Alcohol and illicit substances associated with fatal crashes in Queensland: An examination of the 2011 to 2015 Coroner's findings

Amphetamine-type drug-related fatalities in the context of 8 years of methamphetamine use measured by wastewater analysis in South Australia

Methamphetamine is the illicit stimulant of choice in Australia. Countless initiatives have been employed to reduce methamphetamine use and drug-related harm. Wastewater analysis (WWA) has been used effectively as an objective measure of drug use at a population level and can be compared to indicators of harm, such as the number of drug-related fatalities. This paper attempts to describe methamphetamine use in the context of changes in levels measured in wastewater in South Australia whilst recognising considerable interventions over an 8-year period. Validated liquid chromatography-mass spectrometry methods were used to determine methamphetamine (and MDMA) levels in wastewater over an 8-year interval. The number of drug-induced deaths and driver fatalities involving methamphetamine (and MDMA) was presented and described in the context of changes in use measured by WWA. A rise in methamphetamine use according to WWA was evident up to 2017, followed by a gradual decrease to 2020 back to 2015 levels. Both driver fatalities and drug-induced deaths correlated well with use measured by WWA over the 8-year period. Multiple initiatives to curb supply, distribution and harm within the state and nationally have been implemented. The decrease in methamphetamine use after 2017 suggests that timely interventions have successfully reduced overall drug use and has led to fewer fatalities. This study shows that the response to increasing methamphetamine use in South Australia has resulted in a reversal of the upward trend in consumption and fewer drug-related fatalities.

Choosing to drive from alcohol serving establishments (ASEs)

OBJECTIVE

The prevalence of Driving Under the Influence (DUI) of alcohol or drugs has become a prominent factor in the occurrence of severe road crashes worldwide. Driving often occurs after visiting, and presumably drinking, at Alcohol-Serving Establishments (ASEs), and is thus of interest as a possible source of DUI events.

METHODS

We apply statistical and machine learning models to the Victorian Integrated Survey of Travel and Activity (VISTA) to identify factors that contribute to driving in trips from ASEs in Australia's state of Victoria.

RESULTS

Our results highlight that approximately 10% of individuals who traveled to ASEs as car passengers switched to driving after leaving there. It was also observed that travel distance shorter than 1 km and activity duration between 3 and 4 h positively impacts the mode switching from car driver to other modes in ASEs trips. Further findings illustrate a decline in driving after midnight, with an increase in the use of public transport and taxis. Individuals prefer driving for long-distance ASEs trips and walking for short distances. Going home also increased the likelihood of driving, whereas engaging in other social activities did not. Longer stays at ASEs and leaving vehicles overnight reduce the propensity to drive, likely due to increased alcohol consumption during these times.

CONCLUSIONS

These findings suggest behavioral adjustments that can mitigate driving under the influence. Specifically, people may walk for short-distance trips and use public transport or taxis for longer ASEs trips.

Forensic Assessment of Alcohol Intoxication in Cases of Fatal Road Traffic Accidents in Lithuania

Background

There is strong evidence that alcohol consumption is a significant risk factor for fatal road traffic accidents. It is estimated that the number of alcohol-related road accidents remains high in the past few years in Lithuania. This study aims to examine the prevalence of alcohol in blood samples collected from the autopsy results of road traffic accident victims.

Materials and methods

A retrospective study of 136 road traffic accident victims was performed in State Forensic Medicine Service of Lithuania in the period of 2013 to 2023. We analyzed blood alcohol concentration (BAC) in relation to sex, age, road user type, place and time of the day at death.

Results

31% of the victims were under influence of alcohol at the time of death, with mean BAC 1.99 ± 0.92‰. The mean BAC was 2.16 ± 0.8‰ in male and 1.18 ± 1.12‰ in female group. By the type of road users, 23% of the pedestrians (mean BAC 2.45 ± 0.71‰), 32% of car drivers (mean BAC 2.13 ± 0.75‰), 41% of vehicle passengers (mean BAC of 1.73 ± 1.19‰), 37% of the motorcycle riders (mean BAC of 1.28 ± 0.53‰), 37% of the cyclists (mean BAC of 1.15 ± 0.75‰) were found to be intoxicated during the time of accident. Highest mean blood alcohol concentration was found during the night time hours (9 p. m. - 5 a. m.) 2.28 ± 0.91, comparing to in afternoon hours (12 p. m. - 5 p. m.) 1.49 ± 0.99, evening hours (5 p. m. - 9 p. m.) 2.10 ± 0.73 and morning hours (5 a. m. - 12 p. m.) 1.94 ± 1.00. The mean BAC in road traffic accidents during summer was 1.48 ± 0.71‰, spring 2.25 ± 0.76‰, autumn 2.12 ± 1‰, winter 2.42 ± 1‰.

