Sociodemographic factors associated with aggressive driving behaviors of 3-wheeler taxi drivers in Sri Lanka

Individual characteristics associated with road traffic collisions and healthcare seeking in low- and middle-income countries and territories

Incidence of road traffic collisions (RTCs), types of users involved, and healthcare requirement afterwards are essential information for efficient policy making. We analysed individual-level data from nationally representative surveys conducted in low- or middle-income countries (LMICs) between 2008-2019. We describe the weighted incidence of non-fatal RTC in the past 12 months, type of road user involved, and incidence of traffic injuries requiring medical attention. Multivariable logistic regressions were done to evaluate associated sociodemographic and economic characteristics, and alcohol use. Data were included from 90,790 individuals from 15 countries or territories. The non-fatal RTC incidence in participants aged 24-65 years was 5.2% (95% CI: 4.6-5.9), with significant differences dependent on country income status. Drivers, passengers, pedestrians and cyclists composed 37.2%, 40.3%, 11.3% and 11.2% of RTCs, respectively. The distribution of road user type varied with country income status, with divers increasing and cyclists decreasing with increasing country income status. Type of road users involved in RTCs also varied by the age and sex of the person involved, with a greater proportion of males than females involved as drivers, and a reverse pattern for pedestrians. In multivariable analysis, RTC incidence was associated with younger age, male sex, being single, and having achieved higher levels of education; there was no association with alcohol use. In a sensitivity analysis including respondents aged 18-64 years, results were similar, however, there was an association of RTC incidence with alcohol use. The incidence of injuries requiring medical attention was 1.8% (1.6-2.1). In multivariable analyses, requiring medical attention was associated with younger age, male sex, and higher wealth quintile. We found remarkable heterogeneity in RTC incidence, the type of road users involved, and the requirement for medical attention after injuries depending on country income status and socio-demographic characteristics. Targeted data-informed approaches are needed to prevent and manage RTCs.

Association Between Young-Onset Dementia and Risk of Hospitalization for Motor Vehicle Crash Injury in Taiwan

IMPORTANCE

Several studies have suggested that older-onset dementia is associated with an increased risk of motor vehicle crash injury (MVCI). However, evidence of an association between young-onset dementia and the risk of MVCI is insufficient, particularly in Asia.

OBJECTIVE

To investigate the association between young-onset dementia and MVCI-related hospitalization in Taiwan.

DESIGN, SETTING, AND PARTICIPANTS

In this nationwide, population-based cohort study in Taiwan, a cohort of 39 344 patients aged 40 to 64 years with incident dementia diagnosed between 2006 and 2012 was matched 1:1 with a cohort of participants without dementia by age, sex, and index year (initial diagnosis of dementia). Participants were identified from Taiwan's National Health Insurance Research Database (NHIRD). Data were analyzed between March 25 and October 22, 2021.

EXPOSURES

Dementia, defined by International Classification of Diseases, Ninth Revision, Clinical Modification codes.

MAIN OUTCOMES AND MEASURES

Hospitalization for MVCI, determined using linked data from Taiwan's Police-Reported Traffic Accident Registry and the NHIRD from January 1, 2003, to December 31, 2015. Hazard ratios (HRs) for MVCI-related hospitalization were estimated using Cox proportional hazards regression models adjusted for sex, age, salary-based insurance premium, urbanization level, and comorbidities.

RESULTS

Of the 78 688 participants, 47 034 (59.8%) were male; the mean (SD) age was 54.5 (7.4) years. During the 10-year follow-up period, the incidence density of MVCI-related hospitalization was 45.58 per 10 000 person-years (95% CI, 42.77-48.39 per 10 000 person-years) among participants with dementia and 24.10 per 10 000 person-years (95% CI, 22.22-25.99 per 10 000 person-years) among participants without dementia. Compared with participants without dementia, patients with young-onset dementia were at higher risk of MVCI-related hospitalization (adjusted HR [aHR], 1.83; 95% CI, 1.63-2.06), especially those in younger age groups (aged 40-44 years: aHR, 3.54; 95% CI, 2.48-5.07) and within a shorter period (within 1 year of follow-up: aHR, 3.53; 95% CI, 2.50-4.98) after dementia was diagnosed. Patients with young-onset dementia also had a higher risk of being a pedestrian when the crash occurred (aHR, 2.89; 95% CI, 2.04-4.11), having an intracranial or internal injury (aHR, 2.44; 95% CI, 2.02-2.94), and having a severe injury (aHR, 2.90; 95% CI, 2.16-3.89).

