Youth on racial minority operated U.S. farms, 2008: Demographics and injuries

IntroductionTo obtain injury surveillance data for youth on racial minority operated farms, the National Institute for Occupational Safety and Health developed the Minority Farm Operator Childhood Agricultural Injury Survey (M-CAIS) in collaboration with the U.S. Department of Agriculture.MethodsUsing a regionally stratified telephone survey of U.S. minority operated farm households, M-CAIS data were collected for youth less than 20 years of age.ResultsThere were an estimated 37,443 youth living on racial minority operated U.S. farms in 2008, almost half (46%) of these youth worked on the farm. Racial minority farm operators hired 6,443 youth, and reported an estimated 775,991 youth relative and other visitors on the farm. These youth suffered an estimated 516 injuries (5.9 injuries/1000 farms).ConclusionsHousehold youth had an injury rate of 7.8 injuries/1000 household youth and a work-related injury rate of 6.9 injuries/1000 working household youth.Practical applicationsThe research enables agricultural safety and health researchers, practitioners, and educators to identify priorities and design trainings and interventions to minimize the risk of farm hazards to youth on racial minority farm operations in the United States.     

Tracking the prevalence of rollover protective structures on U.S. farm tractors: 1993, 2001, and 2004

Problem

Between 1992 and 2005, 1412 workers on farms died from tractor overturns. A Rollover Protective Structure (ROPS) is a proven intervention to reduce overturn deaths. However, farm characteristics that are associated with the adoption of ROPS are not well understood.

Methods

ROPS prevalence statistics were derived from National Institute for Occupational Safety and Health (NIOSH) surveys that tracked ROPS use on farms. Data were from the years 1993, 2001, and 2004.

Results

In 1993, 38% of tractors were equipped with ROPS. This increased to 51% by 2004. ROPS prevalence rates were higher on farms in the Southern region of the United States, on farms where the operator was 25-34 years old, and on farms with $100,000 or more of farm sales. Low ROPS prevalence rates were associated with farm operators 65 years old or older and with farms with less than $10,000 of farm product sales.

Summary

The increase in ROPS prevalence between 1993 and 2004 has not been sufficient to decrease the rate of tractor overturn deaths on farms. Incentive programs targeting older farm operators and low-income farm operations are suggested to increase ROPS use on tractors.

Impact on Industry

The study provides farm characteristics associated with low ROPS prevalence rates. The results can be used to target farms for future ROPS promotion activities.     

Intervention strategies for the retro-fitment of Rollover Protective Structures (ROPS) and fleet characteristic,farm tractors

Retro-fitment of Rollover Protective Structures (ROPS) on old tractors continues to be a priority for farm safety in Australia. Methods: A state wide (New South Wales (NSW), Australia) random postal survey asked farmers about awareness of, attitudes to and barriers to fitting ROPS; age and number of tractors with/without ROPS on their farm; and considerations when purchasing a tractor. Results: In NSW there are 2.5 tractors per farm ranging from new to 79 years of age (average 17 years) of which 0.4 per farm do not have a ROPS (18 430 tractors). People who knew of someone who had been injured or killed in a tractor rollover were 3.6 times (CI_95% 3.1–4.2) more likely to have all their tractors fitted with a ROPS. Those who thought ROPS were effective or knew it was a legal requirement were 1.5 (CI_95% 1.2–1.8 and 1.4–1.7 respectively) times more likely to have all their tractors fitted with a ROPS. Some of the barriers to fitting a ROPS were cost, availability of a ROPS and making ROPS a priority. The three most common considerations for farmers when purchasing a tractor are size, jobs to be undertaken and cost with safety coming in fourth. Ideas that were considered useful in prompting farmers to fit a ROPS were threat of fine or prosecution, increased awareness and high rebates. Discussion: As the average age of the primary working tractor is 17 years, any new tractor safety measure will have a long latency period if there is not some sort of retro-fitment. To increase retro-fitment rebates are a useful strategy. Any retro-fitment campaign needs to ensure that they create a need for the safety item and have addressed the barriers.     

