Evaluating impaired drivers confidence and intention to "(Please) drink responsibly"

Introduction

Currently, alcohol industry-sponsored advertisements subsume traditional designated driver and don't drink and drive messages within responsible drinking campaigns. Yet, to date, there remains a dearth of literature specifically examining the attitudinal beliefs impaired drivers attach to the responsible drinking message.

Objective

This investigation sought to examine the responsible drinking attitudes and beliefs of impaired drivers, specifically examining their confidence and intention to drink responsibly the next time they consumed alcohol.

Methods

A random sample of 729 students attending a large, public Texas university completed a web-based administration of the Characteristic of Responsible Drinking Survey (CHORDS).

Results

Participants in this sample who had driven while impaired by alcohol exhibited significantly less confidence in refraining from drinking and driving and reported significantly lower intentions to designate a driver, take a taxi, or use a safe-ride program the next time they consumed alcohol. Additionally, they also reported less confidence, and lower intentions, to ensure their blood alcohol concentrations remained below the legal limit (0.08%) the next time they consumed alcohol.

Conclusions

Drivers who had driven while impaired significantly differed in their confidence and intention to drink responsibly the next time they consumed alcohol. Logistic regression results indicate that by increasing one's confidence in responsible drinking, and increasing their intention to drink responsibly, the likelihood of impaired driving can be decreased.

Impact on industry

Results from this investigation demonstrate one’s responsible drinking attitudinal beliefs accounts for a significant amount of the variance associated with one’s alcohol-related behaviors. Thus, further research should examine and establish how individuals conceptualize and practice responsible drinking.     

Working with cognitively impaired drivers: Legal issues for mental health professionals to consider

Introduction

Mental health professionals are gatekeepers of patient confidentiality. Yet, confidentiality held too strictly, by allowing a potentially dangerous driver to assume control of a car, endangers society. Recent court cases have mandated that mental health professionals must warn those who may be potentially harmed by patients. In spite of this, disagreements linger as to whether it is the responsibility of governmental agencies or mental health professionals to decide who is unfit to operate a vehicle because of cognitive impairment. Methods: This article addresses the legally relevant considerations when working with cognitively compromised individuals who operate a motor vehicle. Legal issues surrounding confidentiality, patient rights, foreseeable risk, and the duty to warn and protect are presented in order to understand their relationship to recent court rulings.

Impact on industry

The impact on the mental health care industry includes not only concerns about increased insurance premiums or costs due to alleged negligence or litigation expenses secondary to failure to ensure the safety of an impaired client under their care. Mental health care providers are aware that the welfare of clients with impairment to cognitive decision making ability may require unique considerations for safety such as ensuring safe and appropriate transportation.     

Impairment due to alcohol,tetrahydrocannabinol, and benzodiazepines in impaired drivers compared to experimental studies

Objective: In some countries, per se laws for other drugs than alcohol are used to judge drunk and drugged drivers. These blood concentration limits are often derived from experimental studies on traffic relevant behavior of healthy volunteers. Knowledge about how results from experimental studies could be transferred to a real-life setting is missing. The aim of this study was to compare impairment seen in experimental studies to the impairment seen at equivalent concentrations in apprehended drunk and drugged drivers.

Methods: Results from previously performed meta-analyses of experimental studies regarding impairment from alcohol, tetrahydrocannabinol (THC), and benzodiazepines were compared to impairment in apprehended drunk and drugged drivers as judged by a clinical test of impairment. Both experimental studies and real-life cases were divided into 4 groups according to increasing blood drug concentration intervals. The percentage of impaired test results in experimental studies was compared to the percentage of impaired subjects among drivers within the same blood drug concentration window.

Results: For ethanol, the percentage of impaired drivers (n = 1,223) increased from 59% in the lowest drug concentration group to 95% in the highest drug concentration group, compared to 7 and 72% in the respective groups in experimental studies. For THC, the percentage of impaired drivers (n = 950) increased from 42 to 58%, the corresponding numbers being 11 and 42% for experimental studies. For benzodiazepines, the percentage of impaired drivers (n = 245) increased from 46 to 76%, the corresponding numbers being 16 and 60% for experimental studies. The increased odds ratio for impairment between 2 concentration groups was comparable for experimental studies and impaired drivers.

