Objective: The purpose of this study was to determine the relationship between blood benzodiazepine concentration and crash risk. Methods: Blood samples from 2500 injured drivers were analyzed for benzodiazepines and the relationship between concentration and crash risk was assessed using culpability analysis. Benzodiazepine concentrations were expressed as a proportion of the peak concentration of the drug in blood or plasma for a standard therapeutic dose of the drug. Results: There were 68 drivers (2.7%) who tested positive for at least one benzodiazepine. Of these, 16 (23.5%) also tested positive for alcohol. Drivers who tested positive for benzodiazepines, either alone or in combination with alcohol, had a higher culpability rate than drug-free drivers. There was a significant linear relationship between benzodiazepine concentration and culpability for drivers who tested positive for benzodiazepines alone. Conclusion: The results here provide clear evidence of increased culpability associated with benzodiazepine use, which was marked at higher concentrations.
Objective: This study investigated the general deterrence effects of red light camera and the warning signs on traffic signal compliance in British Columbia. Methods: The study was conducted in two major cities in the interior region of the province, using a two-staged, quasi-experimental, treatment-control group design. In the first stage, the BC intersection safety camera program (ISC) was implemented in the two study cities simultaneously. In the second stage, 42 extra warning signs, informing the drivers of the ISC program were erected in and around the signage-treated city. In total, close to four million of vehicles were observed over the study periods, using an automated machine vision data collection technique. The data were subjected to Negative Binomial regression analysis, recognizing over-dispersion in violations over Poisson models. Results: The analysis revealed a 69% reduction in red-light violation rate at the study intersections one-month after the introduction of the program. After 6-month program operation, the reduction rate declined to 38%. The study did not found substantial and significant incremental effect of warning signs on red-light violation over and above the standard program configuration. Conclusion: The study found a general deterrence effect of ISC on driver traffic signal compliance. The study did not find evidence for signage effect. The result of the study seems to support the current BC program model, against a potentially cost-saving alternative of using extensive warning signs in lieu of the more expensive camera units.
Objective: To analyse differences in the trend in childhood bicycle-related injuries in Sweden between geographic areas - north/south and urban/rural. Methods: The study population consisted of children 0-14 years of age (both genders). National hospital-discharge data (ICD-9) for bicycle-related injuries were used for the period 1987 to 1996. Multivariate analysis was performed to examine linear and quadratic time trends in a statistical model. Results: There were no differences in incidence rate between the south and the north, except for children 7-14 (higher rate). There are substantial differences between urban and rural areas, and no possible methodological errors could explain this finding. But the picture that emerged from the north/south comparison is not as clear. Conclusion: From methodological point of view the statistical method used with both linear and quadratic modelling of the panels gives a better understanding of the time trends than the traditional linear regression model alone. The study gives a strong support for launching preventive programmes, especially in the urban and suburban (county) areas compared to the rest of Sweden.
Objective: Detection of impaired drivers in sobriety checkpoints is typically low. This study determines if a set of observable driver, vehicle and situational variables has potential value in identifying impaired drivers passing through sobriety checkpoints. The study predicts the blood alcohol concentrations (BAC) of a randomly selected sample of nighttime drivers and classifies them into BAC groups. Methods: The data were obtained from a 1998 roadside survey in three British Columbia communities. Multinomial logit models and discriminant models were estimated to describe, explain, and classify the BAC of nighttime drivers. Results: Several factors increase the odds of being an impaired driver: age group, 26 to 45; education, high school or less; trip origin, bar; passengers, group same sex as driver; and advancing hour of night. The classification function correctly classified more than 65% of all drivers and 62% of impaired drivers. Conclusion. Information in the model is not sufficient to make a reliable determination of BAC but could be used to increase the likelihood of identifying impaired drivers in sobriety checkpoints, thereby improving the efficiency of enforcement operation.
Objective: The basic aim was to study if benzodiazepine users exhibit impaired performance in simulated car driving and in laboratory tests. Effects of a small dose of alcohol on performance were also to be studied. Methods: Comparisons were made between twenty outpatients using benzodiazepines and an individually age and sex matched control group. Driving distance was 120 km. Effect measures were brake reaction time, lateral position variation, and speed variation. The two groups were also compared on three laboratory tests, simple reaction time, choice reaction time, and short-term memory. Alcohol consumption resulted in BACs between 25 mg% and 40 mg%. Results: The users exhibited greater intra individual speed variation at simulated driving, and impaired performance on simple reaction time and memory. No other differences were found. No relationship was found between dosage and behaviour. Alcohol had no effects on performance. Conclusion: The results of the study do not give any clear indication that persons who use prescribed medication with benzodiazepines would constitute a notable traffic safety problem.