Injury risks for on-road farm equipment and horse and buggy crashes in Pennsylvania: 2010–2013

Objective: The purpose of this study was to investigate characteristics associated with farm equipment and horse and buggy roadway crashes in relation to person, incident, and injury characteristics to identify appropriate points for injury incident prevention.

Methods: Information on crashes occurring on public roads during the years 2010–2013 was obtained from the Pennsylvania Department of Transportation (PennDOT) and analyzed.

Results: There were 344 farm equipment and 246 horse and buggy crashes during the 4-year study period. These crashes involved 666 and 504 vehicles and 780 and 838 people, respectively. In incidents with farm equipment, the non-farm equipment drivers had an almost 2 times greater injury risk than farm equipment operators. Horse and buggy crashes were almost 3 times more injurious to the horse and buggy drivers than the drivers of the other vehicles.

Conclusions: The average crash rate for farm equipment was 198.4 crashes per 100,000 farm population and for horse and buggy the crash rate was calculated as 89.4 crashes per 100,000 Amish population per year. This study suggests that road safety and public health programs should focus not only on farm equipment operators and horse and buggy drivers but on other motorists sharing the roadway with them.     

Agricultural injuries in Etawah district of Uttar Pradesh in India

Increased use of farm machinery along with other agricultural inputs has enhanced the production and productivity of Indian farms. Simultaneously, it has also increased occupational health hazards on the farms. Major occupational health hazards are farm related injuries. Very little information is available about the type and nature of agricultural injuries on Indian farms. In the present study, agriculture injuries data were collected for the period 1996–2000 for the Etawah district of Uttar Pradesh in India. It has a total population of 1.4 million while 0.75 million were associated with agricultural activities. The agricultural injuries incidence rate was 0.8 per thousand workers per year in the study area. Out of all agricultural injuries, 9% injuries were fatal. The highest number of injury victims were in the age group of 30–44 years. The highest percentages of injured victims were literate but non-matric. The monetary loss due to agricultural injuries in the study area was estimated to be about US $730,000 per year. To minimize agricultural injuries, development of interventions and trainings needs to be organized at block levels for proper and safe operation of agricultural equipment.     

Risky behaviors and helmet use among young adolescent motorcyclists in Southern Thailand

Background: In Thailand, road traffic injuries are the leading cause of death for youth ages 15–19 years, with 80% of the injuries and deaths from motorcycle accidents. Objectives: To determine the prevalence of child and young adolescent motorcyclists in Hat Yai municipality and their risk behaviors. Method: A cross-sectional study was conducted between June 2011 and March 2012 in which 2,471 students, ages 8 to 18 years, were recruited from 9 primary and secondary schools in Hat Yai municipality. The questionnaire included questions on being a motorcycle rider or passenger, risky behaviors, and helmet use while riding. Results: Of the total, 1,573 (63.7%) were riders and 898 (36.3%) were pillion passengers. The majority of the riders younger than 15 years rode their motorcycle mainly only in narrow streets for a short trip. Only 30% of the riders wore a helmet every time they rode a motorcycle. About 10% of the participants riding or a passenger on a motorcycle had consumed alcohol at least once before riding their motorcycle. Multiple logistic regression analysis found that motorcycle injuries were significantly associated with speeds greater than 60 km/h, not wearing a helmet while riding, and alcohol consumption before riding (odds ratios 1.63, 1.59, and 3.09, respectively). Conclusion: Nearly two thirds of young adolescents in Hat Yai municipality were motorcycle riders. These young adolescents were at risk of traffic injuries because more than 50% of them had ridden at high speed or not worn a helmet while riding, and some of them had consumed alcohol before riding.     

Injury severity related to overturn characteristics of tractors

Introduction

Early studies of injuries associated with overturns indicate that more fatalities occurred when a tractor overturned beyond 90° (continuous roll) relative to the impact plane. Recently, the principle of preventing continuous rolls has re-emerged for the protection of riding lawnmower operators.

