Problem
Each year about 4,000 teens ages 16-19 die on U.S. roads. Injury prevention counseling is recommended as a valuable and cost-effective part of routine health supervision. This study describes pediatrician knowledge and practice regarding teen driving safety.Methods
A 31-item self-administered survey was mailed to pediatricians.Results
160 of 392 pediatricians (41%) completed the survey. During a health supervision visit 93% of pediatricians reported discussing seat belt use, 89% impaired driving, 54% teen licensing laws, and 16% parent teen contract. Half reported having a teen in their practice killed in a crash.Conclusions
A majority surveyed report discussing and counseling teens on first wave teen driver safety issues (seat belts, alcohol use), but most do not discuss graduated driver licensing laws or related issues. Impact on Industry: Broadly adopted, this inexpensive counseling approach, could lead to reductions in teen motorvehicle crash injuries. 相似文献Objective
Enhanced seat belt reminders in automobiles have been shown to increase belt use rates by approximately 3 percentage points. The objective of this study was to estimate the effect of enhanced seat belt reminders on driver fatality risk.Method
Data included all passenger vehicle driver deaths and vehicle registration counts in the United States for calendar years 2000-2007. Driver fatality rates per vehicle registration per year were compared for otherwise identical vehicle models with and without enhanced seat belt reminders.Results
Driver fatality rates were 6% lower for vehicles with enhanced seat belt reminders compared with vehicles without enhanced belt reminders. After adjusting for vehicle age differences, the estimated effect of enhanced belt reminders on driver fatality risk ranged from a 9% reduction for General Motors vehicles to a 2% increase for Honda vehicles. Combining all manufacturers, enhanced belt reminders reduced fatality risk by approximately 2%. Although not statistically significant, the 2% reduction in fatality risk agrees with what should be expected from a 3 percentage point increase in seat belt use rates.Conclusions
Enhanced seat belt reminders have raised driver belt use rates and reduced fatality rates, but more aggressive systems may be needed for some drivers. It can be inferred that nonfatal injury rates also have been reduced.Impact on Industry
Manufacturers should be encouraged to put enhanced seat belt reminders on all vehicles as soon as possible. 相似文献Problem
Motor-vehicle crashes are a leading cause of death in the United States. In the event of a crash, seat belts are highly effective in preventing serious injury and death.Methods
Data from the 2006 Behavioral Risk Factor Surveillance System were used to calculate prevalence of seat belt use by state and territory and by type of state seat belt law (primary vs. secondary enforcement).Results
In 2006, seat belt use among adults ranged from 58.3% to 91.9% in the states and territories. Seat belt use was 86.0% in states and territories with primary enforcement laws and 75.9% in states with secondary enforcement laws.Discussion
Seat belt use continues to increase in the United States. Primary enforcement laws remain a more effective strategy than secondary enforcement laws in getting motor-vehicle occupants to wear their seat belts. 相似文献Problem
A substantial proportion of drivers arrested for DUI refuse the BAC test, thereby reducing the likelihood that they will be convicted and potentially increasing the number of high-risk multiple offenders contributing to alcohol-related crashes.Method
This paper reviews the information on the current status of implied-consent laws (which impose a sanction on offenders who refuse the BAC test) in the 50 states and the other relevant traffic safety laws and policies that may influence state refusal rates.Results
Although there appears to be only a weak relationship between state refusal rates and crash rates, there is strong evidence that BAC test refusals significantly compromise the arrest, prosecution, and sentencing of DUI suspects and the overall enforcement of DUI laws in the United States.Discussion
Laws and policies that may reduce the number of refusals are discussed.Impact on industry
Alcohol-related crash injuries are an important cost problem for U.S. industry because of property damage from crashes, crash injuries to employees that raise health costs, or the reduction of time on the job resulting from a highway injury. 相似文献Objective
To determine and validate patterns of seat belt use and attitudes of taxi drivers on wearing a seat belt following national and provincial seat belt legislation in 2004-2005. Design: Roadside daylight seat belt observation and interview survey methods were used, as well as observations from inside taxis during routine trips and a taxi driver focus group. The setting was Nanjing, Jiangsu Province, PR China in April of 2006 and 2007.Main outcome measures
