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PubMed1997

Differences in hand and foot psychomotor speed among 18 pairs of monozygotic twins discordant for lifelong vehicular driving.

The purpose of this study was to examine driving as a determinant of hand and foot psychomotor reaction times. Visual simple and choice hand and foot psychomotor reaction times were measured. The occupational driving contrast was determined by an interview reviewing every job held during each subject's lifetime. Comparison was made of psychomotor speed among 18 pairs of 39- to 62-year-old monozygotic male twins discordant for lifelong occupational driving. The mean discordance was the equivalent of 16 years of full-time driving. The twins who drove more tended to have slower hand simple and choice reaction times, although only the difference in hand-choice decision time was statistically significant (32 ms, P < 0.05). The drivers also had slower ipsilateral foot-choice decision times (21 ms, P < 0.01), but on average they had faster reaction times in 8 of the 12 ipsilateral and contralateral foot measurements. The slightly longer decision times could be related to some general harmful effects of driving, possibly whole-body vibration. Faster foot movement times of drivers may be affected by practice effects of rapid lower-extremity movements in driving.

Adult↗
PubMed1993

A case-control study of driving-while-impaired offenders.

A case control approach was used to identify variables associated with driving while impaired (DWI). Data utilized for this study were obtained from interviews with individuals in a representative sample of 9943 Canadians. Individuals convicted for DWI were matched with control subjects (i.e. no DWI convictions) by gender, age, province of residence, education, income, and recent drinking behaviour. During the matching process, 39 current abstainers were found among the DWI offenders and were treated as a separate group for statistical purposes. Three groups were compared: 78 DWI cases, 78 matched controls, and 39 DWI current abstainers. Statistical analyses were used to detect significant differences among these three groups for 81 variables within the following categories: (a) attitudes, knowledge and behaviour related to drinking and driving; (b) driving behaviour; (c) drinking behaviour and drug use; (d) social issues; and (e) attitudes towards different policy approaches to reducing drinking and driving. DWI cases were significantly different from control subjects for only 10 variables. A high proportion of differences found between these two groups related to attitudes regarding drinking and driving behaviour. For example, DWI cases were more likely than controls to believe that some people drive better after drinking, that it takes more alcohol to be legally impaired, and that there is an excuse for DWI. DWI cases were more likely to drink due to sadness or loneliness, and reported higher cannabis use over previous years. Little evidence was found to support the hypothesis that DWI offenders are less likely to perceive deterrents to DWI. However, evidence does support the notion that many DWI offenders do not believe that they have a drinking problem. Implications of the findings are discussed.

Adolescent↗
PubMed2005

Factors influencing the use of cellular (mobile) phone during driving and hazards while using it.

This study addressed the strategic decisions on not using a mobile phone at all while driving, and phone-related driving hazards among those drivers who do use one, reflecting tactical and operational level processes. A representative sample of 834 licensed drivers who own a mobile phone were interviewed on their phone use and hazards, background factors, and self-image as a driver. Logistic regression models indicated that older age, female gender, smaller amount of driving, and occupation promoted not using a phone at all while driving. Additionally, low skill level and high safety motivation contributed to this decision. Among those who used a phone while driving, exposure to risk in terms of higher mileage and more extensive phone use increased phone-related hazards, as also did young age, leading occupational position, and low safety motivation. Neither gender nor driving skill level had any effect on such self-reported hazards. This study clearly indicates that potential risks of mobile phones are being controlled at many levels, by strategic as well as tactical decisions and, consequently, phone-related accidents have not increased in line with the use of the mobile phones.

Adolescent↗
PubMed2005

Fatigue, sleep restriction and driving performance.

