Fatal and serious injuries related to vulnerable road users in Canada

IntroductionThe goals of this study were to analyze possible trends of fatal and serious injuries related to vulnerable road users in Canada (pedestrians, cyclists and motorcyclists) from 1990 to 2012 and the role of alcohol and drugs in these cases. Drugs have rarely been documented with respect to vulnerable road users.MethodThe Traffic Injury Research Foundation's National Fatality and Serious Injury Databases and the Public Health Agency of Canada's Canadian Hospitals Injury Reporting and Prevention Program databases were used. Numbers and rates of fatalities and serious injuries among vulnerable road users were analyzed and regression models were used to assess changes over time.ResultsThe analyses show that while the absolute number of fatalities and the rate per 100,000 population among vulnerable road users may be decreasing, no such trends are apparent when looking at the proportions of these road user fatalities out of all motor-vehicle fatalities. The trend for the proportion of motorcyclist fatalities is significantly increasing (coef. = 0.16, p < 0.001). The elderly (76 years or older) are overrepresented among pedestrian fatalities, and serious injuries (they represent 18.5% of all pedestrian fatalities but only 5.8% of the population), while those 15 years or younger are overrepresented among cyclists (they represent 23.3% of cyclist fatalities but 19.5% of the population), and those 16 to 25 years old are overrepresented among motorcyclists (27.2% of motorcyclists fatalities and 13.6% of population). Alcohol and drug use among fatally injured vulnerable road users were significant problems, especially among pedestrians. Among fatally injured pedestrians tested for alcohol and drugs, 39.7% and 43.4% tested positive, respectively.ConclusionsWith the promotion of walking and cycling as forms of exercise and the popularity of motorcycling, the safety of vulnerable road users is an important issue. The results corroborate previous research and extend our understanding about the influence of alcohol and drugs in vulnerable road user injuries.Practical applicationsThese findings can help better inform prevention and mitigation initiatives for vulnerable road users.     

Fatally injured pedestrians and bicyclists in the United States with high blood alcohol concentrations

IntroductionLittle research has focused on the problem of alcohol impairment among pedestrians and bicyclists in the United States. The aim of the current study was to investigate the prevalence, trends, and characteristics of alcohol-impaired fatally injured pedestrians and bicyclists.MethodData from the Fatality Analysis Reporting System (FARS) were analyzed for fatally injured passenger vehicle drivers, pedestrians, and bicyclists 16 and older during 1982–2014. Logistic regression models examined whether personal, roadway, and crash characteristics were associated with high blood alcohol concentrations (BACs) among fatally injured pedestrians and bicyclists.ResultsFrom 1982 to 2014, the percentage of fatally injured pedestrians with high BACs (≥ 0.08 g/dL) declined from 45% to 35%, and the percentage of fatally injured bicyclists with high BACs declined from 28% to 21%. By comparison, the percentage of fatally injured passenger vehicle drivers with high BACs declined from 51% in 1982 to 32% in 2014. The largest reductions in alcohol impairment among fatally injured pedestrians and bicyclists were found among ages 16–20. During 2010–2014, fatally injured pedestrians and bicyclists ages 40–49 had the highest odds of having a high BAC, compared with other age groups.ConclusionsA substantial proportion of fatally injured pedestrians and bicyclists have high BACs, and this proportion has declined less dramatically than for fatally injured passenger vehicle drivers during the past three decades. Most countermeasures used to address alcohol-impaired driving may have only limited effectiveness in reducing fatalities among alcohol-impaired pedestrians and bicyclists.Practical applicationsEfforts should increase public awareness of the risk of walking or bicycling when impaired. Results suggest the primary target audience for educational campaigns directed at pedestrians and bicyclists is middle-age males. Further research should evaluate the effectiveness of potential countermeasures, such as lowering speeds or improving lighting in urban areas.     

On-road measures of pedestrians' estimates of their own nighttime conspicuity

PROBLEM: Most pedestrian fatalities occur at night. Although researchers have long understood that drivers have difficulty seeing pedestrians at night and that reflective clothing can dramatically enhance pedestrian conspicuity, the extent to which pedestrians understand these facts is unclear. This experiment quantified pedestrians' estimates of the ability of an approaching driver to recognize the presence of roadside pedestrians. METHOD: Ten younger and 10 older participants walked in place on the far shoulder of a closed-road circuit and pressed a button when they were confident that the approaching driver could first recognize that a pedestrian was present. RESULTS: Pedestrians overestimated their visibility and dramatically underestimated the benefit of conspicuity treatments. CONCLUSIONS: These results suggest that pedestrians fail to understand the magnitude of the nighttime conspicuity problem and the value of conspicuity treatments. Pedestrians may therefore unknowingly place themselves in danger at night. IMPACT: These results underscore the need to educate pedestrians about the dangers of interacting with traffic at night and about treatments that increase their safety.     