Prevalence of seat belt use and attitudes to wearing a seat belt were determined, as were vehicle and driver characteristics, and comparisons with other motor-vehicle driver's seat belt use and attitudes.Results
Taxi drivers interviewed were predominantly male and aged 30-39 years. They spent more hours per week in their vehicles and had more driving experience than other drivers. Over half (56.2%) of taxi drivers interviewed reported that they always wore seat belts, while observation of taxi drivers showed lower wearing rates (i.e., roadside observation was 43.8%, and observation from inside taxis was 36.2%). Belt tampering was a practice of 12-15% of taxi drivers. “Fine avoidance, safety, high speed and long trips” were given as important reasons for wearing and “feeling trapped and uncomfortable” for not wearing. Seat belt reminder signs in taxis were common (82.6% of taxis), but did not appear to impact on driver seat belt use.Conclusion
The four research methods found taxi drivers to have consistently low “correct wearing” rates.Impact on industry
As in several other countries, taxi drivers are particularly resistant to seat belt use. Innovative strategies, including occupational health and safety approaches, may be required to achieve increased levels of seat belt use. 相似文献Objective
The authors have treated numerous children who have been injured by falling from bicycle-mounted child seats. Despite the greatly increased use of such seats, the understanding of their risk and the importance of helmet use remains alarmingly poor. The objective of this study was to confirm the risk of bicycle-mounted child seats and to evaluate the efficacy of helmets, seat belts, and back seat height in terms of preventing or mitigating contact-type head impacts that occur in falls from bicycle-mounted child seats.Materials and methods
Biometrical dummy tests were performed to examine contact-type head injuries in falls from stationary bicycles. A bicycle with an anthropometric test dummy placed in a bicycle-mounted child seat was tipped over. Each test was repeated three times and three-dimensional acceleration was measured using accelerometer. Head Injury Criteria (HIC) were calculated and the respective influences of a helmet, a seat belt, and increased height of the back of the seat on such impacts were evaluated.Results
Only helmets unequivocally lowered maximal acceleration and/or HIC values with statistical significance. The seat belt lowered HIC values as long as it was used with the high-back seat. Only when the dummy wore a helmet sitting in a high-back seat did the HIC show less than the threshold of 570 for three-year-old children. The HIC showed the lowest score of 161.5 when the dummy wore both a helmet and a seat belt sitting in a high-back seat.Conclusions
Riders in bicycle-mounted child seats definitely have higher risks of contact-type head injuries. In transporting a child on a bicycle-mounted child seat, parents must use both a child-bicycle helmet and a high-back child seat at least; a seat belt is highly recommended as long as it is used with the other safety devices.Impact on Industry
The bicycle-mounted child seat should have a high enough back and an appropriate seat belt to protect the head of the child from a contact-type injury. 相似文献Problem
Enforced primary seatbelt laws can reduce morbidity and mortality associated with motor-vehicle crashes. Constituent support is an important factor associated with legislator voting behavior toward injury prevention laws. Little is known about attitudes toward a primary seat belt law among adults in rural states without a primary seat belt law.Methods
Data from the Behavioral Risk Factor Surveillance System (BRFSS) survey, a telephone survey of a representative sample of adults in Montana, were used to assess attitudes toward a primary seat belt law.Results
Sixty-one percent of respondents supported a primary seat belt law. Using multiple logistic regression analyses, women (AOR 1.87; 95% CI 1.49-2.36), persons aged 65 years and older (1.45; 1.06-1.96), American Indians (2.71; 1.55-4.75), those with health insurance (1.51; 1.07-2.14), and those who reported always wearing their seat belt (4.05; 3.14-5.21) were more likely to support a primary seat belt law than respondents without these characteristics.Conclusions
The majority of adults in a rural state support a primary seat belt law. 相似文献Methods: This cross-sectional study was conducted on a random sample from the population of Mashhad, Iran, in 2014. A checklist and a previously validated questionnaire for the transtheoretical stages of change model (TTM) were used for data collection. Statistical analyses were performed using SPSS 11.5 software with P <.05 statistically significant.