Method

Related to tractors, a population-based study was conducted that compared the severity of fatal and nonfatal injuries between a 90° and continuous roll for tractors equipped with rollover protective structures (ROPS) and not equipped with a ROPS (non- ROPS). In 2002, the Kentucky Farm Tractor Overturn Survey was administered to an 8% random sample (6,063) of Kentucky farm operators. The farmers responded to questions that differentiated between the types of overturns and operator injury outcomes for ROPS-equipped and non-ROPS tractors during overturn events. Overturn characteristics were collected that included 90° to the side, beyond 90° to the side, and to the rear for both ROPS-equipped and non-ROPS tractors.

Results

Of the 541 overturns reported in this study, 535 (99%) of the respondents reported the most recent overturn characteristics of the tractor: 92 (17%) were ROPS-equipped and 443 (83%) were non-ROPS. For side overturns, 67% of the rolls occurred with ROPS-equipped tractors, and 54% occurred with non-ROPS tractors. The percentages of deaths related to rolls to the side for ROPS-equipped and non-ROPS tractors were, respectively, 1.6% and 3.7%. There was one (2%) deaths related to 90° rolls for ROPS-equipped tractors, whereas for continuous rolls there were 6.4% fatalities related to side overturns, 13% resulted in non-fatal injuries with an average of 1 day of hospitalization for ROPS-equipped tractors, and 39% resulted in non-fatal injuries with an average of 18 days of hospitalization for non-ROPS tractors. The results from this study indicated that a ROPS was more effective at stopping an overturn at 90° than no ROPS, with an associated reduction in the severity of injury in the event of a tractor overturn.     

Tractor rollover fatalities,analyzing accident scenario

IntroductionIn many countries, traditional data sources for collecting injuries of workers covered by compulsory accident insurance have recently been integrated by new observatories whose results may differ. A comparative analysis of the Italian data collection systems related to fatal tractor accidents in agriculture was performed focusing on tractor rollover fatalities with the aim of analyzing the accident scenario.MethodData from the Operational Archives of the Italian Workers Compensation Authority (INAIL), which collects injuries of workers covered by compulsory accident insurance and those of the National Surveillance System (INAIL_ASL), which provides narrative text reports of work-related fatal accidents have been analyzed and compared to the information collected by the INAIL Observatory. The INAL Observatory was recently set up to complement the collection of fatal accidents involving agricultural machinery. Italian data were then compared to data available at an international level. Fatal tractor accidents vary considerably with respect to fatal accidents in agriculture, being 10.6 and 43.7% for the Operational Archives and Surveillance System, respectively. National Surveillance System records, implemented with narrative texts allowed the accident scenario to be defined.Results71.7% of fatal tractor-related accidents refer to non-ROPS equipped vehicles and of these, 26.5% involved machines originally mounted with a ROPS that had been removed or was inoperative in the folded-down position during the rollover event. Just one fatal event from a collapsed ROPS on the overturned tractor was recorded. It is interesting that 16.6% of fatal accidents involved a clear environmental factor.Practical applicationA campaign to train tractor drivers on the correct use of the combination ROPS and seatbelt can contribute to decreasing rollover events with fatal outcomes. Contemporarily a strict requirement to install ROPS and a seatbelt on tractors, combined to an official inspection at the farm level, can increase the chance of survival in a rollover accident.     

Knowledge,attitudes, and behaviors related to child safety restraint in citizens of Shenzhen Municipality,China, and the associations between these factors

Objective: A child safety restraint (CSR) is an effective measure to reduce the risk of child injury from traffic collisions. This study aims to explore knowledge, attitudes, and behaviors regarding CSRs in a Chinese population.

Methods: A cross-sectional survey regarding CSR use was conducted from April to May 2014 in Shenzhen municipality. Respondents were parents who had at least one child 0 to 6 years of age and owned a car. These parents provided a self-report of demographic characteristics as well as information about their knowledge, attitudes, and behaviors toward CSR use.

