Socioeconomic background and road traffic injuries: a study of young car drivers in Sweden

The aim of this study is to explore the manner in which different measures of original socioeconomic position (SEP) influence road traffic injuries (RTIs) among young car drivers in Sweden. The study consists of young people age 16-23. Subjects were taken from the Swedish Population and Housing Census of 1990 (n=727,995), and followed up by a search for cases of injury to car drivers in Sweden's National Hospital Discharge Register over the years 1991-96 (n=1,599). Household SEP was measured using social class, education, and disposable income. Relative risks were estimated by Poisson regression and population attributable risks were computed for each measure of SEP. Children of unskilled workers, of the self-employed, and of farmers, as well as children of parents with compulsory education only showed an increased risk of injury as car drivers compared to children in the highest socioeconomic group and children of highly educated parents. By contrast, level of household disposable income was found not to vary with RTI among young drivers. Twenty-five percent of the injuries could be avoided if all young people had the injury rate of the highest socioeconomic group, and 29% if all young people had the injury rate of those with highly educated parents. The reduction of risk differences based on household SEP calls for consideration of factors related to both differential exposure and differential susceptibility, which may be addressed in driver education.     

Post-license education for novice drivers: evaluation of a training programme implemented in Spain

INTRODUCTION: This study evaluated the implementation of a second phase training program for novice drivers in Spain, which puts the primary focus of the training on the higher hierarchical levels of driver behavior. METHOD: Two hundred and sixty-three participants took part throughout the study, which was implemented as an experimental design with the test and control groups assessed before and after the one day safety training. Measurement of the impact of the training program focused on the participants' self-evaluation and self-reporting of some driving behavior indicators related to accident risk. RESULTS: Data analysis showed a change in the expected direction in the scale related to the skills for careful driving, but not for the other four scales considered. A feedback survey about the training course offered some important input for evaluating the organization, contents, tuition, and results of the three parts of the training program (discussion group, on-road and track training) as reported by the participants in the test group. CONCLUSIONS AND SUGGESTIONS: The results of the experiment show that using a one day driver safety course, it is possible to change some of the drivers' evaluations connected to safe driving style into safe direction. The follow-up period was exceptionally long (9 months) and the design (randomly divided experimental and control groups with before and after measurements) was reliable. More effort should be devoted to improving the on-road part of the training, which was often perceived as a typical driving lesson rather than a feedback drive. IMPACT ON INDUSTRY: The findings suggest consideration of a mandatory 2nd phase driver training programme as a means to raise awareness of the full range of risks encountered by novice drivers, and as already introduced in 5 EU countries: Austria, Estonia, Finland, Luxembourg and Switzerland.     

Evaluation of a healthcare safety climate measurement tool

Problem

Psychometrically validated measurement tools are needed to evaluate an organization's safety climate. In 2000, Gershon and colleagues published a new healthcare safety climate measurement tool to determine its relationship to safe work behavior (Gershon, R., Karkashian, C., Grosch, J., Murphy, L., Escamilla-Cejudo, A., Flanagan, P., et al. (2000). Hospital safety climate and its relationship with safe work practices and workplace exposure incidents. American Journal of Infection Control, 28, 211-21). The present study evaluated the psychometric properties of the Gershon tool when modified to address respiratory rather than bloodborne pathogen exposures.

Method

Medical practitioners, nurses, and nurse aides (n = 460) were surveyed using the modified Gershon tool. Data were analyzed by factor analysis and psychometric properties of the tool evaluated.

Results

Eight safety climate dimensions were extracted from 25 items (Cronbach's alpha range: 0.62 - 0.88). Factor extractions and psychometric properties were reasonably consistent with those of the Gershon tool.

Impact on Industry

The Gershon safety climate tool appears to have sufficient reliability and validity for use by healthcare decision makers as an indicator of employee perceptions of safety in their institution.     

