Survival risk factors for fatal injured car and motorcycle drivers in single alcohol-related and alcohol-unrelated vehicle crashes

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.

Which is the role of driver- or passengers-sex on the severity of road crashes?

Aim

The aim of the study is to quantify the main ways in which the sex of the driver/occupant of a passenger car affects the severity of road crashes.

Methods

All 171 230 cars occupied by the driver and one or more passengers included in the Spanish Register of Victims of Road Crashes from 2014 to 2020 were included. We designed two cohort studies: In the first one, we estimated the Incidence Rate Ratios (IRR) between the sex of the drivers and the occurrence of any death and/or severe injuries among their passengers. In the second one we estimated the conditioned IRR between the sex of the occupants of the same car and their risk of death and/or severe injuries. We used fixed Poisson models to obtain IRR estimates, crude and adjusted by individual- environment- and vehicle-related variables.

Results

A consistent inverse relationship between driver's female sex and passenger's severity was found, (IRR 0.72, 95 % CI 0.68-0.77), stronger for single crashes (IRR 0.67, 95 % CI 0.60-0.65). The magnitude decreased after adjusting for vehicle- and environment-related variables (IRR 0.82, 95 % CI 0.73-0.92). In the second study, the risk of death or hospitalization was higher for occupants of female sex (IRR 1.23, 95 % CI 1.17-1.30).

Conclusions

The risk of death or severe injuries among passengers of cars involved in single crashes is lower for female drivers, probably due to safer driving. On the contrary, in similar crashes, the risk of injuries leading to hospitalization is higher for females.

Nationwide Analysis of Motorcycle-Associated Injuries and Fatalities in the United States: Insufficient Prevention Policies or Abandoned Laws?

BACKGROUND

Motorcycle road traffic collisions are a major cause of mortality in the United States. We aimed to analyze the temporal and statewide trends in motorcycle collision fatalities (MCFs) nationwide and their association with state laws regarding motorcycle helmet requirements, lane splitting, speeding, intoxicating driving, and red light cameras.

METHODS

A retrospective review of United States MCF/capita from 2015 to 2019 was performed using the Fatality Analysis Reporting System database. MCF/capita was defined as a motorcyclist death per 100 000 motorcyclist registrations. Independent-samples t-test and ANOVA were used to determine differences, with significance defined as P < .05. Linear regression analysis and Pearson's correlation were used to further determine associations between variables.

RESULTS

The majority of fatalities occurred in males (n = 21 354, 91.0%), ages 25-54 (n = 13 728, 58.5%), and Caucasians (n = 19 195, 81.8%). A total of 24 states and DC exhibited positive trends in MCF/capita from 2015 to 2019. There was no significant difference in MCF/capita between states who had mandatory helmet laws for all, partial requirements, and states with no law (63.4 vs 54.3 vs 33.6, P = .360). Among fatalities involving alcohol, a significantly greater number of MCF/capita were found above the legal limit of .08 compared to the group with a blood alcohol concentration of .01-.07 (17.8 vs 4.5, P < .001).

CONCLUSION

Motorcyclist fatalities continue to pose a public health risk, with 24 states showing an upward trend. Additional interventions and laws are needed to decrease the number of motorcyclist deaths. Further strategy on implementation and enforcement of helmet laws and alcohol consumption may be an essential component.

Factors associated with serious vehicular accidents: A cross-sectional study in hospital emergency rooms

AIMS

Pictograms on medicine boxes warn of potential drug-related driving hazard; we studied their association with serious accidents.