Results: Most respondents had a fair level of knowledge about CSRs, with higher mean knowledge scores demonstrated among the respondents who were male, had an advanced degree, had a higher income, owned an expensive car, had an older child, drove frequently with children, and routinely drove greater distances with children. In addition, most respondents had a more positive attitude toward CSR use, with a higher mean attitude score among those who had an advanced degree, owned an expensive car, drove frequently with children, and routinely drove greater distances with children. However, some myths regarding CSR use also existed (e.g., parents can effectively protect their children in a car collision by holding them, they are not required to purchase the CSR for child safety if there is no mandatory provision by law, among others). Among 3,768 respondents who had at least one child and a car, 27.8% (1,047) had a CSR and 22.9% (864) used the CSR. A logistic regression model showed the likelihood of CSR ownership to be higher if respondents drove frequently or greater distances and was dependent on both the education level of the respondents and the age of the children. The frequency of CSR use increased as the age of children decreased (P = .0274). Respondents who owned a CSR and those who frequently used CSRs had higher mean knowledge and mean attitude scores.

Conclusions: This observational study found that although the majority of respondents had fair levels of knowledge and positive attitudes, they had lower rates of CSR ownership and use. Therefore, efforts at developing opportunities to expand public awareness of CSR use should be made to improve child passenger safety practices and eliminate child injury caused by traffic collisions.     

Bicycle helmet use among children in the United States: The effects of legislation, personal and household factors

Introduction

Children ages 5-14 years have the highest rate of bicycle-related injuries in the country. Bicycle helmets can prevent head and brain injuries, which represent the most serious type of bicycle-related injury.

Objectives

This paper compares children's bicycle helmet use to that estimated from an earlier study, and explores regional differences in helmet use by existing helmet legislation.

Methods

This study was a cross-sectional, list-assisted random-digit-dial telephone survey. Interviews were completed by 9,684 respondents during 2001-2003. The subset with at least one child in the household age 5-14 years (2,409 respondents) answered questions about bicycle helmet use for a randomly selected child in their household.

Results

Almost half (48%) of the children always wore their helmet, 23% sometimes wore their helmet, and 29% never wore their helmet. Helmet wearing was significantly associated with race, ethnicity, and child age but was not associated with the sex of the child. Other significant predictors of use included household income, household education, census region, and bicycle helmet law status. Statewide laws were more effective than laws covering smaller areas. The proportion of children who always wore a helmet increased from 25% in 1994 to 48% in 2001-2002. Significant increases in helmet use from 20% to 26% were seen among both sexes, younger (5-9 years) and older (10-14 years) children, and in all four regions of the country.

Conclusions

While there has been substantial progress in the number of children who always wear their helmets, more than half do not. Further progress will require using a combination of methods that have been shown to successfully promote consistent helmet use. Impact on industry: minimal.     

Drugged driving among US adults: Results from the 2016–2018 national survey on drug use and health

Introduction: Drugged driving, the act of driving while under the influence of one or more illicit substances, remains a critical problem needing to be addressed. The present study sought to analyze risk factors associated with past-year driving under the influence of alcohol and marijuana among a national sample of U.S. adults. Method: Pooled data from the 2016–2018 National Survey on Drug Use and Health were analyzed among 124,466 adults ages 18 years or older. Results: Weighted logistic regression analyses revealed that 8.52% of adults drove under the influence of alcohol in the past year and 4.49% of adults drove under the influence of marijuana in the past year. Of concern, compared to heterosexuals, greater than 1 in 10 sexual minorities drove under the influence of alcohol in the past year. Moreover, a sizeable percentage of adults used other drugs while under the influence of alcohol including inhalants (70.3%), cocaine (68.9%), and hallucinogens (63.7%). Moreover, a great percentage of adults (53.4%) reported using methamphetamine while also under the influence of marijuana. Practical Applications: We believe our findings can inform harm reduction efforts and prevention messaging surrounding the dangers of drugged driving.     

Soccer,concussions, and safety: Perceptions of parents of youth soccer participants