Objective: To improve seat belt usage rate in Jordan through the implementation of a public education campaign was implemented. Educational materials about the safety benefits of seat belts were delivered to the public via Mosques and Churches, television, radio, and newspapers. Methodology: The effectiveness of the campaign in increasing driver seat belt use rate, as well as its level of outreach to the general driver population, were evaluated through two studies. The first study included observational seat belt use of nearly 28000 drivers at 27 stations before and then 4-months after the campaign; and the second study was personal interviews with 3000 drivers. Data were analyzed based on driver gender, vehicle use, and location using Z- and Chi-Square Statistics. Results: The results revealed that the campaign was effective in increasing the seat belt use rate from 19% before the campaign to 28% few months later after the campaign; i. e. a 47% increase was accomplished. Male drivers who had lesser seat belt use before the campaign benefited more from the campaign than their female counterparts. Drivers within city streets environment who had lesser seat belt use before the campaign benefited more from the campaign than drivers within highways environment. The seat belt public education campaign was effective in improving the seat belt use rate among private vehicle drivers on both city streets and highways, and also among taxicab drivers on city streets only. Even though after-campaign improvements had occurred to service vehicle and bus drivers; however, improvements were not statistically significant. Conclusion: The outreach of the seat belt public education campaign invovled nearly 60% of the driver population. Mosques and Churches were the most effective mean of reaching the general driver population compared television, radio, and newspapers.
Objective: The objectives of this research were to assess the extent of drivers' involvement in accident fatalities and injuries in relation to the total fatalities and injuries resulting from accidents in Jordan, to explore driver fatalities and injuries in relation to age, and to identify the main causes for accidents in Jordan. Method: The researcher conducted an extensive review of the records of accidents occurring in Jordan during 1999. All the data were obtained from the Jordan Traffic Institute. The research team was provided full access to the JTI's Accident Computer Database to achieve the objectives of this study. Results: The results indicate that drivers in Jordan accounted for nearly half the fatalities and injuries resulting from accidents involving a driver and/or a passenger only. Drivers in their early to late twenties, and drivers in their late fifties were found to be over-represented in driver fatalities and injuries. Also, tailgating (close following) and drivers' incorrect use of lanes were found to be leading causes of driver fatalities and injuries in Jordan. Conclusions: Based on the above results of this study, drivers between the ages of 18 and 28 years are over-involved in fatalities and injuries. The same result was found for drivers between the ages of 45 to 52 years and 57 to 60 years. It is recommended that funds and grants be geared towards educational efforts to be taken to increase awareness among drivers regarding the hazards associated with such driving malpractices. Such educational materials should target all drivers with emphasis placed on younger drivers.
The bloodshed on asphalt in Greece should be given top priority as an issue of the highest significance for the Nation. Drastic measures are necessary in order to reduce the number of deaths and permanent disabilities in Greece, a demographically weak country. The Olympic Games of 2004 with the anticipated influx of huge numbers of Athletes and Tourists, have already transformed the need for strict Traffic Control, into an urgent matter. Even one deadly car crush, with victims foreign Athletes or Tourists, who might visit ancient Olympia in the Peloponnese, will amount to a big catastrophe for Greece, in the eyes of the whole world. The significant and determined improvement of driving habits and of all other aspects related to traffic control, with the assistance of foreign experts, should be a National goal of the highest priority. Recent research has shown that many automobile crashes are due to a cumulative sleep deficit for people who do not get enough sleep, day after day (New Wellness Encyclopedia 1995). Furthermore the physical and mental tiredness from the infuriating and rich in exhaust-gasses life in Athens, together with alcohol consumption, and the cultural idiosyncrasies, plus the obsolete secondary road network in the provinces, explain quite adequately the bloodshed of Easter 2000. A study by the WHO, Harvard University and the World Bank (World Bank Group 2000) has shown, that during the next 10 years and in the absence of strong measures, there will be 6 million dead and 60 million injured from automobile accidents mainly in third world nations. Statistically useful data are given in the form of deaths per 10,000 vehicles. Norway and Sweden have very few deaths, Greece is ahead of Italy, Spain and Portugal, whereas Ethiopia and Rwanda have the highest numbers (see Table 1). From the 1.7 million deaths and 10 million disabled, reported worldwide per year, 70 per cent are in third world countries, 65 per cent of them are pedestrians and 35 per cent of pedestrians are children. Greece urgently needs draconian measures because the traffic situation is as grim as it can possibly be. This is perhaps the revenge of Technology, as described by Edward Tenner in his 1997 book entitled: Why the Things Bite Back, Technology and the Revenge of Unintended Consequences. Indeed, the automobile is a marvelous product of technology, but it bites back with a vengeance, becoming instantly an instrument of death or injury, when driving in a bad road, and when the driver is flippant, egocentric, sleepy, half-drunk, or is speeding or is talking in his cellular phone, ....sometimes through a satellite.
