Social environment versus cycling competency predicting risk-taking in 11- to 13-year-old cyclists in The Netherlands

Abstract

Objectives: From age 12 onwards, cycling injuries begin rising in The Netherlands. A known contributing factor is younger children’s underdeveloped competency to deal with complex and hazardous traffic situations, and their exposure to such situations strongly increases after transitioning to secondary school. Little is known about intentional risk-taking as a contributing factor. In this developmental stage, children become increasingly vulnerable because of intentional risk-taking, affecting their safety and health. The incidence, predictors in the child’s social environment, and trends of such risks are systematically monitored; for instance, for alcohol use, smoking, and cyber bullying. Such monitors do not include risky road behavior. This exploratory field study examined the frequency of intentional risky cycling, its relationship with the perceived social environment, and relative to cycling competency measured as the ability to detect emerging hazards quickly.

Methods: Three hundred thirty-five students between 11 and 13 years of age (51% male) completed computerized tests of hazard perception skill and surveys on crashes, risk-taking, peer pressure, perceived risk-taking by parents or friends, and exposure to risky driving as passenger.

Results: Frequent risk-taking was associated with higher crash frequency. Stepwise regression confirmed that children who more often took risks on the road were also more sensitive to peer pressure, had more often been passengers of risky drivers, had parents and friends who exhibited risky behaviors in traffic more often, and perceived hazards as less dangerous but, in contrast to expectations, did not do worse on the detection of hazards. The predictors explained 28% of the variance in total risk-taking but varied from 6 to 20% depending on the specific risk-taking behavior concerned.

Conclusions: At least 20% of children sometimes or more often take risks in traffic. Children who feel peer pressure to behave in a risky manner, observe parents and friends behaving in a risky manner in traffic, and have been exposed as passengers to risky driving more often take risks in traffic themselves. These results provide support for including items on risky road behavior in health monitors and to design interventions that address the risk factors in the child’s perceived social environment.     

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.     

Protective factors associated with young passenger intervening in risky driving situations

IntroductionWhile the negative influence of passengers on driving is usually studied, young passengers may protect against young drivers' crash involvement by speaking out and trying to stop unsafe driving behavior. This study sought to examine psychosocial constructs of young passengers who are likely to intervene in their friends' risky driving.MethodUniversity students aged 17 to 25 years who were single (n = 123) or in a romantic relationship (n = 130) completed an online survey measuring protective factors.ResultsThe combination of individual, friend and (for participants in a relationship) romantic partner protective factors predicted self-reported passenger intervening intentions.Impact on IndustrySince peer passengers often increase young drivers' crash risk, research on passenger intervening has significant implications for road safety strategies. The findings provide support for the operationalization of protective factors in strategies that target passenger intervening behavior.     

First aid training in secondary schools: A comparative study and implementation considerations

Introduction: School-based first aid training has benefits for adolescents with an opportunity to increase health and safety knowledge relating to injury and cardiac arrest. Method: Using a quasi-experimental design we evaluated differences among students (M_age = 13.46 years, 55% female) taught first aid through the Skills for Preventing Injury in Youth (SPIY) program (n = 1942), treatment-as-usual school-based first aid training (n = 675), and students who did not receive first aid training (n = 489). Results: Results showed significant differences in self-reported knowledge scores at twelve-month follow-up (controlling for baseline knowledge). Students in the SPIY group and the treatment-as-usual first aid group had higher total scores than the control group. Teachers and students reported positive perceptions to first aid study, in particular the interactive delivery and scenarios for contextualizing information. Practical Applications: The study provides support for the retention of first aid knowledge up to 12-months and thus the inclusion and feasibility of first aid training in secondary school curriculum.     

Alcohol-related deaths among young passengers: An analysis of national alcohol-related fatal crashes