We ran a randomized cross-over design study under sleep-deprived and non-sleep-deprived driving conditions to test the effects of sleep restriction on real driving performance. The study was performed in a sleep laboratory and on an open French highway. Twenty-two healthy male subjects (age = 21.5 +/- 2 years; distance driven per year = 12,225 +/- 4739 km (7641 +/- 2962 miles) [mean +/- S.D.]) drove 1000 km (625 miles) over 10 h during five 105 min sessions on an open highway. Self-rated fatigue and sleepiness before each session, number of inappropriate line crossings from video recordings and simple reaction time (RT) were measured. Total crossings increased after sleep restriction (535 crossings in the sleep-restricted condition versus 66 after non-restricted sleep (incidence rate ratio (IRR): 8.1; 95% confidence interval (95% CI): 3.2-20.5; p < 0.001)), from the first driving session. The interaction between the two factors (conditionxtime of day) was also significant (F(5, 105) = 3.229; p < 0.05). Increasing sleepiness score was associated with increasing crossings during the next driving session in the sleep-restricted (IRR: 1.9; 95% CI: 1.4-2.4) but not in the non-restricted condition (IRR: 1.0; 95% CI: 0.8-1.3). Increasing self-perceived fatigue was not associated with increasing crossings in either condition (IRR: 0.95; 95% CI: 0.93-0.98 and IRR: 1.0; 95% CI: 0.98-1.02). Rested subjects drove 1000 km with four shorts breaks with only a minor performance decrease. Sleep restriction induced important performance degradation even though time awake (8h) and session driving times (105 min) were relatively short. Major inter-individual differences were observed under sleep restriction. Performance degradation was associated with sleepiness and not fatigue. Sleepiness combined with fatigue significantly affected RT. Road safety campaigns should encourage drivers to avoid driving after sleep restriction, even on relatively short trips especially if they feel sleepy.

Adolescent↗
PubMed2005

Subjective and predicted sleepiness while driving in young adults.

Sleepiness is a significant contributor to car crashes and sleepiness related crashes have higher mortality and morbidity than other crashes. Young adult drivers are at particular risk for sleepiness related car crashes. It has been suggested that this is because young adults are typically sleepier than older adults because of chronic sleep loss, and more often drive at times of increased risk of acute sleepiness. This prospective study aimed to determine the relationship between predicted and perceived sleepiness while driving in 47 young-adult drivers over a 4-week period. Sleepiness levels were predicted by a model incorporating known circadian and sleep factors influencing alertness, and compared to subjective ratings of sleepiness during 2518 driving episodes. Results suggested that young drivers frequently drive while at risk of crashing, at times of predicted sleepiness (>7% of episodes) and at times they felt themselves to be sleepy (>23% of episodes). A significant relationship was found between perceived and predicted estimates of sleepiness. However, the participants nonetheless drove at these times. The results of this study may help preventative programs to specifically target factors leading to increased sleepiness when driving (particularly time of day), and to focus interventions to stop young adults from driving when they feel sleepy.

Accidents, Traffic↗
PubMed2005

Engrossed in conversation: the impact of cell phones on simulated driving performance.

The current study examined the effects of cognitively distracting tasks on various measures of driving performance. Thirty-six college students with a median of 6 years of driving experience completed a driving history questionnaire and four simulated driving scenarios. The distraction tasks consisted of responding to a signal detection task and engaging in a simulated cell phone conversation. Driving performance was measured in terms of four categories of behavior: traffic violations (e.g., speeding, running stop signs), driving maintenance (e.g., standard deviation of lane position), attention lapses (e.g., stops at green lights, failure to visually scan for intersection traffic), and response time (e.g., time to step on brake in response to a pop-up event). Performance was significantly impacted in all four categories when drivers were concurrently talking on a hands-free phone. Performance on the signal detection task was poor and not significantly impacted by the phone task, suggesting that considerably less attention was paid to detecting these peripheral signals. However, the signal detection task did interact with the phone task on measures of average speed, speed variability, attention lapses, and reaction time. The findings lend further empirical support of the dangers of drivers being distracted by cell phone conversations.

Adult↗
PubMed2006

Preventing cannabis users from driving under the influence of cannabis.

