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PubMed2003

Tips and falls during electric-powered wheelchair driving: effects of seatbelt use, legrests, and driving speed.

OBJECTIVE: To measure the response of a test dummy while traversing common obstacles encountered by users of electric-powered wheelchairs (EPWs) to determine whether optimal wheelchair fit, use of seatbelts, and driving speed affect the frequency and severity of EPW tips and falls. DESIGN: Repeated-measures comparison study. SETTING: Constructed environment both in and around a Veterans Affairs medical center. PARTICIPANT: A 50th percentile Hybrid II anthropometric test dummy (ATD) was used to simulate a person driving an EPW. INTERVENTIONS: The ATD was driven in 4 different EPWs over commonly encountered obstacles at speeds of 1 and 2m/s, with and without the use of a seatbelt, and at varying legrest heights. MAIN OUTCOME MEASURES: The response and motion of the ATD were observed and recorded as no fall, loss of control (the ATD falls forward or sideways but remains in the EPW), the ATD falls out of the EPW, or the EPW tips completely. RESULTS: A total of 97 adverse events out of 1700 trials were recorded: 88 were losses of control (instability) and 9 were ATD falls. No complete tips of any EPW occurred. Univariate statistical analysis indicated a significant relationship between the adverse events and the use of seatbelts, legrest condition, and test obstacles (P<.05). A mixed-model analysis confirmed the significant relationships between the adverse events and the use of seatbelts, legrest condition, and test obstacles (P<.05). However, the mixed model indicated that (1) there was no significant relationship between the adverse events and driving speed and (2) no one obstacle was designated to be the most problematic. CONCLUSION: Persons who use EPWs should use seatbelts and legrests while driving their EPWs, and clinicians should include common driving tasks when assessing the proper set-up of EPWs.

Acceleration↗
PubMed1991

Improving the driving practices of pizza deliverers: Response generalization and moderating effects of driving history.

A practical intervention program, targeting the safety belt use of pizza deliverers at two stores, increased significantly the use of both safety belts (143% above baseline) and turn signals (25% above baseline). Control subjects (i.e., pizza deliverers at a third no-intervention store and patrons driving to the pizza stores) showed no changes in belt or turn signal use over the course of 7-month study. The intervention program was staggered across two pizza stores and consisted of a group meeting wherein employees discussed the value of safety belts, received feedback regarding their low safety belt use, offered suggestions for increasing their belt use, and made a personal commitment to buckle up by signing buckle-up promise cards. Subsequently, employee-designed buckle-up reminder signs were placed in the pizza stores. By linking license plate numbers to individual driving records, we examined certain aspects of driving history as moderators of pre- and postintervention belt use. Although baseline belt use was significantly lower for drivers with one or more driving demerits or accidents in the previous 5 years, after the intervention these risk groups increased their belt use significantly and at the same rate as drivers with no demerits or accidents. Whereas baseline belt use was similar for younger (under 25) and older (25 or older) drivers, younger drivers were markedly more influenced by the intervention than were older drivers. Individual variation in belt use during baseline, intervention, and follow-up phases indicated that some drivers require more effective and costly intervention programs to motivate their safe driving practices.

Journal Article↗
PubMed1992

Effects of loratadine and cetirizine on actual driving and psychometric test performance, and EEG during driving.

Sixteen healthy male and female volunteers took part in a 6-way, double-blind cross-over trial to compare the effects of single doses of cetirizine 10 mg, loratadine 10 mg and placebo, with and without alcohol (0.72 g.kg-1, lean body mass). Performance was measured in two repetitions of a psychometric test battery, and a standard, over-the-road driving test. EEG was also measured during driving. Alcohol significantly affected almost every performance measure and altered the EEG energy spectrum during driving whilst the blood concentrations declined from 0.37 to 0.20 mg.ml-1. The effects of cetirizine of on driving performance resembled those of alcohol. It caused the subjects to operate with significantly greater variability in speed and lateral position ('weaving' motion). The effects of alcohol and cetirizine appeared to be additive. Certain cetirizine-placebo differences in subjective feelings and test battery performance were also significant. Loratadine had no significant effect on any performance parameter. It was concluded that cetirizine, but not loratadine, generally caused mild impairment of performance after a single 10 mg dose.

Adult↗
PubMed1985

The effect of antipsychotic drugs on driving and driving related psychomotor functions.