Conclusions

Alcohol consumption by road users is a significant contributing factor in road traffic accidents and their outcomes in Lithuania.

Do crashed drivers need more drug testing? A retrospective analysis of blood samples from hospitalised post-crash drivers in New Zealand

Driving under the influence of alcohol and other drugs is a prominent safety concern in New Zealand and across the world. While alcohol testing is routinely performed for drivers involved in hospitalisation crashes, testing for other drugs is often not undertaken. The present study refers to 530 traffic crashes that occurred from October 2019 to January 2020 on New Zealand roads. The blood samples from 550 drivers who were injured in a crash and were admitted to a hospital (66% of all drivers involved in these crashes), previously tested for drugs and/or alcohol, were retested for a wider range of drugs. Alcohol above the applicable limit was found to be present in 38% of hospitalised drivers, while other drugs of interest were found in 47% of hospitalised drivers. Binary logistic regression was used to predict the presence of drugs of interest for a crashed driver using previous offence data. A driver having at least one prior drink and drug driving offence is 61% more likely to be positive for a drug of interest when involved in a crash. Similarly, a driver having at least one prior non-traffic drug offence is 4.7 times more likely to be positive for at least a drug of interest when involved in a crash. While the presence of a drug or drugs cannot be presumed to have played a role in the occurrence of the crash, this study has provided a unique and comprehensive picture of the presence of various drugs present in New Zealand drivers' blood. It is recommended to consider standardising drug testing on all blood specimens taken in relation to a serious injury or fatal crash. This procedure is not only of interest for information purposes but may importantly inform appropriate charging decisions.

Self-Regulation of Driving Behavior Under the Influence of Cannabis: The Role of Driving Complexity and Driver Vision

OBJECTIVE

This study analyzed the self-regulation behaviors of drivers under the influence of cannabis and its relationship with road complexity and some driver traits, including visual deterioration.

BACKGROUND

Cannabis is the illicit drug most often detected in drivers; its use results in significant negative effects in terms of visual function. Self-regulation behaviors involve the mechanisms used by drivers to maintain or reduce the risk resulting from different circumstances or the driving environment.

METHODS

Thirty-one young, occasional cannabis users were assessed both in a baseline session and after smoking cannabis. We evaluated the visual function (visual acuity and contrast sensitivity) and driver self-regulation variables of both longitudinal and lateral control as the speed adaptation and standard deviation of lateral position (SDLP).

RESULTS

Visual function was significantly impaired after cannabis use. Recreational cannabis use did not result in self-regulation, although some road features such as curved roads did determine self-regulation. Male participants adopted mean faster driving speeds with respect to the speed limit. Driver age also determined better lateral control with lower SDLPs. In addition, visual impairment resulting from cannabis use (contrast sensitivity) was linked with self-regulation by changes in longitudinal and lateral control.

CONCLUSION

Contrast sensitivity could be a good indicator of individual visual status to help determine how drivers self-regulate their driving both in normal conditions and while under the influence of cannabis.

APPLICATION

The findings provide new insights about driver self-regulation under cannabis effects and are useful for policy making and awareness campaigns.

Bibliometric evaluation of Forensic Science International as a scholarly journal within the subject category legal medicine

This article presents a bibliometric evaluation of Forensic Science International (FSI) as a scholarly journal within the "legal medicine" subject category. Citation data were retrieved from Science Citation Index (SCI) and Journal Citation Reports (JCR), both of which are part of the Web-of-Science (WOS) database. The most cited articles in FSI were identified along with the most prolific authors. The current journal impact factor (JIF) of FSI is 2.2, which was in good agreement with the 5-year JIF of 2.3. FSI was ranked fourth among 17 journals within the legal medicine subject category. Since 1979, a total of 209 FSI articles were cited over 100 times and the H-index for times cited was 125. Although widely used in academia, bibliometric methods might also prove useful in jurisprudence, such as when evaluating the research and publications of people proposed as expert witnesses.

Prevalence of Substance Abuse Among Trauma Patients in Rural West Virginia

BACKGROUND

 Substance abuse poses considerable clinical, economic, and social challenges. West Virginia is hailed as the epicenter of the substance abuse in the United States, the prevalence and pattern of different trauma mechanisms in a rural context or in patients with different forms of substance abuse remain unclear.

OBJECTIVE

 We performed the following analysis to understand the prevalence of substance abuse in patients with different trauma mechanisms in the rural setting with high substance abuse in the West Virginia.

