Graduated driver licensing: review of evaluation results since 2002

Unintentional injury from motor-vehicle crashes is the number one cause of death among teenagers in the United States. Increasingly, jurisdictions have adopted three-stage graduated driver licensing (GDL) systems for young novice drivers. Since a previous review of U.S. GDL evaluation results, many more U.S. states and Canadian provinces have implemented GDL and/or had enough time pass that additional evaluation results are now available. Twenty-one studies of GDL within 14 individual jurisdictions, and six studies of GDL in the U.S. nationwide, were collected, reviewed, and summarized. Positive results (usually crash reductions) of varying degrees were reported from nearly all the studies. Given differences in approaches, study goals, methods, and analyses, the results are surprisingly consistent. Overall, GDL programs have reduced the youngest drivers' crash risk by roughly 20 to 40%. Research on teen driving and comprehensive GDL enhancements could further reduce teen drivers' motor-vehicle crashes, injuries, and fatalities. IMPACT ON INDUSTRY: Policy-makers, as well as the motor vehicle, insurance, and other industries have been involved in teen driving safety and could enhance and coordinate their roles.     

California's graduated driver license law: Effect on teenage drivers' deaths through 2005

PROBLEM: While many researchers believe Graduated Driver Licensing (GDL) laws save lives by imposing restrictions and delayed licensure on drivers under age 18, longer term effects on older teenagers have not been studied. METHOD: The effects of California's strict GDL law on deaths of drivers ages 16-19 were analyzed for 1995-2005 using Incidence Rate Ratios (IRR) and Auto-Regressive Integrated Moving Average (ARIMA) time series analysis of Fatality Analysis Reporting System mortality data. RESULTS: The two methods yielded similar results. IRR analysis found California 16-year-old drivers subject to the GDL experienced a 15% fatality decline (95% CI, 0.70-0.99), while 18 year-old drivers experienced a 15% increase (95% CI, 1.02-1.27). ARIMA analysis found 16 year-old drivers experienced a near-significant 20% fatality decline (p=0.07), while 18 year-olds experienced a 24% increase (p=0.01). Unlicensed teenage drivers and older teen drivers driving alone and transporting teenage passengers suffered significant fatality increases. SUMMARY AND DISCUSSION: California's GDL may negatively affect older teenagers and other driver subpopulations and merits reevaluation.     

Distraction in older drivers - A face-to-face interview study

The prevalence of older drivers’ engagement in distracting activities while driving is largely unexplored. Face-to-face interviews were conducted in the city of Braunschweig, Germany, comparing a sample of older drivers (n = 205) to a group of middle-aged drivers (n = 209). The drivers were interviewed on their engagement in distracting activities during the last half an hour of their driving trip, including the frequency and duration of these activities, their perception of the risk associated with these distracting activities and the role of these activities in at-fault crashes. Middle-aged drivers were significantly more likely to engage in certain distracting activities than older drivers. With regard to the duration of interactions with the passengers older drivers were significantly more talkative than middle-aged drivers. Middle-aged drivers rated most of the distracting activities as significantly less dangerous than older drivers. Distraction-related crashes are not a special problem of older drivers but seem to be very comparable to the middle-aged drivers. It is concluded that older drivers’ reluctance to engage in distracting tasks while driving is either a process of self-regulation or their age-related prudence. The study is the first to gather knowledge about distraction in German older drivers. Although older drivers are not currently overrepresented in distraction-related crashes, it is important to note that future cohorts of older drivers might differ in the way they engage with vehicles and technologies, which in turn may influence their driving patterns and willingness to engage in potentially distracting activities.     

Work-related road safety: A case study of Roche Australia

Fleet, work-related or occupational road safety has the potential to make a major contribution to reducing both human harm and asset damage. To date, however, there would appear to be a dearth of well researched and evaluated case studies in the public domain in this area.This paper provides an on-going, documented, real-world case study of work-related road safety within an Australian company that has sought to manage, monitor and improve its road safety performance over the last 5 years through a range of proactive, fleet manager, insurance and risk-led initiatives.Roche Australia has successfully implemented a Company Motor Vehicle Safety Program with support from its fleet insurers and risk management advisors. Four key initiatives are set out covering: (1) Driver risk assessment, monitoring and improvement. (2) Policy development and communications. (3) Process and outcomes evaluation. (4) Continuous review and refinement of policies, processes, programs and future developments.The program has led to a range of process and performance-based outcomes. Typical barriers to success in work-related road safety have been identified and overcome. Almost 100% risk assessment and improvement process compliance by drivers has been achieved. A predictive relationship between risk assessment outcomes and collision history has been identified. Reductions in insurance claims, collision costs and claims ratio have been sustained. A detailed project plan is in place to continue the program for the next 3 years.The paper concludes that with effective management, a well developed work-related road safety program can result in performance improvements within the initiating organisation. Several limitations in the case study methodology, as well as areas for further work and lessons for policy makers, researchers and practitioners are also identified.     