Despite the extremely widespread use of antipsychotic medications, there is little evidence from the surveys conducted to date, that this class of psychoactive medications is significantly implicated in vehicular crashes or deaths. In five major surveys of vehicular fatalities, in which drug and alcohol analyses were obtained, only two of over 800 victims studied involved detection of antipsychotic medications. It is clear that the acute administration of antipsychotics in normal individuals does induce sedation and performance decrements in visual-motor coordination and specific attentional behaviors, which have a deleterious effect on driving behavior. On the other hand, it should be emphasized that antipsychotics are rarely used on an acute basis and tolerance to the sedation and decreased alertness does occur during chronic treatment. Antipsychotic drugs have the capacity to potentiate the effects of alcohol, sedative hypnotics, narcotics and antihistamines; therefore, the combination of antipsychotics with these substances increases the impairment of driving behavior. There is an indication that the less sedating piperazine phenothiazines and the butyrophenones may have little or no effect on psychomotor performance, and antipsychotic drugs of these two subclasses may have a distinct advantage, at least in terms of driving performance, over the other more sedating drugs. Antipsychotic drugs are almost never used for recreational or abuse purposes; therefore, more central to the focus of this review is the effect that antipsychotics may have on the driving behavior of those seriously disordered mentally ill patients who require continued maintenance on these medications. There is good agreement in the literature which suggests that schizophrenic patients demonstrate improved psychomotor performance during chronic treatment with antipsychotic drugs.(ABSTRACT TRUNCATED AT 250 WORDS)

Antipsychotic Agents↗
PubMed1988

Coping strategies, reasons for driving, and the effect of self-monitoring in drinking-driving situations.

Male and female volunteers, who were drinking regularly but had not been convicted of DUI, were recruited for interviews about their past drinking episodes in a variety of locations and the reasons why they had or had not driven after drinking. The results of the initial interviews were used to compile a catalog of reported strategies and reasons for not driving after drinking, reported reasons for driving after drinking, and reported strategies to avoid detection or arrest when driving after drinking. Following the initial interview, each subject was randomly assigned to either a self-monitoring group or a no self-monitoring control group for three monthly follow-up interviews. The results of the follow-up revealed no apparent effect of self-monitoring on a variety of both drinking and drinking-and-driving measures.

Accidents, Traffic↗
PubMed2003

Effect of sleep deprivation and driving duration on the useful visual field in younger and older subjects during simulator driving.

Nine older subjects (40-51 years) and 10 younger subjects (18-30 years) took part in two one-hour driving sessions. They performed a very monotonous task during which they had to follow a vehicle either after a complete night of sleep or after one night of sleep deprivation. While driving their useful visual field was assessed by introducing signals that would appear on the whole road scene. The analysis of the data indicates that the ability to process peripheral signals deteriorates with age, driving duration and sleep deprivation. However, the effects of these three variables on the peripheral visual ability are not similar in a dual task. The driver's useful visual field changes with age and prolongation of the monotonous driving activity according to a tunnel vision phenomenon. On the other hand, a sleep debt deteriorates the useful visual field according to a general interference phenomenon. These results are discussed in terms of decrease in the level of arousal and increase of fatigue.

Adolescent↗
PubMedDate not supplied

Hospitalization and mortality succeeding drunk driving and risky driving.

AIMS: The association between drunk driving (DD) and/or risky driving (RD) offences and subsequent hospitalization and mortality was studied during a 25-year period. METHODS: Information about drinking habits and psychosocial factors for the 8122 conscripts from Stockholm County in 1969-1970 was linked to register data on hospitalization, mortality, DD and RD. RESULTS: Analyses comparing background characteristics of DD and RD groups showed that the prevalence of problem behaviour and drug use was highest in the RD group. The relative risk (RR) for hospitalization after DD and/or RD was significantly elevated in multivariate logistic regression analysis for all the studied diagnostic categories (alcohol diagnoses, narcotic diagnoses, suicide attempts, psychoses, E-codes, all diagnoses), and was especially high for alcohol (RR = 7.2) and diagnosis of drug misuse (RR = 9.2). The RR of all hospitalization was 1.5 for the DD group, 1.8 for the RD group, and 1.9 for those who had been sentenced both for drunk driving and risky driving (DRD), all of which were significantly increased. The RR of death was significantly elevated in all three groups. CONCLUSIONS: The results show a significantly increased risk of hospitalization and mortality both in the DD and the RD group. From a public health and traffic safety perspective, this implies a need for developing and implementing better prevention strategies.

Accidents, Traffic↗
PubMed1993

Effect of low and moderate doses of alcohol on driving hazard perception latency and driving speed.

