafe older drivers before a more detailed but expensive road test is considered.     

Concerns, dispositions and behaviors of aggressive drivers: what do self-identified aggressive drivers believe about traffic safety?

INTRODUCTION: The purpose of this investigation was to identify beliefs, driving personality dispositions, and behaviors that distinguish self-defined aggressive drivers from non-aggressive drivers. METHOD: Telephone surveys were used to identify self-reported aggressive drivers (n=305) who were compared to non-aggressive drivers (n=1,715) concerning their beliefs, driving behaviors, and self-described driving dispositions. RESULTS: Aggressive drivers, compared to non-aggressive drivers, were less concerned about speeding, aggressive driving, and cell phone use while driving, yet were more likely to have had an encounter with another aggressive driver. They were also more likely to report that they had driven when they knew they had too much to drink, yet they felt less likely that they would be stopped by the police. CONCLUSION: Aggressive drivers display many dispositions that define them as high risk drivers and public information/motivational campaigns alone will likely be ineffective with this group of drivers. Strategies that combine visible enforcement with widespread publicity campaigns appear to be necessary.     

A cost-benefit analysis of risk-reduction strategies targeted at older drivers

OBJECTIVE: The risk of motor-vehicle collisions increases as driving-related functional abilities decline. These declines can accompany normal or pathological aging and can be identified through driving-related functional screening exams upon license renewal. The objective of this cost-benefit analysis was to determine the utility of four functional screening procedures used to identify drivers at risk for motor-vehicle collisions, as well as an intervention designed to maintain or improve functional abilities. Additionally, this study sought to determine the expected cost per driver if an intervention was designed to target only those drivers who failed the functional ability-based driving screen, versus the expected cost per driver if the intervention was distributed en masse to all drivers 75 years and older. Improving functional abilities in older adults has potential far-reaching health and financial impacts which are broader than their impact of maintaining mobility. METHODS: A decision tree was constructed to evaluate the expected costs and benefits of (a) screening all drivers and intervening when indicated (several screening batteries of varying length were considered), (b) no screening, but intervening with all drivers of older age, or (c) neither screening nor intervening (i.e., re-licensing per usual). Test characteristics and risk probabilities were based on a cohort of drivers aged 75 and older from a previous study (Ball et al., 2006). Relevant sensitivity analyses were conducted. RESULTS: Providing all drivers with the speed-of-processing intervention is the most cost-beneficial option (expected cost per driver = $493.30), even if the cost of the intervention doubles. Sensitivity analysis indicated the effectiveness of the intervention could drop from 86% to 25% and the preventative approach of intervening with all drivers remains the most cost-beneficial strategy. The least cost-beneficial option is almost always re-licensing per usual (expected cost per driver = $1,562.84). CONCLUSION: Screening drivers upon license renewal is not currently beneficial because the available technology cannot consistently identify drivers at risk for a collision. However, the speed-of-processing intervention has demonstrated efficacy in improving driving competence (Roenker et al., 2003) and is a non-invasive, moderate-cost intervention that has the potential to protect the safety and mobility, as well as the financial interests, of older drivers and the community at large.     

Identification of aggressive driving from naturalistic data in car-following situations

Introduction: Aggressive driving has been associated as one of the causes for crashes, sometimes with very serious consequences. The objective of this study is to investigate the possibility of identifying aggressive driving in car-following situations on motorways by simple jerk metrics derived from naturalistic data. Method: We investigate two jerk metrics, one for large positive jerk and the other for large negative jerk, when drivers are operating the gas and brake pedal, respectively. Results: The results obtained from naturalistic data from five countries in Europe show that the drivers from different countries have a significantly different number of large positive and large negative jerks. Male drivers operate the vehicle with significantly larger number of negative jerks compared to female drivers. The validation of the jerk metrics in identifying aggressive driving is performed by tailgating (following a leading vehicle in a close proximity) and by a violator/non-violator categorization derived from self-reported questionnaires. Our study shows that the identification of aggressive driving could be reinforced by the number of large negative jerks, given that the drivers are tailgating, or by the number of large positive jerks, given that the drivers are categorized as violators. Practical applications: The possibility of understanding, classifying, and quantifying aggressive driving behavior and driving styles with higher risk for accidents can be used for the development of driver support and coaching programs that promote driver safety and are enabled by the vast collection of driving data from modern in-vehicle monitoring and smartphone technology.     

