Understanding the context of alcohol impaired driving for fatal crash–involved drivers: A descriptive case analysis

Objective: The objective of this study was to understand the social context and circumstances surrounding alcohol-impaired driving prior to fatal crash involvement for drivers with an illegal blood alcohol concentration (BAC ≥ 0.05 g/100 ml or 0.00 g/100 ml for restricted license holders).

Methods: Coroners' case reports investigating fatal crashes in South Australia over a 3-year period (2008–2010) were examined. The personal and crash characteristics of drivers with an illegal BAC were compared with those who had a legal BAC. For each driver with an illegal BAC, information was recorded including characteristics of last trip, location and social context of alcohol consumption, quantity and type of alcohol consumed, BAC level, presence of drugs, perceived alcohol intoxication, and alcohol dependence. Official traffic offense records were also obtained.

Results: Of the 284 fatal crashes included in the study, 34% (n = 95) involved a driver or rider with an illegal BAC. Prior to the crash, alcohol was most frequently consumed by drivers in rural areas, within private homes, and was part of normal social activities. Drivers recorded a high level of alcohol impairment, with a mean BAC of 0.173 g/100 ml and a level of alcohol dependence that was above the Australian national average (7.4 vs. 3.9%). In addition, 23% of drivers were known to be experiencing psychological stress at the time of the crash. The results also confirm that drink driving recidivism continues to be a significant problem, with 44% of drivers recording at least one prior alcohol driving offense.

Conclusions: Alcohol-impaired driving continues to be a leading cause of fatal crashes. The popularity of drinking at home, particularly in rural areas, has implications for police enforcement strategies and suggests that drink driving interventions that focus on community values and looking after friends might be beneficial. Importantly, the study highlights the need for a broader holistic approach to reduce the high levels of alcohol consumption and alcohol dependence underlying drink driving behavior.     

“流空间”视域下淮海经济区城乡融合发展驱动机制

从要素流动多维重构淮海经济区城乡融合评价体系,以动态耦合协调度模型测度城乡融合水平并分析其时空分异规律,最后从“流空间”视角探索城乡融合发展驱动机制。结果表明：（1）研究区城乡融合水平整体较低但趋势向好,其正向空间关联和局域内向集聚特征明显。（2）流空间视角下区域呈多中心网络结构,且在人流和资金流下相对紧密,而物流和信息流下“核—辐”结构突出。（3）推动核心区集聚效应转向扩散效应,发挥各城市节点比较优势,合理调节要素流动强度、方向和质量,并在实施地方和国家政策时配套相关制度,方能实现淮海经济区城乡融合“量”“质”同升。     

A pre/post evaluation of fatigue,stress and vigilance amongst commercially licensed truck drivers performing a prolonged driving task

Purpose. The main purpose of this research study was to evaluate changes in fatigue, stress and vigilance amongst commercially licensed truck drivers involved in a prolonged driving task. The secondary purpose was to determine whether a new ergonomic seat could help reduce both physical and cognitive fatigue during a prolonged driving task. Two different truck seats were evaluated: an industrial standard seat and a new truck seat prototype. Methods. Twenty male truck drivers were recruited to attend two testing sessions, on two separate days, with each session randomized for seat design. During each session, participants performed two 10-min simulated driving tasks. Between simulated sessions, participants drove a long-haul truck for 90 min. Fatigue and stress were quantified using a series of questionnaires whereas vigilance was measured using a standardized computer test. Results. Seat interactions had a significant effect on fatigue patterns. Conclusion. The new ergonomic seat design holds potential in improving road safety and vehicle accidents due to fatigue-related accidents.     

Blood alcohol concentration in fatally injured drivers and the efficacy of alcohol policies of the new law on road traffic safety: A retrospective 10-year study in autonomous province of Vojvodina,Republic of Serbia

Objective: The aim of this study was primarily to evaluate inebriated fatally injured drivers (FIDs) according to blood alcohol concentration (BAC) in a 10-year period (2004–2013) in Autonomous Province (AP) of Vojvodina, Republic of Serbia, to analyze the efficacy of alcohol polices in the new law on road traffic safety through changes in the number of inebriated FIDs before and after implementation of the law, as well as to identify factors that influence the occurrence of FIDs with BACs above the legal limit.

