Overestimation of self-reported driving exposure: Results from the SHRP2 Naturalistic Driving Study

Objectives: The accuracy of self-reported driving exposure has questioned the validity of using self-reported mileage to inform research questions. Studies examining the accuracy of self-reported driving exposure compared to objective measures find low validity, with drivers overestimating and underestimating driving distance. The aims of the current study were to (1) examine the discrepancy between self-reported annual mileage and driving exposure the following year and (2) investigate whether these differences depended on age and annual mileage.

Methods: Two estimates of drivers’ self-reported annual mileage collected during vehicle installation (obtained via prestudy questionnaires) and approximated annual mileage driven (based upon Global Positioning System data) were acquired from 3,323 participants who participated in the Strategic Highway Research Program 2 (SHRP2) Naturalistic Driving Study.

Results: A Wilcoxon signed rank test showed that there was a significant difference between self-reported and annual driving exposure during participation in SHRP 2, with the majority of self-reported responses overestimating annual mileage the following year, irrespective of whether an ordinal or ratio variable was examined. Over 15% of participants provided self-reported responses with over 100% deviation, which were exclusive to participants underestimating annual mileage. Further, deviations in reporting differed between participants who had low, medium, and high exposure, as well as between participants in different age groups.

Conclusions: These findings indicate that although self-reported annual mileage is heavily relied on for research, such estimates of driving distance may be an overestimate of current or future mileage and can influence the validity of prior research that has utilized estimates of driving exposure.     

Impact of perceptual countermeasures on driving behavior at curves using driving simulator

Objective: The probability of crash occurrence on horizontal curves is 1.5 to 4 times higher than that on tangent sections. A majority of these crashes are associated with human errors. Therefore, human behavior in curves needs to be corrected.

Methodology: In this study, 2 different road marking treatments, optical circles and herringbone patterns, were used to influence driver behavior while entering a curve on a 2-lane rural road section. A driving simulator was used to perform the experiment. The simulated road sections are replicas of 2 real road sections in Flanders.

Results: Both treatments were found to reduce speed before entering the curve. However, speed reduction was more gradual when optical circles were used. A herringbone pattern had more influence on lateral position than optical circles by forcing drivers to maintain a safe distance from opposing traffic in the adjacent lane.

Conclusion: The study concluded that among other low-cost speed reduction methods, optical circles are effective tools to reduce speed and increase drivers’ attention. Moreover, a herringbone pattern can be used to reduce crashes on curves, mainly for head-on crashes where the main problem is inappropriate lateral position.     

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.     

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.     

Evaluating the impact of criminalizing drunk driving on years of life lost due to road traffic deaths in one megacity,China

Objective: Road safety is an important public health issue worldwide. However, few studies have analyzed the association between criminalizing drunk driving and years of life lost (YLL) due to road traffic deaths (RTDs). Our study can provide useful information about this policy.

Methods: We used interrupted time-series analysis to find the changes in monthly YLL and RTD before and after law enforcement began using RTD data from 2008 to 2014 in Tianjin.

Results: After adjustment for seasonality, months, holidays, and the number of people in each district, criminalizing drunk driving was followed by a 11.1% (95% confidence interval [CI], 1.1–21.1%) reduction in risk of RTDs and a corresponding 778.1-year (95% CI, 200–1,355.1) reduction in monthly YLL. The reduction in YLL was especially significant among males, those aged 16–64 years old, and suburban residents.

Conclusions: This study highlights that the law can lead to a reduction in YLL due to RTDs in Tianjin, China. Large immediate public health benefits resulted from the new road traffic law in China. YLL provides a complementary measure for examining the effect of criminalization on drunk driving RTDs.     

Driving anger among motor vehicle drivers in China: A cross-sectional survey

Objective: Driving anger is a common emotion while driving and has been associated with traffic crashes. This study aimed to investigate situations that increase driving anger among Chinese drivers.

Methods: A cross-sectional study was conducted among 3,101 drivers in southern China. The translated version of the 33-item Driving Anger Scale (DAS) was used to measure driving anger. Data were collected by face-to-face interviews between June 2016 and September 2016.

Results: Confirmatory factor analysis showed that the fit of the original 6-factor model (discourtesy, traffic obstacles, hostile gestures, slow driving, illegal driving, and police presence) was satisfactory, after removing 2 items and allowing 5 error pairs to covary. The model showed satisfactory fit: goodness of fit index (GFI) = 0.90, incremental fit index (IFI) = 0.90, root mean square error of approximation (RMSEA) = 0.06, 90% confidence interval (CI) = 0.061–0.064. Driving anger among Chinese drivers was lower than that in some Western countries. Compared to older and experienced drivers, younger and new drivers were more likely to report driving anger. There was no difference in total reported driving anger between males and females. Additionally, the higher the driver’s anger level was, the more likely he or she was to have had a traffic crash.