Face-to-face, structured interviews were conducted with 320 recent cannabis users in New South Wales, Australia to assess the likely deterrent effects of (a) increasing the certainty of apprehension for driving under the influence of cannabis (DUIC) and (b) doubling the severity of penalties for DUIC. Participants were presented with a drug-driving scenario and asked to indicate their likelihood of driving given that scenario. The perceived risk of apprehension and severity of punishment were manipulated in each scenario to create four different certainty/severity conditions and participants were randomly allocated to one of these four groups. A subsidiary aim was to assess the likely impact of providing factual information about the accident risk associated with DUIC. Recent drug drivers who felt at low risk of accident when DUIC were asked to rate their willingness to drive if convinced that it was dangerous. The results suggested that increasing the certainty but not severity of punishment would produce reductions in cannabis-intoxicated driving among recent cannabis users. Providing factual information about the risks associated with DUIC would appear to have little impact on drug-driving rates among this population.

Accidents, Traffic↗
PubMed2005

Oculomotor changes due to road events during prolonged monotonous simulated driving.

The possible influence of occuring external events on driver attention and vigilance level was assessed during a prolonged simulated driving task. Special attention was given to the duration of the task, as well as to the influence of time of day and of individual factors. Thirty six subjects drove for two hours. Blinking activity and eye movements associated with glances to the speedometer were recorded during the entire driving task and particularly during specific road events. During significant events, blinking and ocular activity decreased, attesting a higher attention of the driver. With increased duration of driving, the reduction in blinking and ocular activity was progressively smaller for the less significant events, indicating a reduction in attention. During driving, women blinked more frequently than men. With increased duration of driving, drivers adopted different behavioural strategies depending on their age and sex to reach a safe and adapted method of driving.

Adult↗
PubMed2004

A driving simulation task: correlations with Multiple Sleep Latency Test.

Sleepiness and driving is a dangerous combination that causes thousands of crashes each year resulting in injury and death. In the last few years, driving simulators have been used to study the performance decrements associated with drowsiness. We correlated performances of a driving simulation task in healthy volunteers in different alertness conditions with objective (MSLT: Multiple Sleep Latency Test) and subjective (SSS: Stanford Sleepiness Scale; VAS: Visual Analogue Scale) sleepiness measurements. The subjects were tested on two days, after a normal night of sleep and after a night of complete sleep deprivation. The study consists of four sessions of MSLT, each one followed by subjective measurements of sleepiness and by a 30 min driving simulation task with a monotonous driving scenario. The parameters that correlate most highly with MSLT are the standard deviation of lane position, the mean RT, crash frequency and exceeding the speed limit frequency. The monotonous driving simulation we adopted showed strong correlations with MSLT and subjective sleepiness scales in healthy subjects and is suitable to evaluate excessive daytime sleepiness in patients.

Adult↗
PubMed2004

Reliability of a driving simulation task for evaluation of sleepiness.

Driving Simulators reproduce situations that require tracking and visual searching, the main features of real driving. This study measured the reliability of a monotonous driving scenario to detect the circadian variations of alertness in healthy subjects. Five men and five women underwent a monotonous 30 min driving simulation task every 2 h. Before each driving task subjects completed the Stanford Sleepiness Scale (SSS) and the Visual Analogue Scale (VAS) to correlate the subjective measurements of sleepiness to the objective data of the simulator. Driving performances deteriorated or improved according to the circadian variation of alertness. The scenario is suitable to detect the consequences of sleepiness related to the circadian variations of alertness. The standard deviation of lane position, comparing the differences among the 10 min blocks in each task is the parameter most significant for the evaluation of sleepiness.

Adult↗
PubMed2006

Drug and alcohol-impaired driving among electronic music dance event attendees.

BACKGROUND: Drug-impaired driving has received increased attention resulting from development of rapid drug-screening procedures used by police and state laws establishing per se limits for drug levels in drivers. Venues that host electronic music dance events (EMDEs) provide a unique opportunity to assess drug-impaired driving among a high proportion of young adult drug users. EMDEs are late-night dance parties marked by a substantial number of young adult attendees and elevated drug involvement. No studies to date have examined drug-impaired driving in a natural environment with active drug and alcohol users. METHODS: Six EMDEs were sampled in San Diego, California, and Baltimore, Maryland. A random sample of approximately 40 attendees per event were administered surveys about alcohol and other drug (AOD) use and driving status, given breath tests for alcohol, and asked to provide oral fluid samples to test for illicit drug use upon entering and exiting the events. RESULTS: Driving status reduced the level of alcohol use (including abstaining) but the impact on drug-taking was not significant. However, 62% of individuals who reported their intention to drive away from the events were positive for drugs or alcohol upon leaving. This suggests that these events and settings are appropriate ones for developing interventions for reducing risks for young adults.