Introduction: There is consensus that riding with an impaired driver (RWI) constitutes a major threat to public health. The aim of this study was to characterize the factors contributing to the motor-vehicle deaths of 15–20 year-old (y/o) passengers that RWI with a peer. Method: Secondary analyses of the 2010–2018 Fatality Analysis Reporting System. 5,673 passengers aged 15–20 y/o killed while riding in passenger cars with a driver aged 21 or older, 3,542 of these drivers also aged 15–20 y/o. Analyses were conducted between October 2019 and December 2020. Results: Sixty-three percent of the young passengers were killed while riding with a driver 15–20 y/o. Of these drivers, 26.8% had a blood alcohol concentration (BAC) >0.00 g/dL and 77.1% had a BAC ≥0.08 g/dL. Compared with those occurring during the day on weekdays, fatalities of young passengers who RWI with a peer driver with a BAC ≥ 0.08 g/dL often occurred on weekend nights (OR = 8.2) and weekday nights (OR = 5.2), and when the passenger and driver were both male (OR = 1.8). Race/ethnicity was not a significant contributor to RWI fatalities. Conclusions: Most 15–20 y/o RWI fatalities occurred on weekends, at night, when the driver was a young peer with a high BAC, and the passenger and driver were male. The high prevalence of fatalities in these high-risk situations suggests that young driver-passenger dynamics may contribute to alcohol-related fatalities. Practical Applications: To curb RWI fatalities among underage passengers, countermeasures should focus not only on underage drinking drivers and riders, but also on drinking drivers of all ages. Prevention should increase focus on situations in which both the young passenger and young driver are males.     

Severity of passenger injuries on public buses: A comparative analysis of collision injuries and non-collision injuries

Introduction: Although public buses have been demonstrated as a relatively safe mode of transport, the number of injuries to public bus passengers is far from negligible. Existing studies of public bus safety have focused primarily on injuries caused by collisions. Surprisingly, limited effort has been devoted to identifying factors that increase the severity of passenger injuries in non-collision incidents. Method: Our study therefore investigated the injury risk of public bus passengers involved in collision incidents and non-collision incidents comparatively, based on a police-reported dataset of 17,383 passengers injured on franchised public buses over a 10-year period in Hong Kong. A random parameters logistic model was established to estimate the likelihood of fatal and severe injuries to passengers as a function of various factors. Results: Our results indicated substantial inconsistences in the effects of risk factors between models of non-collision injuries and collision injuries. The severity of passenger injuries tended to increase significantly when non-collision incidents occurred due to excessive speed of bus drivers, on double-decker buses, in less urbanized areas, in winter, in heavy rains, during daytime, and at night without street lighting. Elderly female passengers were also found more likely to be fatally or severely injured in non-collision incidents if they lost their balance while boarding, alighting from, or standing on a bus. In comparison, the following factors were associated with a greater likelihood of fatal or severe injuries in collision incidents: elderly female passengers, standing passengers who lost balance, buses out of driver control, double-decker buses, collisions with vehicles or objects, and less urbanized areas. Practical Applications: Based on our comparative analysis, more targeted countermeasures, namely “4E” (engineering, enforcement, emergency, and education) and “3A” (awareness, appreciation, and assistance), were recommended to mitigate collision injuries and non-collision injuries to public bus passengers, respectively.     

How many crashes are caused by driver interaction with passengers? A meta-analysis approach

IntroductionConversation and other interactions with passengers while driving induce a level of distraction to the person driving.MethodThis paper conducts a qualitative literature review on the effect of passenger interaction on road safety and then extends it by using meta-analysis techniques.ResultsThe literature review indicates that the distraction due to passengers is a very frequent risk factor, with detrimental effects to various driving behavior and safety measures (e.g., slower reaction times to events, increased severity of injuries in crashes), associated with non-negligible proportions of crashes. Particular issues concern the effect of passenger age (children, teenagers) on which the literature is inconclusive. Existing studies vary considerably in terms of study methods and outcome measures. Nevertheless, a meta-analysis could be carried out regarding the proportion of crashes caused by this distraction factor. The selection of studies for the meta-analysis was based on a rigorous method including specific study selection criteria. The findings of the random-effects meta-analyses that were carried out showed that driver interaction with passengers causes a non-negligible proportion of road crashes, namely 3.55% of crashes regardless of the age of the passengers and 3.85% when child and teen passengers are excluded. Both meta-estimates were statistically significant, revealing the need for further research, especially considering the role of passenger age.Practical applicationsStakeholders could make good estimates on future crash numbers and causes and take action in order to counter the effects of passenger interaction.     