Association between driver and child passenger restraint: Analysis of community-based observational survey data from 2005 to 2019

Introduction: Crash data suggest an association between driver seatbelt use and child passenger restraint. However, community-based restraint use is largely unknown. We examined the association between driver seatbelt use and child restraint using data from a state-wide observational study. Methods: Data from Iowa Child Passenger Restraint Survey, a representative state-wide survey of adult seat belt use and child passenger safety, were analyzed. A total of 44,996 child passengers age 0–17 years were observed from 2005 to 2019. Information about driver seatbelt use and child restraint was directly observed by surveyors and driver age was reported. Logistic regression was used to examine the association between driver seatbelt use and child restraint adjusting for vehicle type, community size, child seating position, child passenger age, and year. Results: Over the 15-year study period, 4,114 (9.1%) drivers were unbelted, 3,692 (8.2%) children were completely unrestrained, and another 1,601 (3.6%) children were improperly restrained (analyzed as unrestrained). About half of unbelted drivers had their child passengers unrestrained (51.8%), while nearly all belted drivers had their child passengers properly restrained (92.3%). Compared with belted drivers, unbelted drivers had an 11-fold increased odds of driving an unrestrained child passenger (OR = 11.19, 95%CI = 10.36, 12.09). The association between driver seatbelt use and child restraint was much stronger among teenage drivers. Unbelted teenage drivers were 33-fold more likely (OR = 33.34, 95%CI = 21.11, 52.64) to have an unrestrained child passenger. Conclusion: These data suggest that efforts to increase driver seatbelt use may also have the added benefit of increasing child restraint use. Practical applications: Enforcement of child passenger laws and existing education programs for new drivers could be leveraged to increase awareness of the benefits of seatbelt use for both drivers themselves and their occupants. Interventions aimed at rural parents could emphasize the importance of child safety restraints.     

Probationary and non-probationary drivers' nighttime crashes in Western Australia, 1996-2000

INTRODUCTION: This study was designed to explore the temporal aspects of crashes for probationary and non-probationary drivers. METHODS: Data from the West Australian Road Injury Database from 1996-2000 were used to calculate age-sex-specific crash rates per 100,000 person-days and to plot proportions of fatal and hospital crashes by time for probationary and non-probationary drivers. The population attributable risk was used to estimate the potential number of lives saved by nighttime driving restriction in the probationary period. RESULTS: Probationary drivers were seven times more likely to crash than non-probationary drivers. While the highest number of crashes was in the daytime, probationary drivers had a higher proportion of fatal or hospitalization crashes at night than non-probationary drivers. CONCLUSION: Restrictions on driving at night could form part of graduated driver training. Even if some probationary drivers disobeyed the restriction, a substantial reduction in car occupant fatalities and hospitalizations could result.     

Difficulties in emotion regulation and risky driving among Lithuanian drivers

Background: Risky driving is a common cause of traffic accidents and injuries. However, there is no clear evidence of how difficulties in emotion regulation contribute to risky driving behavior, particularly in small post-Soviet countries. The present study aimed to investigate the relationship between difficulties in emotion regulation and self-reported risky driving behavior in a sample of Lithuanian drivers.

Methods: A total of 246 nonprofessional Lithuanian drivers participated in a cross-sectional survey. Difficulties in emotion regulation were assessed using the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer 2004), and risky driving behavior was assessed using the Manchester Driver Behaviour Questionnaire (DBQ; Lajunen et al. 2004).

Results: Males scored higher than females in aggressive violations and ordinary violations. Females scored higher for the nonacceptance of emotional responses, whereas males had more difficulties with emotional awareness than females. More difficulties in emotion regulation were positively correlated with driving errors, lapses, aggressive violations, and ordinary violations for both males and females. Structural equation modeling showed that difficulties in emotion regulation explained aggressive and ordinary violations more clearly than lapses and errors. When controlling for interactions among the distinct regulation difficulties, difficulties with impulse control and difficulties engaging in goal-directed behavior predicted risky driving. Furthermore, nonacceptance of emotional responses and limited access to emotion regulation strategies were related to less violations and more driving errors.

