A comparison of the effect of mobile phone use and alcohol consumption on driving simulation performance

Gap acceptance behaviour and crash risks of mobile phone distracted young drivers at roundabouts: A random parameters survival model

Navigating through complex road geometries, such as roundabouts, poses significant challenges and safety risks for drivers. These challenges may be exacerbated when drivers are distracted by mobile phone conversations. The interplay of road geometry, driving state, and driver characteristics in creating compound risks remains an underexplored area in existing literature. Proper understanding of such compound crash risk is not only crucial to improve road geometric design but also to educate young drivers, who are particularly risk-takers and to devise strict penalties for mobile phone usage whilst driving. To fill this gap, this study examines crash risks associated with gap acceptance manoeuvres at roundabouts in the simulated environment of the CARRS-Q driving simulators, where 32 licenced young drivers were exposed to a gap acceptance scenario in three phone conditions: baseline (no phone conversation), handheld, and hands-free. A parametric random parameters survival modelling approach is adopted to understand safety margins-characterised by gap times-during gap acceptance scenarios at roundabouts, concurrently uncover driver-level heterogeneity with mobile phone distraction and capture repeated measures of experiment design. The model specification includes the handheld phone condition as a random parameter and hands-free phone condition, acceleration noise, gap size, crash history, and gender as non-random parameters. Results suggest that the majority of handheld distracted drivers have smaller safety margins, reflecting the negative consequences of engaging in handheld phone conversations. Interestingly, a group of drivers in the same handheld phone condition have been found to exhibit cautious/safer behaviour, as evidenced by longer gap times, reflecting their risk compensation behaviour. Female distracted drivers are also found to exhibit safer gap acceptance behaviour compared to distracted male drivers. The findings of this study shed light on the compound risk of mobile phone distraction and gap acceptance at roundabouts, requiring policymakers and authorities to devise strict penalties and laws for distracted driving.

Drinking and driving: A systematic review of the impacts of alcohol consumption on manual and automated driving performance

INTRODUCTION

Almost a third of car accidents involve driving after alcohol consumption. Autonomous vehicles (AVs) may offer accident-prevention benefits, but at current automation levels, drivers must still perform manual driving tasks when automated systems fail. Therefore, understanding how alcohol affects driving in both manual and automated contexts offers insight into the role of future vehicle design in mediating crash risks for alcohol-impaired driving.

METHOD

This study conducted a systematic review on alcohol effects on manual and automated (takeover) driving performance. Fifty-three articles from eight databases were analyzed, with findings structured based on the information processing model, which can be extended to the AV takeover model.

RESULTS

The literature indicates that different Blood Alcohol Concentration (BAC) levels affect driving skills essential for traffic safety at various information processing stages, such as delayed reacting time, impaired cognitive abilities, and hindered execution of driving tasks. Additionally, the driver's driving experience, drinking habits, and external driving environment play important roles in influencing driving performance.

CONCLUSIONS

Future work is needed to examine the effects of alcohol on driving performance, particularly in AVs and takeover situations, and to develop driver monitoring systems.

PRACTICAL APPLICATIONS

Findings from this review can inform future experiments, AV technology design, and the development of driver state monitoring systems.

Influence of distracted driving of online car-hailing drivers on overall driving performance

The distraction affects driving performance and induces serious safety issues. To better understand distracted driving, this study examines the influence of distracted driving on overall driving performance. This paper analyzes the distraction behavior (mobile phone use, entertainment activities, and passenger interference) under three driving tasks. The statistical results show that viewing or sending messages is common during driving. Smoking, phone calls, and talking to passengers are evident in cruising, ride request and drop-off, respectively. Then, overall driving performance is proposed based on velocity, longitudinal acceleration (longacc) and yaw_rate. It is divided into three categories, high, medium, and low, by k-means algorithms. The average speed increases from low to high performance; however, the longacc and yaw_rate decrease. Finally, the influence of distracted driving on overall driving performance is analyzed using C4.5 algorithm. The result shows that when time is peak, the probability of high performance (HP) is higher than off-peak. The possibility of HP increases with the increase of duration; the number of, talking to passengers, listening to music or radio, eating; the duration of, viewing or sending messages, phone calls; but reduces with the increase of the number of phone calls. These findings provide theoretical support for driving performance evaluation.

Road rule enforcement and where to find it: An investigation of applications used to avoid detection when violating traffic rules

INTRODUCTION

One of the primary countermeasures in place to prevent road rule violations is legal enforcement, yet there are numerous applications that can undermine such efforts by notifying drivers of enforcement locations. However, the capabilities of these applications and how they can impact offending behavior is currently unknown.

METHOD

Two studies were conducted to understand which of these applications are being used by drivers and how these applications are impacting road rule violations. Study 1 consisted of a content analysis that involved searching the Google Play Store and Apple iTunes Store for applications that could be used to avoid road rule violations using pre-determined keywords. Meanwhile, Study 2 consisted of 468 licensed Australian drivers (54.5% males) over the age of 17 years (Mage = 35 years) who completed a survey.

RESULTS

A total of 73 applications were identified for Study 1, with most of the applications displaying speed camera locations. It was found that applications that notify drivers of traffic enforcement locations are widely prevalent, can be used on a variety of interfaces and include numerous additional features. Study 2 found that those who use the applications were more willing to speed than those who do not use the applications, while there was no difference in phone use while driving between those who do and do not use the applications.

PRACTICAL APPLICATIONS

The findings have important implications for stakeholders, policy, and future research. For example, it is suggested that specific functions of these applications need to be regulated to reduce road rule violations and crash risk. Meanwhile, enforcement initiatives need to evolve at a faster rate to keep up to date with the changing technology that can undermine them.

Persistent effects of mobile phone conversation while driving after disconnect: Physiological evidence and driving performance

Cognitive workload has been known as a key factor in traffic accidents, which can be highly increased by talking on the phone while driving. A wide range of studies around the world investigated the effects of mobile phone conversations on driving performance and traffic accidents. But less noticed is the durability of cognitive effects of mobile phone conversations. This study aimed to determine the effects of different types of mobile phone conversations on physiological response and driving performance during and after the conversation. Heart rate, heart rate variability (physiological response), Standard deviation of lane position (SDLP), and the relative distance between two cars (driving performance) of 34 samples (male and female) in the driving simulator were recorded. In this study, three types of conversations (neutral, cognitive, and arousal) were used. Neutral conversation did not pursue specific purpose questions. Cognitive conversations were simple mathematical problem-solving questions and arousal conversations aimed at arousing participant emotions. Each conversation was used as a secondary task in a condition. The study had three conditions; in each condition the participant drove for 15 min. Each condition consisted of 5 min of driving (Background), 5 min of driving and conversation (dual tasks) and 5 min of driving after conversation to trace the effects of the conversation. Vehicle speed was 110 km/h in each of the three conditions using car-following scenario. The results showed that neutral conversations had no significant effects on physiological response. Though, arousal conversations had significant effects on physiological responsiveness and driving performance during conversations, where it was even more significant after disconnection. Therefore, the content of the conversation determines the amount of cognitive load imposed on the driver. Considering the persistence of cognitive effects caused by conversation, the risk of traffic accidents is still high even after disconnection.