METHODS

 We performed a cross-sectional retrospective analysis of adult trauma patients (motor vehicle, fall, assault, firearm suicide, brawl/rape and machinery) hospitalized in two tertiary care hospitals in West Virginia between 2006 and 2016. We identified all patients who had a urine drug screen (UDS) test and extracted the data related to the substance and trauma.

RESULTS

 Among 8734 patients screened using UDS, 5940 (68.1%) patients were tested positive for the substance. Opiates, alcohol, benzodiazepines, and cannabis were the four most common substances identified in trauma victims. In all instances, the prescribed drug was less than 20%. Fatal outcome was observed in 366 patients in the sample, with 44% (n=162) testing positive for UDS, 12% (n=45) testing positive for only alcohol, and 15% (n=56) testing positive for both alcohol and UDS. Regarding the trauma mechanism, the motor vehicle accident (MVA) was the most prominent with a clear association of substance abuse with fatal outcome.

CONCLUSION

 The most prevalent trauma mechanism was a MVA, with a strong link between drug usage and mortality. Due to the high incidence of positive substance abuse screens, UDS tests may need to be more widely implemented in trauma in the West Virginia region. The findings of this study might help in establishing regional or national policies to reduce acute substance abuse.

Effects of psychotropic drugs on ocular parameters relevant to traffic safety: A systematic review

Driving is a complex neurobehavioural task necessitating the rapid selection, uptake, and processing of visual information. Eye movements that are critical for the execution of visually guided behaviour such as driving are also sensitive to the effects of psychotropic substances. The Embase (via Ovid), EBSCOHost, Psynet, Pubmed, Scopus and Web of Science databases were examined from January 01st, 2000 to December 31st, 2021. Study selection, data extraction and Cochrane Risk of Bias (RoB2) assessments were conducted according to PRISMA guidelines. The review was prospectively registered (CRD42021267554). In total, 36 full-text articles examined the effects of six principal psychotropic drug classes on measures of oculomotor parameters relevant to driving. Centrally depressing substances affect oculomotor responses in a dose-dependent manner. Psychostimulants improve maximal speed, but not accuracy, of visual search behaviours. Inhaled Δ-9-tetrahydrocannabinol (THC) increases inattention (saccadic inaccuracy) but does not consistently affect other oculomotor parameters. Alterations to composite ocular parameters due to psychoactive substance usage likely differently compromises performance precision during driving through impaired ability to select and process dynamic visual information.

Modeling Motorcyclists’ Aggressive Driving Behavior Using Computational and Statistical Analysis of Real-Time Driving Data to Improve Road Safety and Reduce Accidents

Driving behavior is considered one of the most important factors in all road crashes, accounting for 40% of all fatal and serious accidents. Moreover, aggressive driving is the leading cause of traffic accidents that jeopardize human life and property. By evaluating data collected by various collection devices, it is possible to detect dangerous and aggressive driving, which is a huge step toward altering the situation. The utilization of driving data, which has arisen as a new tool for assessing the style of driving, has lately moved the concentration of aggressive recognition research. The goal of this study is to detect dangerous and aggressive driving profiles utilizing data gathered from motorcyclists and smartphone APPs that run on the Android operating system. A two-stage method is used: first, determine driver profile thresholds (rules), then differentiate between non-aggressive and aggressive driving and show the harmful conduct for producing the needed outcome. The data were collected from motorcycles using -Speedometer GPS-, an application based on the Android system, supplemented with spatiotemporal information. After the completion of data collection, preprocessing of the raw data was conducted to make them ready for use. The next steps were extracting the relevant features and developing the classification model, which consists of the transformation of patterns into features that are considered a compressed representation. Lastly, this study discovered a collection of key characteristics which might be used to categorize driving behavior as aggressive, normal, or dangerous. The results also revealed major safety issues related to driving behavior while riding a motorcycle, providing valuable insight into improving road safety and reducing accidents.

A Comprehensive Review on the Behaviour of Motorcyclists: Motivations, Issues, Challenges, Substantial Analysis and Recommendations