METHODS

Prospective study in emergency departments of the hospitals in Bordeaux and Périgueux (France), of drivers with serious (admitted at least 24 hours) or nonserious vehicular accidents. Minors, passengers, pedestrians or subjects incapable of answering an interview were excluded. Interviews ascertained driver and accident characteristics, use of drugs with or without pictograms, use of alcohol and abuse substances, sleepiness, distractions, and mind wandering at the time of the accident, RESULTS: Between 18 October 2016 and 26 December 2018, 1200 of the 6212 drivers admitted to the hospital emergency rooms, 741 nonserious, 459 serious, were interviewed. Serious accidents were associated with male sex (odds ratio 1.89, 95% confidence interval [1.36-2.64]), age above 60 years (3.64 [2.21-6.00]), driving on local roads (3.34 [2.34-4.76]), driving a motorcycle (3.39 [2.29-5.00]), having drunk alcohol within 6 hours (2.89 [1.85-4.51]) and using a drug with a pictogram during the 24 hours previous to the accident (1.57 [1.06-2.32]). From 207 police reports, 101 drivers were not responsible, and 106 were responsible, associated with age below 40 years, driving in overcast or rainy weather (2.62 [1.29-5.33]), on local roads (3.89 [1.90-7.95]), and use of at least 1 pictogram drug in the previous week (3.12 [1.31-7.41]).

CONCLUSION

The known risks of alcohol and pictogram drugs, of riding motorcycles and using local roads were confirmed. As measured, behavioural sleepiness did not predict accidents.

Enhancement of unsafe behaviors in simulated moped-riding performance under the influence of low dose of alcohol

The effects of low levels of blood alcohol concentration (BAC) on motorcyclist performance are still not fully comprehended. The great majority of the studies are, in fact, focused on car driving. So far, it is known that even BAC levels below the legal limit negatively affect riding motor skills correlated with crash rate. In the present study, we used a moped riding simulator to investigate the effects of low alcohol dosages (under the limits established in Italy, and in most European countries) on the defensive riding ability of light drinkers, particularly focusing on the degree of danger characterizing their riding performance. We recruited 24 participants through a double-blind, random distribution, balanced, cross-over design. We administered moderate amounts of alcohol to participants during two sessions of moped riding simulation. The results showed that even though BAC levels were always below (mean value: 0.03 g/dL) the limit allowed by Italian traffic law (0.05 g/dL), alcohol induced a reduction in safe riding behaviors, as indicated by the greater amount of hazardous scenes faced with dangerous riding behaviors when participants were under the influence of alcohol than when they were sober. Moreover, low BAC levels had a greater detrimental influence when a certain amount of learning had already been achieved by the participants (i.e., in the last experimental session). The results suggest that the effect of a low dose of alcohol interacts with participants' self-confidence.

Understanding motorcyclist-related accidents in Colombia

In 2016, Colombia's position regarding motorcyclist fatalities per 100,000 inhabitants was tenth worldwide and second in South America. In the seven years from 2012-2018, the proportion of deceased and injured motorcyclists among all road users was 50%. To analyse the significant aspects of the accident rate of motorcyclists in Colombia from 2016 to 2018 and estimate cost social value of motorcycle-related deaths. The global numbers of fatalities and injuries were compared to the Colombian context. Descriptive and inferential statistics were conducted to explore the association of fatal trauma and motorcycle accidents. P values and odds ratios were calculated. Bogotá, Cali, and Medellín were the cities with the most accidents. The month, day, time, age of the victims, and climatic conditions had a statistically significant association with the fatal trauma. Most victims were between the ages of 20-29 years. Motorcycles were involved in more than 60% of accidents. The social cost of a life lost in a motorcycle accident was estimated at $2,418 million Colombian pesos (725,400 USD) per year. The establishment of countermeasures for the road safety of vulnerable users should focus on associated causal factors in order to develop strategies to effectively reduce the number of accidents.

Different demographic and drinking profiles of motorcyclists and car drivers with the first-time offense of driving/riding under the influence of alcohol

BACKGROUND

Driving/riding under the influence (DUI) of alcohol is a major public concern worldwide. Only a few studies have distinguished DUI-related variables between motorcyclists and car drivers. This study examined the differences in demographic characteristics and drinking behaviors among first-time DUI offenders operating different transportation vehicles, and risk factors for frequent DUI (fDUI) among them.