CONCLUSIONS AND RELEVANCE

In this retrospective cohort study, patients in Taiwan with a diagnosis of young-onset dementia had a higher risk of MVCI-related hospitalization than did individuals without dementia and the risk varied by age, disease duration, transport mode, injury type, and injury severity. These findings suggest a need for the planning of strategies to prevent transportation crashes among patients with young-onset dementia.

Levels and Relationships of Impulsivity and Aggressive Driving in Shaqra, Saudi Arabia

Background: Aggressive driving is prevalent and may be associated with impulsivity. The relationships between these variables among Saudi drivers have received scant attention. In this study, we aimed to examine the level of aggressive driving and its relationships with impulsivity among Saudi drivers in Shaqra. Methods: Overall, 504 Saudi drivers were recruited and assessed in this cross-sectional study using demographic and driving proforma, a self-reporting Barratt impulsiveness scale (BIS), and an Aggressive Driving Behavior Scale (ADBS). Results: BIS and ADBS had mean scores of 37.97 (3.24) and 21.74 (8.51), respectively. In linear regression analysis, the value of the BIS non-planning subscale negatively predicted the value of the ADBS Conflict subscale (beta = -.151, p = .002) and Speeding subscale (beta = -.103, p = .031). In contrast, the value on the score of the BIS Motor subscale statistically significantly and positively predicted the value on the score of the ADBS Speeding subscale (Beta = -.103, p = .032). Conclusion: The result shows a differential link between the component of impulsivity and aggressive driving. The lack of foresight is negatively linked with conflict behavior and high- speed driving, whereas acting without thinking is positively associated with high-speed driving.

Phenomenology of being a safe taxi driver

BACKGROUND

In developing countries, a great number of people typically utilize public transportation such as Taxis. Therefore, taxi drivers have an important role in residents' well-being and safety. The aim of this study was to describe the subjective experiences and insights on safe driving among taxi drivers in Zanjan, Iran.

METHOD

In this qualitative study, 17 taxi drivers (23-54 years) were purposefully selected to participate in 11 semi-structured interviews, as well as one focus group (n = 6). The data was then analyzed based on a combination of Braun's and Colaizzi's methods.

RESULT

By analysis of the qualitative data, four main themes emerged from expressed experiences by taxi drivers, including 1) traffic chaos, 2) social prestige, 3) economic pressure, and 3) job satisfaction.

CONCLUSION

The emerging concepts of the present study imply a threefold structure of existence, which introduced by Heidegger, as taxi drivers' (the self) feelings and experiences of being under pressure of traffic chaos (the world), accompanied by low social prestige, economic pressure and job dissatisfaction (being in). Thus, strategic planning for traffic safety should consider taxi drivers' needs to feel a friendly world, as well as, to find themselves in a respectful and supportive environment.

Occupational risk factors for low back pain among drivers of three-wheelers in Sri Lanka

BACKGROUND

Approximately 5% of all households in Sri Lanka operate a three-wheeler as their primary source of income. However, very little is known about the occupational health risks associated with driving these vehicles.

OBJECTIVES

The aim of this study was to assess occupational risk factors, including the number of hours worked associated with the 4-week prevalence of low back pain (LBP) among drivers of three-wheelers.

METHODS

Questionnaires were administered to 200 full-time drivers of three-wheelers from the Galle District in Sri Lanka. Occupational, psychological, socio-demographic, lifestyle, and anthropometric variables were collected. Univariate and multivariate analysis were used to investigate the correlation between occupational risk factors of the prevalence of LBP.

RESULTS

15·5% of respondents reported experiencing LBP in the previous 4 months. Univariate analysis revealed that the number of hours worked per week, feeling pressure to compete with other drivers, and perceived stress scale scores were significantly associated with the 4-week prevalence of LBP. Multivariate analysis found that the number of hours worked per week and engine type were significantly associated with LBP.

CONCLUSIONS

LBP is common among drivers of three-wheelers in Sri Lanka. Long work hours and two-stroke engines were significantly associated with LBP. Results from this study point towards a role for educational, behavioral health, and policy interventions to help prevent and reduce LBP among these drivers.