Car safety and social differences in traffic injuries among young adult drivers: a study of two-car injury-generating crashes in Sweden

Objective—The study examines whether socioeconomic and sex differences in road-traffic crashes leading to injury vary according to car-safety level.Method—Individuals records of subjects born 1970–1972 registered in the Swedish Census of 1985 (n = 334,070) are linked to road-traffic-crash data for the period 1988–2000 for first police-registered two-car crashes leading to severe or fatal injury (n = 4875). Injuries are split into categories according to level of car safety on a five-point scale, based on criteria related to crash safety. Account is taken of both how the car is constructed and the effectiveness of its safety equipment (such as airbags and seat belts). For each car-safety level, relative risks are computed considering socioeconomic groups of origin, educational level, and sex.Results—No substantial differences between drivers in different socioeconomic positions of origin is observed except for crashes involving cars 30% better than average with regard to safety. There are consistent risk differences across all car-safety categories according to educational level. Male drivers show an elevated risk of injury in all car categories, except for cars with the poorest safety where they are at significant under-risk.Conclusions—Car-safety level impacts on social differences in road-traffic injury risks in specific and restricted manners. Car-safety development is an important factor in improved road safety, but it may not benefit all to the same extent.     

Characteristics of drivers not using seat belts in a high belt use state

A study was undertaken in North Carolina to determine the characteristics of the minority of drivers who were not using seat belts following an extensive publicity/enforcement campaign, which had increased statewide use to 80%. Vehicles and drivers whose seat belt use was observed at sites across North Carolina were matched against Division of Motor Vehicles registration and driver history files for vehicle owners. The study file consisted of those observed drivers who matched the owners with respect to sex, race, and approximate age. The results of this investigation indicate that nonuse of seat belts was associated with males; younger age (<35); older vehicles (pre-1985); vehicles other than cars, especially pickups; and poor driving records. Telephone survey information indicated that nonusers were less likely to have health care coverage, more likely to acknowledge having consumed large amounts of alcohol in the past year, and more likely to have an arrest record. When asked about enforcement of the belt use law, many nonusers said that they would not respond to higher fines but they would respond to driver license points. To change the belt use behavior of this hard-core nonuser population, it well may be necessary as was done in Canada to combine publicity/enforcement campaigns with driver license points as a penalty for nonuse.     

Predicting categories of drugs used by suspected drug-impaired drivers using the Drug Evaluation and Classification Program tests

Objective: The purpose of this study was to statistically determine which combination(s) of drug-related signs and symptoms from the Drug Evaluation and Classification (DEC) protocol best predict the drug category used by the suspected drug-impaired driver.

Methods: Data from 1,512 completed DEC evaluations of suspected impaired drivers subsequently found to have ingested central nervous system (CNS) depressants, CNS stimulants, narcotic analgesics, and cannabis were analyzed using a multinomial logistic regression procedure. A set of evaluations completed on drug-free subjects was also included. The relative importance of clinical, behavioral, and observational measures in predicting drug categories responsible for impairment was also examined.

Results: Thirteen drug-related indicators were found to significantly contribute to the prediction of drug category, including being under the care of a doctor or dentist, condition of the eyes, condition of the eyelids, mean pulse rate, assessment of horizontal gaze nystagmus (HGN), convergence, performance on the One Leg Stand (OLS) Test, eyelid tremors, pupil size in darkness, reaction to light, presence of visible injection sites, systolic blood pressure, and muscle tone. Indicators related to the appearance and physiological response of the eye contributed the most to the prediction of drug category, followed closely by clinical indicators and performance on the psychophysical tests.

Conclusions: The findings from this study suggest that drug recognition experts (DREs) should be careful to review a set of key signs and symptoms when determining the category of drug used by suspected drug-impaired drivers. Drug use indicators related to the appearance and physiological response of the eye were found to contribute the most to the prediction of the drug category responsible for the impairment. These results could help form the basis of a core set of indicators that DREs could initially consult to form their opinion of drug influence. This in turn may enhance the validity, effectiveness, and efficiency of drug detection and identification by DREs and lead to a more effective and efficient DEC program, improved enforcement of drug-impaired driving, and greater acceptance of the DEC program by the courts.     