Conclusions: Fewer test results indicated impairment in experimental studies compared to impaired drivers in real life when influenced by similar blood concentrations of either ethanol, THC, or benzodiazepines. In addition, a comparable relationship between drug concentration and impairment was seen for both experimental studies and real-life cases.

We believe that the present study strengthens the background for using experimental studies to establish fixed concentration limits for drunk and drugged drivers, but experimental studies in an impaired driver population could further expand our knowledge.     

The influence of the age and sex distributions of drivers on the reduction of impaired crashes: Ontario, 1974-1999

Legislative changes and public media campaigns to prevent impaired driving are often cited as explanations for the reduction in the rate of impaired crashes over the past 25 years in most of the industrialized world. Other factors may have contributed to these reductions, such as changes in the age and sex distribution of the driver population. The primary purpose of this article is to assess the extent to which the reduction in impaired crashes in Ontario, Canada, may be attributable to the changing age and sex distribution of drivers. In Ontario, the rate of impaired crashes declined by 78.1% from 1974 to 1999. During this time period, the average age of drivers increased from 39.4 years in 1974 to 43.2 in 1999. Similarly, from 1974 to 1999 the percentage of all drivers that were women increased from 39.6% to 46.8%. Since statistics show the likelihood of impaired crashes is lower for both older drivers and women, the reduction of impaired crashes is partially due to these demographic changes. Using indirect standardization, the aging population accounted for an 8.6% decline in the rate of impaired crashes. The changing sex distribution of drivers accounted for a 9.4% decline in impaired crashes. Other global factors may also help to explain the reduction of impaired crashes, such as general road safety improvements and reductions in per adult consumption of alcohol.     

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.     

Hard core drinking drivers

The term "hard core" has been used extensively over the past 15 years to identify persons who drink and drive regularly, typically at high blood alcohol levels. This article discusses how the term arose and clarifies what it means, both as a concept and in practice. It describes the characteristics of hard core drinking drivers and estimates their contribution to drinking driver trips, arrests, and crashes. It summarizes current knowledge and recommendations on the most effective means to affect their behavior and reduce their drinking and driving.     

Technology and teen drivers

The rapid evolution of computing, communication, and sensor technology is likely to affect young drivers more than others. The distraction potential of infotainment technology stresses the same vulnerabilities that already lead young drivers to crash more frequently than other drivers. Cell phones, text messaging, MP3 players, and other nomadic devices all present a threat because young drivers may lack the spare attentional capacity for vehicle control and the ability to anticipate and manage hazards. Moreover, young drivers are likely to be the first and most aggressive users of new technology. Fortunately, emerging technology can also support safe driving. Electronic stability control, collision avoidance systems, intelligent speed adaptation, and vehicle tracking systems can all help mitigate the threats to young drivers. However, technology alone is unlikely to make young drivers safer. One promising approach to tailoring technology to teen drivers is to extend proven methods for enhancing young driver safety. The success of graduated drivers license programs (GDL) and the impressive safety benefit of supervised driving suggest ways of tailoring technology to the needs of young drivers. To anticipate the effects of technology on teen driving it may be useful to draw an analogy between the effects of passengers and the effects of technology. Technology can act as a teen passenger and undermine safety or it can act as an adult passenger and enhance safety. Impact on industry: Rapidly developing technology may have particularly large effects on teen drivers. To maximize the positive effects and minimize the negative effects will require a broad range of industries to work together. Ideally, vehicle manufacturers would work with infotainment providers, insurance companies, and policy makers to craft new technologies so that they accommodate the needs of young drivers. Without such collaboration young drivers will face even greater challenges to their safety as new technologies emerge.     