Key factors associated with parents' illegal engagement with their smartphones while driving their children

This study aimed to examine the key factors associated with parents' and caregivers' illegal engagement with their smartphones while driving with their children aged 10 years and younger. Five hundred and ten participants completed an online survey (M = 40.4 years, SD = 6.9, Range = 20.0-69.0 years; Female: 79.2%). Most participants reported that they 'never' accessed social media, talked or composed a text on their smartphone (while handheld) while driving with their children (88.0%, 85.3%, and 80.0%, respectively). However, it was interesting to note that more than one-quarter of the sample reported that they had read a text message or used an app on their handheld smartphone while driving their children (36.3%, and 28.6%, respectively). The results of a logistic regression model showed that participants': age, severity of nomophobia (the fear of being without a mobile phone), and self-reported engagement in other risky driving behaviours (i.e., errors, violations) were significantly associated with illegal engagement with their smartphone while driving their child aged 10 years and younger. With the growing prevalence of mobile phone use and the impact of distraction due to child occupants, it is important to consider the compounded effect of these factors on driver performance, as well as the influence of driver risk-taking behaviour while engaging with smartphones and the consequences of this on children who observe this behaviour.

Alcohol impairs driver attention and prevents compensatory strategies

While the negative effects of alcohol on driving performance are undisputed, it is unclear how driver attention, eye movements and visual information sampling are affected by alcohol consumption. A simulator study with 35 participants was conducted to investigate whether and how a driver's level of attention is related to self-paced non-driving related task (NDRT)-engagement and tactical aspects of undesirable driver behaviour under increasing levels of breath alcohol concentration (BrAC) up to 1.0 ‰. Increasing BrAC levels lead to more frequent speeding, short time headways and weaving, and higher NDRT engagement. Instantaneous distraction events become more frequent, with more and longer glances to the NDRT, and a general decline in visual attention to the forward roadway. With alcohol, the compensatory behaviour that is typically seen when drivers engage in NDRTs did not appear. These findings support the theory that alcohol reduces the ability to shift attention between multiple tasks. To conclude, the independent reduction in safety margins in combination with impaired attention and an increased willingness to engage in NDRTs is likely the reason behind increased crash risk when driving under the influence of alcohol.

Distraction "Hangover": Characterization of the Delayed Return to Baseline Driving Risk After Distracting Behaviors

OBJECTIVE

We measured how long distraction by a smartphone affects simulated driving behaviors after the tasks are completed (i.e., the distraction hangover).

BACKGROUND

Most drivers know that smartphones distract. Trying to limit distraction, drivers can use hands-free devices, where they only briefly glance at the smartphone. However, the cognitive cost of switching tasks from driving to communicating and back to driving adds an underappreciated, potentially long period to the total distraction time.

METHOD

Ninety-seven 21- to 78-year-old individuals who self-identified as active drivers and smartphone users engaged in a simulated driving scenario that included smartphone distractions. Peripheral-cue and car-following tasks were used to assess driving behavior, along with synchronized eye tracking.

RESULTS

The participants' lateral speed was larger than baseline for 15 s after the end of a voice distraction and for up to 25 s after a text distraction. Correct identification of peripheral cues dropped about 5% per decade of age, and participants from the 71+ age group missed seeing about 50% of peripheral cues within 4 s of the distraction. During distraction, coherence with the lead car in a following task dropped from 0.54 to 0.045, and seven participants rear-ended the lead car. Breadth of scanning contracted by 50% after distraction.

CONCLUSION

Simulated driving performance drops dramatically after smartphone distraction for all ages and for both voice and texting.

APPLICATION

Public education should include the dangers of any smartphone use during driving, including hands-free.

Texting While Driving: A Literature Review on Driving Simulator Studies

Road safety is increasingly threatened by distracted driving. Studies have shown that there is a significantly increased risk for a driver of being involved in a car crash due to visual distractions (not watching the road), manual distractions (hands are off the wheel for other non-driving activities), and cognitive and acoustic distractions (the driver is not focused on the driving task). Driving simulators (DSs) are powerful tools for identifying drivers' responses to different distracting factors in a safe manner. This paper aims to systematically review simulator-based studies to investigate what types of distractions are introduced when using the phone for texting while driving (TWD), what hardware and measures are used to analyze distraction, and what the impact of using mobile devices to read and write messages while driving is on driving performance. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) guidelines. A total of 7151 studies were identified in the database search, of which 67 were included in the review, and they were analyzed in order to respond to four research questions. The main findings revealed that TWD distraction has negative effects on driving performance, affecting drivers' divided attention and concentration, which can lead to potentially life-threatening traffic events. We also provide several recommendations for driving simulators that can ensure high reliability and validity for experiments. This review can serve as a basis for regulators and interested parties to propose restrictions related to using mobile phones in a vehicle and improve road safety.

Talking on the Phone While Driving: A Literature Review on Driving Simulator Studies

Distracted driving is a growing concern around the world and has been the focus of many naturalistic and simulator-based studies. Driving simulators provide excellent practical and theoretical help in studying the driving process, and considerable efforts have been made to prove their validity. This research aimed to review relevant simulator-based studies focused on investigating the effects of the talking-on-the-phone-while-driving distraction on drivers' behavior. This work is a scoping review which followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines. The search was performed on five databases, covering twenty years of research results. It was focused on finding answers to three research questions that could offer an overview of the main sources of distraction, the research infrastructure, and the measures that were used to analyze and predict the effects of distractions. A number of 4332 studies were identified in the database search, from which 83 were included in the review. The main findings revealed that TPWD distraction negatively affects driving performance, exposing drivers to dangerous traffic situations. Moreover, there is a general understanding that the driver's cognitive, manual, visual, and auditory resources are all involved, to a certain degree, when executing a secondary task while driving.

Smartphone use among anesthesiologists during work hours: A survey-based study

Context:

Smartphone use has revolutionized life in all spheres, including the medical field. Smartphones provide immense opportunities but may also lead to negative consequences due to the element of distraction. In the medical profession and more so among anesthesiologists, multitasking has become very common, but the presence of mind is equally important. This study attempts to analyze the smartphone practices and trends among anesthesiologists during work hours in our country.

Aims:

The study aimed to identify recent trends and practices of smartphone use among anesthesiologists during working hours and its distribution as per designation and institutions. It also intends to determine the purposes of smartphones and their impact on patient care.

Settings and Design:

Online survey consisting of open-ended multiple-choice questions was conducted and circulated as Google Forms via E-mail and WhatsApp.

Subjects and Methods:

This survey was conducted to compare the respondents' views as per designation and workplace distribution. In addition, participants were asked about the current practices in smartphone use at their workplace, purposes of use, time spent on smartphones, and any negative medical consequences faced due to the same.

Statistical Analysis Used:

One-way ANOVA test was used to compare the means between the groups. Chi-square test/Fisher's exact test was used to compare the proportions.