Healthcare utilization and costs among older adult female drivers and former drivers

PurposeThis study compared the healthcare utilization and costs for specific types of medical services among older adult women who currently drive and those who no longer drive.MethodsThis study included 347 women aged 65 or older who were either former (had stopped driving) or current drivers, randomly sampled from a large U.S. health plan to participate in a telephone survey, and who had automated health records with healthcare utilization and cost data. Bivariate analyses and generalized linear modeling were used to examine associations between driving status and healthcare utilization and costs.ResultsAdjusting for age, income, and marital status, former drivers were more likely than current drivers to use mental health care services (RR = 3.37; 95% CI: 1.03, 10.98). Former drivers also tended to use more inpatient (RR = 1.85; 95% CI: 0.88, 3.87) and emergency services (RR = 1.89; 95% CI: 0.96, 3.70), but results did not reach statistical significance. Total annual healthcare costs in 2005 were almost twice as high for former drivers compared with current drivers ($13,046 vs. $7,054; mean difference = $5,992; 95% CI: -$360, $12,344), although this relationship was not statistically significant (CR = 1.61; 95% CI: 0.88, 2.96).Impact on IndustryFormer drivers were more than three times as likely as current drivers to use mental health services, and tended to use more emergency and inpatient services. Further research on factors that potentially mediate the relationship between driving status and health service use is warranted.     

Passengers of impaired drivers

IntroductionThe aims of this study are: (a) to estimate the prevalence of passengers riding with alcohol-impaired drivers; (b) to investigate the role of demographic factors (age, gender, race/ethnicity, educational status) and relevant driving conditions (time of the day, trip origin, vehicle ownership) on shaping the likelihood of alcohol-impaired driving; (c) to identify and estimate the prevalence of passengers as alternative drivers (PADs); and (d) to examine the role that vehicle ownership plays in shaping the occurrence of PADs.MethodData came from a unique convenience sample of passengers obtained from the 2007 National Roadside Survey, a random sample of drivers from the 48 contiguous states.ResultsThe prevalence of PADs in the targeted population (mostly weekend night vehicles) was higher with drivers at .00 < BAC < .08 (17%-43%) than at BAC ≥ .08 (6%-29%) drivers. The evidence suggests that targeted policies to encourage PADs to drive might be possible. However, vehicle ownership is a large impediment for PADs to act as designated drivers. We speculate that vehicle ownership may be a main reason for the less-than expected success of the “designated driver” concept.     

A study of pedestrian and bicyclist exposure to head injury in passenger car collisions based on accident data and simulations

The objective was to assess head injury risks and kinematics of adult pedestrians and bicyclists in primary impact to the passenger cars and secondary impact to the ground using real world accident data and computer reconstructions of the accidents. For this purpose, a subsample of 402 pedestrians and 940 bicyclists from the GIDAS database, Germany, was used for the statistical analysis, from which 22 pedestrian and 18 bicyclist accidents were further selected for reconstruction. PC-Crash was used to calculate impact conditions, such as vehicle impact velocity, vehicle kinematic sequence, and thrown distance. These conditions were employed to identify the initial conditions in reconstruction in MADYMO program. A comparable analysis was conducted based on the results from accident analysis and computer reconstructions for the impact configurations and the resulting injury patterns of pedestrians and bicyclists in view of head injury risks. Differences in HIC, head-relative impact velocity, linear acceleration, maximum angular velocity and acceleration, contact force, thrown distance, Wrap Around Distance (WAD), and head contact time were evaluated. Injury risk curves were generated by using a logistic regression model for vehicle impact velocity. The results indicate that bicyclists suffered less severe injuries compared with severity of pedestrian injuries. In the selected samples, the AIS 2+ and AIS 3+ head injury risks for pedestrians are 50% probability at impact speed of 38.87 km/h and 54.39 km/h respectively, while for bicyclists at 53.66 km/h and 58.89 km/h respectively. The findings of high injury risks suggested that in the area with high frequency car-pedestrian accidents, the vehicle speed limit should be 40 km/h, while in the area with high frequency car-cyclist accidents the vehicle speed limit should be 50 km/h.     

Traffic environment and demographic factors affecting impaired driving and crashes

IntroductionData availability has forced researchers to examine separately the role of alcohol among drivers who crashed and drivers who did not crash. Such a separation fails to account fully for the transition from impaired driving to an alcohol-related crash.MethodIn this study, we analyzed recent data to investigate how traffic-related environments, conditions, and drivers’ demographics shape the likelihood of a driver being either involved in a crash (alcohol impaired or not) or not involved in a crash (alcohol impaired or not). Our data, from a recent case–control study, included a comprehensive sampling of the drivers in nonfatal crashes and a matched set of comparison drivers in two U.S. locations. Multinomial logistic regression was applied to investigate the likelihood that a driver would crash or would not crash, either with a blood alcohol concentration (BAC) = .00 or with a BAC ≥ .05.ConclusionsTo our knowledge, this study is the first to examine how different driver characteristics and environmental factors simultaneously contribute to alcohol use by crash-involved and non-crash-involved drivers. This effort calls attention to the need for research on the simultaneous roles played by all the factors that may contribute to motor vehicle crashes.     