METHODS

We conducted an anonymous survey for 561 first-time DUI offenders who attended a mandatory educational program. Participants self-administered questionnaires concerning alcohol drinking behaviors and DUI. We defined fDUI as at least two DUI behaviors per month based on self-reported information. Demographic and drinking characteristics were compared between DUI offenders, car drivers and motorcyclists. Logistic regression analysis was used to examine risk factors for fDUI.

RESULTS

Two-thirds of first-time DUI offenders were motorcyclists. Compared with car drivers, motorcyclists were younger and less educated, with a higher percentage of them being women and unmarried. Car drivers reported a higher rate of fDUI than motorcyclists (16.5% vs. 9.7%). Regression analysis revealed that binge drinkers had a higher fDUI risk in both groups. Regarding the drinking place prior to DUI behavior, workplace was significantly associated with fDUI in car drivers.

CONCLUSIONS

Distinct strategies may be required for motorcyclists and car drivers for DUI recidivism prevention, and drinking place interventions should also be considered.

Effects of socio-demographic, personality and mental health factors on traffic violations in Chinese bus drivers

The present study aims to determine the association between bus drivers' socio-demographic characteristics, personality traits, mental health and traffic violations. This case-control study included 596 bus drivers who were recruited during October 2014 to May 2016, including 295 drivers with traffic violations and 301 drivers without traffic violations. The bus drivers' personality traits and mental health were assessed by the Eysenck Personality Questionnaire (EPQ) and the Symptom Checklist (SCL-90-R). Drivers aged 26-35 years were 72% less likely to be involved in traffic violations compared to drivers aged ≤25 years (OR:0.284,95%CI:0.137-0.586). Drivers with ≤2 years driving experience were associated with almost a three-fold increased risk of traffic violations compared to ≥21 years driving experience (OR:3.174,95%CI:1.097-9.187). The OR value decreased with the increase of annual income (OR:4.631,95%CI:2.667-8.042;OR:3.569,95%CI:2.038-6.251;OR:3.781,95%CI:1.999-7.151). Occasionally drinking drivers and regularly drinking drivers, compared to nondrinking drivers, exhibited a higher risk of traffic violations (OR:2.487,95%CI:1.521-4.065;OR:3.271,95%CI:1.387-7.716).Extroversion and neuroticism were identified as significant factors associated with traffic violations (OR:1.262,95%CI:1.145-1.393;OR:1.159,95%CI:1.060-1.267).Somatization increased eleven-fold risk of bus drivers' traffic violations (OR:11.185,95%CI:4.563-27.419). The results revealed that bus drivers' traffic violations were mainly affected by specific socio-demographic characteristics, personality traits and mental health, which increase the risk of traffic violations.

Crash risk by driver age, gender, and time of day using a new exposure methodology

INTRODUCTION

Concerns have been raised that the nonlinear relation between crashes and travel exposure invalidates the conventional use of crash rates to control for exposure. A new metric of exposure that bears a linear association to crashes was used as basis for calculating unbiased crash risks. This study compared the two methods - conventional crash rates and new adjusted crash risk - for assessing the effect of driver age, gender, and time of day on the risk of crash involvement and crash fatality.

METHOD

We used police reports of single-car and multi-car crashes with fatal and nonfatal driver injuries that occurred during 2002-2012 in Great Britain.

RESULTS

Conventional crash rates were highest in the youngest age group and declined steeply until age 60-69 years. The adjusted crash risk instead peaked at age 21-29 years and reduced gradually with age. The risk of nighttime driving, especially among teenage drivers, was much smaller when based on adjusted crash risks. Finally, the adjusted fatality risk incurred by elderly drivers remained constant across time of day, suggesting that their risk of sustaining a fatal injury due to a crash is more attributable to excess fragility than to crash seriousness.

CONCLUSIONS

Our findings demonstrate a biasing effect of low travel exposure on conventional crash rates. This implies that conventional methods do not yield meaningful comparisons of crash risk between driver groups and driving conditions of varying exposure to risk. The excess crash rates typically associated with teenage and elderly drivers as well as nighttime driving are attributed in part to overestimation of risk at low travel exposure. Practical Applications: Greater attention should be directed toward crash involvement among drivers in their 20s and 30s as well as younger drivers. Countermeasures should focus on the role of physical vulnerability in fatality risk of elderly drivers.