Results:

Two hundred and sixteen (54%) were resident doctors, whereas 184 (46%) were consultants. Most of the respondents were young, with a mean age around 36 years. 31.5% of the residents used smartphones very often during anesthetized patient care compared to 10.3% of the consultants. Purposes of using smartphones were multiple, with phone calls (100%) being the most common followed by WhatsApp messaging (79.2%). 86.1% of the residents, as compared to 61% of the consultants, had anesthesia/intensive care unit-related apps on their smartphones. There was almost an equivocal response to how the smartphone has impacted patient care. 50.9% of the residents and 43% of the consultants felt improved patient care, whereas 38% of the residents and 43.5% of the consultants believed it had worsened.

Conclusion:

There was no clear-cut consensus whether smartphone use improved or worsened patient care. On the one hand, there can be distractions leading to adverse medical consequences, while on the other hand, the use of medical apps has been made possible because of the handy and easily accessible smartphones. Thus, the use of smartphones may be carried out with a sense of responsibility by the anesthesiologists during work hours.

Alcohol and Alcohol Combined with Texting: Evaluation of Driving Impairment Effects in a Closed-Course Section

OBJECTIVE

Examine the driving impairment effects of alcohol alone and of alcohol combined with texting.

METHODS

Fifteen drivers (nine male, six female; mean age: 31.1 ± 6.9 years, range: 23 to 43 years) with similar drinking habit (i.e., social drinkers) completed a lap in a closed-course section in six different situations: (I) sober; (II) sober and while texting; (III) 30 minutes after ingesting a moderate dose of ethanol (0.50 g/kg); (IV) 30 minutes after drinking and while texting; (V) 60 minutes after drinking, (VI) 60 minutes after drinking and while texting. Driving performance was analyzed by means of maximum and mean speed, braking time and braking distance; and ability to control the car (i.e., evaluating if the drivers hit a traffic cone or exceeded the boundaries of the course). P values of < 0.05 were considered significant.

RESULTS

Pre and post-alcohol consumption results show a significant increase concerning the drivers' mean and maximum speed after drinking (p < 3.2x10^-8). However, neither alcohol nor texting had significant effects on braking parameters (p > 0.05). Traffic cones were knocked down only in texting experiments. In addition, when using the cell phone drivers tended to reduce the speed, and to accelerate abruptly right after they finish texting.

CONCLUSION

Our findings strengthen the hypothesis that even moderate alcohol doses may significantly impair the driving performance. Additionally, alcohol and texting have complementary effects on driving impairment, and their combination represents a significant risk factor for crashes.

Examining the relationship between poor sleep health and risky driving behaviors among college students

Objective: Risky driving behaviors, such as texting while driving, are common among young adults and increase risk of traffic accidents and injuries. We examine the relationship between poor sleep and risky driving behaviors among college students as potential targets for traffic injury prevention.Methods: Data for this study were obtained from a cross-sectional survey administered to a college student sample in the United States Midwest (n = 1,305). Sleep was measured using the Pittsburgh Sleep Quality Index (PSQI). Risky driving behaviors were measured, including sending texts/emails; reading texts/emails while driving; talking on the phone while driving; falling asleep while driving; and driving under the influence. Risky driving behavior was defined as a response of "just once," "rarely," "sometimes," "fairly often" or "regularly" (reference = "never"). Logistic regression was used to examine the relationship between sleep and risky driving, after adjusting for confounders.Results: Among participants, 75% reported sending texts/emails while driving, 82% reported reading texts/emails while driving, and 84% reported phone talking while driving; 20% reported falling asleep while driving; 8% reported driving under the influence; and 62% reported 3 or more risky behaviors. Compared to those reporting no sleep disturbance, those with sleep disturbance "once or twice a week" were more likely to report sending a text/email while driving (aOR: 2.9, 95%CI:1.7-4.9), reading a text/email while driving (aOR:3.1,95%CI:1.5-5.5), talking on the phone while driving (aOR:1.9, 95%CI:1.0-3.4), and falling asleep while driving (aOR:3.4,95%CI:1.5-7.4). Compared to those reporting no daytime dysfunction, those reporting issues "once or twice a week" were more likely to report talking on the phone while driving (aOR:1.7, 95%CI:1.1-2.7) and falling asleep while driving (aOR:3.6,95%CI:2.3-5.6).Conclusions: Future research may consider designing behavioral interventions that aim to improve sleep, reduce drowsy driving among young adults.

Modeling the influence of 0.03%, 0.05% and 0.08% blood alcohol concentrations on lane positioning and steering control of Indian drivers

OBJECTIVE

Alcohol-impairment of drivers has significant influence on road traffic safety; however, no experimental research has been conducted on the lateral driving control of Indian drivers. Therefore, the present study investigates the effects of different Blood Alcohol Concentration (BAC) levels (0%, 0.03%, 0.05% and 0.08%) and driver attributes on the lane positioning and steering control of Indian drivers.

METHOD

A driving simulator experiment was designed where 82 adult licensed drivers (62 males, 20 females) completed driving on the simulated urban arterial road environment under the influence of varying BACs. Lateral driving performance measures associated with lane positioning (lane position variability) and steering control of drivers (steering angle variability and steering reversal rates (SRR)) were analyzed.

RESULTS

The findings reported that lane position variability was significantly influenced only at 0.08% BAC (5.8% increment); no significant influence was observed at 0.03% and 0.05% BACs. Compared to 0% BAC, steering angle variability increased by 0.105 degrees or 15.7%, 0.142 degrees or 21.4%, and 0.176 degrees or 25.7% at 0.03%, 0.05% and 0.08% BACs respectively. No significant differences were observed between the sober-state driving and alcohol-impaired driving at 1^ο and 5^ο SRR. However, 10^ο SRR was found to be higher by 36%, 65% and 92% at 0.03%, 0.05% and 0.08% BACs compared to 0% BAC. Among the driver attributes, male drivers displayed higher impairment in lane positioning behavior as compared to female drivers. One-year increase in drivers' age reduced the lane position variability by 0.6%. Drivers who performed regular physical exercise were found to have better lateral control on the vehicle, as observed in their steering angle variability. Prior crash history had negative association with the steering reversal rates, indicating that drivers who have previous experience of crash involvement show better steering control than the drivers without any crash experience.

CONCLUSION

In conclusion, the outcomes of this study provide novel insights into the alcohol-impaired lateral vehicle control of Indian drivers which can assist in policy interventions aiming to reduce crashes with alcohol as a major crash causation factor.