Recent developments in young driver education, training and licensing in Australia

Australian young driver education and training approaches have differed from the mandatory school-based programs found internationally; generally comprising voluntary programs conducted outside of licensing. This paper reports on recent developments pertaining to the pre-learner, learner, and provisional license stages. Given its important context, state-based graduated driver licensing systems are also reviewed. There has been a shift toward starting driver education younger (pre-learner), greater involvement of parents, and more school-based programs; many now conducted by licensing authorities. The majority of initiatives are yet to be evaluated, particularly relative to crash outcomes; however, some studies suggest other positive outcomes, including increased supervised practice and delayed licensure. Furthermore, the federal government is proceeding with plans for a national license-based program. Several jurisdictions have also announced the introduction of passenger and nighttime restrictions on provisional licenses. Together these initiatives offer promise of reductions in young driver-related fatalities and injuries in the very near future.     

Enhancing safety competencies of young adults: A randomized field trial (RCT)

IntroductionYoung workers are exposed to various occupational hazards, often with limited experience and skills. In this study, we investigated the effects of the Attitude to Work Program on the safety competencies of young workers. Based on the social cognitive theory, the intervention was developed to help young people adopt an active role in preventing occupational hazards and overcoming barriers to safe work.MethodThe program was implemented in eight upper secondary-level vocational schools in Finland during 2015. A total of 464 students participated in the cluster randomized field trial. Those in the intervention group (n = 229) participated in the Attitude to Work Program. During the program, students identified and practiced behavioral strategies to prevent occupational hazards. Students in the control condition (n = 235) received written material about the same safety-related topics.ResultsThe short-term follow-up showed that the intervention significantly increased safety preparedness and the internal safety locus of control among the students in the intervention condition in comparison to those in the control condition. Students in the intervention condition also showed reduced risk-taking attitudes relative to those in the control condition. Furthermore, those who benefited most from the program were high conscientiousness students. The sensation-seeking level or vocational track did not moderate any of the intervention effects.ConclusionThe results demonstrated that safety competencies can be modified by intervention techniques based on a social-cognitive framework.Practical implicationsThis study provides tools for school-based safety training and future intervention development. Further research is needed to study the relationships between cognitive factors, safety behavior, and accidents.     

Case study: 128 injured in rollover coach crashes in Sweden—Injury outcome,mechanisms and possible effects of seat belts

The risk for injuries in rollover coach crashes are dependent on whether the occupants are belted or not. However, the influence of the different belt systems for reducing injuries has remained unclear. Since many injuries sustained are caused by impacts with the interior, passenger interactions or ejection through a window, the advantages by proper seat belt systems are evident. In this study, representing the most common serious crash scenario for serious injury, 128 injured in rollover cases were analysed with regard to the injury outcome, mechanisms and the possible injury reduction for occupants when using a safety belt. Furthermore, the different belt systems were compared to explain their contribution to increased safety. Based on medical reports and questioning of the passengers, the injuries sustained are recorded according to the AIS classification. The next step was the identification of the injury mechanisms, using the passenger statements as well as results from numerical occupant simulations. It is important to mention that this study was purely focused on detection of the injury mechanism to avoid the reported injuries. The possibility of additional injuries due to the wearing of a belt were not taken into account. However, the analysis of the 128 injured showed a considerable increase in safety for belted occupants through limiting interior contacts, minimising passenger interaction and reducing the possibility of ejection.     

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.     

The provisional license: nighttime and passenger restrictions--a literature review

PROBLEM: Due to inexperience and inadequate driving skills, the road is a very risky place for young and beginning drivers, yet such experience and skills can only be built by increased driving and exposure to risks on the road. Graduated driver licensing (GDL) allows beginning drivers to get their initial driving experience under less risky conditions and gradually eases them into more complex driving situations. This paper reviews the literature exploring two key features of the intermediate licensing phase of GDL, nighttime driving restrictions and passenger restrictions. METHOD: Literature review. RESULTS: Nighttime driving restrictions have been shown to effectively reduce the number and rate of crash involvements on the part of teenage drivers. Data suggest that having passengers in the car increases the likelihood of a fatal injury in young drivers and that this risk increases with the number of passengers. Young drivers were more likely to cause a crash when accompanied by their peers. DISCUSSION: Nighttime driving and passenger restrictions are effective in decreasing injuries among teenage drivers and their passengers, especially in the context of a full GDL system. Several research questions remain to be answered in order to fully refine and optimize the impact of these provisional measures.     

Requiring belt use as part of a school parking permit program: does it increase students' belt use?