Evaluation of a safety training program in three food service companies

Problem: Outcome measures for safety training effectiveness research often do not include measures such as occupational injury experience. Effectiveness mediators also receive sparse attention. Method: A new safety training curriculum was delivered to workers in a stratified random sample of food service facilities across three companies. A similar group of facilities received usual training. We collected post-test measures of demographic variables, safety knowledge, perceptions of transfer of training climate, and workers' compensation claim data for one year after the initial training activities. Results: Knowledge test scores were apparently higher in the new-training units than in the usual-training units. Some demographic variables were inconsistently associated with these differences. Evidence for reduction of the injury rate associated with the new training was observed from two companies but only approached significance for one company. A second company revealed a similar but non-significant trend. Knowledge scores were not significantly associated with lower injury rates. Discussion: We found evidence that safety training increases knowledge and reduces injuries. We found almost no evidence of effects of training effectiveness mediators, including no relationship between safety knowledge and injury experience. Methodological issues related to conducting a large study may have influenced these results. Impact on Industry: Although safety training leads to greater knowledge and, in some cases, reduced occupational injuries, the influence of mediating variables remains to be fully explained.     

Risk-mitigating beliefs,risk estimates,and self-reported speeding in a sample of Australian drivers

PROBLEM: Research suggests that people who engage in risk-taking behaviors often hold specific beliefs that can mitigate or reduce their perceptions of risk associated with those behaviors. METHOD: A scale was developed (Speeding Risk Belief Scale (SRBS)) to assess beliefs about speeding-related risk and predict self-reported speeding in a random-digit telephone survey of 800 South Australian drivers between the ages of 16 and 50. RESULTS: The scale was internally consistent, and path analyses showed it to be associated with self-reported speeding, both directly and indirectly through participants' estimates of speeding-related risk. DISCUSSION: Origins of risk-mitigating beliefs and the extent to which they may be causally linked with speeding are discussed, and recommendations are made for future research. IMPACT ON INDUSTRY: This research has strong implications for the conduct of countermeasure campaigns that disseminate information on speeding-related risk.     

Parental supervision of teenage drivers in a graduated licensing system

OBJECTIVES: Most states now have lengthy learner periods for young, beginning drivers as part of their graduated driver licensing (GDL) systems. Although parents play a vital role during the learner stage of GDL by supervising driving practice, virtually nothing is known about the nature and quality of parental supervision. The objectives of this study were to investigate parents' supervisory behavior and parent-teen relationships during the learner stage of graduated licensing and to evaluate two approaches for assisting parents in supervising their teenager's early driving experience. METHODS: Families of teenagers applying for a learner permit received either a booklet describing highly structured practice sessions for beginning drivers, a series of "tip sheets" offering more generalized guidance, or no special materials. Questionnaires were sent separately to parents and teenagers three to six months after teenagers obtained their permit. RESULTS: Of 1,190 participating families, 653 parents (55%) and 609 teenagers (51%) responded. Both parents and teenagers perceived parents as supportive and helpful during driving sessions. Parents often demonstrated positive behaviors, such as complimenting their teenager and pointing out possible hazards; they also exhibited less desirable behaviors, such as raising their voice, but these were less frequent. A majority of parents (71%) and teenagers (52%) reported that they enjoyed spending this time together. About four months after obtaining a permit, most parents believed their teenager did not yet have enough experience and was not ready to drive unsupervised. Although the reported behaviors are encouraging, within-family agreement was low on most items. Finally, efforts to assist parents proved unsuccessful. Although parents thought the booklet and tip sheets were helpful, most used these materials only in a general way. CONCLUSIONS: The extended learning experience required by GDL programs is a positive experience for many families. However, finding a method for helping parents achieve maximum benefits during this process will be challenging. The results also suggest that current requirements in the learner phase of most state GDL systems (six months; 30-50 hours) may be inadequate to ensure that teenagers obtain a sufficient amount of experience to begin driving safely on their own.     

The characteristics of young Indigenous drink drivers in Queensland,Australia

Objective: This study investigates the prevalence and characteristics of first drink driving convictions among young Aboriginal and Torres Strait Islander (Indigenous) Australians (aged from 14 to 24) and considers some of the risk factors associated with recidivism.

Methods: Convictions recorded between 2006 and 2013 were extracted from the Queensland Department of Justice and Attorney General database. Convictions were regrouped by gender, age, Accessibility/Remoteness Index of Australia classification, and sentence severity. Chi-square analyses and logistic regression were conducted to identify group differences in offense characteristics for gender and recidivism (recidivists versus nonrecidivists).