Characteristics of driver cell phone use and their influence on driving performance: A naturalistic driving study

Cell phone use while driving is becoming a key problem in traffic safety as it causes visual-manual distraction and has been linked to increases in crash rates. The use of hand-held phones has been banned in several countries, yet research comparing the safety of hands-free phone use with hand-held has produced inconsistent results. Analysis of specific phone use characteristics could help move this traffic safety problem toward a solution, but few studies have considered the influence on driving performance of specific sets of phone use characteristics in combination with other factors such as driving context and driver demographic characteristics. The main objective of this paper is therefore to identify and analyze these factors to determine their effects on driving performance indicators such as speed changes. To this end, 1244 phone events were collected from 52 drivers from the Shanghai Naturalistic Driving Study (SH-NDS), the first naturalistic driving data in China. Because subtasks within a phone event may cause different visual-manual distractions, a hierarchical coding structure for phone events was built. A total of 5662 eyes-off-road (EOR) cases and 4237 subtasks were extracted. The results showed that on average, the participating drivers used the phone for 6.08 % of their driving time; for 17 % of phone use time, drivers used both hands to manipulate the phone; and their average EOR time was 3.16 s, which is equivalent to driving blindly for 22.82 m at an average speed of 7.22 m/s, or 26 km/hr. The effect of phone use on driving performance, including speed, headway, and lane offset, was analyzed with ANOVA. Results showed that standard deviations (SD) of all three parameters were significantly lower during phone periods than during baseline periods. The speed SD during phone use was 0.95 lower than baseline, the headway SD was 2.48 lower, and the absolute lane offset SD was 685.72 lower than baseline. These lower SDs indicate that drivers operated their vehicles with less fluctuation during phone use. While we were unable to find similar differences in mean speed and mean headway, mean lane offset was also significantly lower with phone use than without. A decision tree was developed to identify the factors influencing driver speed change. Results showed that drivers increased, decreased, or maintained speed depending on the type and duration of phone tasks, the duration of the trip, and the type of roadway. Greater understanding of the specific aspects of phone use and their influences on driver distraction and performance will permit the development of more effective countermeasures, including legislation, enforcement, blocking technologies, social norms education, and sending Do Not Disturb messages to callers, all of which will be required to mitigate continued deaths and injuries from phone use while driving.

An assessment of the centrally acting muscle relaxant tolperisone on driving ability and cognitive effects compared to placebo and cyclobenzaprine

WHAT IS KNOWN AND OBJECTIVE

Tolperisone is a centrally acting muscle relaxant under development in the United States as a treatment for acute and painful symptoms of muscle spasms. The objective of this three-way, randomized, blinded, three-period crossover study was to assess the safety and cognitive effects of tolperisone compared to placebo and the widely used muscle relaxant cyclobenzaprine in healthy volunteers.

METHODS

Subjects were randomized to 1 of 3 treatment arms to receive tolperisone (150 mg), cyclobenzaprine (10 mg) or placebo 3 times per day (TID) in 3 separate study periods. Subjects completed a driving test on the Cognitive Research Corporation's Driving Simulator (CRCDS Mini-Sim), a validated driving simulator, on day 1 at time to maximum plasma concentration, on day 2 before the morning dose of study drug and on day 3 at steady state following the morning dose. Subjects were assessed on various driving parameters and on a computer-administered digit-symbol substitution test (CogScreen symbol digit coding test). The driving scenario is a monotonous 100 km highway route on which subjects are instructed to maintain speed and lane position.

RESULTS AND DISCUSSION

The performance of subjects who had received tolperisone was not significantly different from those who had received placebo in terms of the primary end point: standard deviation of lateral position, a measure of weaving. Subjects who had received tolperisone also performed comparably to those who had received placebo on a range of secondary measures assessing driving ability, cognition and psychomotor performance. In contrast, subjects who had received cyclobenzaprine showed significant impairment compared to placebo (P < .01) on the primary end point of standard deviation of lateral position and on the majority of the secondary end points of driving ability. Despite their markedly poorer driving performance after receiving cyclobenzaprine, few subjects reported feeling unsafe to drive on day 1 (10.3%) and day 2 (3.4%). The incidence of adverse events was similar for tolperisone (36.4%) and placebo (29.0%) and was greater for cyclobenzaprine (45.4%).

WHAT IS NEW AND CONCLUSION

Subjects who received tolperisone (150 mg TID) experienced no impact on various measures of driving, self-reported sleepiness and cognition measures compared to placebo, in contrast to those who received the widely used muscle relaxant cyclobenzaprine (10 mg TID).

Evaluating the causal effects of cellphone distraction on crash risk using propensity score methods

INTRODUCTION/OBJECTIVE

This paper evaluates the causal effects of cellphone distraction on traffic crashes using propensity score weighting approaches and naturalistic driving study (NDS) data.

METHODS

We adopt three propensity score weighting approaches to estimate the causal odds ratio (OR) of cellphone use on three different event-populations, including average treatment effect (ATE) on the whole population, average treatment effect on the treated population (ATT), and average treatment effect on the overlapping population (ATO). Three types of cellphone distractions are evaluated: overall cellphone use, talking, and visual-manual tasks. The propensity scores are estimated based on driver, roadway, and environmental characteristics. The Second Strategic Highway Research Program NDS data used in this study include 3400 participant drivers with 1047 severe crashes and 19,798 random case-cohort control driving segments.

RESULTS

The study reveals several highly imbalanced potential confounding factors among cellphone use groups, e.g., income, age, and time of day, which could lead to biased risk estimation. All three propensity score approaches improve the balance of the baseline characteristics. The propensity score adjusted ORs differ from unweighted ORs substantially, ranging from -44.25% to 54.88%. Specifically, the adjusted ORs for young drivers are higher than unweighted ORs and these for middle-age drivers are lower. Among different cellphone related distractions, the ORs associated with visual-manual tasks (OR range: 3.47-6.63) are uniformly higher than overall cellphone distraction and cellphone talking (OR range: 0.63-4.15). Cellphone talking increases the risk for young drivers but has no significant impact on middle-age drivers.

CONCLUSION

Propensity score approaches effectively mitigate potential confounding effect caused by imbalanced driver environmental characteristics in the observational NDS data. The ATT and ATO estimands are recommended for NDS case-cohort studies. ATT reflects the effect among exposed events, i.e. crashes or controls with cellphone exposure and ATO reflects the effect among events with similar characteristics. The study confirms the significant causal effect of overall cellphone distraction on crash risk and the heterogeneity in safety impact by age group.

Gender differences in driving control of young alcohol-impaired drivers

BACKGROUND

Male and female drivers exhibit different degrees of vehicle control while driving under the influence of alcohol. However, this interaction between alcohol and gender is understudied. The present study examined the effects of different alcohol levels on the driving control of male and female drivers with the help of driving simulator experiments in heterogeneous traffic conditions.

METHOD

Forty young drivers (20 males and 20 females) completed simulated driving at four Blood Alcohol Concentration (BAC) levels: 0% (control), 0.03%, 0.05% and 0.08%. Driving impairment in vehicle control was measured in terms of average speed, acceleration variability and reaction time of drivers. Repeated-measures ANOVA tests were conducted and regression models were developed for male and female drivers to quantify the effects of BAC levels and driver characteristics on the driving control measures.

RESULTS

Significant effects of gender were observed for average speed (p <  0.001) and acceleration variability (p = 0.015) but not for reaction time of drivers (p =  0.891). Further, the effect of BAC was significant in all the three measures of vehicle control (p <  0.001). Driving control improved with increasing age of male drivers while caffeine consumption was observed as an alcohol-antagonizing factor in female drivers.

CONCLUSION

The findings suggest that vehicle control of female drivers is more likely to get affected even at low BAC levels, providing evidence that they belong to critical section of driving community in terms of alcohol-related impairment. The findings may help in discouraging drinking and driving among male and female drivers.