Evaluation of an in-vehicle monitoring system (IVMS) to reduce risky driving behaviors in commercial drivers: Comparison of in-cab warning lights and supervisory coaching with videos of driving behavior

PROBLEM

Roadway incidents are the leading cause of work-related death in the United States.

METHODS

The objective of this research was to evaluate whether two types of feedback from a commercially available in-vehicle monitoring system (IVMS) would reduce the incidence of risky driving behaviors in drivers from two companies. IVMS were installed in 315 vehicles representing the industries of local truck transportation and oil and gas support operations, and data were collected over an approximate two-year period in intervention and control groups. In one period, intervention group drivers were given feedback from in-cab warning lights from an IVMS that indicated occurrence of harsh vehicle maneuvers. In another period, intervention group drivers viewed video recordings of their risky driving behaviors with supervisors, and were coached by supervisors on safe driving practices.

RESULTS

Risky driving behaviors declined significantly more during the period with coaching plus instant feedback with lights in comparison to the period with lights-only feedback (ORadj=0.61 95% CI 0.43-0.86; Holm-adjusted p=0.035) and the control group (ORadj=0.52 95% CI 0.33-0.82; Holm-adjusted p=0.032). Lights-only feedback was not found to be significantly different than the control group's decline from baseline (ORadj=0.86 95% CI 0.51-1.43; Holm-adjusted p>0.05).

CONCLUSIONS

The largest decline in the rate of risky driving behaviors occurred when feedback included both supervisory coaching and lights.

PRACTICAL APPLICATIONS

Supervisory coaching is an effective form of feedback to improve driving habits in the workplace. The potential advantages and limitations of this IVMS-based intervention program are discussed.

A comparison of contributing effects on 2-vehicle alcohol-related crashes between impaired and nonimpaired operators

OBJECTIVE

Driving under the influence of alcohol is a crime that places the lives of all motorists in danger. Though it is a largely preventable act, impaired driving has accounted for 31 to 38% of fatal crashes across the country over the last decade. When an impaired operator crashes his or her vehicle, there is often a second unit, of which the operator is not impaired, involved in the crash.

METHODS

This research looks at approximately 14,000 2-unit crashes involving an impaired operator in the State of Ohio from 2008 through 2012. The research is focused on determining the effects of crash and operator characteristics in 2-unit alcohol-related crashes through the use of 2 mixed logit models.

RESULTS

It is found that several factors have similar effects on the injury severities of both the impaired and nonimpaired operators, including head-on crashes, the use of seat belts, and the deployment of airbags. There are, however, several factors that affect the 2 operators differently. It is found that the impaired operator's injury severity is based on the type and, more important, the size of the vehicle he or she is driving, the roadway geometry, and the speed of the vehicle driven by the nonimpaired operator. The nonimpaired operator is equally affected by the speed of the impaired vehicle as much as his or her own speed, and the nonimpaired operator's injury severity is virtually independent of the type of vehicle being driven.

CONCLUSIONS

Researchers may disseminate the results to community groups such as Mothers Against Drunk Driving and Safe Communities to increase awareness of the dangers of drunk driving in an effort to reduce the number of alcohol-related crashes.

Prevalence and risk factors of alcohol and substance abuse among motorcycle drivers in Fars province, Iran

PURPOSE

The aim of this present study is to investigate the prevalence of alcohol and substance abuse (ASA) and its relationship with other risky driving behaviors among motorcycle drivers.

METHODS

This is a cross sectional study which is performed at Shiraz city of Iran. Data from motorcycle drivers were collected using a standard questionnaire in eight major streets at different times of the day. The data includes consumption of alcohol and other substances two hours before driving and some of the risky behaviors during driving.