Results: The sample consisted of 1,583 individuals (74.1% males) convicted in the 8-year period. Gender comparisons showed that there was no significant difference in age at time of first offense, blood alcohol concentration (BAC) level at apprehension, or type of penalty received between males and females. However, males received larger fines and longer periods of license disqualification. Comparisons for reoffending and non-reoffending revealed that males, drivers aged 14–17 years of age and 18 to 20 years of age, and inner regional drivers were more likely to reoffend.

Conclusions: There were limited differences between females and males or recidivists and nonrecidivists at first conviction. Convictions for drink driving may provide an opportunity for early alcohol intervention with Indigenous young drivers (<20 years) because it is likely to be an individual's first alcohol-related conviction.     

Crash risk by driver age,gender, and time of day using a new exposure methodology

Introduction: Concerns have been raised that the nonlinear relation between crashes and travel exposure invalidates the conventional use of crash rates to control for exposure. A new metric of exposure that bears a linear association to crashes was used as basis for calculating unbiased crash risks. This study compared the two methods – conventional crash rates and new adjusted crash risk – for assessing the effect of driver age, gender, and time of day on the risk of crash involvement and crash fatality. Method: We used police reports of single-car and multi-car crashes with fatal and nonfatal driver injuries that occurred during 2002–2012 in Great Britain. Results: Conventional crash rates were highest in the youngest age group and declined steeply until age 60–69 years. The adjusted crash risk instead peaked at age 21–29 years and reduced gradually with age. The risk of nighttime driving, especially among teenage drivers, was much smaller when based on adjusted crash risks. Finally, the adjusted fatality risk incurred by elderly drivers remained constant across time of day, suggesting that their risk of sustaining a fatal injury due to a crash is more attributable to excess fragility than to crash seriousness. Conclusions: Our findings demonstrate a biasing effect of low travel exposure on conventional crash rates. This implies that conventional methods do not yield meaningful comparisons of crash risk between driver groups and driving conditions of varying exposure to risk. The excess crash rates typically associated with teenage and elderly drivers as well as nighttime driving are attributed in part to overestimation of risk at low travel exposure. Practical Applications: Greater attention should be directed toward crash involvement among drivers in their 20s and 30s as well as younger drivers. Countermeasures should focus on the role of physical vulnerability in fatality risk of elderly drivers.     

Evaluation of a new ballistic vest design for compliance with Standard No. PN-V-87000:2011 using physiological tests

Research into newly developed ballistic vests to be worn by police officers under clothing was carried out with air temperature conditions of +20 °C. A ballistic vest should incorporate protective features, comfort and ergonomics. The thermal strain on users who wore the vests was evaluated as an average and individually, after they had been conditioned in high (+50 °C), low (?40 °C) or neutral (+20 °C) air temperatures, while performing various occupational activities. Research involved six police officers aged 36–42 years, who wore civilian clothing used in moderate environmental conditions. During the tests, physiological parameters (internal temperature, local skin temperatures and amount of sweat secreted) were determined. The ease of doing exercises while wearing the vests, vest service and level of discomfort in use were assessed. Research showed that the vests tested, both as an average and individually, meet the requirements of Standard No. PN-V-87000:2011 (clause 4.5).     

Occupational safety conditions of bus drivers in Metro Manila,the Philippines

The study looks into the occupational safety and working conditions among bus drivers in Metro Manila, the Philippines. Quantitative data were collected through survey interviews of 95 bus drivers using the stratified sampling technique. Results showed that bus drivers worked an average of 16?h/day and were engaged in risky driving behaviors such as over-speeding and road racing in order to reach their quota for the day. Fifty-nine percent experienced work-related accidents, with a mean of three accidents. The most common accident was hitting another vehicle followed by side swipe. The accidents were blamed on other drivers, followed by vehicle defect, inattentiveness and tiredness/micro-sleep or sudden involuntary sleep while driving. The most common health symptoms experienced by the bus drivers were fatigue, back pain, and cough and colds. This study underlines the need for an occupational health and safety program for bus drivers in the Philippines.     