Adolescent↗
PubMed2005

Driving under the influence of chlormethiazole.

This article describes a case of driving under the influence of the sedative-hypnotic-anticonvulsant drug chlormethiazole. The suspect, who was a physician, was driving dangerously on a busy highway and caused a traffic collision. When apprehended by the police, the man had bloodshot and glazed eyes and pupil size was enlarged. He could not answer the questions properly and his gait was unsteady. A roadside breath-alcohol screening test was positive but an evidential breath-alcohol test conducted about one hour later was below the legal limit for driving of 0.10 mg/L (10 microg/100 mL or 0.021 g/210 L). Because of the special circumstances of the traffic crash and the man's appearance and behaviour, the police suspected that drugs other than alcohol were involved and obtained a venous blood sample for toxicological analysis. The blood contained 0.23 mg/g alcohol, which is above the legal limit for driving in Sweden 0.20 mg/g (20 mg/100 mL or 0.020 g/100 mL), and codeine was also present at a therapeutic concentration of 0.02 mg/L. The conflict between the clinical signs of impairment and the toxicology report prompted a reanalysis of the blood sample with major focus on sedative-hypnotic drugs. Analysis by capillary GC-NPD identified chlormethiazole at a concentration of 5mg/L, the highest so far encountered in traffic cases in Sweden. In 13 other impaired driving cases over 10 years the mean (median) and range of concentrations of chlormethiazole were 1.6 mg/L (1.6 mg/L) and 0.3-3.3 mg/L. This case report underscores the need to consider clinical observations and the person's behaviour in relation to the toxicology report when interpreting and testifying in drug-impaired driving cases.

Accidents, Traffic↗
PubMed2006

Psychomotor disturbance in depression: assessment using a driving simulator paradigm.

BACKGROUND: Psychomotor disturbance is an essential feature of Major Depressive Disorder (MDD) and has been associated with impaired functioning on cognitively demanding tasks. Given the psychomotor demands required to navigate a motor vehicle and the disastrous effects of motor vehicles accidents, patients with MDD present a population of clinical interest. The goal of this investigation was to examine the association between MDD and driving ability assessed within a simulated driving paradigm. METHODS: 18 outpatients currently meeting diagnostic criteria for MDD and 29 control participants completed four 30-min simulated driving trials at 10:00 am, 12:00 pm, 2:00 pm, and 4:00 pm. Participants also completed the Beck Depression Inventory (BDI) to assess for depression severity and the Epworth Sleepiness Scale (ESS) to assess for everyday sleepiness. RESULTS: After controlling for age and sleepiness, the depressed sample exhibited slower steering reaction times across trials (p<.05) and an increased number of crashes across trials (p<.05) when compared to controls. These differences were characterized by a medium effect size. No significant time-of-day effects were found. LIMITATIONS: MDD patients were free of anti-depressant medication and findings may not generalize to medicated populations. Also, a rural highway driving route was used which may not generalize well to urban driving settings. CONCLUSIONS: Patients with untreated MDD demonstrate impaired simulated driving performance. Further research into whether these findings translate into on-the-road impairment is important for public health and safety.

Accidents, Traffic↗
PubMed2006

The Driving Cognitions Questionnaire: development and preliminary psychometric properties.

Recent research has suggested that fear of driving is common in the general population. People may have various concerns when driving, and instruments for the assessment of these concerns are lacking. The present paper describes the development and preliminary evaluation of the Driving Cognitions Questionnaire (DCQ). The DCQ is a 20-item scale that measures three areas of driving-related concerns--panic-related, accident-related, and social concerns. In three separate samples from different countries (n=69, 100, and 78), the scale showed good internal consistency and substantial correlations with measures of the severity of driving fear. It discriminated well between people with and without driving phobia. It also showed convergent validity with other measures. The questionnaire shows promise for use in research and clinical practice.

