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PubMed2006

Excessive daytime sleepiness and on-road driving performance in patients with Parkinson's disease.

The impact of excessive daytime sleepiness (EDS) on road test performance was examined in patients with Parkinson's disease (PD). Twenty-one patients with PD completed the Epworth Sleepiness Scale (ESS) and an on-road driving test. Five participants had EDS according to their self-report on the ESS. Neither EDS nor PD medications were associated with on-road driving performance. These findings suggest that in this pilot study EDS did not impair PD patients' driving skills on a formal driving evaluation.

Aged↗
PubMed2006

The effectiveness of reducing illegal blood alcohol concentration (BAC) limits for driving: evidence for lowering the limit to .05 BAC.

PURPOSE: This scientific review provides a summary of the evidence regarding the benefits of reducing the illegal blood alcohol concentration (BAC) limit for driving and providing a case for enacting a .05 BAC limit. RESULTS: Fourteen independent studies in the United States indicate that lowering the illegal BAC limit from .10 to .08 has resulted in 5-16% reductions in alcohol-related crashes, fatalities, or injuries. However, the illegal limit is .05 BAC in numerous countries around the world. Several studies indicate that lowering the illegal per se limit from .08 to .05 BAC also reduces alcohol-related fatalities. Laboratory studies indicate that impairment in critical driving functions begins at low BACs and that most subjects are significantly impaired at .05 BAC. The relative risk of being involved in a fatal crash as a driver is 4 to 10 times greater for drivers with BACs between .05 and .07 compared to drivers with .00 BACs. SUMMARY: There is strong evidence in the literature that lowering the BAC limit from .10 to .08 is effective, that lowering the BAC limit from .08 to .05 is effective, and that lowering the BAC limit for youth to .02 or lower is effective. These law changes serve as a general deterrent to drinking and driving and ultimately save lives. IMPACT ON INDUSTRY: This critical review supports the adoption of lower illegal BAC limits for driving.

Accidents, Traffic↗
PubMed2006

Young driver risk in relation to parents' retrospective driving record.

PROBLEM: Parents are an important potential influence on the driving safety of their children. This study examined the relationship of parental driving record on male and female offspring's at-fault collision risk. METHOD: Drivers aged 16-21 on the date of full licensure were selected from driver records and a matching process was used to identify putative parents in two-parent households. Poisson regression models were developed to predict at-fault collisions of male and female youth in the three years following full licensure from parents' at-fault collisions, speeding offenses, and other moving offenses in the four years prior to children's licensure. One set of models examined the relative risk associated with increasing numbers of maternal and paternal at-fault collisions and offenses. Other models examined the joint versus separate maternal and parental contributions. RESULTS: Controlling for region of residence, both mothers' and fathers' at-fault collisions were associated with an increased risk in both male and female youth at-fault collisions. Mothers' and fathers' speeding offenses were also associated with increased relative risk of at-fault collisions for both sons and daughters, while fathers' other moving offenses increased collision risk for sons but not daughters. DISCUSSION: Further research is required to identify how parental driving risk is transmitted to children. IMPACT ON INDUSTRY: (a) Parents of young children should be informed of their role in influencing their children's future driving risk; (b) The results identify risk factors that could be of interest to licensing authorities and the insurance industry.

Accidents, Traffic↗
PubMed2003

Effects of after-midnight intake of zolpidem and temazepam on driving ability in women with non-organic insomnia.

BACKGROUND: Occasionally, insomniac patients may take a sleeping pill after midnight. This may have consequences on their ability to drive a car and result in an increased risk of car accidents. METHODS: This double-blind, randomized, placebo-controlled, three-treatment three-period cross-over study investigated the effects of two frequently prescribed hypnotics of different classes in a real life condition on driving performance and psychomotor skills in insomniac women. Single doses of zolpidem 10 mg (Z), temazepam 20 mg (T) or placebo (P) were administered at 2:00 a.m. to 19 women aged 35-60 years in three treatment periods separated by wash-out periods of 3-14 days. After polysomnography at baseline and each treatment night, patients underwent, 5.5 h after drug intake at 7:30 a.m. on the next morning, a STISIM driving simulator test, and a subsequent neuropsychological test (FePsy). RESULTS: Eighteen insomniac women were included in the analysis (mean age 50 years, mean weight 69 kg, mean BMI 25.6 kg/m2). There were no differences between treatments for the primary outcome measure (mean time to collision; baseline: 0.120 s, P: 0.124, T: 0.118, Z: 0.124; P> or =0.12 for all pairwise comparisons). No differences were recorded for speed deviation and reaction time to tasks for the verum treatments, however, lane position deviation was greater after administration of zolpidem in comparison to both placebo and temazepam (P=0.025 and 0.05, respectively). There were no differences between treatments in the FePsy test. Both medications were well tolerated. CONCLUSIONS: 5.5 h after drug administration there were no major differences in psychomotor performances between both zolpidem and temazepam compared to placebo, which indicates the absence of significant residual effects at that time. However, certain patients were more susceptible than others to the drug effects (two patients with high number of collisions). This underlines the necessity to strongly advocate against the late intake of hypnotics if patients intend to drive a car early the next morning.