Knowledge,attitudes and practices of occupational risks in Colombian taxi drivers

Objective. The objective of this study was to learn about the health and safety strategies in a sample of taxi drivers in Bucaramanga, Colombia. Methods. A cross-sectional study was conducted among 138 taxi drivers. A survey was used to identify the socio-demographic and working characteristics, knowledge, attitudes and practices according to their occupational risk. Results. Eighty-five percent of the workers labored 9–15?h/day. Of those who suffered accidents, 27% were not affiliated to an occupational risk administrator (p = 0.028). Of the workers who had a work-related accident, 58% considered that the use of a cell phone while driving would not always reduce their attention, 50% always used their seat belt and 7% took active breaks and wore their seat belt (p = 0.01). Conclusions. Within this group of taxi drivers, having or believing to possess knowledge regarding an occupational risk did not ensure that they had a safe attitude or safe working practices.     

Experimental analysis of using examples and non-examples in safety training

IntroductionThe effects of training content consisting of examples and/or non-examples was studied on the acquisition of safety-related skills.MethodParticipants (N = 160) were randomly assigned to first receive computer-based training on office ergonomics that included either no examples of safe or at-risk postures, safe examples only, at-risk examples only, or both safe and at-risk examples. Participants then attempted to classify as safe or at-risk various postures depicted in short video clips and demonstrate with their own posture the range of safe postures.ResultsGroups that were trained with both safe and at-risk examples showed greater classification accuracy and less error in their demonstration of safe postures. Training with only safe or at-risk examples resulted in a moderate amount of error and a consistent underestimation of risk.ConclusionTraining content consisting of both examples and non-examples improved acquisition of safety-related skills.Practical applicationsThe strategic selection of training content may improve identification of risks and safe work practices.     

Hazard perception of stroke drivers in a video-based Japanese hazard perception task

Objective: Hazard perception (HP) is the ability to identify a hazardous situation while driving. Though HP has been well studied among neurologically intact populations, little is known about the HP of neurologically impaired populations (in this study, stroke patients). The purpose of this study is, first, to investigate the HP of stroke patients and, second, to verify the effect of lesion side (right or left hemisphere) on HP, from the viewpoint of hazard types.

Methods: Sixty-seven neurologically intact age-matched older drivers and 63 stroke patients with valid driver’s licenses conducted a video-based Japanese HP task. Participants were asked to indicate the hazardous events in the driving scenario. These events were classified into 3 types: (1) behavioral prediction hazards (BP), which are those where the cause is visible before it becomes a hazard; (2) environmental prediction hazards (EP), which are those where the ultimate hazard may be hidden from view; and (3) dividing and focusing attention hazards (DF), which are those where there is more than one potential hazard to monitor on approach．Participants also took part in the Trail Making Test (TMT) to evaluate visual information processing speed.

Results: The results showed that the number of responses was significantly fewer for stroke patients than for age-matched drivers for all hazard types (P < .001), and this difference was not affected by lesion side (P > .05). It was also found that stroke patients showed a slower response time than age-matched drivers only for BP (P < .001). The lesion side did not affect response latency (P > .05). Results of the TMT revealed that age-matched drivers completed the task significantly faster than stroke patients (P < .001) and that neither TMT-A nor TMT-B differentiated between patients with left hemisphere damage and patients with right hemisphere damage (P > .05).

Conclusions: Firstly, HP in stroke patients is low compared to age-matched drivers. Secondly, even if stroke patients notice hazards, their response may be delayed in a BP situation, due to a slower visual information processing speed. Thirdly, the lesion side does not appear to affect HP.     

Cannabis use and self-reported collisions in a representative sample of adult drivers

PROBLEM: This study examines the relationships between collision involvement and several measures of cannabis use, including driving after using cannabis, among drivers, based on a population survey of Ontario adults in 2002 and 2003. METHOD: Logistic regression analyses examined self-reported collision involvement in the last 12 months by lifetime use of cannabis, past year use of cannabis, and past year driving after using cannabis, while controlling for demographic characteristics. RESULTS: We found that the odds of reporting collision involvement was significantly higher among cannabis users, and among those who reported driving after cannabis use. Some evidence for a dose-response relationship was seen as well. DISCUSSION: Cannabis users and people who report driving after cannabis use are also more likely to report being involved in a collision in the past year. These observations suggest that collision prevention efforts could be aimed at these groups. Additional work to determine the causal pathways involved in the relationships observed here is needed. IMPACT ON INDUSTRY: None.