Tracing the physiological response and behavioral performance of drivers at different levels of mental workload using driving simulators

INTRODUCTION

The use of mobile phones while driving is known to be a distraction factor and a cause of accidents. The way in which different kinds of conversations affect the behavioral performance of the driver as well as the persistence of the effects are not yet fully understood.

METHOD

In this study, in addition to comparing brain function and behavioral function in dual task conditions in three conversations types, the persistent effects of these types of conversations have also been traced.

RESULTS

The results show that the content of the mobile phone conversation while driving is the cause of the persistent changes in behavioral and brain functions. Increased time headway and lane departure was observed during and up to 5 min after the emotional conversation was finished. EEG bands also varied in different types of conversations. Cognitive conversations caused an increase in the activity of the alpha and beta bands while emotional conversations enhanced the rate of gamma and beta bands. A meaningful correlation was found between changes in the theta and alpha bands and changes in behavioral performance both during the dual task condition and after the conversation was finished, was also observed.

CONCLUSIONS

The content of the conversation is one of the most important factors that increase the risk of road accidents. This can also deteriorate the behavioral performance of the driver and can have persistent effects on behavioral performance and the brain. Practical applications: The findings of this study provide a basis to measure and tracing drivers' cognitive distractions induced by different levels of mental workload through physiological and behavioral performances.

Laboratory analysis of driving behavior and self-perceived physiological impairment at 0.03%, 0.05% and 0.08% blood alcohol concentrations

BACKGROUND

Alcohol-impaired driving is a critical factor leading to traffic crashes worldwide. Since decades, researchers from the developed nations have been investigating the effects of alcohol intoxication on their drivers. However, alcohol effects on the drivers of developing counties remain understudied. The extent of alcohol impairment may vary among the drivers of developed and developing nations due to the differences in drivers' physiology, driving conditions, drinking habits, policy enforcement and driving attitude.

METHODS

This study examined the effects of different Blood Alcohol Concentration (BAC) levels (0%, 0.03%, 0.05%, and 0.08%) on 75 licensed Indian drivers (56 males and 19 females) with the help of a fixed-base driving simulator. Subjects completed driving simulations for all the BAC levels in a driving environment representing heterogeneous traffic conditions. Performance measures included longitudinal and lateral driving control indicators (obtained from simulator) along with the self-reported physiological changes in the drivers (obtained from questionnaire) with varying BAC levels.

RESULTS

Mean speed was the only performance measure significantly affected at 0.03% BAC. At 0.05% BAC, mean speed and mean steering wheel angle were the two significantly impaired measures. At 0.08% BAC, all the driving performance measures showed significant impairment except steering wheel angle variability. Physiological characteristics of drivers deteriorated with rising BAC levels.

CONCLUSIONS

Alcohol significantly impaired the physiology of Indian drivers resulting in impairment in their driving performance. Mean speed was the only performance measure significantly affected by all the BAC levels, making it a suitable parameter to detect the alcohol-impaired state of the drivers.

Quantifying driver cell phone use at signalized intersections using software-defined radio

Objective: This article outlines a data collection process that quantifies driver cell phone use using a software-defined radio (SDR) at a signalized intersection. Cell phone use while driving has been shown to be factor that increases the risk of a crash incident. Both operational and enforcement strategies can be applied at locations where high driver cell phone use is identified. Methods: A baseline driver cell phone use observation was made at the intersection, where 9,699 vehicles were observed at the intersection of Carlton Road and State Route 31 (Pennington Road) in Ewing, New Jersey. An SDR cell phone detection device created as part of this study was then deployed at the same intersection to determine whether the SDR device could detect an active cell phone signal. The identification of vehicle cell phone activity using the SDR was conducted a sample of 4,000 vehicles. A visual observation, along with a motion detection camera, was made alongside the SDR to visually confirm cell phones use. Results: Of the 4,000 vehicles sampled using the SDR cell phone detection device, 6.1% of the a.m. peak travel time and 7.6% of the p.m. peak travel time had an active cellular device. A concurrent visual field verification of driver cell phone use showed that approximately 57% (a.m. peak) and 67% (p.m. peak) of the SDR-detected cell phones were visually confirmed to be associated with distracted cell phone use. Conclusions: Once characterized, the frequency of driver cell phone use can be used to justify changes to signal timing protocols. These adjustments could include extending the signal's "all-red time" or holding "yellow time" longer in order to properly clear the intersection. These data can also be used to identify locations that may require more enforcement measures to dissuade driver cell phone use. Furthermore, the impact of anti-cell phone campaigns or new laws can be quantified by measuring before and after cell phone use in the near term rather than waiting for crash studies at intersections to be completed and analyzed.

Does Talking on a Cell Phone, With a Passenger, or Dialing Affect Driving Performance? An Updated Systematic Review and Meta-Analysis of Experimental Studies

Objective An up-to-date meta-analysis of experimental research on talking and driving is needed to provide a comprehensive, empirical, and credible basis for policy, legislation, countermeasures, and future research. Background The effects of cell, mobile, and smart phone use on driving safety continues to be a contentious societal issue. Method All available studies that measured the effects of cell phone use on driving were identified through a variety of search methods and databases. A total of 93 studies containing 106 experiments met the inclusion criteria. Coded independent variables included conversation target (handheld, hands-free, and passenger), setting (laboratory, simulation, or on road), and conversation type (natural, cognitive task, and dialing). Coded dependent variables included reaction time, stimulus detection, lane positioning, speed, headway, eye movements, and collisions. Results The overall sample had 4,382 participants, with driver ages ranging from 14 to 84 years ( M = 25.5, SD = 5.2). Conversation on a handheld or hands-free phone resulted in performance costs when compared with baseline driving for reaction time, stimulus detection, and collisions. Passenger conversation had a similar pattern of effect sizes. Dialing while driving had large performance costs for many variables. Conclusion This meta-analysis found that cell phone and passenger conversation produced moderate performance costs. Drivers minimally compensated while conversing on a cell phone by increasing headway or reducing speed. A number of additional meta-analytic questions are discussed. Application The results can be used to guide legislation, policy, countermeasures, and future research.

Doctors' use of mobile devices in the clinical setting: a mixed methods study

BACKGROUND

Mobile device use has become almost ubiquitous in daily life and therefore includes use by doctors in clinical settings. There has been little study as to the patterns of use and impact this has on doctors in the workplace and how negatively or positively it impacts at the point of care.

AIM

To explore how doctors use mobile devices in the clinical setting and understand drivers for use.

METHODS

A mixed methods study was used with doctors in a paediatric and adult teaching hospital in 2013. A paper-based survey examined mobile device usage data by doctors in the clinical setting. Focus groups explored doctors' reasons for using or refraining from using mobile devices in the clinical setting, and their attitudes about others' use.

RESULTS

The survey, completed by 109 doctors, showed that 91% owned a smartphone and 88% used their mobile devices frequently in the clinical setting. Trainees were more likely than consultants to use their mobile devices for learning and accessing information related to patient care, as well as for personal communication unrelated to work. Focus group data highlighted a range of factors that influenced doctors to use personal mobile devices in the clinical setting, including convenience for medical photography, and factors that limited use. Distraction in the clinical setting due to use of mobile devices was a key issue. Personal experience and confidence in using mobile devices affected their use, and was guided by role modelling and expectations within a medical team.