RESULTS

A total of 414 drivers with a mean ± SD age of (27.0 ± 9.3) years participated in the study. Alcohol or substance consumptions two hours before driving was significantly associated with risky driving behaviors such as using mobile phone during driving, poor maneuvering, and driving over the speed limit (both p < 0.001). It was also associated with carelessness about safety such as driving with technical defects (p < 0.001) and not wearing a crash helmet (p=0.008).

CONCLUSION

Screening for alcohol and substance consumption among motorcycle drivers is an efficient way to identify drivers that are at a greater risk for road traffic accidents.

Facial trauma among victims of terrestrial transport accidents

Introduction

In developing countries, terrestrial transport accidents – TTA, especially those involving automobiles and motorcycles – are a major cause of facial trauma, surpassing urban violence.

Objective

This cross-sectional census study attempted to determine facial trauma occurrence with terrestrial transport accidents etiology, involving cars, motorcycles, or accidents with pedestrians in the northeastern region of Brazil, and examine victims’ socio-demographic characteristics.

Methods

Morbidity data from forensic service reports of victims who sought care from January to December 2012 were analyzed.

Results

Altogether, 2379 reports were evaluated, of which 673 were related to terrestrial transport accidents and 103 involved facial trauma. Three previously trained and calibrated researchers collected data using a specific form. Facial trauma occurrence rate was 15.3% (n = 103). The most affected age group was 20–29 years (48.3%), and more men than women were affected (2.81:1). Motorcycles were involved in the majority of accidents resulting in facial trauma (66.3%).

Conclusion

The occurrence of facial trauma in terrestrial transport accident victims tends to affect a greater proportion of young and male subjects, and the most prevalent accidents involve motorcycles.

Modeling the effect of operator and passenger characteristics on the fatality risk of motorcycle crashes

BACKGROUND

In Iran more than 25% of crash fatalities belong to motorcycle operators and passengers in the recent years, from which about 20% are related to passenger fatalities.

METHODS

The aim of this study was to investigate the motorcycle operator and passenger characteristics as well as other contributory factors that may affect the fatality risk of motorcyclists involved in traffic crashes. To this end, motorcycle crash data between 2009 and 2012 was extracted from Iran traffic crash database and a logistic regression analysis was performed to obtain odds ratio estimates for each of the study variables.

RESULTS

The fatality risk of motorcyclists has a direct relationship with the number of pillion passengers carried. Results also indicate that the amount of increase in the likelihood of having a fatality in a motorcycles crash is considerably higher when the operator is accompanied by a male passenger of the same age. Furthermore, results showed that if the crash is occurred in the darkness, on curves, in rural areas and on highways, then the crash would be more likely to be fatal. Moreover, the head-on collisions, older operators, unlicensed operators and not using a safety helmet were found to increase the likelihood of a fatality in a motorcycle crash.

CONCLUSIONS

Preventative measures such as, imposing stricter rules regarding safety helmet usage and confining the number of pillion passengers to one, might be implemented to reduce the fatality risk in motorcycle crashes. In addition, more appropriate infrastructures for penalizing offending motorcyclists could also reduce the frequency of law violations such as not wearing helmet or riding without motorcycle license, which in turn, would result into a reduction in the fatality risk of motorcycle crashes.

A case study analysis to examine motorcycle crashes in Bogota, Colombia

INTRODUCTION

Contributory factors to motorcycle crashes vary among populations depending on several aspects such as the users' profiles, the composition and density of traffic, and the infrastructure features. A better understanding of local motorcycle crashes can be reached in those places where a comprehensive analysis is performed. This paper presents the results obtained from a case study analysis of 400 police records of accidents involving motorcycles in Bogota.

METHOD

To achieve a deeper level of understanding of how these accidents occur, we propose a systemic approach that uses available crash data. The methodology is inspired by accident prototypical scenarios, a tool for analysis developed in France.

RESULTS

When grouping cases we identified three categories: solo motorcycle accidents, motorcyclist and pedestrian accidents, and accidents involving a motorcycle and another vehicle. Within these categories we undertook in-depth analyses of 32 groups of accidents obtaining valuable information to better comprehend motorcyclists' road crashes in a local context. Recurrent contributory factors in the groups of accidents include: inexperienced motorcyclists, wide urban roads that incite speeding and risky overtaking maneuvers, flowing urban roads that encourage high speed and increased interaction between vehicles, and lack of infrastructure maintenance.