Tracking progress in teenage driver crash risk in the United States since the advent of graduated driver licensing programs

IntroductionThis study examined U.S. teenagers' crash rates since 1996, when the first graduated driver licensing (GDL) program in the United State was implemented.MethodsPassenger vehicle driver crash involvement rates for 16–19 and 30–59 (middle-aged) year-olds were examined, using data from the Fatality Analysis Reporting System, National Automotive Sampling System General Estimates System, Census Bureau, and National Household Travel Surveys.ResultsPer capita fatal and police-reported crash rates in 2012 were lower for 16 year-olds than for middle-aged drivers but older teenagers' rates were higher. Mileage-based fatal and police-reported crash rates in 2008 were higher for teenagers than for middle-aged drivers and higher for 16–17 year-olds than for older teenagers. In 1996–2012, teenagers' per capita fatal and police-reported crash rates declined sharply, especially for 16–17 year-olds, and more so than for middle-aged drivers. Substantial declines also occurred in teenagers' mileage-based fatal and police-reported crash rates from 1995–96 to 2008, generally more so than for middle-aged drivers. Regarding factors in fatal crashes in 1996 and 2012, proportions of young teenagers' crashes occurring at night and with multiple teenage passengers declined, more so than among older teenagers and middle-aged drivers. The proportion of fatally injured drivers who had been drinking declined for teenagers but changed little for middle-aged drivers. Improvements were not apparent in rates of driver errors or speeding among teenage drivers in fatal crashes.ConclusionsTeenage drivers' crash risk dropped during the period of implementation of GDL laws, especially fatal crash types targeted by GDL. However, teenagers' crash risk remains high, and important crash factors remain unaddressed by GDL.Practical applicationsAlthough this study was not designed to examine the role of GDL, the results are consistent with the increased presence of such laws. More gains are achievable if states strengthen their laws.     

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.     

“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.     

Brake reactions of distracted drivers to pedestrian Forward Collision Warning systems

Introduction: Forward Collision Warning (FCW) can be effective in directing driver attention towards a conflict and thereby aid in preventing or mitigating collisions. FCW systems aiming at pedestrian protection have been introduced onto the market, yet an assessment of their safety benefits depends on the accurate modeling of driver reactions when the system is activated. This study contributes by quantifying brake reaction time and brake behavior (deceleration levels and jerk) to compare the effectiveness of an audio-visual warning only, an added haptic brake pulse warning, and an added Head-Up Display in reducing the frequency of collisions with pedestrians. Further, this study provides a detailed data set suited for the design of assessment methods for car-to-pedestrian FCW systems. Method: Brake response characteristics were measured for heavily distracted drivers who were subjected to a single FCW event in a high-fidelity driving simulator. The drivers maintained a self-regulated speed of 30 km/h in an urban area, with gaze direction diverted from the forward roadway by a secondary task. Results: Collision rates and brake reaction times differed significantly across FCW settings. Brake pulse warnings resulted in the lowest number of collisions and the shortest brake reaction times (mean 0.8 s, SD 0.29 s). Brake jerk and deceleration were independent of warning type. Ninety percent of drivers exceeded a maximum deceleration of 3.6 m/s² and a jerk of 5.3 m/s³. Conclusions: Brake pulse warning was the most effective FCW interface for preventing collisions. In addition, this study presents the data required for driver modeling for car-to-pedestrian FCW similar to Euro NCAP's 2015 car-to-car FCW assessment. Practical applications: Vehicle manufacturers should consider the introduction of brake pulse warnings to their FCW systems. Euro NCAP could introduce an assessment that quantifies the safety benefits of pedestrian FCW systems and thereby aid the proliferation of effective systems.     