Both driving speed and speed of detection of potentially hazardous events while driving have been found to correlate positively with accident rates across individuals. Alcohol ingestion is also known to increase risk of a traffic accident. This paper reports two double-blind, placebo-controlled studies: one on the effect of alcohol on driving speed and the other on the effect of alcohol on time taken to detect potential traffic hazards. Moderate drinkers aged between 30 and 55 took part. Each subject underwent three experimental conditions on separate days: no alcohol, low alcohol (0.025% BAC) and moderate alcohol (0.05% BAC). The order of conditions was counterbalanced. The moderate alcohol dose increased mean time taken to respond to hazards (2.5 s in no alcohol condition compared with 3.2 s in moderate alcohol condition) but did not affect mean driving speed (indexed by time taken to travel sections of a fixed route; 19.3 s in no alcohol compared with 19.0 s in moderate alcohol). The results support the view that at least part of the excess risk of accident associated with alcohol ingestion is attributable to an increase in the time taken to respond to traffic hazards.

Adult↗
PubMed2002

Driving anger and other driving-related behaviors in high and low ADHD symptom college students.

This study examined differences between college students with high and low symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD). Fifty-nine introductory psychology students completed ADHD diagnostic measures and were compared on measures of driving anger and driving anger expression; accident-related, aggressive, and risky driving behaviors; general anger; and general anger expression. Results indicated high ADHD symptom college students experience more driving anger, display such anger in more hostile/aggressive ways, are more aggressive and risky on the road, experience more crash-related outcomes, are more generally angry, and tend to display anger in socially unacceptable ways. Results are discussed in regard to the understanding and treatment of ADHD.

Adolescent↗
PubMed1992

Drinkers and their driving: compliance with drinking-driving legislation in four Australian states.

This study replicates work in Norway and the United States in investigating the extent to which Australian drivers attempt to comply with drinking-driving legislation. In a four-state survey of 1,133 drinkers, it was found that people were aware of the need to control their alcohol input before driving, and derived estimates of blood alcohol after a recent away-from-home drinking occasion demonstrated that the amount people drank was influenced by whether or not they were driving. Drivers reported drinking less than nondrivers and were also those who usually consumed less alcohol. These findings were also true of people with different levels of normal consumption. Although these results are encouraging, it is suggested that there is need for further modification of sanctions, and that the community needs more information about the alcohol content of drinks and drink sizes if people are to moderate effectively their drinking before driving.

Accidents, Traffic↗
PubMed1977

[Effect of air-electric fields on driving and reaction patterns. Test subjects in the car driving simulator (author's transl)].

In the relevant frequency range of about 10 Hertz cars can be considered very largely as Faraday cages and consequently as screens against air-electric fields. This may have a negative influence on driving and reaction patterns as a result. In an extensive investigation 48 subjects in a driving simulator were exposed to definite artificially produced air-electric fields. The self-rating of the performance and concentration of the subjects, reaction times and driving errors were determined. While the reaction times remained practically constant, the driving behavior of the subjects improved.

Adolescent↗
PubMed1985

The relationships among driving while impaired charges, police drinking-driving roadcheck activity, media coverage and alcohol-related casualty traffic accidents.

A correlational examination of 54 consecutive months of data from British Columbia on the relationships among the number of vehicles checked in police drinking-driving roadchecks, the number of driving while impaired (DWI) charges laid, the number and percent of alcohol-related casualty traffic accidents, and the extent of media coverage on drinking-driving (as measured by print media coverage), revealed that: the extent of media coverage, and not the extent of roadchecks or charging activity is probably the critical element in the reduction of drinking-driving accidents. The failure of the minimally publicized April-May 1984 British Columbia police roadcheck "blitz" to reduce either the number or proportion of alcohol-related casualty traffic accidents lent support to these correlational findings.

Accidents, Traffic↗
PubMed2000

Drink driving as a social problem: comparing the attitudes and knowledge of drink driving offenders and the general community.

Using data from a community survey together with data from a survey of drink-driving offenders, this paper compares the attitudes and knowledge of two matched samples on a number of drink driving issues. The total sample (149 offenders and 149 community sample respondents) were interviewed using a survey instrument containing a number of comparable questions. The offender sample were interviewed by trained interviewers in a face-to-face format, while the general community sample were interviewed using a computer aided telephone interview system. The specific issues dealt with include: a) knowledge of safe drinking and blood alcohol consumption (BAC) levels; b) attitudes towards strategies for avoiding drink driving; and c) general attitudes regarding drink driving. The analysis uses logistic regression to investigate the differences between the responses given by the two samples. The findings illustrate a number of significant differences in knowledge and attitudes between offenders and the general community.

Accidents, Traffic↗
PubMed1999

Prolonged exposure to glare and driving time: effects on performance in a driving simulator.