PRACTICAL APPLICATIONS

The results obtained are a valuable asset to define measures that will be conveniently adapted to the group of accident on which we want to act. The methodology exposed in this paper is applicable to the study of road crashes that involve all types of actors, not only the motorcyclists, and in contexts different than those presented in Bogota.

Alcohol-related hospitalizations of adult motorcycle riders

OBJECTIVE

To provide an overview of the demographic characteristics of adult motorcycle riders with alcohol-related hospitalizations.

METHODS

Data obtained from the Trauma Registry System were retrospectively reviewed for trauma admissions at a level I trauma center between January 1, 2009 and December 31, 2013. Out of 16,548 registered patients, detailed information was retrieved regarding 1,430 (8.64%) adult motorcycle riders who underwent a blood alcohol concentration (BAC) test. A BAC level of 50 mg/dL was defined as the cut-off value for alcohol intoxication.

RESULTS

In this study, alcohol consumption was more frequently noted among male motorcycle riders, those aged 30-49 years, those who had arrived at the hospital in the evening or during the night, and those who did not wear a helmet. Alcohol consumption was associated with a lower percentage of sustained severe injury (injury severity score ≥25) and lower frequencies of specific body injuries, including cerebral contusion (0.6; 95% confidence interval [CI] = 0.42-0.80), lung contusion (0.5; 95% CI = 0.24-0.90), lumbar vertebral fracture (0.1; 95% CI = 0.01-0.80), humeral fracture (0.5; 95% CI = 0.27-0.90), and radial fracture (0.6; 95% CI = 0.40-0.89). In addition, alcohol-intoxicated motorcycle riders who wore helmets had significantly lower frequencies of cranial fracture (0.4; 95% CI = 0.29-0.67), epidural hematoma (0.5; 95% CI = 0.29-0.79), subdural hematoma (0.4; 95% CI = 0.28-0.64), subarachnoid hemorrhage (0.5; 95% CI = 0.32-0.72), and cerebral contusion (0.4; 95% CI = 0.25-0.78).

CONCLUSIONS

Motorcycle riders who consumed alcohol presented different characteristics and bodily injury patterns relative to sober patients, suggesting the importance of helmet use to decrease head injuries in alcohol-intoxicated riders.

A data mining approach to investigate the factors influencing the crash severity of motorcycle pillion passengers

INTRODUCTION

Motorcycle passengers comprise a considerable proportion of traffic crash victims. During a 5 year period (2006-2010) in Iran, an average of 3.4 pillion passengers are killed daily due to motorcycle crashes. This study investigated the main factors influencing crash severity of this group of road users.

METHOD

The Classification and Regression Trees (CART) method was employed to analyze the injury severity of pillion passengers in Iran over a 4 y ear period (2009-2012).

RESULTS

The predictive accuracy of the model built with a total of 16 variables was 74%, which showed a considerable improvement compared to previous studies. The results indicate that area type, land use, and injured part of the body (head, neck, etc.) are the most influential factors affecting the fatality of motorcycle passengers. Results also show that helmet usage could reduce the fatality risk among motorcycle passengers by 28%.

PRACTICAL APPLICATIONS

The findings of this study might help develop more targeted countermeasures to reduce the death rate of motorcycle pillion passengers.

Motorcycle riding under the influence of alcohol: results from the SARTRE-4 survey

Riding a motorcycle under the influence of alcohol is a dangerous activity, especially considering the high vulnerability of motorcyclists. The present research investigates the factors that affect the declared frequency of drink-riding among motorcyclists in Europe and explores regional differences. Data were collected from the SARTRE-4 (Social Attitudes to Road Traffic Risk in Europe) survey, which was conducted in 19 countries. A total sample of 4483 motorcyclists was interviewed by using a face-to-face questionnaire. The data were analyzed by means of multilevel ordered logit models. The results revealed significant regional differences (between Northern, Eastern and Southern European countries) in drink-riding frequencies in Europe. In general, declared drinking and riding were positively associated with gender (males), increased exposure, underestimation of risk, friends' behaviour, past accidents and alcohol ticket experience. On the other hand, it was negatively associated with underestimation of the amount of alcohol allowed before driving, and support for more severe penalties.