Teenage drivers: patterns of risk

PROBLEM: To determine patterns of risk among teenage drivers. METHOD: Review and synthesis of the literature. RESULTS: On most measures, crash rates during the teenage years are higher than at any other age, for both males and females. Risk among teenagers varies greatly by driving situation; it is particularly low in some situations (e.g., the learner period) and particularly high in others (e.g., right after licensure, late at night, with passengers present). In some of these high-risk driving situations, risk is elevated for drivers of all ages (e.g., late night driving), in others risk is elevated more for teens than adults (e.g., driving after consuming alcohol), and in others the risk is unique to teen drivers (e.g., having passengers). IMPACT ON RESEARCH, PRACTICE, AND POLICY: These varying patterns of risk form the basis for graduated licensing systems, which are designed to promote low-risk and discourage high-risk driving.     

Passenger distractions among adolescent drivers

PROBLEM: Adolescents who drive with peers are known to have a higher risk of crashes. While passengers may distract drivers, little is known about the circumstances of these distractions among teen drivers. METHOD: This study used survey data on driving among 2,144 California high school seniors to examine distractions caused by passengers. RESULTS: Overall, 38.4% of youths who drove reported having been distracted by a passenger. Distractions were more commonly reported among girls and students attending moderate- to high-income schools. Talking or yelling was the most commonly reported type of distraction. About 7.5% of distractions reported were deliberate, such as hitting or tickling the driver or attempting to use the vehicle's controls. Driving after alcohol use and having had a crash as a driver were both significant predictors of reporting passenger-related distraction. CONCLUSION: Adolescents often experience distractions related to passengers, and in some cases these distractions are intentional. IMPACT ON INDUSTRY: These results provide information about teenage drivers who are distracted by passenger behaviors. In some cases, passengers attempted to use vehicle controls; however, it seems unlikely that this behavior is common enough to warrant redesign of controls to make them less accessible to passengers.     

Schedule tightness among tractor-trailer drivers

The extent to which schedules are sufficiently tight to encourage violations of Hours-of-Service Regulations, speed limits, or both was investigated through a survey of over 1,600 tractor-trailer drivers. The focus was on drivers with refrigerated trailers. The results indicate high incidence levels of tight schedules. For example, assuming average speed limits of 65 mph, 24% had violation-inducing schedules with regard to the movement they were making at the time of the interviews. Incorporating information about previous driving, the incidence of violation-inducing schedules rose to 40%. Comparison with an earlier study suggests that, despite increases in speed limits which would tend to loosen schedules, schedules have become tighter over the past decade. The implications of these findings for reforms of Hours-of-Service Regulations are briefly discussed.     

Effectiveness of mandatory license testing for older drivers in reducing crash risk among urban older Australian drivers

Most licensing jurisdictions in Australia maintain mandatory assessment programs targeting older drivers, whereby a driver reaching a specified age is required to prove his or her fitness to drive through medical assessment and/or on-road testing. Previous studies both in Australia and elsewhere have consistently failed to demonstrate that age-based mandatory assessment results in reduced crash involvement for older drivers. However studies that have based their results upon either per-population or per-driver crash rates fail to take into account possible differences in driving activity. Because some older people maintain their driving licenses but rarely if ever drive, the proportion of inactive license-holders might be higher in jurisdictions without mandatory assessment relative to jurisdictions with periodic license assessment, where inactive drivers may more readily either surrender or lose their licenses. The failure to control for possible differences in driving activity across jurisdictions may be disguising possible safety benefits associated with mandatory assessment. The current study compared the crash rates of drivers in Melbourne, Australia, where there is no mandatory assessment and Sydney, Australia, where there is regular mandatory assessment from 80 years of age onward. The crash rate comparisons were based on four exposure measures: per population, per licensed driver, per distance driven, and per time spent driving. Poisson regression analysis incorporating an offset to control for inter-jurisdictional road safety differences indicated that there was no difference in crash risk for older drivers based on population. However drivers aged 80 years and older in the Sydney region had statistically higher rates of casualty crash involvement than their Melbourne counterparts on a per license issued basis (RR: 1.15, 1.02-1.29, p=0.02) and time spent driving basis (RR: 1.19, 1.06-1.34, p=0.03). A similar trend was apparent based on distance travelled but was of borderline statistical significance (RR: 1.11, 0.99-1.25, p=0.07). Collectively, it can be inferred from these findings that mandatory license re-testing schemes of the type evaluated have no demonstrable road safety benefits overall. Further research to resolve this on-going policy debate is discussed and recommended.     