OBJECTIVE: Teenagers have very high motor vehicle crash rates, and their use of seat belts is generally lower than that of adults. A potential school-based strategy to increase teenagers' belt use is a policy making parking privileges contingent on belt use by student drivers and their passengers. This study evaluated the effects of implementing a school belt policy. METHODS: The effects of a belt policy were evaluated during the 2003-2004 school year at high schools in two states: Connecticut, a state with a primary enforcement belt law and high belt use rates, and Mississippi, a state with a secondary enforcement law and generally low use rates. Both schools enforced the policy, and violations resulted in a graduated set of penalties leading to the potential loss of parking privileges. Baseline and post-policy belt use rates were obtained from observation surveys of student drivers and their teenage passengers coming to and from school. Changes in belt use were examined relative to belt use trends at comparison schools without a belt policy. Implementation of the policies also was monitored. RESULTS: In Mississippi, among students arriving at school in the morning, driver belt use increased from 42% before the policy to 67% about 6 months after; passenger belt use increased from 16% to 61%, although sample sizes were small. These increases were significantly larger than expected, based on belt use trends at the comparison school in Mississippi. In Connecticut, where 86% of drivers and 79% of their passengers already were belted prior to the policy, there was no significant change. Both schools publicized and monitored the belt policy, and most enforcement occurred in the morning as students arrived at school. CONCLUSIONS: Based on a small-scale application of a belt policy at two schools in different states, a school belt policy may have stronger effects in states where belt use is low. Strong penalties and enforcement are essential elements of an effective policy. Adequate resources and commitment are needed for schools to implement and monitor the type of strong policy needed to sustain high belt use rates. Replication of this study in additional schools appears warranted.     

地铁乘客疏散帮助行为及其影响因素的SEM模型*

为研究地铁疏散中乘客帮助行为及其影响因素之间的作用机制,通过对武汉市地铁站乘客疏散行为进行问卷调查,从普通乘客特征、特殊群体特征、安全认知、疏散环境和恐慌心理5个维度出发,构建地铁乘客疏散帮助行为及其影响因素的结构方程模型。研究结果表明:普通乘客特征、特殊群体特征、安全认知对帮助行为具有直接正向影响,其中安全认知对乘客是否提供帮助行为的影响最大;恐慌心理、疏散环境对帮助行为具有直接负向影响,其中恐慌心理影响较大;安全认知还通过中介变量普通乘客特征、特殊群体特征、疏散环境和恐慌心理对帮助行为产生间接影响。     

The effect of extending graduated driver licensing to older novice drivers in Indiana

Introduction: Graduated driver licensing (GDL) systems have been shown to reduce rates of crashes, injuries, and deaths of young novice drivers. However, approximately one in three new drivers in the United States obtain their first driver’s license at age 18 or older, and thus are exempt from most or all provisions of GDL in most states. Method: In July 2015, the state of Indiana updated its GDL program, extending its restrictions on driving at night and on carrying passengers during the first 6 months of independent driving, previously only applicable to new drivers younger than 18, to all newly-licensed drivers younger than 21 years of age. The current study examined monthly rates of crashes per licensed driver under the affected conditions (driving at night and driving with passengers) among Indiana drivers first licensed at ages 18, 19, and 20 under the updated GDL system compared with drivers licensed at the same ages under the previous GDL system. We used Poisson regression to estimate the association between the GDL system and crash rates, while attempting to control for other factors that might have also influenced crash rates. We used linear regression to estimate the association between the GDL system and the proportion of all crashes that occurred under conditions restricted by the GDL program. Results: Results showed, contrary to expectations, that rates of crashes during restricted nighttime hours and with passengers were higher among drivers licensed under the updated GDL system. This mirrored a statewide increase in crash rates among drivers of all ages over the study period and likely reflected increased overall driving exposure. The proportions of all crashes that were at night or with passengers did not change. Practical Applications: More research is needed to understand how older novice drivers respond when GDL systems originally designed for younger novice drivers are applied to them.     