Arousal↗
PubMed2004

Influence of age, speed and duration of monotonous driving task in traffic on the driver's useful visual field.

Recent research has shown that the useful visual field deteriorates in simulated car driving when the latter can induce a decrease in the level of activation. The first aim of this study was to verify if the same phenomenon occurs when driving is performed in a simulated road traffic situation. The second aim was to discover if this field also deteriorates as a function of the driver's age and of the vehicle's speed. Nine young drivers (from 22 to 34 years) and nine older drivers (from 46 to 59 years) followed a vehicle in road traffic during two two-hour sessions. The car-following task involved driving at 90 km.h(-1) (speed limit on road in France) in one session and at 130 km.h(-1) (speed limit on motorway in France) in the other session. While following the vehicle, the driver had to detect the changes in colour of a luminous signal located in the central part of his/her visual field and a visual signal that appeared at different eccentricities on the rear lights of the vehicles in the traffic. The analysis of the data indicates that the useful visual field deteriorates with the prolongation of the monotonous simulated driving task, with the driver's age and with the vehicle's speed. The results are discussed in terms of general interference and tunnel vision.

Adult↗
PubMed2002

Drinking and driving among Mexican American and non-Hispanic white males in Long Beach, California.

Although drinking and driving in the United States has declined substantially during the past two decades, this trend has not been seen among Hispanic drivers. Higher rates of driving while impaired (DWI) arrests and alcohol-related crashes, particularly among Mexican Americans, also have been noted. The extent to which this reflects a lack of understanding of DWI laws rather than a disregard for them is unknown. A survey was conducted among Mexican American and non-Hispanic white male DWI arrestees in Long Beach, California, to ascertain alcohol use, attitudes toward drinking and drinking and driving, and knowledge of DWI laws. The findings were compared with those of Mexican American and non-Hispanic white males recruited from the local community. Mexican American males, both DWIs and those from the community, reported heavier drinking than non-Hispanic white males. All four groups of respondents tended to underestimate the number of drinks needed to achieve the blood alcohol concentration (BAC) threshold at or above which it is illegal to drive under California law. Estimations were around 2-3 drinks rather than a more realistic estimate of 4-5 drinks. However, Mexican American DWIs and their comparison group vastly overestimated the number of drinks to make them unsafe drivers (8- 10 drinks). Furthermore, fewer than half were aware of the BAC threshold in California (0.08%) compared with between 60 and 78% of non-Hispanic whites. This study is limited in scope and needs to be replicated in other communities and with other racial/ethnic groups. However, the clear lack of knowledge of the DWI law in California and a lack of understanding of the relationship between number of drinks and BAC point to the need for culturally sensitive programs that are developed and implemented within the Mexican American community.

Accidents, Traffic↗
PubMed1998

Driving behavior in a real and a simulated road tunnel--a validation study.

The aim was to validate driving behaviour in a simulated road tunnel. Speed and lateral position of 20 subjects were measured in a real tunnel and in the same tunnel implemented in the VTI driving simulator. In both situations a left-hand steered and manually geared passenger car was used. Driving speed was higher in the simulated tunnel than in the real tunnel. Elimination of speed information from the speedometer caused a similar small speed increase in both situations. Also, the difference in speed between driving lanes was similar in both cases. The effects on speed variation were similar to that for speed level. Regarding lateral position, subjects positioned the car somewhat further away from the nearest tunnel wall in the real tunnel than in the simulated tunnel. In both situations the distance to the nearest wall was greater when it was located to the left of the driver than on the opposite side. Lateral position deviation was about the same when the road was straight, but in a curved section it was somewhat greater for the simulated tunnel. It is concluded that behavioural validity in absolute terms was not quite satisfactory, especially regarding choice of speed, whereas relative validity was good for both speed and lateral position.