Conclusion: Emotion regulation difficulties were associated with the self-reported risky driving behaviors of Lithuanian drivers. This provides useful hints for improving driver training programs in order to prevent traffic injuries.     

Physiological signal analysis for fatigue level of experienced and inexperienced drivers

Objective: We studied the changes in driving fatigue levels of experienced and inexperienced drivers at 3 periods of the day: 9:00 a.m.–12:00 p.m., 12:00 p.m.–2:00 p.m., and 4:00 p.m.–6:00 p.m.

Methods: Thirty drivers were involved in 120-min real-car driving, and sleepiness ratings (Stanford Sleepiness Scale, SSS; Hoddes et al. 1973 Hoddes E, Zarcone V, Smythe H, Phillips R, Dement WC. Quantification of sleepiness: a new approach. Psychophysiology. 1973;10:431–436.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]), electroencephalogram (EEG) signals, and heart rates (HRs) were recorded. Together with principal component analysis, the relationship between EEG signals and HR was explored and used to determine a comprehensive indicator of driving fatigue. Then the comprehensive indicator was assessed via paired t test.

Results: Experienced and inexperienced drivers behaved significantly differently in terms of subjective fatigue during preliminary trials. At the beginning of trials and after termination, subjective fatigue level was aggravated with prolonged continuous driving. Moreover, we discussed the changing rules of EEG signals and HR and found that with prolonged time, the ratios of δ and β waves significantly declined, whereas that of the θ wave significantly rose. The ratio of (α + θ)/β significantly rose both before trials and after termination, but HR dropped significantly. However, one-factor analysis of variance shows that driving experience significantly affects the θ wave, (α + θ)/β ratio, and HR.

Conclusions: We found that in a monotonous road environment, fatigue symptoms occurred in inexperienced drivers and experienced drivers after about 60 and 80 min of continuous driving, respectively. Therefore, as for drivers with different experiences, restriction on continuous driving time would avoid fatigued driving and thereby eliminate traffic accidents. We find that the comprehensive indicator changes significantly with fatigue level. The integration of different indicators improves the recognition accuracy of different driving fatigue levels.     

A new approach to managing work-related road traffic injury: The development of a health investment framework

Objective: Statistics indicate that employees commuting or traveling as part of their work are overrepresented in workplace injury and death. Despite this, many organizations are unaware of the factors within their organizations that are likely to influence potential reductions in work-related road traffic injury.

Methods: This article presents a multilevel conceptual framework that identifies health investment as the central feature in reducing work-related road traffic injury. Within this framework, we explore factors operating at the individual driver, workgroup supervisor, and organizational senior management levels that create a mutually reinforcing system of safety.

Results: The health investment framework identifies key factors at the senior manager, supervisor, and driver levels to cultivating a safe working environment. These factors are high-performance workplace systems, leader–member exchange and autonomy, trust and empowerment, respectively. The framework demonstrates the important interactions between these factors and how they create a self-sustaining organizational safety system.

Conclusions: The framework aims to provide insight into the future development of interventions that are strategically aligned with the organization and target elements that facilitate and enhance driver safety and ultimately reduce work-related road traffic injury and death.     

Medical referral and license disposition for drivers in Iowa

Introduction: Driver retirement and determination of fitness-to-drive are important aspects of reducing the risk of motor-vehicle collision for an older driver. A lack of information about the review process may lead to poor evaluation of drivers or an increased testing burden to referred drivers. Methods: This paper evaluates the license review process for the state of Iowa. We evaluated data from January 2014 to January 2018 and described the source of referral, testing process, and ultimate license disposition. Cox proportional hazards for competing risk were used to determine the risk of having a change in restrictions on the license and the risk of license denial. Results: 20,742 individuals were followed through the medical referral process. The most common source of referrals was licensing officials (39.7%). Drivers referred by licensing officials were less likely to be denied their license when compared to drivers from other sources (HR = 0.92 95%CI: 0.87–0.98); however, licensing official referrals were more likely to result in license restrictions compared to other sources (HR = 1.91, 95%CI: 1.82–2.00). Drivers referred by either law enforcement or a physician were more likely to ultimately have their license denied. Conclusions: Physician and law enforcement referred the drivers most likely to have their license denied. A smaller proportion of drivers were referred by physicians and law enforcement compared to licensing officials. Practical Applications: Licensing agencies should work with physicians and law enforcement to identify drivers who may need a review of their license. Comprehensive tracking of all medical referrals for a driver’s license review is important for individual states to understand the burden of their driver referral process and for identifying referral sources with a high proportion of referrals with no licensing change for targeted outreach and education.