Twelve experienced truck drivers drove a fixed-base driving simulator for two 8 h sessions, including: (1) no glare and (2) intermittent glare presented in the exterior rear-view mirrors to simulate headlights from following vehicles. The driving task combined vehicle control on straight and curved road segments with detection of pedestrians appearing alongside the road and targets appearing in the rear-view mirrors. The results provided no evidence to support the hypothesis that prolonged exposure to glare impairs driving performance. However, we found time-related changes in target-detection and critical tracking performance, some of which were consistent with established patterns of diurnal variation. Subjective sleepiness ratings also increased over time. The results were interpreted within a model according to which drivers are able to maintain effective performance at early levels of impairment, thus compensating for increasing feelings of subjective tiredness.

Adult↗
PubMed1992

The driving advisement system: a computer-augmented quasi-simulation of the cognitive prerequisites for resumption of driving after brain injury.

No other activity so starkly pits the needs of the individual recovering from brain injury against the protection of society than does operating a motor vehicle. Cognitive abilities (e.g., response to complex processing demands, impulse control, ability to sustain performance, mental flexibility, and judgment), while evident only indirectly, are essential to performance, yet few are well sampled in currently used assessment procedures, which, instead, emphasize visuo-motor coordination and reaction time. In response to this need, a computerized quasi-simulation, the Driving Advisement System (DAS), was developed and is introduced here. The DAS incorporates a set of computer-based tasks for use by professionals charged with rendering advice concerning cognitive abilities necessary for driving safely. Normative data on DAS measures were obtained from a group of over 60 safe drivers free of significant neurological impairment. Preliminary validation findings are summarized. A sample DAS-generated report for a brain-injury survivor, who sought to resume driving, is used to illustrate the graphic norm-referenced presentation of an individual's performance together with self-appraisal ratings.

Automobile Driver Examination↗
PubMed1998

Interactive effects of sleep deprivation, time of day, and driving experience on a driving task.

Performance decrements after more than 24 hours of sleep deprivation (SD) are not only a monotonic function of the duration of SD, but are the result of an interaction between SD and time of day. The major deteriorations in performance during SD are still evident throughout the night, as in the non-sleep-deprived state. Twelve experienced and 12 inexperienced drivers drove a driving simulator for 20 minutes at 0800, 1100, 1400, 1700, and 2000 hours on two testing days. One testing day was conducted after a normal night's sleep, and the other after one night of SD. Reaction time (RT) was also measured while driving. The standard deviation of both lateral position and speed were significantly higher during SD. Performance steadily improved across the day between 0800 and 2000 hours, and the absence of any sleep-by-time interactions suggests that the rhythm of driving performance across the day was similar after both normal sleep and SD. Inexperienced drivers had higher RTs than experienced drivers in both sleep-deprived and non-sleep-deprived conditions. These results have important implications for those involved in the transport industry.

Adult↗
PubMed1991

A study on driving status in 98 epileptic patients with driving licences.

As to the driving status in the period between January 1984 and December 1988, 98 epileptic patients with driving licences were examined, paying regard to their clinical conditions. Sixty-one (62%) of the patients were seizure-free for the last five years or more in December 1988. Eighty-one (83%) were actually driving motor vehicles at the time of this study, and 27 (33%) of the 81 drivers still had fits during the past five years. Nine patients (9%) had caused traffic accidents, but no accident had occurred due to seizures. The type of the nine accidents was as follows: One case of a slight physical injury to the other person, four cases of the driver's own car damage without other material damage, and four of the accidents involving other cars.

Accidents, Traffic↗
PubMed1995

To drive or not to drive: neuropsychological assessment for driver's license among stroke patients.

Seventy-two stroke patients, 43 with right hemisphere (RHD) and 29 with left hemisphere damage (LHD), and 7 coronary infarct controls with no evidence of cerebral damage, were neuropsychologically tested as part of an assessment program for driver's license. Mean age in the group was 53 years. Stroke patients were tested on average 4 months post injury. The groups did not differ on major demographic variables except that RHD patients were more often hemiplegic than LHD patients. The test battery was factor analyzed into 4 valid principal components: (I) visual perception, (II) spatial attention, (III) visuospatial processing, and (IV) language/praxis. The presence of hemianopia (factor I) excludes driving. In addition, measures of neglect and reduced speed of mental processing from factor II, III and IV, were found to be the most discriminating variables when classifying patients for driving. Even though neglect was more frequently observed among RHD than LHD patients, the two hemisphere groups did not differ significantly in number of patients denied driving, 58% RHD compared to 41% LHD patients. The need for comprehensive neuropsychological assessment is underlined.

Adult↗