Introduction: The rate of concussions in youth soccer is among the highest of all youth sports. Parents play an important role in caring for their children and making decisions regarding whether they should participate in a sport, such as soccer, where concussions are well known. This study examined parental perceptions regarding: (a) coaches’ role in concussion management, (b) heading restriction policies, and (c) overall concussion risk and participation issues. Method: Online surveys were completed by 419 parents of youth soccer players who participated in the largest U.S. youth soccer programs nationwide. Results: Findings indicated 44.5% of the respondents had considered keeping their children from playing organized soccer and 47.2% were concerned about a potential decline in youth soccer participation due to concussions. Nearly 69% of responding parents agreed that heading should be banned for participants 10 years old or younger, while 56.5% thought heading should not be limited for participants 13 or older. Only 35% of parents were very confident about their child’s coach’s ability to properly identify concussions and remove those suspected of a concussion from play. Parents’ socioeconomic status (SES), soccer coaching and playing experience, and previous history of concussion(s) were key predictors of greater perceived risk about concussions. Conclusions: Findings from this study shed light on parents’ perceptions about concussions and related safety issues in youth soccer. Understanding what parents believe about concussions is vital to preserve youth soccer participation and can be used to strengthen education and policies that promote a safer environment for youth sport participants. Practical Applications: Youth soccer coaches can benefit from stronger, comprehensive educational efforts at the league/club level. Additionally, parents of youth athletes who are in the lower SES communities should be targeted to receive concussion safety information and/or interventions that would improve their knowledge, attitude, and practices regarding concussion safety.     

Who's not driving among U.S. high school seniors: A closer look at race/ethnicity,socioeconomic factors,and driving status

Objectives: We examined associations among race/ethnicity, socioeconomic factors, and driving status in a nationally representative sample of >26,000 U.S. high school seniors.

Methods: Weighted data from the 2012 and 2013 Monitoring the Future surveys were combined and analyzed. We imputed missing values using fully conditional specification multiple imputation methods. Multivariate logistic regression modeling was conducted to explore associations among race/ethnicity, socioeconomic factors, and driving status, while accounting for selected student behaviors and location. Lastly, odds ratios were converted to prevalence ratios.

Results: 23% of high school seniors did not drive during an average week; 14% of white students were nondrivers compared to 40% of black students. Multivariate analysis revealed that minority students were 1.8 to 2.5 times more likely to be nondrivers than their white counterparts, and students who had no earned income were 2.8 times more likely to be nondrivers than those earning an average of ≥$36 a week. Driving status also varied considerably by student academic performance, number of parents in the household, parental education, census region, and urbanicity.

Conclusions: Our findings suggest that resources—both financial and time—influence when or whether a teen will learn to drive. Many young people from minority or lower socioeconomic families who learn to drive may be doing so after their 18th birthday and therefore would not take advantage of the safety benefits provided by graduated driver licensing. Innovative approaches may be needed to improve safety for these young novice drivers.     

The effects of persistent audible seat belt reminders and a speed-limiting interlock on the seat belt use of drivers who do not always use a seat belt

Introduction: Vehicle technologies that increase seat belt use can save thousands of lives each year. Kidd, Singer, Huey, and Kerfoot (2018) found that a gearshift interlock was more effective for increasing seat belt use than an intermittent audible reminder, but interlocks may not be more effective than persistent audible reminders lasting at least 90 seconds. Method: Forty-nine part-time belt users with a recent seat belt citation who self-reported not always using a seat belt drove two vehicles for 1 week each. Thirty-three drove a Chevrolet with an intermittent audible reminder followed by either a BMW with a persistent 90-second audible reminder (n = 17) or a Subaru with an incessant audible reminder (n = 16). The other 16 participants experienced the BMW persistent reminder followed by an interlock that limited speed to 15 mph during unbelted driving. These data were combined with data from 32 part-time belt users in Kidd et al. (2018) who experienced the intermittent reminder for 2 weeks or the intermittent reminder for 1 week and a gearshift interlock the next. Results: Relative to the intermittent reminder, seat belt use was significantly increased an estimated 30% by the BMW persistent reminder, 34% by the Subaru incessant reminder, and 33% by the speed-limiting interlock. Belt use was increased an estimated 16% by the gearshift interlock, but this change was not significant. More participants circumvented the speed-limiting interlock to drive unbelted than the audible reminders. Responses to a poststudy survey indicated that interlocks were less acceptable than reminders. Conclusions: Audible reminders lasting at least 90 seconds and a speed-limiting interlock were more effective for increasing seat belt use than an intermittent audible reminder, but reminders were found more acceptable. Practical applications: Strengthening existing U.S. safety standards to require audible reminders lasting at least 90 seconds for front-row occupants could save up to 1,489 lives annually.     