Adult↗
PubMed1998

Driving avoidance and functional impairment in older drivers.

The purpose of this study was to examine the association between visual and cognitive impairment in older drivers and their avoidance of potentially challenging, driving situation. A group of 257 older drivers participated in assessments of visual sensory function, eye health and cognitive function including the useful field of view test, and completed a structured questionnaire on driving exposure and how frequently they avoided challenging driving situations. Results replicated earlier studies showing that many older drivers limit their exposure to driving situations which are generally believed to be more difficult (e.g. rain, night, heavy traffic, rush hour). Furthermore, older drivers with objectively determined visual and/or attentional impairments reported more avoidance than those free of impairments; those with the most impairment reported avoiding more types of situations than other less impaired or non-impaired drivers. Older drivers with a history of at-fault crashes in the prior five years reported more avoidance than those who had crash-free records. Future research should evaluate the potentially beneficial role of self-regulation in enhancing older driver safety, particularly in those older drivers with visual and attentional processing impairments who have elevated crash risk.

Aged↗
PubMed2002

The driving anger expression inventory: a measure of how people express their anger on the road.

Four ways people express their anger when driving were identified. Verbal Aggressive Expression (alpha=0.88) assesses verbally aggressive expression of anger (e.g., yelling or cursing at another driver); Personal Physical Aggressive Expression (alpha=0.81), the ways the person uses him/herself to express anger (e.g., trying to get out and tell off or have a physical fight with another driver); Use of the Vehicle to Express Anger (alpha=0.86), the ways the person uses his/her vehicle to express anger (e.g., flashing lights at or cutting another driver off in anger); and Adaptive/Constructive Expression (alpha=0.90), the ways the person copes positively with anger (e.g., focuses on safe driving or tries to relax). Aggressive forms can be summed into Total Aggressive Expression Index (alpha=0.90). Aggressive forms of expression correlated positively with each other (rs=0.39-0.48), but were uncorrelated or correlated negatively with adaptive/constructive expression (rs=-0.02 to -0.22). Aggressive forms of anger expression correlated positively with driving-related anger, aggression, and risky behavior; adaptive/constructive expression tended to correlate negatively with these variables. Differences in the strengths of correlations and regression analyses supported discriminant and incremental validity and suggested forms of anger expression contributed differentially to understanding driving-related behaviors. Theoretical and treatment implications were explored.

Adult↗
PubMed1999

Acquisition and severity of driving-related fears.

Rachman's theory of fear acquisition proposes that directly-conditioned fears will differ from indirectly-conditioned fears in magnitude and anxiety response patterns, however the theory has received inconsistent empirical support. The aim of the present study was to describe the fear acquisition pathways for a community sample who reported driving-related fears, and to test Rachman's theory of fear acquisition. One hundred and ninety participants completed a questionnaire which assessed a variety of driving-related situations, reactions to motor vehicle accidents (MVAs), and anxiety response patterns. Professional psychological helpseeking and perceived need for treatment for driving-related fears were also assessed. Results failed to support Rachman's predictions. However, it was confirmed that respondents who had been involved in an MVA were more likely to ascribe their fears to a directly-conditioned pathway. The theoretical and methodological implications of the findings are discussed, along with suggestions for assessment of those with driving-related fears.

Accidents, Traffic↗
PubMed2002

Safety to drive after common limb fractures.

One hundred Orthopaedic Consultants in the UK were randomly selected and asked to complete a postal questionnaire indicating when they felt patients with treated, pain free, common limb fractures could return to driving. Seventy-two questionnaires were returned. Six were not completed leaving 66 completed questionnaires. Analysis revealed a clear mandate to allow or prevent driving in patients with certain treatment modalities and stages of union. In the lower limb there was majority agreement of suitability to drive in 61% of the 28 presented scenarios. Opinion was more divided for the upper limb, with only 43% of the scenarios having majority agreement. Our results show that while for some common limb fractures there is a clear body of opinion supporting safety to drive, for other common fractures opinion is less clear cut. This has important financial, medico-legal and legal implications that could be resolved by formal testing.

Arm Injuries↗
PubMed2003

Graduated driver licensing and safer driving.