大城市无信号控制人行横道行人过街延误分析

从心理学角度,以大城市无信号控制人行横道过街行人为研究对象,对行人过街延误进行定量分析研究。以北京市两个典型无信号控制人行横道为实例进行交通调查分析,计算行人的临界穿越间隙,安全穿越间隙出现的概率,及行人穿越该处的总延误时间。计算结果表明:观测路段车流中提供的安全穿越间隙的概率比较低;行人强行穿越的重要原因是行人过街延误超出了行人等待心理极限;验证了模型的精度;找出了观测路段交通秩序混乱的原因。针对大城市无信号控制人行横道的分析结果,提出了具体的改进建议和交通改善措施,为国内大城市行人交通安全管理提供了决策依据和有益参考。     

Pedestrian crossing behaviors at uncontrolled multi-lane mid-block crosswalks in developing world

IntroductionThe gap acceptance theory was primarily used to study pedestrian crossing behaviors, in accordance to static gaps that are calculated in the light of the cross section of crosswalk. However, pedestrians will face a series of dynamic gaps (especially at any uncontrolled multi-lane crosswalk) when they decide to cross the street, thus, pedestrians' decisions are made based on the dynamic gaps of each lane.MethodPedestrians' crossing behaviors at uncontrolled multi-lane mid-block crosswalk were investigated in this study. The lane-based gap (LGAP) was defined and five mid-block crosswalks were selected for observation in Wuhan, China. Pedestrians' behaviors and the corresponding traffic statuses were videoed as collected data, whose statistical analysis indicates that most pedestrians choose the rolling gap crossing strategy, which is different from existing research. Moreover, a logistic regression model was established to evaluate various influencing parameters (such as gender, age, waiting time and traffic volume) on the pedestrians' crossing strategy, whose accuracy is not satisfying. Therefore, the pedestrian dynamic gap acceptance (PDGA) model was put forward to describe pedestrians' crossing behaviors at any multi-lane crosswalk based on detailed analysis of the pedestrians' decision procedure.ResultsThe corresponding results show that its accuracy may be up to 88.6% to well describe pedestrians' crossing behaviors.ConclusionsThe PDGA model is appropriate to analyze pedestrians' dynamic decision procedures at multi-lane mid-block crosswalks.Practical applicationThe findings of this study can be used for safety and performance evaluation of crosswalks at mid-block locations in developing countries like China and India.     

Risk factors associated with bus accident severity in the United States: A generalized ordered logit model

IntroductionRecent years have witnessed a growing interest in improving bus safety operations worldwide. While in the United States buses are considered relatively safe, the number of bus accidents is far from being negligible, triggering the introduction of the Motor-coach Enhanced Safety Act of 2011.MethodThe current study investigates the underlying risk factors of bus accident severity in the United States by estimating a generalized ordered logit model. Data for the analysis are retrieved from the General Estimates System (GES) database for the years 2005–2009.ResultsResults show that accident severity increases: (i) for young bus drivers under the age of 25; (ii) for drivers beyond the age of 55, and most prominently for drivers over 65 years old; (iii) for female drivers; (iv) for very high (over 65 mph) and very low (under 20 mph) speed limits; (v) at intersections; (vi) because of inattentive and risky driving.     

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.     

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.     

Pedestrian crossing behavior at midblock crosswalks

IntroductionThis study investigated the pedestrian crossing behavior at midblock crosswalks, in Istanbul. Method: Data were compiled from field studies at four selected crosswalks that were on one-way streets. Three of the crosswalks were located on three-lane streets while the other one was on a two-lane street. By using two-hour video recordings at each crosswalk, information was collected about pedestrian crossing preferences, pedestrian platoons both at curbside and during the crossing, traffic characteristics including volume, crosswalk occupancy and illegal parking, and pedestrian characteristics comprising age, gender and distraction status. These data were stratified with respect to the number of lanes and two multinomial logit models for platooning and individual crossing behavior was estimated for each stratum. Results: The results showed that the likelihood of platooning increases as the traffic volume and platoon size increase. Moreover, pedestrians who waited for little or no at the curbside and started to cross when one or more lanes were occupied generally lost time during the crossing. In terms of policy, the formation of platoons should be prevented by enforcement or demand-responsive traffic signals with push-to-walk buttons, etc. Overall, the study revealed that the presence of midblock crosswalks is questionable.     

Crossing a two-way street: comparison of young and old pedestrians

IntroductionChoosing a safe gap in which to cross a two-way street is a complex task and only few experiments have investigated age-specific difficulties.MethodA total of 18 young (age 19–35), 28 younger-old (age 62–71) and 38 older-old (age 72–85 years) adults participated in a simulated street-crossing experiment in which vehicle approach speed and available time gaps were varied. The safe and controlled simulated environment allowed participants to perform a real walk across an experimental two-way street. The differences between the results for the two lanes are of particular interest to the study of visual exploration and crossing behaviors.ResultsThe results showed that old participants crossed more slowly, adopted smaller safety margins, and made more decisions that led to collisions than did young participants. These difficulties were found particularly when vehicles approached in the far lane, or rapidly. Whereas young participants considered the time gaps available in both lanes to decide whether to cross the street, old participants made their decisions mainly on the basis of the gap available in the near lane while neglecting the far lane.ConclusionsThe present results point to attentional deficits as well as physical limitations in older pedestrians. Several practical and have implications in terms of road design and pedestrian training are proposed.