Accidents, Traffic↗
PubMed2003

Driving and alternatives: older drivers in Michigan.

METHOD: A statewide telephone survey of Michigan drivers and former drivers aged 65 and older collected information on transportation mode choices, experience with alternatives to driving, and whether drivers planned for when they could no longer drive. RESULTS: Results showed that most older adult households owned at least one automobile, and that the automobile was the primary mode of transportation. Most former drivers obtained rides from relatives and friends. Use of public transportation was low, and some seniors were not aware of available public transportation services. Older drivers did not plan for driving cessation. Over half the drivers who perceived a likelihood of driving problems within 5 years expected to keep driving beyond 5 years. IMPACT ON INDUSTRY: Because of their lifelong reliance on the automobile, their desire to drive themselves, and their lack of experience with public transportation, efforts to enhance the mobility of older people should consider this background while alternatives to the personal automobile are developed.

Aged↗
PubMed2003

Improving older driver knowledge and self-awareness through self-assessment: the driving decisions workbook.

PURPOSE: This study aims to assess whether the Driving Decisions Workbook, a self-assessment instrument for older drivers, increased self-awareness and general knowledge. This study also assessed perceptions regarding its usefulness, particularly as a tool for facilitating discussions within families of older drivers. A secondary purpose of the study was to determine if problems identified by drivers in the workbook related to problems they had with actual driving. DESIGN AND METHODS: The Driving Decisions Workbook was administered along with a questionnaire and a road test. A convenience sample of 99 licensed drivers aged 65 and above was used. RESULTS: After completing the workbook, about three fourths of the participants reported being more aware of changes that could affect driving. Fourteen percent reported that they had discovered a change in themselves of which they had not been previously aware. All respondents found the workbook to be at least a little useful and thought the workbook could help facilitate family discussions. Workbook responses were positively correlated with overall road test scores. Significant correlations were also noted between the road test and a majority of workbook subsection responses. IMPLICATIONS: This study indicates that the workbook may be a useful first-tier assessment instrument and educational tool for the older driver. It may encourage an older driver to drive more safely and/or to seek clinical assessment, and help in facilitating discussions about driving within their families.

Accidents, Traffic↗
PubMed2004

An in-depth look at parent-imposed driving rules: their strengths and weaknesses.

INTRODUCTION: With a growing interest in increasing parental involvement in teen driving, it is important to find out what parents are already doing. METHOD: This study assessed the content, delivery, rigidity, and consequences of 143 driving rules reported by 24 parent-teen dyads. RESULTS: Strengths included that driving rules covered the full range of concerns, especially night driving limits and passenger limits, and most parents and teens reported that violations would be followed by consequences, especially talk/warn or no driving. Weaknesses included that many rules were not very strict and only half showed parent-teen agreement on content. CONCLUSIONS: These findings suggest that teen driving rules are not clearly defined.

Accidents, Traffic↗
PubMed2001

Novice drivers' accidents and violations--a failure on higher or lower hierarchical levels of driving behaviour.

The study compared accident and offence rates of 28 500 novice drivers in Finland. The purpose was to study differences in accident and offence rates between male and female novice drivers of different age. The drivers reported in a mailed questionnaire, how many accidents they had been involved in and how much they had driven during their whole driving career. All the drivers had a driving experience of 6-18 months. Information about offences for a 2-year period was obtained from an official register of drivers' licences. The drivers were classified into three age brackets: 18-20, 21-30 and 31-50 years. The effect of driving experience was controlled by dividing the drivers into different mileage brackets. The data was analysed and the results were discussed in the framework of the hierarchical model of driving behaviour. Young novice drivers and especially young male drivers showed more problems connected to the higher hierarchical levels of driving behaviour than middle-aged novice drivers. The number of accidents and offences was highest among the young males and their accidents took place more often at night than female or older drivers' accidents. Female drivers showed more problems connected to the lower hierarchical levels of driving behaviour, e.g. problems in vehicle handling skills. Ways of measuring accident risk of different driver groups were also discussed, as well as the usefulness and reliability of self-reports in accident studies.

Accidents, Traffic↗