Other high-risk factors for young drivers--how graduated licensing does,doesn't,or could address them

PROBLEM: Young drivers, particularly those who are newly licensed, have a very high crash risk. This paper examines the risk factors underlying their high crash rates and assesses the extent to which existing graduated licensing programs address these risks and whether improvements to these programs should be considered. METHOD: Review and synthesis of the literature. RESULTS: The elevated risk among young drivers of being in an injury crash is the result of a number of factors found alone or in combination, such as risky driving, alcohol use, seat belt nonuse, driver distraction, fatigue, and vehicle choice. Nighttime and passenger restrictions, adopted widely in the United States, work by keeping drivers out of hazardous situations rather than by addressing risk factors directly. However, the risk factors remain in play in driving situations not specifically restricted by law. Although other graduated licensing components adopted around the world-more stringent exit tests (i.e., you need to pass a test to move to the next stage), hazard perception tests, and restrictions on speed, vehicle power, and roadway access-make sense based on the identified risk factors, they are not yet supported by research. Should research findings warrant it, consideration should be given to providing guidance to parents about how to keep their beginning drivers safe, including information on vehicle choice. IMPACT ON RESEARCH, PRACTICE, AND POLICY: Researchers should continue to monitor and to evaluate innovative approaches to reduce the crash risk of young drivers. The effectiveness of new approaches should be established before adoption on a wider scale takes place.     

Changes in driving behavior and cognitive performance with different breath alcohol concentration levels

OBJECTIVE: This study examines the changes in driving behavior and cognitive performance of drivers with different breath alcohol concentration (BrAC) levels. METHODS: Eight licensed drivers, aged between 20 and 30 years, with BrAC levels of 0.00, 0.25, 0.4 and 0.5 mg/l performed simulated driving tests under high- and low-load conditions. Subjects were asked to assess their subjective psychological load at specified intervals and perform various tasks. The outcome was measured in terms of reaction times for task completion, accuracy rates, and driver's driving behavior. RESULTS: The effects of BrAC vary depending on the task. Performance of tasks involving attention shift, information processing, and short-term memory showed significant deterioration with increasing BrAC, while dangerous external vehicle driving behavior occurred only when the BrAC reached 0.4 mg/l and the deterioration was marked. CONCLUSION: We can conclude that the cognitive faculty is the first to be impaired by drinking resulting in deteriorated performance in tasks related to divided attention, short-term memory, logical reasoning, followed by visual perception. On the other hand, increasing alcohol dose may not pose an immediate impact on the external vehicle driving behavior but may negatively affect the driver's motor behavior even at low BrAC levels. Experience and will power could compensate for the negative influence of alcohol enabling the drivers to remain in full steering control. This lag between alcohol consumption and impaired driving performance may mislead the drivers in thinking that they are still capable of safe steering and cause them to ignore the potential dangers of drunk driving.     

Practicing for and performance on drivers license tests in relation to gender differences in crash involvement among novice drivers