Objective: Riyadh, capital of the Kingdom of Saudi Arabia, is a fast developing and modern city. With a population of three million inhabitants and a motorized rate (population per vehicle) of 3.8, Riyadh has been experiencing increasing traffic accident problems. Official statistics have shown that more than 400 fatalities and 3000 injuries occur annually, due to traffic accidents. The severity index of traffic accidents over the past four years is higher for Riyadh than the corresponding nationwide index. This study aims at investigating the severity of traffic accidents in Riyadh. Methods: An attempt was made to compare property damage only (PDO) accidents with severe accidents in order to analyze the nature of severe accidents and determine their characteristics so that some remedies can be recommended. For this purpose, a total of 1774 reported accidents were collected in a systematic random manner for the period of 1996 through 1997. Analysis, using various test statistics, was conducted to compare the two categories of accidents. Results: The study found that improper driving behavior is the primary cause of accidents in Riyadh and the young drivers are most often the victims in such accidents. In addition, the taxis and pick-up trucks are at high risk of being involved in accidents. Conclusion: The analysis indicates that there is an urgent need for reviewing existing public awareness programs and law enforcement strategies.
Objective: To estimate how risk of death from the same physical impact changes as people age. Method: Fatality risks are estimated using data for 252,564 people killed when traveling in cars, light trucks, or motorcycles containing at least two occupants. Combinations of safety-belt use, helmet use, and seating location lead to 16 male and 14 female occupant categories. Results: Relationships between fatality risk and age are similar for the 16 male occupant categories and for the 14 female occupant categories, but are different for males and females. Because details of injury mechanism differ between the occupant categories, such agreement suggests that the results apply to blunt trauma in general (for example, due to falls) and not just to the traffic laboratory that provided the data. Conclusions. After age 20, the risk of death from the same impact increases at compound rates of (2.52 (plus or minus) 0.08)% per year for males and (2.16 (plus or minus) 0.10)% per year for females. Risk at age 70 exceeds risk at age 20 by 250% for males and 190% for females.
Objective: The aim of this study was to investigate how symptoms of psychopathology and demographic variables are related to traffic accident involvement among professional drivers. Methods: Two-hundred and seventy-three male professional drivers living in Ankara volunteered to fill in a form including Brief Symptom Inventory (BSI), questions about their accident history and background information. BSI scales scores showed high internal consistency. Data were analyzed by using logistic regression analysis. Results: Two models were composed. The first model included age, annual mileage, education, type of vehicle driven at work. None of these variables was related to accidents. In the second model, BSI scales (anxiety, depression, hostility, paranoid ideation and psychoticism) were entered to the model. Anxiety was found to have a positive and paranoid ideation a negative relationship to accident involvement. Conclusion: It was suggested that drivers applying a professional driver's license should be subjected to a screening test to screen out psychologically unfit candidates.
Aim and method: In order to study transport access and safety for children with disabilities, international literature was reviewed with respect to road vehicle transportation for the target group. Results: The transport of children with disabilities was found to be complex and insufficiently described in the literature. Some regulations and standards were identified. The outstanding finding was that only insufficient and fragmentary knowledge of parents' and other transport providers' perception of risks and problems associated with entering or exiting the vehicle, was described in the literature. The same holds true with respect to traveling the vehicle and the behavior of the driver. Furthermore, there was a lack of data on the extent of travel by children with disabilities. Conclusion: It was concluded that the problem of poor compatibility between the need for safe road transportation and the use of technical aids and special seating devices for children with disabilities needs be subjected to future research.