CONCLUSION

Doctors use mobile devices to enhance efficiency in the workplace. In the current environment, doctors are making their own decisions based on balancing the risks and benefits of using mobile devices in the clinical setting. There is a need for guidelines around acceptable and ethical use that is patient-centred and that respects patient privacy.

Mobile phone use during driving: Effects on speed and effectiveness of driver compensatory behaviour

This study analysed and modelled the effects of conversation and texting (each with two difficulty levels) on driving performance of Indian drivers in terms of their mean speed and accident avoiding abilities; and further explored the relationship between speed reduction strategy of the drivers and their corresponding accident frequency. 100 drivers of three different age groups (young, mid-age and old-age) participated in the simulator study. Two sudden events of Indian context: unexpected crossing of pedestrians and joining of parked vehicles from road side, were simulated for estimating the accident probabilities. Generalized linear mixed models approach was used for developing linear regression models for mean speed and binary logistic regression models for accident probability. The results of the models showed that the drivers significantly compensated the increased workload by reducing their mean speed by 2.62m/s and 5.29m/s in the presence of conversation and texting tasks respectively. The logistic models for accident probabilities showed that the accident probabilities increased by 3 and 4 times respectively when the drivers were conversing or texting on a phone during driving. Further, the relationship between the speed reduction patterns and their corresponding accident frequencies showed that all the drivers compensated differently; but, among all the drivers, only few drivers, who compensated by reducing the speed by 30% or more, were able to fully offset the increased accident risk associated with the phone use.

Effects of acute alcohol consumption on measures of simulated driving: A systematic review and meta-analysis

Driving simulators are used in a wide range of research settings to help develop an understanding of driver behavior in complex environments. Acute alcohol impairment is an important research topic for traffic safety and a large number of studies have indicated levels of simulated driving impairment imposed by alcohol across a range of performance outcome variables. The aim of the present study was to examine the impact of acute alcohol consumption on simulated driving performance by conducting a systematic review and meta-analysis of the available evidence. The online databases PubMed (MEDLINE), Web of Science (via Thomas Reuters) and Scopus were searched to identify studies that measured simulated car driving performance under control ('no alcohol' or 'placebo alcohol' ingestion) and intervention (acute alcohol ingestion) conditions, using repeated-measures experimental designs. Primary research outcomes were standard deviation of lane position (SDLP) and standard deviation of speed (SDSP); (total number of lane crossings (LC) and average speed (Speed) were secondary research outcomes). Meta-analytic procedures were used to quantify the effect of acute alcohol consumption on vehicle control, and to determine the influence of methodological variables (i.e. the duration of the simulated driving task, the limb of the BAC curve (ascending vs. descending) and the type of driving simulator employed (i.e. car vs. PC-based)) on the magnitude of the performance change due to alcohol consumption. 423 records were screened, and 50 repeated-measures trials (n=962 participants, 62% male) derived from 17 original publications were reviewed. 37 trials (n=721 participants) used a 'placebo alcohol' comparator to determine the effect of alcohol consumption on SDLP (32/37) and SDSP (22/37). Alcohol consumption significantly increased SDLP by 4.0±0.5cm (95% CI: 3.0, 5.1) and SDSP by 0.38±0.10km⋅h^-1 (95% CI: 0.19, 0.57). Regression analyses indicate BAC (p=0.004) and driving simulator platform (p<0.001) influence the magnitude of the SDLP change, such that higher BAC levels and the use of PC-based driving simulators were associated with larger performance decrements (R²=0.80). The limb of the BAC curve and the duration of the driving task did not significantly alter the magnitude of the performance change. Eleven trials (n=205 participants) used a 'no alcohol' comparator to measure the effect of alcohol consumption on SDLP (10/11); few trials assessed SDSP (3/11). Alcohol consumption resulted in a small significant increase in SDLP under these conditions (standardized difference in means=0.23, 95% CI: 0.06, 0.39). These results demonstrate that lateral (SDLP and LC) and longitudinal (SDSP) vehicle control measures in a driving simulator are impaired with acute alcohol consumption. However, SDLP appears to be a more sensitive indicator of driving impairment than other driving performance variables and the results of the present study support its use as a performance outcome when examining alcohol-induced simulated driving impairment.

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.

The dangers of rumination on the road: Predictors of risky driving

Past studies found many different types of factors can influence dangerous driving behaviors. Driver inattention, such as driving under the influence or using a cell phone while driving, was found to contribute to risky driving behaviors. Rumination is a cognitive process that may also contribute to risky driving behaviors due to its influence on attention and limited executive processes. The present study explores the potential role of rumination in dangerous driving behavior endorsement. It was hypothesized that trait rumination would be significantly related to dangerous driving behaviors and that this relationship would be conditional to the sex of the participant. Six-hundred and fifty-three Southeastern university students were recruited to participate and asked to complete multiple questionnaires measuring anger rumination, thought content, driving anger, and dangerous driving behaviors. It was demonstrated that self-reported risky driving behaviors significantly predicted dangerous driving behavior endorsement on the Dula Dangerous Driving Index. Trait rumination scores were found to predict self-reported dangerous driving, aggressive driving, and risky driving behaviors as well as trait driving anger scores. However, no conditional effects based on the sex of the participant were found. It appeared males and females were equally likely to report dangerous driving behaviors, driving anger thoughts, and trait anger rumination. Findings from the current study may assist in understanding how cognitive processes influence different driving behaviors and help develop methods to re-direct attention to safe driving behaviors, and conversely away from ruminative thoughts that increase the likelihood of dangerous driving.

Using alcohol intoxication goggles (Fatal Vision® goggles) to detect alcohol related impairment in simulated driving

OBJECTIVE

Fatal vision goggles (FVGs) are image-distorting equipment used within driver education programs to simulate alcohol-related impairment. However, there is no empirical evidence comparing the behavioral effects associated with wearing FVGs to alcohol intoxication. The purpose of this study was to determine the validity of FVGs in producing alcohol-related impairment in simulated driving.

METHODS

Twenty-two healthy males (age: 23 ± 3 years, mean ± SD) participated in a placebo-controlled crossover design study involving 4 experimental trials. In each trial, participants completed a baseline level simulated driving task followed by an experimental driving task, involving one of 4 treatments: (1) a dose of alcohol designed to elicit 0.080% breath alcohol concentration (BrAC; AB), (2) an alcohol placebo beverage (PB), (3) FVG (estimated % blood alcohol concentration [BAC] 0.070-0.100+), and (4) placebo goggles (PGs). The driving tasks included 3 separate scenarios lasting ∼5 min each; these were a simple driving scenario, a complex driving scenario, and a hazard perception driving scenario. Selected lateral control parameters (standard deviation of lane position [SDLP]; total number of lane crossings [LCs]) and longitudinal control parameters (average speed; standard deviation of speed [SDSP]; distance headway; minimum distance headway) were monitored during the simple and complex driving scenarios. Latency to 2 different stimuli (choice reaction time [CRT]) was tested in the hazard perception driving scenario. Subjective ratings of mood and attitudes toward driving were also provided during each of the trials.