Results: Totally 431 individuals were included with a mean age of 30 ± 11.3 years. Forty-three percent (183) were male. The TTM model revealed that participants were mostly in pre-actional phases regarding not using a cell phone while driving (80%), fastening the driver's seat belt (66%), front seat belt (68%), and rear seat belt (85%) The penalty was a protective factor only for using cellphone (odd ratio [OR] = 0.82, 95% confidence interval [CI], 0.68–0.98). Lower education (OR = 0.12, 95% CI, 0.01–0.94) and male gender (OR = 0.35, 95% CI, 0.14–0.83) were indicative of lower rates of fastening the front and rear seat belts.
Conclusion: The stages of change model among study participants is a proper reflection of the effectiveness of the current policies. More serious actions regarding these high-risk behaviors should be considered in legislation. 相似文献
Introduction
Fatalities from traffic accidents in less-motorized societies are an important global issue. We aimed to characterize the geographic differences of fatalities in such societies to facilitate the development of targeted interventions.Method
This study linked police reports, hospital data, and vital registration data from Taiwan with special reference to accident factors in pre-hospital deaths and medical care in hospital deaths.Results
A higher percentage of pre-hospital deaths were observed following rural as compared to urban traffic accidents. The deaths due to rural accidents can be attributed to lower use of restraints (i.e., helmets or seat belts), lower percentage of motorcyclists, and more highway accidents. A higher percentage of victims in rural accidents were transported to distant medical centers rather than to local hospitals.Conclusion
Specific interventions, such as intelligent emergency medical systems, campaigns for helmets and seat belt usage, enforcement of helmets and seat belt use, and speed control measures should be targeted to rural areas.Impact on industry
Cooperation between the vehicle industry and emergency medical providers in rural traffic accident rescue teams may decrease the numbers of deaths in these regions. 相似文献Methods: The research involved 2 methodologies. First, 1,389 face-to-face interviews were conducted with male and female adults in regional shopping plazas regarding their own and their children's restraint use in their vehicles and reasons for these attitudes and beliefs. Second, 2 on-road observation studies of adult and child restraint use were conducted by trained observers. Occupants of approximately 5,000 passenger vehicles were observed while stopped at representative signalized traffic intersections.
Results: The findings showed front seat belt use rates of between 43 and 47% for drivers and 26 to 30% for front seat passengers; rear seat belt use rates were lower. While there seemed to be some knowledge about the purpose and reasons for restraining both adults and children in suitable restraints, this failed to be confirmed in the on-road observations.
Conclusions: Reasons for these rates and findings are discussed fully, and recommendations for improving seat belt use in the Dammam Municipality are included. 相似文献
Problem
U.S. teenaged and young-adult drivers' elevated rates of fatal traffic crash involvement typically are attributed to biological and developmental risk-taking associated with young age. However, young drivers differ from older ones along several sociodemographic dimensions, including higher poverty rates and greater concentration in poorer areas, which may contribute to their risks.Method
Using Fatality Analysis Reporting System, Census, and Federal Highway Administration data for 1994-2007, bivariate and multivariate regression analyses were conducted of fatal motor-vehicle crash involvements per 100 million miles driven by driver age (16 through 74) and state along with 14 driver-, vehicle-, and state-level variables.Results
Driver age was not a significant predictor of fatal crash risk once several factors associated with high poverty status (more occupants per vehicle, smaller vehicle size, older vehicle age, lower state per-capita income, lower state population density, more motor-vehicle driving, and lower education levels) were controlled. These risk factors were significantly associated with each other and with higher crash involvement among adult drivers as well.Summary and Discussion
The strong association between fatal crash risk and environments of poverty as operationalized by substandard vehicle and driving conditions suggests a major overlooked traffic safety factor particularly affecting young drivers. 相似文献Problem
Limited literature suggests that gasoline prices have substantial effects on reducing fatal crashes. However, the literature focuses only on fatal crashes and does not examine the effects on all traffic crashes.Methods
Mississippi traffic crash data from April 2004–December 2008 from the Mississippi Highway Patrol and regular-grade unleaded gasoline price data from the Energy Information Administration of the U.S. Department of Energy were used to investigate the effects of gasoline prices on traffic safety by age, gender, and race.Results
Gasoline prices have both short-term and intermediate-term effects on reducing total traffic crashes and crashes of females, whites, and blacks. The intermediate-term effects are generally stronger than the short-term effects. Gasoline prices also have short-term effects on reducing crashes of younger drivers and intermediate-term effects on older drivers and male drivers.Impact on Industry
Higher gasoline taxes reduce traffic crashes and may result in additional societal benefits. 相似文献Objectives
The objective was to determine if teenage driving behavior improves when a monitoring and feedback device is installed in the teen's vehicle.Methods