A review of powered-two-wheeler behaviour and safety

Powered-two-wheelers (PTWs) constitute a very vulnerable type of road users. The notable increase in their share in traffic and the high risk of severe accident occurrence raise the need for further research. However, current research on PTW safety is not as extensive as for other road users (passenger cars, etc.). Consequently, the objective of this research is to provide a critical review of research on Power-Two-Wheeler behaviour and safety with regard to data collection, methods of analysis and contributory factors, and discuss the needs for further research. Both macroscopic analyses (accident frequency, accident rates and severity) and microscopic analyses (PTW rider behaviour, interaction with other motorised traffic) are examined and discussed in this paper. The research gaps and the needs for future research are identified, discussed and put in a broad framework. When the interactions between behaviour, accident frequency/rates and severity are co-considered and co-investigated with the various contributory factors (riders, other users, road and traffic environment, vehicles), the accident and injury causes as well as the related solutions are better identified.

Maintenance of Wakefulness Test scores and driving performance in sleep disorder patients and controls

OBJECTIVE

Sleepiness at the wheel is a risk factor for traffic accidents. Past studies have demonstrated the validity of the Maintenance of Wakefulness Test (MWT) scores as a predictor of driving impairment in untreated patients with obstructive sleep apnea syndrome (OSAS), but there is limited information on the validity of the maintenance of wakefulness test by MWT in predicting driving impairment in patients with hypersomnias of central origin (narcolepsy or idiopathic hypersomnia). The aim of this study was to compare the MWT scores with driving performance in sleep disorder patients and controls.

METHODS

19 patients suffering from hypersomnias of central origin (9 narcoleptics and 10 idiopathic hypersomnia), 17 OSAS patients and 14 healthy controls performed a MWT (4×40-minute trials) and a 40-minute driving session on a real car driving simulator. Participants were divided into 4 groups defined by their MWT sleep latency scores. The groups were pathological (sleep latency 0-19 min), intermediate (20-33 min), alert (34-40 min) and control (>34 min). The main driving performance outcome was the number of inappropriate line crossings (ILCs) during the 40 minute drive test.

RESULTS

Patients with pathological MWT sleep latency scores (0-19 min) displayed statistically significantly more ILC than patients from the intermediate, alert and control groups (F (3, 46)=7.47, p<0.001).

INTERPRETATION

Pathological sleep latencies on the MWT predicted driving impairment in patients suffering from hypersomnias of central origin as well as in OSAS patients. MWT is an objective measure of daytime sleepiness that appears to be useful in estimating the driving performance in sleepy patients.

Impairment of simulated motorcycle riding performance under low dose alcohol

Crash statistics that include the blood alcohol concentration (BAC) of vehicle operators reveal that crash involved motorcyclists are over represented at low BACs (e.g., ≤0.05%). This riding simulator study compared riding performance and hazard response under three low dose alcohol conditions (sober, 0.02% BAC, 0.05% BAC). Forty participants (20 novice, 20 experienced) completed simulated rides in urban and rural scenarios while responding to a safety-critical peripheral detection task (PDT). Results showed a significant increase in the standard deviation of lateral position in the urban scenario and PDT reaction time in the rural scenario under 0.05% BAC compared with zero alcohol. Participants were most likely to collide with an unexpected pedestrian in the urban scenario at 0.02% BAC, with novice participants at a greater relative risk than experienced riders. Novices chose to ride faster than experienced participants in the rural scenario regardless of BAC. Not all results were significant, emphasising the complex situation of the effects of low dose BAC on riding performance, which needs further research. The results of this simulator study provide some support for a legal BAC for motorcyclists below 0.05%.