RESULTS

Neither placebo treatment influenced simulated driving performance. Mean BrAC was 0.060 ± 0.010% at the time of driving on the AB trial. Lateral control: In the simple driving scenario, SDLP and LC were not affected under any of the experimental treatments. However, in the complex driving scenario, significantly greater SDLP was observed on both the FVG and AB trials compared to their respective baseline drives. LC increased significantly from baseline on the AB trial only. Longitudinal control: Speed was not affected by any of the experimental treatments; however, SDSP increased significantly from baseline on the FVG trial. A significant reduction in distance headway and minimum distance headway was detected on the FVG trial compared to baseline. Hazard perception: Neither AB nor FVG trials were influential on CRT. Subjective mood ratings were significantly altered on the AB and FVG trials compared to baseline and placebo conditions. Participants reported reduced willingness and ability to drive under the active treatments (AB and FVG) than the placebo treatments (PB and PG).

CONCLUSIONS

FVGs may have some utility in replicating alcohol-related impairment on specific driving performance measurements. Hence, the equipment may offer an alternative approach to researching the impact of alcohol intoxication on simulated driving performance among populations where the provision of alcohol would otherwise be unethical (e.g., prelicensed drivers).

Texting while driving: the development and validation of the distracted driving survey and risk score among young adults

BACKGROUND

Texting while driving and other cell-phone reading and writing activities are high-risk activities associated with motor vehicle collisions and mortality. This paper describes the development and preliminary evaluation of the Distracted Driving Survey (DDS) and score.

METHODS

Survey questions were developed by a research team using semi-structured interviews, pilot-tested, and evaluated in young drivers for validity and reliability. Questions focused on texting while driving and use of email, social media, and maps on cellular phones with specific questions about the driving speeds at which these activities are performed.

RESULTS

In 228 drivers 18-24 years old, the DDS showed excellent internal consistency (Cronbach's alpha = 0.93) and correlations with reported 12-month crash rates. The score is reported on a 0-44 scale with 44 being highest risk behaviors. For every 1 unit increase of the DDS score, the odds of reporting a car crash increases 7 %. The survey can be completed in two minutes, or less than five minutes if demographic and background information is included. Text messaging was common; 59.2 and 71.5 % of respondents said they wrote and read text messages, respectively, while driving in the last 30 days.

CONCLUSION

The DDS is an 11-item scale that measures cell phone-related distracted driving risk and includes reading/viewing and writing subscores. The scale demonstrated strong validity and reliability in drivers age 24 and younger. The DDS may be useful for measuring rates of cell-phone related distracted driving and for evaluating public health interventions focused on reducing such behaviors.

Smartphone use habits of anesthesia providers during anesthetized patient care: a survey from Turkey

Background

Smartphones are used in many areas of anesthesia practice. However, recent editorial articles have expressed concerns about smartphone uses in the operating room for non-medical purposes. We performed a survey to learn about the smartphone use habits and views of Turkish anesthesia providers.

Methods

A questionnaire consisting of 14 questions about smartphone use habits during anesthesia care was sent anesthesia providers.

Results

In November-December 2015, a total of 955 participants answered our survey with 93.7 % of respondents responding that they used smartphones during the anesthetized patient care. Phone calls (65.4 %), messaging (46.4 %), social media (35.3 %), and surfing the internet (33.7 %) were the most common purposes. However, 96.7 % of respondents indicated that smartphones were either never or seldom used during critical stages of anesthesia. Most respondents (87.3 %) stated that they were never distracted because of smartphone use; however, 41 % had witnessed their collagues in such a situation at least once.

Conclusions

According to the results of the survey, smartphones are used in the operating room often for non-medical purposes. Distraction remains a concern but evidence-based data on whether restrictions to smartphone use are required are not yet available.

The Legal Limit: Differences in Injury Severity Score for Vehicular Crashes

In 2013, the National Transportation Safety Board advised lawmakers in the United States to reduce the legal limit of blood alcohol content (BAC) from 0.08% to 0.05%. The purpose of this research was to evaluate the rationale for reducing the legal limit of BAC to 0.05% through analysis of the relationship between BAC and injury severity. A correlational study was conducted on patients with positive BAC involved in a motor vehicular collision. Retrospective review of 446 trauma patients (aged 18-80 years) injured in a vehicular collision routinely screened for BAC was conducted. Two groups were compared: Group 1, patients with nonzero blood alcohol concentration (n = 101); and Group 2, patients with zero blood alcohol (n = 345). Standard statistical analyses were utilized. A total of 101 patients (23%) had a detectable BAC on admission. Patients with a detectable BAC were younger (33 and 44 years) and more likely to be male (27% and 16%). There was no statistically significant association between both injury severity score (ISS) and BAC or between ISS and age. There was no significant correlation between higher BAC and a higher ISS. Positive BAC alone may not affect ISS, but the potential for risk-taking behaviors by drivers under the influence may increase injury severity.

Simulator study of young driver's instinctive response of lower extremity to a collision

OBJECTIVE

A driver's instinctive response of the lower extremity in braking movement consists of two parts, including reaction time and braking reaction behavior. It is critical to consider these two components when conducting studies concerning driver's brake movement intention and injury analysis. The purposes of this study were to investigate the driver reaction time to an oncoming collision and muscle activation of lower extremity muscles at the collision moment. The ultimate goal is to provide data that aid in both the optimization of intervention time of an active safety system and the improvement of precise protection performance of a passive safety system.

METHOD

A simulated collision scene was constructed in a driving simulator, and 40 young volunteers (20 male and 20 female) were recruited for tests. Vehicle control parameters and electromyography characteristics of eight muscles of the lower extremity were recorded. The driver reaction time was divided into pre-motor time (PMT) and muscle activation time (MAT). Muscle activation level (ACOL) at the collision moment was calculated and analysed.

RESULTS

PMT was shortest for the tibialis anterior (TA) muscle (243∼317 ms for male and 278∼438 ms for female). Average MAT of the TA ranged from 28-55 ms. ACOL was large (5∼31% for male and 5∼23% for female) at 50 km/h, but small (<12%) at 100 km/h. ACOL of the gluteus maximus was smallest (<3%) in the 25 and 100 km/h tests. ACOL of RF of men was significantly smaller than that of women at different speeds.

CONCLUSIONS

Ankle dorsiflexion is firstly activated at the beginning of the emergency brake motion. Males showed stronger reaction ability than females, as suggested by male's shorter PMT. The detection of driver's brake intention is upwards of 55ms sooner after introducing the electromyography. Muscle activation of the lower extremity is an important factor for 50 km/h collision injury analysis. For higher speed collisions, this might not be a major factor. The activations of certain muscles may be ignored for crash injury analysis at certain speeds, such as gluteus maximus at 25 or 100 km/h. Furthermore, the activation of certain muscles should be differentiated between males and females during injury analysis.