Conclusion: Driving anger is a common emotion among Chinese drivers and has a strong correlation with aggressive driving behavior and traffic crashes.     

Effects of cognitive distraction on speed control in curve negotiation

Objective: Maintaining a lower speed is recommended for curve negotiation and it has been shown that cognitive distraction may impair driving performance. This study examines the effects of different levels of cognitive distraction on the speed control of drivers negotiating a curve.

Methods: Experiments were conducted on a 6 degrees of freedom driving simulator with 28 participants. A comparison of the speed and acceleration from 300 m before to 100 m after the curve was performed for baseline driving (without distraction) and 3 levels of cognitive distractions using n-back tasks.

Results: The speed was significantly higher at the highest level of cognitive distraction (8%) than in baseline driving from the beginning of the curve to 50 m after it and the ratio of the highest level to the baseline was even greater throughout the range. The average acceleration was significantly higher than the baseline at the highest and the medium levels (80 and 70%, respectively) from 250 m before the curve to the one-quarter curve and from 250 to 150 m before the curve, respectively. It was also found that the point of deceleration was significantly delayed at the highest level of cognitive distraction and occurred only after the middle of the curve, whereas deceleration in baseline driving occurred just before entering the curve.

Conclusions: The impairment due to cognitive distraction was confirmed in this study but was only significant at a high level of cognitive distraction. The highly distracted drivers failed to perceive the curve in advance, resulting in a slower response to changes in the roadway. The findings indicate that acceleration may be an indicator of cognitive distraction while negotiating curves. A driver is prone to cognitive distraction and the driving performance is affected when driving requires excessive attention such as curve negotiation.     

Marijuana trajectories and associations with driving risk behaviors in Canadian youth

Objective: Research on risky driving practices involving marijuana use among youth and young adults often relies on cross-sectional data, which fail to account for longitudinal changes in substance use patterns. A better understanding of the longitudinal patterns of marijuana use and its effect on risky driving practices during young adulthood is needed in order to better inform prevention efforts. The current study examined whether different longitudinal patterns of marijuana use across the transition from adolescence to young adulthood are associated with impaired driving risks in young adulthood.

Methods: Data were from the longitudinal Victoria Healthy Youth Survey, which interviewed youth biennially on 6 occasions across 10 years (2003 to 2013).

Results: Youth who reported consistently high levels of marijuana use from adolescence to young adulthood (chronic users) and youth who reported increasing levels of use across this period (increasers) were more likely to engage in risky impaired driving behaviors compared to the other 3 user groups (occasional users, decreasers, and abstainers). Frequency of marijuana use was also predictive of impaired driving risks in young adulthood after controlling for individual characteristics (age, sex, socioeconomic status, age of onset of marijuana use), frequency of other substance use (heavy episodic drinking and illicit drug use), and simultaneous use of marijuana and other substances (alcohol and illicit drugs). By young adulthood, youth who use marijuana more than once a week are more likely to simultaneously use alcohol and engage in heavy episodic drinking. They are also more likely take driving risks.

Conclusions: Harm reduction strategies and legislative approaches targeting impaired driving risks associated with marijuana use should include approaches to target these high-risk groups and to reduce simultaneous use of alcohol.     

Estimating resource utilization demands in implementing statewide screening,brief intervention,and referral to treatment for alcohol-impaired drivers

Objectives: The Alcohol Use Disorders Identification Test (AUDIT) is used to assess the level of alcohol use/misuse and to inform the intensity of intervention delivered within screening, brief intervention, and referral to treatment (SBIRT) programs. Policy initiatives are recommending delivery of SBIRT within health care settings to reduce alcohol misuse and prevent alcohol-impaired driving. Recent reports are considering extending delivery of SBIRT to criminal justice settings. One consideration in implementing SBIRT delivery is the question of resource utilization; the amount of effort required in delivering the 4 different intensities of intervention in SBIRT: Alcohol education, simple advice, brief counseling and continued monitoring, and brief counseling and referral to specialist (from least to most intense in terms of delivery time, the skill level of the provider, and personnel resources).

Methods: In order to inform expectations about intervention intensity, this article describes the AUDIT scores from 982 adults recently arrested for alcohol-impaired driving. The distribution of scores is extrapolated to state rates for individuals arrested for alcohol-impaired driving by intervention level.

Results: Though alcohol education was the most common intervention category, about one quarter of the sample scored in a range corresponding with the more intensive interventions using the brief counseling, continued monitoring for ongoing alcohol use, and/or referral to specialist for diagnostic evaluation and treatment.