Vehicles of 85 teenage drivers were fit with a device that detected all instances of sudden braking/acceleration, speeding, and nonuse of seat belts. Drivers were assigned randomly to one of four research groups, differing in whether or not an alert sounded in the vehicle and whether or not parents were given access to websites containing notification records. Time trends in event rates per mile traveled were compared using Poisson regression.Results
Seat belt use improved when violations were reported to the parent websites, and improved even more when in-vehicle alerts were activated. Consistent reductions in speeding were achieved only when teenagers received alerts about their speeding behavior, believed their speeding behavior would not be reported to parents if corrected, and when parents were being notified of such behavior by report cards.Conclusions
Electronic monitoring of teenage drivers can reduce the incidence of risky behavior, especially seat belt nonuse. More complicated behavior is more difficult to change, however.Impact on Industry
Parent participation is key to successful behavioral modification, but it is yet to be determined how best to encourage such participation. 相似文献Introduction
The effectiveness of ignition interlocks at reducing drunk driving has been limited by the ability of driving-while-intoxicated (DWI) offenders to avoid court orders to install the devices.Methods
In a pilot program in New Mexico, four Santa Fe County judges imposed home confinement (via electronic monitoring bracelets) on offenders who claimed to have no car or no intention to drive. Interlock installation rates for Santa Fe County were compared with all other counties in New Mexico over a 2-year program and 2-year post-program period.Results
During the two program years, 70% of the drivers convicted of DWI in Santa Fe County installed interlocks, compared to only 17% in the other counties, but when the program was terminated, the Santa Fe installation rate fell by 18.8 percentage points.Summary
Mandating the alternative sanction of house arrest led to the highest reported interlock installation rate for DWI offenders.Impact on Industry
Impaired driving is a substantial expense to employers, particularly when it bars driving that interferes with employment. Interlocks provide a method of protecting the public while permitting the offender to drive sober. This study was directed at increasing interlock use by DWI offenders. 相似文献Methods: Annual DUI citation data (2000 to 2013), RBS and SH policies, and city-wide demographic, economic, and environmental information were collected and applied to each of the 20 cities in San Diego County, California. A structural equation model was fit to estimate the relative contribution of the variables of interest to DUI citation rates.
Results: Alcohol consumption and alcohol outlet density both demonstrated a significant increase in DUI rates, whereas RBS laws, SH laws, alcohol tax rates, media clusters, gas tax rates, and unemployment rates demonstrated significant decreases in DUI rates.
Conclusions: At the county level, although RBS laws, SH laws, and media efforts were found to contribute to a significant reduction in DUI rates, the largest significant contributors to reducing DUI rates were alcohol and gas taxation rates. Policy makers interested in reducing DUI rates among teenagers should examine these variables within their specific communities and consider conducting community-specific research to determine the best way to do so. Future efforts should be made to develop models that represent specific communities who are interested in reducing DUI rates among drivers aged 16–20 years. 相似文献
Problem
The efficacy of drink driving (driving under the influence, DUI) countermeasures to deter motorists from driving over the legal limit is extremely important when considering the personal and economic impact the offending behavior has on the community. This paper reports on an examination of 780 Queensland motorists' perceptions of legal and non-legal sanctions and their deterrent impact on self-reported offending behavior. Method: The data were collected via a telephone survey of motorists recruited from a random sample of all listed telephone numbers in the state, adjusted according to district population figures. Results: The results indicated that there were a range of legal and non-legal factors that were significantly associated with self-reported DUI including: the perceived risk of apprehension and license loss (legal factors); and concerns relating to the possibility of being involved in a crash and hurting another person (non-legal factors). However, additional multivariate analyses indicated that while both legal and non-legal factors significantly predicted self-reported DUI, higher alcohol consumption levels and more favorable attitudes to the behavior also appear to increase the likelihood of DUI. Discussion: The paper will outline the direct implications of the research project such as the development and promotion of countermeasures that both effectively deter motorists and address pro-offending attitudes. Impact on industry: The findings also highlight that DUI remains a relatively common behaviour among some motoring groups and that there is a need to extend current levels of enforcement as well as adopt innovative strategies to enhance the impact of these operations on the offending behaviour. 相似文献Methods: Poisson regression was used to model state-by-state annual traffic fatality rates per mile of travel as a function of time, the unemployment rate, the percentage of the driving age population that was younger than 25, per capita alcohol consumption, and the maximum posted speed limit on any road in the state. Separate analyses were conducted for all roads, interstates and freeways, and all other roads.