The sensitivity of laboratory tests assessing driving related skills to dose-related impairment of alcohol: A literature review

Laboratory tests assessing driving related skills can be useful as initial screening tools to assess potential drug induced impairment as part of a standardized behavioural assessment. Unfortunately, consensus about which laboratory tests should be included to reliably assess drug induced impairment has not yet been reached. The aim of the present review was to evaluate the sensitivity of laboratory tests to the dose dependent effects of alcohol, as a benchmark, on performance parameters. In total, 179 experimental studies were included. Results show that a cued go/no-go task and a divided attention test with primary tracking and secondary visual search were consistently sensitive to the impairing effects at medium and high blood alcohol concentrations. Driving performance assessed in a simulator was less sensitive to the effects of alcohol as compared to naturalistic, on-the-road driving. In conclusion, replicating results of several potentially useful tests and their predictive validity of actual driving impairment should deserve further research. In addition, driving simulators should be validated and compared head to head to naturalistic driving in order to increase construct validity.

Distracted Driving, A Major Preventable Cause of Motor Vehicle Collisions: "Just Hang Up and Drive"

For years, public health experts have been concerned about the effect of cell phone use on motor vehicle collisions, part of a phenomenon known as “distracted driving.” The Morbidity and Mortality Weekly Report (MMWR) article “Mobile Device Use While Driving - United States and Seven European Countries 2011” highlights the international nature of these concerns. Recent (2011) estimates from the National Highway Traffic Safety Administration are that 10% of fatal crashes and 17% of injury crashes were reported as distraction-affected. Of 3,331 people killed in 2011 on roadways in the U.S. as a result of driver distraction, 385 died in a crash where at least one driver was using a cell phone. For drivers 15–19 years old involved in a fatal crash, 21% of the distracted drivers were distracted by the use of cell phones. Efforts to reduce cell phone use while driving could reduce the prevalence of automobile crashes related to distracted driving. The MMWR report shows that there is much ground to cover with distracted driving. Emergency physicians frequently see the devastating effects of distracted driving on a daily basis and should take a more active role on sharing the information with patients, administrators, legislators, friends and family.

Effects of alcohol on automated and controlled driving performances

RATIONALE

Alcohol is the most frequently detected substance in fatal automobile crashes, but its precise mode of action is not always clear.

OBJECTIVE

The present study was designed to establish the influence of blood alcohol concentration as a function of the complexity of the scenarios. Road scenarios implying automatic or controlled driving performances were manipulated in order to identify which behavioral parameters were deteriorated.

METHOD

A single blind counterbalanced experiment was conducted on a driving simulator. Sixteen experienced drivers (25.3 ± 2.9 years old, 8 men and 8 women) were tested with 0, 0.3, 0.5, and 0.8 g/l of alcohol. Driving scenarios varied: road tracking, car following, and an urban scenario including events inspired by real accidents. Statistical analyses were performed on driving parameters as a function of alcohol level.

RESULTS

Automated driving parameters such as standard deviation of lateral position measured with the road tracking and car following scenarios were impaired by alcohol, notably with the highest dose. More controlled parameters such as response time to braking and number of crashes when confronted with specific events (urban scenario) were less affected by the alcohol level.

CONCLUSION

Performance decrement was greater with driving scenarios involving automated processes than with scenarios involving controlled processes.

Patterns of mobile device use by caregivers and children during meals in fast food restaurants

BACKGROUND AND OBJECTIVES

Mobile devices are a ubiquitous part of American life, yet how families use this technology has not been studied. We aimed to describe naturalistic patterns of mobile device use by caregivers and children to generate hypotheses about its effects on caregiver-child interaction.

METHODS

Using nonparticipant observational methods, we observed 55 caregivers eating with 1 or more young children in fast food restaurants in a single metropolitan area. Observers wrote detailed field notes, continuously describing all aspects of mobile device use and child and caregiver behavior during the meal. Field notes were then subjected to qualitative analysis using grounded theory methods to identify common themes of device use.

RESULTS

Forty caregivers used devices during their meal. The dominant theme salient to mobile device use and caregiver-child interaction was the degree of absorption in devices caregivers exhibited. Absorption was conceptualized as the extent to which primary engagement was with the device, rather than the child, and was determined by frequency, duration, and modality of device use; child response to caregiver use, which ranged from entertaining themselves to escalating bids for attention, and how caregivers managed this behavior; and separate versus shared use of devices. Highly absorbed caregivers often responded harshly to child misbehavior.

CONCLUSIONS

We documented a range of patterns of mobile device use, characterized by varying degrees of absorption. These themes may be used as a foundation for coding schemes in quantitative studies exploring device use and child outcomes.

Deterioration in driving performance during sleep deprivation is similar in professional and nonprofessional drivers

OBJECTIVE

There is some suggestion in the literature that professional drivers might self-select to be more resistant to the effects of sleep deprivation; however, this question has not been directly examined. The current laboratory study aimed to compare performance changes during acute sleep deprivation between professional and nonprofessional drivers.

METHODS

Twenty volunteer male professional drivers and 20 nonprofessional drivers performed a simulated driving task (AusEd) and the Psychomotor Vigilance Task (PVT) during 24 hours of continuous wakefulness. Ratings of subjective sleepiness were also examined.

RESULTS

There was a progressive and significant increase in lateral lane position and speed variability on the simulated driving task and an increase in PVT reaction times and lapses after participants had been awake for 17 to 24 hours (Ps < .01). There was no difference in performance changes between the professional and nonprofessional drivers.

CONCLUSIONS

Professional drivers in this study had the same susceptibility to sleep deprivation as nonprofessional drivers. This finding does not support the concept that professional drivers are resistant to sleep loss.

Alcohol calibration of tests measuring skills related to car driving

RATIONALE

Medication and illicit drugs can have detrimental side effects which impair driving performance. A drug's impairing potential should be determined by well-validated, reliable, and sensitive tests and ideally be calibrated by benchmark drugs and doses. To date, no consensus has been reached on the issue of which psychometric tests are best suited for initial screening of a drug's driving impairment potential.

OBJECTIVE

The aim of this alcohol calibration study is to determine which performance tests are useful to measure drug-induced impairment. The effects of alcohol are used to compare the psychometric quality between tests and as benchmark to quantify performance changes in each test associated with potentially impairing drug effects.

METHODS

Twenty-four healthy volunteers participated in a double-blind, four-way crossover study. Treatments were placebo and three different doses of alcohol leading to blood alcohol concentrations (BACs) of 0.2, 0.5, and 0.8 g/L.

RESULTS

Main effects of alcohol were found in most tests. Compared with placebo, performance in the Divided Attention Test (DAT) was significantly impaired after all alcohol doses and performance in the Psychomotor Vigilance Test (PVT) and the Balance Test was impaired with a BAC of 0.5 and 0.8 g/L. The largest effect sizes were found on postural balance with eyes open and mean reaction time in the divided attention and the psychomotor vigilance test.

CONCLUSIONS

The preferable tests for initial screening are the DAT and the PVT, as these tests were most sensitive to the impairing effects of alcohol and being considerably valid in assessing potential driving impairment.