基于地铁乘客个体特征的非适应性行为研究

为减少应急疏散时地铁乘客的非适应性行为,提高应急疏散效率,以知信行(KAP)理论为基础,构建地铁疏散乘客非适应性行为模型,在此基础上编制乘客非适应性行为调查问卷,运用SPSS软件中的T检验和方差分析方法分析乘客个体基础特征对非适应性行为的影响,并运用结构方程模型研究疏散乘客安全知识及安全态度与非适应性行为的关系。结果表明:疏散乘客的性别、年龄及火灾经历对非适应性行为具有显著影响,文化程度及乘车频次对非适应性行为无显著影响;疏散乘客的安全知识和安全态度对非适应性行为均具有显著的负向影响。     

Investigating traffic fatality trends and restraint use among rear-seat passengers in the United States, 2000–2016

Introduction: Motor-vehicle crash is one of the leading causes of unintentional injury death in the United States. Previous studies focused on fatalities among drivers and front-seat passengers, with a limited number of studies examining rear-seat passenger fatalities. The objectives of this study were to assess trends in rear-seat passenger motor-vehicle fatalities in the United States from 2000 to 2016 and to identify demographic factors associated with being unrestrained among fatally injured rear-seat passengers. Methods: Rear-seat passenger fatality data were obtained from the Fatality Analysis Reporting System (FARS) database. The fatality rate ratios for overall rear-seat passengers and for different age and sex groups were determined by comparing fatality rates in 2000 and 2016 using random effects models. Risk ratios of being unrestrained for age and sex groups were obtained using general estimating equations. Results: Compared to 2000, the overall rear-seat passenger fatality rate in 2016 decreased by 44% (95% confidence interval [CI]: 39–49%). In particular, the fatality rate among rear-seat passengers decreased more in males than females, and passengers aged 14–19 years experienced a larger decline than all other age groups. Fatally injured male rear-seat passengers had a higher risk of being unrestrained (adjusted risk ratio: 1.06, 95% CI: 1.04–1.07) than their female counterparts, and both youngest (≤13 years) and oldest (65–85 years) passengers were less likely to be unrestrained than those aged 20–64 years. Conclusions: Overall, fatality rates among rear-seat passengers have declined, with differential degrees of improvement by age and sex. Practical Applications: Continued restraint use enforcement campaigns targeted at teenagers and males would further preserve them from fatal injuries and improve traffic safety for the overall population.     

地铁恐怖袭击下乘客疏散交通方式调查研究

为科学地认识地铁恐怖袭击事件下乘客疏散方式决策行为,基于随机抽样调查,采集乘客疏散交通方式选择意向数据,揭示不同地铁恐怖袭击场景下乘客心理特征及疏散交通方式选择行为差异。结果表明:地铁恐怖袭击事件引发乘客恐慌,恐慌程度与性别、年龄、文化程度、月收入、是否接受恐袭安全教育和通勤距离6个因素显著相关;除常规的行程时间、出行费用等因素外,安全性是乘客进行疏散交通方式选择的首要因素;在恐怖袭击事件导致地铁网络重要站点关闭情况下,仍有部分乘客选择地铁作为疏散交通方式,且选择比例随出行距离增加而增加;恐怖袭击事件的攻击方式影响乘客疏散交通方式选择,爆炸恐怖袭击下地面公交客流分担率高于其他方式,而持刀伤人事件下地铁客流分担率最高。     

Passenger effects on teenage driving and opportunities for reducing the risks of such travel

OBJECTIVES: To review the research evidence concerning the effects of passengers on teenage driving and crash involvement, and to explore ways to reduce negative effects. METHODS: Review of the international literature on these topics. RESULTS: Passenger presence increases crash risk for teenage drivers, especially when the passengers are other teenagers and especially when they are male. Female passengers do not have the same effects. Teenagers are more susceptible to peer influences than adults. The combination of passenger-induced distraction and driving inexperience can disrupt driving behavior, and there is evidence that teenage driver risk taking increases in vehicles with multiple teenagers. Possible ways to reduce the resulting crash problem include altering the in-vehicle behavior of teenagers or influencing their selection of travel partners. Legal restrictions on passengers with teenage drivers have been found effective in reducing the crash problem. Parental monitoring of teenage driving behavior, and programs aimed at teenagers themselves, could be other options but their efficacy is unproven. It currently is unknown why female passengers have a different effect than males or if that might offer clues about future interventions. CONCLUSIONS: Despite passenger restrictions in the majority of states, 42% of 16- and 17-year-old drivers in fatal crashes in 2005 were transporting teenagers with no adults in the vehicle; 61% of teenage passenger deaths (1,222 in 2005) occurred in vehicles driven by other teenagers. Wider application of passenger restrictions is indicated. IMPACT ON INDUSTRY: Ways to make passenger restrictions more effective are needed, and other techniques for reducing this major problem need development and testing.