Objective: To evaluate the effect of child restraint use law enacted in Aug. 1997 with special reference to frequency of restraint use and extent of publicity. Method: 3000 passenger cars with children under five years of age were surveyed at three different locations to see whether in -car child safety device was used or not. Interview with 100 parents who have restraint system in their cars was conducted to investigate source of information on the system and their awareness of the law being enacted. Results: The overall frequency of child restraint use accounted for 13.6 %, 409 among 3,000 cars surveyed. The vast majority of parents obtained information on child restraint system via private sources rather than public media and were unaware of the law came into effect. Conclusion: In the situation with unacceptable level of frequency as well as publicity of child restraint use, it needs a coalition structure for cooperative work with relevant professionals. The positive role can be played by leadership of government authorities and particularly of health professions in raising awareness and encouraging increased use of the system.
Objective: In Germany on 1st August 1998 Section 24a of the road traffic law was expanded so that any person who has certain drugs detected in blood is deemed to have committed a regulatory offense. It is, therefore, worthwhile to increase the detection and withdrawal of drivers under the influence of drugs by training police officers. Methods: In order to enable the police to recognize drivers under the influence of drugs, the Drug Recognition in Road Traffic training program was developed and made available to police academies. A one-week training course has been regularly held for high-ranking police officers; it is intended that they should then act as multipliers, passing on their knowledge to the lower ranking police officers. Results: An indication of the success of the drug recognition program can be seen in the increase in blood samples sent by the police to toxicological institutes to be investigated for drugs. From Saarland, exact figures are available. In 1995, the number of blood samples after a road accident hardly increased. In 1998, the number of blood samples was 2.5 times as high as in 1997, and in 1999 it was 7 times higher. The increase in 1998 was mainly due to the use of the drug recognition program; in 1999 the coming into force of the amended Section 24a of the road traffic law was also responsible for this trend. Conclusion: These figures are impressive proof that amendments in laws and training of the police can increase the number of detected drug journeys. Further studies are intended to investigate the extent to which these results also apply in other parts of Germany.
Objective: For blunt impact injury, patient mortality increases if multiple injuries are complicated with thoracic injury. The purpose of this paper is to evaluate the prognosis value of ASCOT, a severity characterization of trauma, for thoracic patients injured from traffic accidents. This study aims to evaluate the prognosis value of ASCOT (A Severity Characteristics of Trauma) for thoracic patients injured from traffic accidents. Method: 341 thoracic patients from 2261 cases of traffic injuries were assessed with RTS, AIS-ISS and ASCOT, and the prognostic value in predicting survival and death were compared with actual outcomes. Results: ASCOT was satisfactory in the prognosis of survival patients, but not sensitive to death patients, e.g., there was a high incidence of mistaking death patients as survival. The causes of such aberration might be: 1) systemic errors of using foreign standard of trauma score to Chinese traffic wound; 2) deficiencies of trauma score system; 3) technical errors of one who performs trauma score assessment. Conclusions: It necessary to establish a Chinese database of trauma material and to enact trauma score standards or rectification coefficients of weighting factor congruous with the China situation.
The Prevalence of Learner Drivers with Cerebral Palsy who Are in Need of Highly Specialized Driver Education
Objectives: To assess the influence of lighting condition and speed on road accidents in typical urban locations; and to evaluate the adequacy of illumination systems in these locations in enhancing the safety of transportation systems. Method: National accident records for the year 1997 are analyzed. Three speed limit levels (40, 60, and 70 km/hr) and three lighting conditions (day, night, and sunset) are considered. Accident rates are compared for different accident types (injury, fatal, property damage, and overall accidents). Analysis of variance (ANOVA) is used as a tool for comparison. Results: Speed limit and lighting condition effects are significant in the less Severe accident types. Higher accident rates are observed at lower speed limits. Fatal accidents are seldom in urban streets. Conclusion: Accident risk during darkness is not more than that during daytime. Illumination systems in urban streets in Jordan are, therefore, efficient. Efforts should be directed to reduce accident rates at lower speeds.