PROBLEM: Young male novice drivers are overrepresented in injury motor-vehicle crashes compared to females in the same category. This difference in crash involvement is often assumed to include factors such as overestimation, risk acceptance, and sensation seeking, but it can also be related to acquisition of knowledge, skills, insight, and driving experience. Therefore, this study explored possible gender differences among 18-24-year-olds in Sweden regarding practicing as learners, outcome of the driver's tests, and crash involvement during the first year after licensure. METHOD: Data for 2005 from different sources (e.g., questionnaires, license test, and crash statistics) were examined. It was not possible to follow individual subjects through all stages or in all analyses. Nevertheless, the study design did enable scrutinization and discussion of gender differences between younger inexperienced drivers with respect to education and training, license test results, and initial period of licensure. RESULTS: Males and females assimilated tuition in different ways. Females studied more theory, pursued training in a more structured manner, practiced more elements of driving in several different environments, and participated more extensively in driving school instruction. National statistics showed that females did better on the written test but not on the driving test. Males were involved in 1.9 more injury crashes per 1,000 drivers than females during their first year of licensed driving. The proportional distribution of crash types was the same for both sexes during the first period as novice drivers, but the circumstances surrounding the accidents varied (e.g., males were involved in more night crashes). IMPACT ON TRAFFIC SAFETY: More structured training while learning appears to be one of the reasons why females initially do better than males as novice drivers. Therefore, in the future, driver education should focus not only on matters such as the amount of time spent on training and preconditioning, but also on the importance of the organization and content of the learning process.     

The provisional license: nighttime and passenger restrictions--a literature review

PROBLEM: Due to inexperience and inadequate driving skills, the road is a very risky place for young and beginning drivers, yet such experience and skills can only be built by increased driving and exposure to risks on the road. Graduated driver licensing (GDL) allows beginning drivers to get their initial driving experience under less risky conditions and gradually eases them into more complex driving situations. This paper reviews the literature exploring two key features of the intermediate licensing phase of GDL, nighttime driving restrictions and passenger restrictions. METHOD: Literature review. RESULTS: Nighttime driving restrictions have been shown to effectively reduce the number and rate of crash involvements on the part of teenage drivers. Data suggest that having passengers in the car increases the likelihood of a fatal injury in young drivers and that this risk increases with the number of passengers. Young drivers were more likely to cause a crash when accompanied by their peers. DISCUSSION: Nighttime driving and passenger restrictions are effective in decreasing injuries among teenage drivers and their passengers, especially in the context of a full GDL system. Several research questions remain to be answered in order to fully refine and optimize the impact of these provisional measures.     

Assessment of older drivers: relationships among on-road errors, medical conditions and test outcome

PROBLEM: It is essential that driver licensing authorities have a valid and reliable system for evaluating older drivers' continuing competency; road tests are usually required as part of such a system. This study sought to find information about the nature of driving errors made during license review tests, and about relationships between error type and test outcome for older drivers. METHOD: Data from licensing authority files from 533 road tests during a 12-month period were analyzed; medical and other referral information was included. Average driver age was 76 years. Performance scores were generated for intersection negotiation, lane changing, low speed manoeuvres, positioning and speed control, safety margin, and car control. RESULTS: Logistic regression analysis showed that test outcome was well predicted by a subset of driving performance scores; adding driver age to the model explained very little variance. Age alone was strongly associated with outcome. Relationships between referral information and test outcome are also reported. IMPACT: Results highlight several factors relevant to the development of more valid and reliable road tests for older drivers.     

Introducing a multi-variate classification method: Risky driving acceptance among different heterogeneous driver sub-cultures

Introduction: Heterogeneous driving populations with many different origins are likely to have various sub-cultures that comprise of drivers with shared driver characteristics, most likely with dissimilar traffic safety cultures. An innovative methodology in traffic safety research is introduced which is beneficial for large datasets with multiple variables, making it useful for the multi-variate classification of drivers, driving attitudes and/or (risky) driving behaviours. Method: With the application of multidimensional scaling analysis (MDS), this study explores traffic safety culture in the State of Qatar using a questionnaire and investigates the similarity patterns between the questionnaire items, aiming to classify attitudes towards risky driving behaviours into themes. MDS is subsequently applied to classify drivers within a heterogeneous driving sample into sub-cultures with shared driver characteristics and different risky driving attitudes. Results: Results show that acceptance of speeding is highest among the young Arabic students and acceptance of distraction and drivers’ negligence such as phone use and not wearing a seatbelt is highest among male Arab drivers. Acceptance of extreme risk-taking like intoxicated driving and red-light running is highest among South-Asian business drivers. Conclusion: It is important and practical to understand risky behavioural habits among sub-cultures and thereby focussing on groups of drivers instead of individuals, because groups are easier to approach and drivers within sub-cultures are found to influence each other. By indicating which groups of drivers are most likely to perform specific risky driving themes, it is possible to target these groups and effectively emphasise certain subsets of risky driving behaviours during training or traffic safety education. Practical Applications: This study provides guidance for the improvement of driver education and targeted traffic safety awareness campaigns, intending to make changes to attitudes and habits within specific driver sub-cultures with the aim to improve traffic safety on the longer term.     

