Pediatrician attitudes, knowledge, and practice behavior regarding teen driving safety

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.     

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.     

Dissociation between driving performance and drivers' subjective estimates of performance and workload in dual-task conditions

Introduction

The current study measured how concurrent driving and in-vehicle activities of different levels of engagement varied in terms of performance and subjective estimates of demand and performance.

Method

In this test track study, 41 younger and older drivers completed a series of cognitive tasks while driving an instrumented vehicle. One task involved an engaging guessing game where drivers tried to guess the identity of an object. The other task involved a simple mental arithmetic task.

Results

We observed some dissociation between drivers' performance and their subjective reports. For instance, drivers tended to estimate their performance as better for the more engaging guessing task than the arithmetic task, though their performance was actually worse. At the same time, subjective estimates of workload across the two tasks did not vary in the dual-task condition even though they did in the single-task baseline conditions, suggesting that drivers failed to account for the added demands in dual-task situations.

Conclusions

We discuss the implications of these findings for driver safety.

Impact on Industry

Crashes due to distraction can carry tremendous costs for employers, in terms of injury, disability, and loss of potentially productive work years, whether these crashes occur on or off the job.     

Results from a national survey of Crown prosecutors and defense counsel on impaired driving in Canada: A “System Improvements” perspective

Introduction

This article summarizes the main findings from a study designed to examine the legal process in Canada as it applies to alcohol-impaired driving from the point of view of Crown prosecutors and defense counsel, and to identify evidentiary or procedural factors that may impact the legal process, the rights of the accused, and interactions of all parts in the legal process.

Method

The data in this study were collected by means of a survey that was mailed out to the population of Crown prosecutors and defense counsel in Canada. In total, 765 prosecutors and 270 defense lawyers or an estimated 33% of all Canadian prosecutors and 15% of defense lawyers completed and returned the questionnaire. The "systems improvement" paradigm was used to interpret the findings and draw conclusions. Such an approach acknowledges the importance of the context in which countermeasures are implemented and delivered and the structures or entities used to deliver countermeasures to a designated target group.

Results

Results on type of charges and breath alcohol concentration, caseload, case outcomes, case preparation time, conviction rate at trial and overall conviction rate, reasons for acquittals and time to resolve cases are described.

Discussion

The findings from this national survey suggest that there are important challenges within the criminal justice system that impede the effective and efficient processing of impaired driving cases. Some of these challenges occur as a function of practices and policies, while others occur as a function of legislation.

Impact on industry

This study illustrates that a "system improvements" approach that acknowledges the importance of all elements of the criminal justice system and the interaction between those elements, can be beneficial in overcoming the alcohol-impaired driving problem.     

Attitudes toward a primary seat belt law among adults in a rural state with a secondary seat belt law

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.     

Does the built environment affect when American teens become drivers? Evidence from the 2001 National Household Travel Survey

Problem

Motor vehicle crashes are the most common cause of death for American adolescents. However, the impact of where teens live on when they begin driving has not been studied.

Method

Data from the 2001 National Household Travel Survey were used to estimate the effect of residential density on the driver status of teens aged 16 to 19 years after matching on demographic characteristics.

Results

Controlling for demographic characteristics, 16 and 17 year old teens in high density neighborhoods had driver rates 15 percentage points below teens living in less dense areas (p < 0.001). The effect for 18 and 19 year olds was a 9 percentage point decrease (p < 0.001).

Summary

These results suggest teens living in less dense and more sprawling communities initiate driving at a younger age than comparable teens in compact areas, placing them at increased risk for crash related injuries. Impact on Industry: The role of environmental factors, such as neighborhood walkability and provision of transit, should be considered in young driver programs.     

The conspicuity of first-responder safety garments

Introduction

This study compared the conspicuity of three types of first-responder safety garments (NFPA 1971-2007 turnout gear coats, and ANSI/ISEA 107 and 207 safety vests).

Method

Participants drove instrumented vehicles on a closed track during both daytime and nighttime, indicating when they could first detect pedestrians in a simulated emergency response scene. Pedestrians wore one of the safety garments and stood on either side of the emergency scene, facing or perpendicular to oncoming traffic, and either stationary or walking in place.