New Zealand drivers study: developing a methodology for conducting a follow-up study of newly licensed drivers

PROBLEM: In recent years, there has been a significant reduction in traffic crash injury among young people, but they continue to be overrepresented in the traffic crash statistics. To improve this situation, sound scientific evidence is needed to develop effective policies and programs. METHOD: The aim of the proposed study is to provide this evidence by examining early driving and driving-related experiences of newly licensed drivers as they progress through the learner-, restricted-, and full-license stages of the graduated licensing system and to determine the impact of these experiences on subsequent negative traffic-related outcomes (risky driving behavior, injury traffic crashes, noninjury traffic crashes, infringements, convictions). Given the size and complexity of the proposed study, a comprehensive pilot study was undertaken to determine the feasibility of conducting a New Zealand-wide cohort study of newly licensed drivers. RESULTS: This article describes the pilot study process and the methodology that has been developed for the New Zealand-wide study.     

Views of US drivers about driving safety

Problem: To assess how drivers view dangers on the highway, what motivates them to drive safely, how they say they reduce their crash and injury risk, and how they rate their own driving skills. Results: Most drivers rated their skills as better than average. The biggest motivating factor for safe driving was concern for safety of others in their vehicle, followed by negative outcomes such as being in a crash, increased insurance costs, and fines. The greatest threats to their safety were thought to be other drivers' actions that increase crash risk such as alcohol impairment or running red lights. In terms of reducing crashes and injuries, drivers tended to focus on actions they could take such as driving defensively or using seat belts. There was less recognition of the role of vehicles and vehicle features in crash or injury prevention. Impact on research, practice, and policy: Knowing how drivers view themselves and others, their concerns, and their motivations and techniques for staying out of trouble on the roads provides insight into the difficulty of changing driving practices.     

Identifying risky drivers with simulated driving

Objective: The present study aimed to examine whether high-risk drivers differ from low-risk drivers in driving behavior in a simulated environment.

Method: The 2 risk groups including 36 drivers (18 males and 18 females) performed driving tasks in a simulated environment. The simulated driving behaviors are compared between the 2 risk groups.

Results: The high-risk drivers drove much faster and exhibited larger offsets of the steering wheel than did the low-risk drivers in events without incidents. Additionally, the high-risk drivers used turn signals and horns less frequently than the low-risk drivers.

Conclusions: The present study revealed that the high-risk group differed from the low-risk group in driving behavior in a simulated environment. These results also suggest that simulated driving tasks might be useful tools for the evaluation of drivers’ potential risks.     

Occupational injuries of immigrant and Finnish bus drivers

Problem

With baby boomers reaching retirement age, Western countries may need more immigrant workers to ensure productivity. Many studies have suggested a higher occupational injury frequency among immigrant workers, which could considerably reduce their contribution to society. The aim of this study was to examine whether immigrant workers have a higher injury frequency compared to Finnish workers when performing the exact same tasks under the same working conditions.

Method

A total of 176 Finnish and 130 immigrant bus drivers were asked about their occupational injuries during the past 12 months via a questionnaire. In addition, the data contained 134 injuries reported by the transport firm to an insurance company.

Results

There was no significant difference in reporting occupational injuries by self-reporting or by company-records. Because there were more accident-repeaters among Finnish drivers, their injury frequency (114) was higher than that of immigrant drivers (78).

Application/Impact

This study showed that immigrant workers did not have a higher injury frequency than other workers when they worked in the exact same conditions. Immigrant workers can work as safely as native-Finnish workers, when their working conditions and job contracts are at the same level as those of the original population. Immigrant workers can compensate for the shortage of workforce caused by an aging population.