To speed or not to speed: Thematic analysis of American driving narratives

IntroductionSpeeding is a major cause of unintentional roadway death in the United States. Existing data show that U.S. drivers tend to speed less as they age, but reasons for this change remain largely unknown. Limited research has examined why U.S. drivers decide to speed or why U.S. drivers decide not to speed, and none to date has determined why speeding behaviors change over the life course. Research into these issues can provide insight that may be harnessed for more effective anti-speeding interventions that catalyze decisions not to speed. Methods: The current study asked a national sample of U.S. drivers (N = 309) about their driving behaviors and how they have changed over time using an open-ended prompt in an online survey. The authors qualitatively coded responses using a narrative analysis lens to identify common themes. Results: Results show U.S. drivers often make deliberate choices to speed and some do not consider speeding to be dangerous after achieving perceived mastery of driving skills. Participants tended to report speeding less over time, citing increased concern for family and other roadway users, which may help explain national speeding data trends. Several other themes emerged identifying individual cognitive factors, environmental contexts, and key persons impacting speeding decisions. Practical Applications: Findings show that the most effective means of encouraging U.S. drivers to decide not to speed may be multi-pronged intervention approaches highlighting how speeding reduces roadway driver control, connecting speeding with safety, and encompassing road design and law enforcement strategies.     

What’s in a name? Drivers’ perceptions of the use of five SAE Level 2 driving automation systems

Introduction: Automobile manufacturers are developing increasingly sophisticated driving automation systems. Currently, the highest level of automation available on the market is SAE Level 2, which provides sustained assistance for both lateral and longitudinal vehicle control. The purpose of this study was to evaluate how drivers’ perceptions of what behaviors secondary to driving are safe while a Level 2 system is operating vary by system name. Methods: A nationally representative telephone survey of 2005 drivers was conducted in 2018 with questions about behaviors respondents perceived as safe while a Level 2 driving automation system is in operation. Each respondent was asked about two out of five system names at random for a balanced study design. Results: The name “Autopilot” was associated with the highest likelihood that drivers believed a behavior was safe while in operation, for every behavior measured. There was less variation observed among the other four SAE Level 2 system names when compared with each other. A limited proportion of drivers had experience with advanced driver assistance systems and fewer of these reported driving a vehicle in which Level 2 systems were available. Drivers reported that they would consult a variety of sources for information on how to use a Level 2 system. Conclusions: The names of SAE Level 2 driving automation systems influence drivers’ perceptions of how to use them, and the name “Autopilot” was associated with the strongest effect. While a name alone cannot properly instruct drivers on how to use a system, it is a piece of information and must be considered so that drivers are not misled about the correct usage of these systems. Practical Applications: Manufacturers, suppliers, and organizations regulating or evaluating SAE Level 2 automated driving systems should ensure that systems are named so as not to mislead drivers about their safe use.     