Results

All three garment standards provided equal levels of conspicuity, in that the distances at which the pedestrians were detected were equivalent. Time of day was a significant factor, with longer mean detection distances being observed in daytime. Pedestrian orientation was significant, with mean detection distances being longest when facing traffic. Pedestrian motion did not result in significant differences in detection distance.

Discussion

The results suggest that all three garment types studied are equivalent in making first responders conspicuous as pedestrians when working an emergency response scene in close proximity to traffic.

Impact on Industry

Whether an NFPA or ANSI/ISEA compliant is worn, first responders are equally likely to be detected by passing motorists, and as such these garments should be considered to be equivalent.     

An analysis of injury claims from low-seam coal mines

Introduction

The restricted workspace present in low-seam coal mines forces workers to adopt awkward working postures (kneeling and stooping), which place high physical demands on the knee and lower back.

Method

This article provides an analysis of injury claims for eight mining companies operating low-seam coal mines during calendar years 1996-2008. All cost data were normalized using data on the cost of medical care (MPI) as provided by the U.S. Bureau of Labor Statistics.

Results

Results of the analysis indicate that the knee was the body part that led in terms of claim cost ($4.2 million), followed by injuries to the lower back ($2.7 million). While the average cost per injury for these body parts was $13,100 and $14,400, respectively (close to the average cost of an injury overall), the high frequency of these injuries resulted in their pre-eminence in terms of cost. Analysis of data from individual mining companies suggest that knee and lower back injuries were a consistent problem across companies, as these injuries were each among the top five most costly part of body for seven out of eight companies studied.

Application/Impact

Results of this investigation suggest that efforts to reduce the frequency of knee and low back injuries in low-seam mines have the potential to create substantial cost savings.     

The role of production and teamwork practices in construction safety: A cognitive model and an empirical case study

Problem

In construction, the challenge for researchers and practitioners is to develop work systems (production processes and teams) that can achieve high productivity and high safety at the same time. However, construction accident causation models ignore the role of work practices and teamwork. This study investigates the mechanisms by which production and teamwork practices affect the likelihood of accidents.

Method

The paper synthesizes a new model for construction safety based on the cognitive perspective (Fuller's Task-Demand-Capability Interface model, 2005) and then presents an exploratory case study. The case study investigates and compares the work practices of two residential framing crews: a 'High Reliability Crew' (HRC)—that is, a crew with exceptional productivity and safety over several years, and an average performing crew from the same company.

Results

The model explains how the production and teamwork practices generate the work situations that workers face (the task demands) and affect the workers ability to cope (capabilities). The case study indicates that the work practices of the HRC directly influence the task demands and match them with the applied capabilities. These practices were guided by the 'principle' of avoiding errors and rework and included work planning and preparation, work distribution, managing the production pressures, and quality and behavior monitoring.

Summary

The Task Demand-Capability model links construction research to a cognitive model of accident causation and provides a new way to conceptualize safety as an emergent property of the production practices and teamwork processes. The empirical evidence indicates that the crews' work practices and team processes strongly affect the task demands, the applied capabilities, and the match between demands and capabilities.

Impact on Industry

The proposed model and the exploratory case study will guide further discovery of work practices and teamwork processes that can increase both productivity and safety in construction operations. Such understanding will enable training of construction foremen and crews in these practices to systematically develop high reliability crews.     

Falls from height during the floor slab formwork of buildings: Current situation in Spain

Problem

One of the phases with the highest risk of falls from a height in the construction of a building is during the floor slab formwork stage. This paper analyzes this particular risk, as well as the most frequently used fall-protection systems.

Method

A survey was carried out to define the current situation in Spain with regard to falls from a height during floor slab formwork and the fall-protection systems used to prevent such a risk.

Results

The results of the survey clarified the current situation in Spain with regard to this risk, and made it clear that there is considerable risk of falling from a height during the floor slab formwork stage.

Discussion

All the safety systems analyzed presented a series of weak points that should be studied in detail before they can be used on building sites.

Impact on industry

The risk of falling associated with floor slab formwork and the most frequently used protection systems are analyzed. As no research had been carried out to date on this type of risk, we consider the research presented in this article to be a pioneer in the field.