Methods: All data for this retrospective study were obtained from the Centre of Forensic Medicine, Toxicology and Molecular Genetics of Clinical Centre of Vojvodina, Novi Sad. Autopsy records for each case included age, gender, BAC, type of vehicle, and date of accident (year, month, and recalculated day of the week). BAC was determined by gas chromatography with flame ionization detection. Statistical analysis was carried out by chi-square tests and Student's t test, with P < .05 as a statistical significance, and multiple binary logistic regression.

Results: Of the 354 inebriated FIDs (60% of all FIDs), the majority had BACs between of 0.031 and 0.3 mg/ml (28%), followed by those with BAC > 2.01 mg/ml (23%). The average BAC of those driving under the influence of alcohol (DUIA) for the whole period was 1.235 ± 1.00 mg/ml and the average number of DUIA/year was 35. Among the total number of FIDs there were significantly more males (93.7%; P < .001) than females (6.3%), though the distribution of intoxicated men and women was not different (P > .05). There was a statistically significant difference in the distribution of sober and inebriated FIDs according to age (P < .001) with the predominance of inebriated FIDs between 21 and 30 years. Although gender and age were found to be significant predictors of BAC above legal limit in FIDs, the area under the receiver operating characteristics (ROC) curve showed that the model had poor discrimination (ROC = 0.673). Of all observed FIDs, 65 cases per year were attributed to the first 5-year period (2004–2009) and 49 to the second 5-year (2010–2013) period, which indicates that there was no statistically significant decrease in the number of FIDs after implementation of the new law.

Conclusion: The highest number of intoxicated FIDs during the period in AP Vojvodina were mildly and completely inebriated. In the 4-year post-policy period (2010–2013), the number of FIDs and average BAC levels of inebriated FIDs did not significantly change. The abolition of a permissible BAC should be considered.     

Slow eyelid closure as a measure of driver drowsiness and its relationship to performance

Objective: Slow eyelid closure is recognized as an indicator of sleepiness in sleep-deprived individuals, although automated ocular devices are not well validated. This study aimed to determine whether changes in eyelid closure are evident following acute sleep deprivation as assessed by an automated device and how ocular parameters relate to performance after sleep deprivation.

Methods: Twelve healthy professional drivers (45.58 ± 10.93 years) completed 2 randomized sessions: After a normal night of sleep and after 24 h of total sleep deprivation. Slow eye closure (PERCLOS) was measured while drivers performed a simulated driving task.

Results: Following sleep deprivation, drivers displayed significantly more eyelid closure (P < .05), greater variation in lane position (P < .01) and more attentional lapses (P < .05) compared to after normal sleep. PERCLOS was moderately associated with variability in both vigilance performance (r = 0.68, P < .05) and variation in lane position on the driving task (r = 0.61, P < .05).

Conclusions: Automated ocular measurement appears to be an effective means of detecting impairment due to sleep loss in the laboratory.     

“Are you still driving?” Metasynthesis of patient preferences for communication with health care providers

Aim: The aim of this study was to synthesize published qualitative studies to identify older adults' preferences for communication about driving with health care providers.

Background: Health care providers play a key role in addressing driving safety and driving retirement with older adults, but conversations about driving can be difficult. Guides exist for family members and providers, but to date less is known about the types of communication and messages older drivers want from their health care providers.

Design: A qualitative metasynthesis of studies published on or before October 10, 2014, in databases (PubMed, CINAHL, PsycINFO, and Web of Science) and grey literature was performed.

Review Methods: Twenty-two published studies representing 518 older adult drivers met the following inclusion criteria: the study (1) was about driving; (2) involved older drivers; (3) was qualitative (rather than quantitative or mixed methods); and (4) contained information on older drivers' perspectives about communication with health care providers.