Motorists' knowledge,attitudes and practices toward alcohol-impaired driving/riding in Ghana

Objectives: The main objective of this study was to establish the knowledge, attitudes, and practices toward drink driving/riding as a risk factor for road traffic crashes in 3 regional capitals in Ghana.

Methods: The study used a face-to-face approach to randomly sample motorists who were accessing various services at fuel/gas stations, garages, and lorry terminals in 3 cities in Ghana.

Results: Over the previous 12 months, 24% of all motorists and 55% of motorists who were current alcohol users reported driving or riding a vehicle within an hour of alcohol intake. On average, motorists/riders who were current alcohol users consumed 4 standard drinks per drinking occasion. Generally, 83% of motorists who currently use alcohol walked, rode, or drove home after consuming alcohol away from their homes. Motorists/riders who reported drink driving were 4 times more likely to have had previous traffic violation arrests compared to those who reported no drink driving/riding (P =.001). Respondents were of the opinion that speeding was the major cause of traffic crashes, followed by driver carelessness, poor road conditions, inexperienced driving, and drink driving, in that order. Thirty-six percent of motorists who use alcohol had the perception that consuming between 6 and 15 standard drinks was the volume of alcohol that will take them to the legal blood alcohol concentration (BAC) limit of 0.08%. Compared to females, male motorists/riders were more likely to report drink driving (adjusted odds ratio [AOR] = 5.15; 95% confidence interval [CI], 2.31 to 11.47). Private motorists also reported a higher likelihood of drink driving compared to commercial drivers (AOR = 3.36; 95% CI, 1.88 to 6.02). Only 4% of motorists knew the legal BAC limit of Ghana and only 2% had ever been tested for drink driving/riding.

Conclusion: The volumes of alcohol that motorists typically consume per drinking occasion were very high and their estimates of the number of drinks required to reach the legal BAC limit was also very high. Provision of authoritative information advising motorists about safe, responsible, or low-risk levels of alcohol consumption is imperative. Many traffic violations including drink driving were reported, thus suggesting a need for enhanced policing and enforcement. However, given the low level of knowledge of the legal BAC limit, educating motorists about how many drinks will approximate the legal BAC should be intensified prior to an increase in enforcement; otherwise, the desired outcome of enforcement may not be achieved.     

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.     

Young drivers' determinants of driving under the influence of cannabis: Findings from the Youth Cannabis and Driving Survey (YouCanDS)

Introduction: Driving under the influence of cannabis (DUIC) is proven to increase the risk of collisions and is most common among young drivers (ages 16 to 24). However, little is known about the specific determinants of DUIC behavior among youth, which limits the capacity to develop evidence-based prevention and intervention efforts. This study developed and evaluated a youth DUIC questionnaire, which was used to establish the DUIC determinants of young drivers. Method: The questionnaire was based on the theoretical framework of general deterrence and general prevention. Data obtained included: demographics, past cannabis use and DUIC experiences, DUIC intention, experiences riding as a passenger with someone DUIC, knowledge and credibility of the law, attitudes towards DUIC, and social controls. The resulting questionnaire was validated for a sample of 426 young drivers in the province of Ontario, Canada. An ordinal regression was conducted to examine the relationships between questionnaire items and DUIC intention. Results: The questionnaire displayed good construct validity and internal consistency across four out of five domains (KMO and Cronbach α values ≥ 0.70). Of the 426 respondents (52.6% female), 356 (83.6%) reported previous cannabis use, with 296 (69.5%) doing so in the past year, and 142 (33.3%) reporting DUIC. Furthermore, 179 (42%) study participants indicated at least a slight chance of DUIC in the next year. The regression analysis identified six variables predictive of DUIC intention: past DUIC incidence, perceived percent of those convicted that receive the penalty, moral awareness, perceived dangerousness, minor accident risk, and vicarious punishment avoidance. Conclusions: Preventive efforts should emphasize these determinants when designing targeted strategies and interventions. Practical Applications: These efforts should focus on educating the dangers and risk of a vehicle collision, that law enforcement has the capacity to apprehend and appropriately punish individuals DUIC, and that DUIC is wrong and socially unacceptable.