Assessing driver behavior using shrp2 adverse weather data

IntroductionThis study explored how drivers adapt to inclement weather in terms of driving speed, situational awareness, and visibility as road surface conditions change from dry to slippery and visibility decreases. The proposed work mined existing data from the SHRP 2 NDS for drivers who were involved in weather-related crash and near-crash events. Baseline events were also mined to create related metadata necessary for behavioral comparisons. Methods: Researchers attempted, to the greatest extent possible, to match non-adverse-weather driving scenarios that are similar to the crash and near-crash event for each driver. The ideal match scenario would be at a day prior to the crash during non-adverse weather conditions having the same driver, at the same time of day, with the same traffic level on the same road on which the crash or near-crash occurred. Once the matched scenarios have been identified, a detailed analysis will be performed to determine how a driver’s behavior changed from normal driving to inclement-weather driving. Results: Data collected indicated that, irrespective of site location (i.e., state), most crashes and near-crashes occurred in rain, with only about 12% occurring in snowy conditions. Also, the number of near-crashes was almost double the number of crashes showing that many drivers were able to avoid a crash by executing an evasive maneuver such as braking or steering. Conclusions: Most types of near crashes were rear-end and sideswipe avoidance epochs, as the drivers may have had a difficult time merging or trying to change lanes due to low visibility or traffic. Hard braking combined with swerving were the most commonly used evasive maneuvers, occurring when drivers did not adjust their speeds accordingly for specific situations. Practical applications: Results from this study are expected to be utilized to educate and guide drivers toward more confident and strategic driving behavior in adverse weather.     

Factorial structure of recklessness: to what extent are older drivers different?

PROBLEM: This study tests whether the original factorial structure of a recklessness questionnaire can be maintained for the current Spanish population of older drivers. JUSTIFICATION: Our recent interest in dedicating special attention to senior citizen mobility (Monterde, 2001), is due to the impending increase of the aging population in Western countries; this has led us to reinitiate the psychometric study of the construct validity, revising and including older drivers in the psychometric aspects of those evaluation instruments that will then be used in the Spanish psycho-medical check of drivers and in research. METHODS: Factorial analysis was used to determine validity. RESULTS: There was an appearance of a different psychological pattern in elderly drivers, specifically, a psychological anxiety trait related to the task of driving. Furthermore, interesting data were found about the attitude of this sector toward the "traffic society" and toward some of the measures included in Spanish legislation that affect especially older drivers (such as the psycho-medical check). IMPACT ON INDUSTRY, RESEARCH AND PRACTICE: These results suggest the possible existence of some kind of "compensation phenomenon," which could have influence over the scores obtained and their interpretation. Consequently, the evaluation instruments should be tested and, if necessary, adapted or specifically created for use with this age group.     

Cell phones and driving: review of research

OBJECTIVE: The research literature on drivers' use of cell phones was reviewed to identify trends in drivers' phone use and to determine the state of knowledge about the safety consequences of such use. METHODS: Approximately 125 studies were reviewed with regard to the research questions, type and rigor of the methods, and findings. Reviewed studies included surveys of drivers, experiments, naturalistic studies (continuous recording of everyday driving by drivers in instrumented vehicles), studies of crash risk, and evaluations of laws limiting drivers' phone use. RESULTS: Observational surveys indicate drivers commonly use cell phones and that such use is increasing. Drivers report they usually use hand-held phones. Experimental studies have found that simulated or instrumented driving tasks, or driving while being observed, are compromised by tasks intended to replicate phone conversations, whether using hand-held or hands-free phones, and may be further compromised by the physical distraction of handling phones. Effects of phone use on driving performance when drivers are in their own vehicles are unknown. With representative samples of adequate size, naturalistic studies in the future may provide the means to document the patterns and circumstances of drivers' phone use and their effects on real-world driving. Currently, the best studies of crash risk used cell phone company billing records to verify phone use by crash-involved drivers. Two such studies found a fourfold increase in the risk of a property-damage-only crash and the risk of an injury crash associated with phone use; increased risk was similar for males and females, younger and older drivers, and hands-free and hand-held phones. A number of jurisdictions in the United States and around the world have made it illegal for drivers to use hand-held phones. Studies of these laws show only limited compliance and unclear effects on safety.CONCLUSIONS: Even if total compliance with bans on drivers' hand-held cell phone use can be achieved, crash risk will remain to the extent that drivers continue to use or switch to hands-free phones. Although the enactment of laws limiting drivers' use of all phones is consistent with research findings, it is unclear how such laws could be enforced. At least in the short term, it appears that drivers' phone use will continue to increase, despite the growing evidence of the risk it creates. More effective countermeasures are needed but are not known at this time.