Graduated Driver Licensing (GDL) inserts between the leaner permit and full licensure an intermediate or "provisional" license that allows novices to drive unsupervised but subject to provisions intended to reduce the risks that accompany entry into highway traffic. Introduction of GDL has been followed by lowered accident rates, resulting from both limiting exposure of novices to unsafe situations and by helping them to deal with them more safely. Sources of safer driving include extended learning, early intervention, contingent advancement, and multistage instruction. To extend the learning process, most GDL systems lengthen the duration of the learner phase and require a specified level of adult-supervised driving. Results indicate that extended learning can reduce accidents substantially if well structured and highly controlled. Early intervention with novice traffic violators have shown both a general deterrent effect upon novice violators facing suspension and a specific effect upon those who have experienced it. Making advancement to full licensure contingent upon a violation-free record when driving on the provisional license has also evidenced a reduction in accidents and violations during that phase of licensure. Multistage instruction attempts development of advanced skills only after novices have had a chance to master more basic skills. Although this element of GDL has yet to be evaluated, research indicates crash reduction is possible in situations where it does not increase exposure to risk. While the various elements of GDL have demonstrated potential benefit in enhancing the safety of novice drivers, considerable improvement in the nature and enforcement of GDL requirements is needed to realize that potential.

Accidents, Traffic↗
PubMedDate not supplied

[Prevalence of mobile phone use while driving vehicles].

OBJECTIVE: To estimate the prevalence of mobile telephone use while driving vehicles in the city of Lleida (Spain). METHODS: A random sample of 1536 cars passing through six intersections regulated by traffic lights in Lleida were selected (three with urban traffic and three with interurban traffic). Cyclists, motorcyclists and driving school cars were excluded. The variables studied were mobile telephone use, age, (18-40; 41-60; >61), sex, the presence of passengers, type of intersection (urban traffic/interurban traffic), day of the week (working day/weekend or holiday) and hour of the day (rush hour/non-rush hour). The prevalence of mobile telephone use was calculated in percentages with a 95% CI. The relationship among the dependent variable (mobile telephone use) and the other independent variables was studied using odds radios (OR) and 95% CI. RESULTS: A total of 1536 direct observations were made and mobile telephone use was detected in 50 drivers. The prevalence was 3.3 (95% CI, 2.4-4.3). The prevalence was higher in men (OR = 2.2; 95% CI, 1.0-5.7), in drivers aged more than 60 years old (OR = 2.2; 95% CI, 0.5-8,4) and in those aged 18-40 years old (OR =1.5; 95% CI, 0.8-3.0), in unaccompanied drivers (OR = 3.0; 95% CI, 1.5-6.3), in urban intersections (OR = 2.7; 95% CI, 1.2-5.9), on workdays (OR = 2.0; 95% CI, 0.9-4.4) and at the rush hour (OR =1.4; 95% CI, 0.8-2.4). CONCLUSIONS: The prevalence of mobile telephone use while driving vehicles can be considered high, because of the increase in car accidents. The profile of drivers using mobile telephones corresponds to men aged 18-40 years or more than 61 years, in urban intersections, without passengers, during workdays and at the rush hour. We recommend the implementation of measures to decrease the use of mobile telephones while driving.

Adolescent↗
PubMed2002

Driving-related fear: a review.

This article reviews the research on driving-related fear (DRF). Until recently, research has concentrated almost exclusively on the effect of motor vehicle accidents (MVAs) on subsequent levels of DRF. However, recent findings have suggested that MVAs are not solely responsible for this fear reaction, and that non-MVA driving fear can be just as strong. Studies of the broader driving-fearful population have encountered difficulty with diagnostic conceptualisation of DRF, although some have investigated a possible typology of DRF. Driving skill has been a neglected issue in the DRF research, and may prove to be a useful part of assessment and remediation of this potentially debilitating problem. Issues of definitional inconsistency are highlighted, and suggestions are made for several directions that future research might profitably take.

Accidents, Traffic↗
PubMed1999

Drugged driving in the Nordic countries--a comparative study between five countries.