With the continuous emergence of new technologies and the adaptation of smart systems in transportation, motorcyclist driving behaviour plays an important role in the transition towards intelligent transportation systems (ITS). Studying motorcyclist driving behaviour requires accurate models with accurate and complete datasets for better road safety and traffic management. As accuracy is needed in modelling, motorcyclist driving behaviour analyses can be performed using sensors that collect driving behaviour characteristics during real-time experiments. This review article systematically investigates the literature on motorcyclist driving behaviour to present many findings related to the issues, problems, challenges, and research gaps that have existed over the last 10 years (2011-2021). A number of digital databases (i.e., IEEE Xplore®, ScienceDirect, Scopus, and Web of Science) were searched and explored to collect reliable peer-reviewed articles. Out of the 2214 collected articles, only 174 articles formed the final set of articles used in the analysis of the motorcyclist research area. The filtration process consisted of two stages that were implemented on the collected articles. Inclusion criteria were the core of the first stage of the filtration process keeping articles only if they were a study or review written in English or were articles that mainly incorporated the driving style of motorcyclists. The second phase of the filtration process is based on more rules for article inclusion. The criteria of inclusion for the second phase of filtration examined the deployment of motorcyclist driver behaviour characterisation procedures using a real-time-based data acquisition system (DAS) or a questionnaire. The final number of articles was divided into three main groups: reviews (7/174), experimental studies (41/174), and social studies-based articles (126/174). This taxonomy of the literature was developed to group the literature into articles with similar types of experimental conditions. Recommendation topics are also presented to enable and enhance the pace of the development in this research area. Research gaps are presented by implementing a substantial analysis of the previously proposed methodologies. The analysis mainly identified the gaps in the development of data acquisition systems, model accuracy, and data types incorporated in the proposed models. Finally, research directions towards ITS are provided by exploring key topics necessary in the advancement of this research area.

Review article: DINED (Delivery-related INjuries in the Emergency Department) part 1: A scoping review of risk factors and injuries affecting food delivery riders

This scoping review describes the current state of research about two-wheeled delivery riders who have been injured while performing commercial food delivery. The key areas of interest are the patterns of injury, associated risk factors and current gaps in knowledge. Five databases were searched to identify key papers that describe injuries to two-wheeled food delivery riders. Papers were assessed for quality and eligibility and key information was extracted relating to patterns of injury and risk factors. From an initial 264 records from PubMed, Embase, CINAHL, Scopus and SafetyLit, studies were screened by title, abstract and full text to yield 12 key papers for analysis. No papers reporting on Australian data were identified. Men comprise over 85% of workers in the food delivery industry. The average age of injured riders varies by country, but is commonly under 30 years old. Most injuries are lower limb musculoskeletal injuries, although there are no consistent data about frequency, severity or cost to the healthcare system. Twenty-three key risk factors were categorised according to rider characteristics, working conditions and environmental factors. The most common risk factors were younger age, lack of driving experience, time-pressured work and inadequate protective gear. There are very few publications describing food delivery rider injuries and risk factors. This is an emerging industry in which the worker population may be younger and more vulnerable. Given the different legal and cultural contexts across different countries, Australian-specific research is needed.

The effects of alcohol intoxication on cognitive functions critical for driving: A systematic review

Alcohol is the most frequently detected substance in drivers involved in road traffic collisions. Given that up to 35% of fatal road collisions are alcohol-related, it is important to determine the influence of alcohol intoxication on driving-related skills. This review provides an updated and systematic evaluation of the available research concerning the effect of alcohol intoxication on cognitive functions critical for driving. Databases EBSCOhost, PsycInfo, PubMed, Scopus, Transport Research International Documentation (TRID) and Web of Science were searched for controlled trials examining the effect of alcohol on divided attention, executive functioning, perception, psychomotor skills, reaction time and/or vigilance. Fourteen studies met the inclusion criteria and were included in this review. We found that each of the cognitive domains assessed in this review showed impairment at blood alcohol concentrations equal to or below the legal driving limit in many jurisdictions. Future research could determine the effects of alcohol on cognitive functioning with greater accuracy by employing more consistent, reliable and comparable measures while considering the translation of deficits to real-life driving.

A state-of-the-art review of factors that predict mortality among traumatic injury patients following a road traffic crash

BACKGROUND

Traffic related injuries are a major public health problem worldwide with millions of people dying every year. The objective of this state-of-the-art review was to identify the factors reported in the literature as being associated with mortality for trauma patients following road traffic crashes.

METHOD

A systematic search was undertaken of PubMed/MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane Library databases to identify articles published in the past two decades (2000-2020). Of 8257 records, 4507 remained for title, abstract and full text screening after duplicates were removed. The level of evidence of selected studies was assessed using The National Health and Medical Research Council (NHMRC) guideline.

RESULTS

This review included eighty primary research studies examining mortality risk factors following a road traffic crash. The study identified factors in five categories; (i) demographic factors; (ii) behavioural factors; (iii) crash characteristics; (iv) environmental and timing factors; (v) injury severity and pre-injury/condition. The primary studies are summarised in a matrix. Included studies included level II to level IV levels of evidence based on the NHMRC criteria.

CONCLUSION

This study shows that there are a large number of factors associated with increased risk of mortality following diverse types of traffic crashes. Understanding these wide-ranging factors can strengthen injury and mortality prevention by guiding decision makers about where to focus strategy implementation.