Conclusions: This article provides local distribution of AUDIT scores and state estimates for the number of individuals scoring in each level of risk (AUDIT risk zone) and corresponding intervention type. Routine criminal justice practice is well positioned to deliver alcohol screening, education, simple advice, and continued alcohol monitoring, making delivery of SBIRT feasible for the majority of alcohol-impaired drivers. Challenges to implementing the full range of SBIRT services include resource demands of brief counseling, identifying the appropriate providers within a criminal justice context, and availability of community providers for referral to diagnostic and specialty care. Solutions may vary by state due to differences in population density and incidence rates of alcohol-impaired 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.     

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.     

Effects of mobile phone use on driving performance in a multiresource workload scenario

Objective: This study explores the influence of mobile phone secondary tasks on driving from the perspective of visual, auditory, cognitive, and psychomotor (VACP) multiple resource theory, and it is anticipated to benefit the human-centered design of mobile phone use while driving.

Methods: The present study investigated 6 typical phone use scenarios while driving and analyzed the effects of phone use distractions on driving performance. Thirty-six participants were recruited to participate in this experiment. We abandoned traditional secondary tasks such as conversations or dialing, in which cognitive resources can become interference. Instead, we adopted an arrow secondary task and an n-back delayed digit recall task.

Results: The results show that all mobile phone use scenarios have a significant influence on driving performance, especially on lateral vehicle control. The visual plus psychomotor resource occupation scenario demonstrated the greatest deterioration of driving performance, and there was a significant deterioration of driving speed and steering wheel angle once the psychomotor resource was occupied.

Conclusions: Phone use distraction leads to visual, cognitive, and/or motor resource functional limitations and thus causes lane violations and traffic accidents.     

A novel driver hazard perception sensitivity model based on drivers’ characteristics: A simulator study

Objective: Considering the high annual number of fatal driving accidents in Iran, any approach for reducing the number or severity of driving accidents is a positive step toward decreasing accident-related losses. Accidents can often be avoided by a timely reaction of the driver. One of the steps before reacting to a hazard is perception. Some driver characteristics may affect road hazard perception. In this research, it was assumed that various driver characteristics, including demographic characteristics and cognitive characteristics, have an impact on driver perception.

Methods: The driving simulator used in this research provides various scenarios; for example, passing a pedestrian or animal across the road or placing fixed objects in a 2-lane separated rural road for 2 groups of experienced and inexperienced drivers under day and night lighting conditions. The go/no-go test was carried out in order to assess drivers’ attention to driving tasks and inhibitory control. A structural equation model (SEM) was used to estimate the relation between driver characteristics and sensitivity to road hazard perception. A new hazard perception index was proposed based on the time intervals in the hazard vulnerability.

Results: The results show that the most effective variables in the analysis of sensitivity to hazard perception are driving experience (in kilometers) during the last 3 years and road lighting conditions. Moreover, hazard perception sensitivity was improved by better inhibitory control, selective attention, and decision making, more carefulness, the average amount of daily sleep, and marital status.

Conclusion: The results of this research may be useful in educating and advertising programs. It also could enhance sensitivity to perception of hazards such as pedestrians, animals, and fixed obstacles among young and novice drivers.     

First evaluation of the possibility of testing for drugged driving using exhaled breath sampling

Objective: Driving under the influence of psychoactive drugs causes an increased risk for accidents. In combating this, sobriety tests at the roadside are common practice in most countries. Sampling of blood and urine for forensic investigation cannot be done at the roadside and poses practical problems associated with costs and time. An alternative specimen for roadside testing is therefore warranted and the aerosol particles in exhaled breath are one such alternative.

Methods: The present study investigated how the exhaled breath sample compared with the routine legal investigations of blood and urine collected from suspects of drugged driving at 2 locations in Sweden. Exhaled breath was collected using a simple filter collection device and analyzed with state-of-the-art mass spectrometry technique.

Results: The total number of cases used for this investigation was 67. In 54 of these cases (81%) the results regarding a positive or negative drug test result agreed and in 13 they disagreed. Out of these, the report from the forensic investigation of blood/urine was negative in 21 cases. In 6 of these, analytical findings were made in exhaled breath and these cases were dominated by the detection of amphetamine. In 7 cases a positive drug test from the forensic investigation was not observed in the breath sample and these cases were dominated by detection of tetrahydrocannabinol in blood. In total, 45 samples were positive with breath testing and the number of positives with established forensic methods was 46.

Conclusion: The promising results from this study provide support to exhaled breath as a viable specimen for testing of drugged driving. The rapid, easy, and convenient sampling procedure offers the possibility to collect a drug test specimen at the roadside. The analytical investigation must be done in a laboratory at present because of the need for a highly sensitive instrument, which is already in use in forensic laboratories. The analytical work is not more challenging than for blood or oral fluid and should not cause an increase in cost. However, more studies need to be done before exhaled breath drug testing can be applied routinely for drugged driving investigation.     

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.     

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.     

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.     

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.