The purpose of this study was to compare whether the high incidence of drugged driving in Norway was different to that in the other Nordic countries. All blood samples received by Nordic forensic institutes during one week in 1996, from drivers suspected by the police of driving under the influence (Denmark: n = 255, Finland: n = 270, Iceland: n = 40, Sweden: n = 86, Norway: n = 149), were analysed for alcohol and drugs (benzodiazepines, cannabinoids, amphetamines, cocaine, opiates and a number of antidepressant drugs) independent of the primary suspicion, and using the same analytical cut-off levels at the different institutes. The primary suspicion was directed towards drugs in more than 40% of the Norwegian cases, drugs were detected in more than 70% of these samples. In only 0-3% of the cases from Denmark, Finland and Iceland, were drugs suspected, while the corresponding frequency for Sweden was 17%. However, evidential breath analyses were used for about three-quarters of the Swedish drivers suspected to be influenced by alcohol. Blood alcohol concentrations (BAC's) below the legal limits were found in 32, 18 and 2% of the Norwegian, Icelandic and Finnish cases, respectively (BAC < 0.05%), in 10% of the Danish cases (BAC < 0.08%) and in 20% of the Swedish cases (BAC < 0.02%). Drugs were most frequently found in the Norwegian and Swedish cases with no alcohol (80-83%). Similar frequencies of drugs in samples with BAC's above the legal limits (19-22%), were obtained for all countries. Benzodiazepines, tetrahydrocannabinol and amphetamine represented the most commonly detected drugs. Our results show that differences between Norway and other Nordic countries with regard to drugs and driving, are connected to the selection criteria made by the police and with more focus on drugged driving in Norway.

Adult↗
PubMed2003

Examining trajectories of adolescent risk factors as predictors of subsequent high-risk driving behavior.

PURPOSE: To examine the effects on early high-risk driving behavior of changes over time (trajectories) in adolescent alcohol use, friends' support for drinking, susceptibility to peer pressure, and tolerance of deviance. METHODS: Statewide driving data were obtained for 4813 subjects who had completed at least two previous school-based questionnaires. The self-administered questionnaire data provided predictor measures from 5th through 10th grades. Trajectory information on predictor measures was summarized using each measure's slope over time and level at the 10th grade data collection (last value). Regression models used serious offenses, alcohol-related offenses, serious crashes, and alcohol-related crashes as outcomes, trajectory measures as predictors, and produced parameter estimates adjusted for demographic measures. Probabilities of having a serious offense or serious crash for five sample trajectories on each measure were obtained from the estimated regression models. RESULTS: All four predictor measures were important, particularly in predicting serious offenses, alcohol-related offenses, and alcohol-related crashes. The highest probabilities for young adult high-risk driving were found among those with consistently high or increasingly high trajectories of friends' support for drinking, susceptibility to peer pressure, and tolerance of deviance. CONCLUSIONS: Programs to prevent adolescent risk behavior should take into account environmental and personality influences. Prevention efforts need to emphasize preserving low levels, preventing increases, and promoting decreases over time of adolescent risk factors for unhealthy behaviors, such as high-risk driving.

Accidents, Traffic↗
PubMed2002

Sex difference in geographical knowledge: driving experience is not essential.

When required to locate places on outline maps, males consistently perform more accurately than females. This sex difference in geographical knowledge has been observed in samples throughout the United States, in all age ranges examined from the second to the 9th decade of life and in samples differing in average education level from high school to postgraduate degrees. Both males and females appear to acquire geographical knowledge during surface travel through the environment. The information acquired during everyday travel is apparently integrated into topographic representations that comprise a cognitive map. This process is less efficient in females probably because they attend to and remember more about landmarks and less about distance and directional cues than do males. To examine the importance of driving experience on the ability to locate places on an outline map of the Oklahoma City metropolitan area, adolescents who were too young to drive and older persons with varying amounts of experience traveling in the metropolitan area were studied. In the present study the magnitude of the sex difference in accuracy, though not the absolute level of performance, was similar in groups of people too young to drive and in younger and older drivers. Hence, the sex difference in geographical knowledge cannot be the product of differences in driving that may exist between males and females.

Adolescent↗
PubMed2003

Driving and arrhythmias: implications of new data.

Patients with ventricular arrhythmias are often restricted from driving by their physicians for several months. These recommendations are based more on convention than evidence, due to the paucity of data previously available on the safety of driving in these patients. Over the past few years, however, more data have become available that suggests that it is safe to drive within three months of their ventricular tachyarrhythmia. In this paper, we look at this more recent data and make the suggestion that patients with well maintained cardiac function, no recurrent ventricular arrhythmias (i.e. electrical storm) and no persistent medical condition predisposing them to ventricular arrhythmias should be allowed to resume driving soon after their ventricular tachyarrhythmia.

Accidents, Traffic↗