Determinants of road traffic injury among adult motorcyclists in Malé, Maldives

This study investigates the incidence of nonfatal road traffic injuries (RTIs) in Malé, the capital city of the Maldives, and identifies risk factors associated with RTIs. A cross-sectional descriptive study was conducted among young adult motorcyclists in 3 public areas. A total of 350 self-administered questionnaires were distributed to the motorcycle riders who visited the study areas between December 2012 and January 2013. The incidence of RTIs for the previous 12 months was 39.8% among the 294 respondents who returned a completed questionnaire. About half (49.6%) of those were caused by the riders. The majority of riders were male (96.6%). None of the motorcycle riders wore a helmet. RTIs had a significant association with sex, age, and attitude. Young riders were 1.6 times more likely to be involved in an RTI (adjusted odds ratio [AOR] = 1.67; 95% confidence interval [CI] = 0.94-2.95). Having a negative attitude about road safety was a risk factor of RTIs (AOR = 1.84; 95% CI = 1.11-3.03). Based on the results of the present study, it is important to promote safe riding attitudes in young riders.

The role of marital status in the association between benzodiazepines, psychotropics and injurious road traffic crashes: a register-based nationwide study of senior drivers in Sweden

BACKGROUND

Among senior drivers, benzodiazepines (BZDs) have a documented effect on the risk of road traffic crashes (RTCs). It remains unclear however if BZDs play the same role when considering marital status. Therefore, we aimed to investigate the role of marital status in the association between BZD use and injurious RTCs among senior drivers.

METHODS

Matched case-control study based on five national Swedish registers (n = 154 225). Cases comprised the first non-alcohol-related injurious RTC sustained by drivers aged 50-80 years from July 2005 to December 2009 and controls included registered residents with a valid license who did not crash during that period. Four controls were matched to each case by sex, age and place of residence. Conditional logistic regression analysis for injurious RTC was performed with adjustment for occupation and number of medications. The main exposure was dispensation of BZDs, alone or in combination with other psychotropic medications, 1-30 days prior to the crash date stratified by marital status.

RESULTS

BZD use, alone or in combination with other psychotropic medications, increased the risk of being involved in an RTC (BZD only: adjusted OR: 1.26, 95% CI: 1.17-1.36; BZDs and other psychotropics: adjusted OR: 1.25, 95% CI: 1.12-1.41). Compared to married drivers, those divorced (1.48, 1.43-1.53) and widowed (1.54; 1.45-1.63) had higher adjusted ORs. Marital status modified the association between BZDs and RTCs, particularly among younger male drivers.

CONCLUSIONS

Both BZDs and marital status independently affect the risk for senior drivers to be involved in an RTC. However, marital status plays a role in the association between BZD use and RTCs and this may have implications for targeting risk populations for RTCs among senior drivers.

A study into blood alcohol concentration in fatal accidents among vulnerable road users in a tertiary care hospital Sri Lanka

Reckless driving behaviour associated with alcohol has been well known. In Sri Lanka, research on blood alcohol concentration (BAC) in road fatalities is scares. Thus, we studied the BAC in vulnerable road users (VRUs) encountered in medico-legal autopsies. A retrospective descriptive study based on case records of VRU fatalities from 2005 to 2012 referred for a tertiary care unit for post-mortem examination was conducted. A pro-forma was developed to extract data from the post-mortem blood alcohol reports. Data were analysed using percentages and p-values. There were 119 cases from the 328 autopsies to investigate blood alcohol tests. A total of 51% (n = 61) out of 119 had BAC above 80 mg/100 ml and mean level was 103 mg/100 ml. 2/3 of pedestrians had a BAC above 80 mg/100 ml with a mean level of 139 mg/dl. The highest mean blood alcohol (158 mg/dl) was reported from three-wheeler users. Majority of cases with more than 80 mg/100 ml BAC was reported in the age group of 40-60 years, while 40% of the elderly too had a BAC above 80 mg/100 ml. The comparison between pedestrians having above 80 mg/100 ml of BAC with that of other VRUs (active road users) showed a significant statistical difference (p = 0.017). The study results suggest that alcohol influence among pedestrians represent a significant risk factor for fatal road traffic accidents.