Results: A 5 mph increase in the maximum state speed limit was associated with an 8% increase in fatality rates on interstates and freeways and a 4% increase on other roads. In total, there were an estimated 33,000 more traffic fatalities during the years 1995–2013 than would have been expected if maximum speed limits had not increased. In 2013 alone, there were approximately 1,900 additional deaths—500 on interstates/freeways and 1,400 on other roads.
Conclusions: There is a definite trend of increased fatality risk when speed limits are raised. As roadway sections with higher speed limits have become more ubiquitous, the increase in fatality risk has extended beyond these roadways. The increase in risk has been so great that it has now largely offset the beneficial effects of some other traffic safety strategies. State policy makers should keep this trade-off in mind when considering proposals to raise speed limits. 相似文献
Introduction
The high crash rate of youthful novice drivers has been recognized for half a century. Over the last decade, graduated driver licensing (GDL) systems, which extend the period of supervised driving and limit the novice's exposure to higher-risk conditions (such as nighttime driving), have effectively reduced crash involvements of novice drivers.Method
This study used data from the Fatality Analysis Reporting System (FARS) and the implementation dates of GDL laws in a state-by-year panel study to evaluate the effectiveness of two key elements of GDL laws: nighttime restrictions and passenger limitations.Results
Nighttime restrictions were found to reduce 16- and 17-year-old driver involvements in nighttime fatal crashes by an estimated 10% and 16- and 17-year-old drinking drivers in nighttime fatal crashes by 13%. Passenger restrictions were found to reduce 16- and 17-year-old driver involvements in fatal crashes with teen passengers by an estimated 9%.Conclusions
These results confirm the effectiveness of these provisions in GDL systems. Impact on Public Health. States without the nighttime or passenger restrictions in their GDL law should strongly consider adopting them.Impact on Industry
The results of this study indicate that nighttime restrictions and passenger limitations are very important components of any GDL law. 相似文献Methods: We included only drivers of passenger cars involved in fatal traffic crashes between January 1, 1999, and December 31, 2012. Obesity was classified according to the World Health Organization guidelines and profiled between 1999 and 2012 using the adjusted prevalence ratio (aPR) from log-binomial regression models. Differences in crash risks (e.g., driver's fatality, drunk driving, seat belt nonuse) between obese and nonobese drivers were estimated as adjusted odds ratios (aORs) using logistic regression models.
Results: A total of 753,024 U.S. drivers were involved in fatal crashes, for which obesity information was available for 534,887. About 56% (n = 299,078) were driving passenger cars. The prevalence of class I obesity increased from 10% in 1999 to 14% in 2012 (aPR = 1.50, 95% confidence interval [CI], 1.42–1.58), class II obesity from 3 to 5% (aPR = 2.22, 95% CI, 2.05–3.01), and class III obesity from 1 to 2% (aPR = 2.65; 95% CI, 2.27–3.10). Compared to nonobese controls, obese drivers had significantly higher risks for fatality (1.10 ≤ aOR ≤ 1.47), seat belt nonuse (1.00 ≤ aOR ≤ 1.21), need for extrication (1.01 ≤ aOR ≤ 1.23), and ambulance transport time ≥30 min (1.01 ≤ aOR ≤ 1.28). Compared to nonobese controls, obese drivers were less likely to drink drive (0.41 ≤ aOR ≤ 0.72) or speed >65 mph (0.78 ≤ aOR ≤ 0.93).
Conclusion: The rising national prevalence of obesity extends to U.S. drivers involved in fatal crashes and indicates the need to improve seat belt use, vehicle design, and postcrash care for this vulnerable population. 相似文献