Results: We identified 5 major themes regarding older adults' communication preferences: (1) driving discussions are emotionally charged; (2) context matters; (3) providers are trusted and viewed as authority figures; (4) communication should occur over a period of time rather than suddenly; and (5) older adults desire agency in the decision to stop driving.

Conclusion: Various stakeholders involved in older driver safety should consider older drivers' perspectives regarding discussions about driving. Health care providers can respect and empower older drivers—and support their family members—through tactful communication about driving safety and mobility transitions during the life course.     

Crash risk perception of sleepy driving and its comparisons with drink driving and speeding: Which behavior is perceived as the riskiest?

Objective: Driver sleepiness is a major crash risk factor but may be underrecognized as a risky driving behavior. Sleepy driving is usually rated as less of a road safety issue than more well-known risky driving behaviors, such as drink driving and speeding. The objective of this study was to compare perception of crash risk of sleepy driving, drink driving, and speeding.

Methods: Three hundred Australian drivers completed a questionnaire that assessed crash risk perceptions for sleepy driving, drink driving, and speeding. Additionally, the participants' perceptions of crash risk were assessed for 5 different contextual scenarios that included different levels of sleepiness (low, high), driving duration (short, long), and time of day/circadian influences (afternoon, nighttime) of driving.

Results: The analysis confirmed that sleepy driving was considered a risky driving behavior but not as risky as high levels of speeding (P < .05). Yet, the risk of crashing at 4 a.m. was considered as equally risky as low levels of speeding (10 km over the limit). The comparisons of the contextual scenarios revealed driving scenarios that would arguably be perceived as quite risky because time of day/circadian influences were not reported as high risk.

Conclusions: The results suggest a lack of awareness or appreciation of circadian rhythm functioning, particularly the descending phase of circadian rhythm that promotes increased sleepiness in the afternoon and during the early hours of the morning. Yet, the results suggested an appreciation of the danger associated with long-distance driving and driver sleepiness. Further efforts are required to improve the community's awareness of the impairing effects from sleepiness and, in particular, knowledge regarding the human circadian rhythm and the increased sleep propensity during the circadian nadir.     

基于驾驶员模型参数辨识的疲劳驾驶研究

提出一种利用驾驶员模型反演方法来进行驾驶员疲劳诊断研究的新方法。首先利用预瞄神经网络建立适应于复杂路况条件下的驾驶员-汽车-道路闭环模型,然后定义特定行驶轨迹内理论数据与试验数据的近似度为目标函数,将驾驶员参数的反演问题转化为多目标优化问题,采用基于实数编码混沌变异量子遗传算法的优化方法,获得全局最优解。试验中采用脑电和主观疲劳心理评测结合的方法确定被试者的疲劳状况。在每种疲劳状况下对驾驶员参数进行辨识,对结果进行统计分析表明,在考虑到车型、道路曲率等因素条件下驾驶员参数分布与驾驶员的疲劳状况有很强的相关性。     

大城市边缘区土地利用时空格局模拟--以武汉市洪山区为例

大城市边缘区的土地利用变化复杂而迅速,采用定量模型对此地域的时空格局进行模拟,在土地规划领域有重大意义。以武汉市洪山区为例,首先采用DPSIR模型对大城市边缘区的工业用地、居住用地、服务设施用地、绿地等进行驱动力机制的定性分析,得出每种用地相应的驱动力、压力和状态;进而采用CLUE S模型,通过用地变化驱动力因子作用权重系数的求解,模拟时段内各类用地的需求分析与用地变化的动态分配过程,对边缘区的用地演变进行模拟;最后通过用地现状图对模拟用地进行验证,模拟结果基本拟合。在模拟的基础之上,设定了两种大城市边缘区空间发展的情景模式,即不作任何空间约束的用地演变和进行可持续发展约束的用地演变,有针对性地提出该区域的发展需要重点保护水体和自然风景区。其方法及成果可为大城市边缘区制定发展管理政策提供科学参考。