Changing mobility patterns and road mortality among pre-license teens in a late licensing country: an epidemiological study

Behavioral Health at School: Do Three Competences in Road Safety Education Impact the Protective Road Behaviors of Spanish Children?

Background: Education in road safety (also known as Road Safety Education-RSE) constitutes, nowadays, an emergent approach for improving present and future road behaviors, aiming at taking action against the current, and concerning, state-of-affairs of traffic crashes, through a behavioral perspective. In the case of children, and despite their overrepresentation in traffic injury figures, RSE-based strategies for behavioral health in transportation remain a "new" approach, whose impact still needs to be empirically tested. Objective: The aim of this study is to assess the impact of three key road safety skills of the Positive Attitudes, Risk perception and Knowledge of norms (PARK) model, addressed in RSE-based interventions, on the safe road behavior of Spanish children. Methods: For this cross-sectional study, a representative sample of 1930 (50.4% males and 49.6% females) Spanish children attending primary school, with a mean age of 10.1 (SD = 1.6) years, was gathered from 70 educational centers across all Spanish regions, through a national study on RSE and road safety. Results: Road safety skills show a positive relationship with children's self-reported safe behaviors on the road. However, the knowledge of traffic norms alone does not predict safe behaviors: it needs to be combined with risk perception and positive attitudes towards road safety. Furthermore, the degree of exposure to previous RSE interventions was shown to have an effect on the score obtained by children in each road safety skill; on the other hand, road misbehaviors observed in parents and peers had a negative impact on them. Conclusion: The outcomes of this study suggest that education in road safety is still a key process for the acquisition of safe habits, patterns and behaviors among young road users.

Social environment versus cycling competency predicting risk-taking in 11- to 13-year-old cyclists in The Netherlands

Objectives: From age 12 onwards, cycling injuries begin rising in The Netherlands. A known contributing factor is younger children's underdeveloped competency to deal with complex and hazardous traffic situations, and their exposure to such situations strongly increases after transitioning to secondary school. Little is known about intentional risk-taking as a contributing factor. In this developmental stage, children become increasingly vulnerable because of intentional risk-taking, affecting their safety and health. The incidence, predictors in the child's social environment, and trends of such risks are systematically monitored; for instance, for alcohol use, smoking, and cyber bullying. Such monitors do not include risky road behavior. This exploratory field study examined the frequency of intentional risky cycling, its relationship with the perceived social environment, and relative to cycling competency measured as the ability to detect emerging hazards quickly.Methods: Three hundred thirty-five students between 11 and 13 years of age (51% male) completed computerized tests of hazard perception skill and surveys on crashes, risk-taking, peer pressure, perceived risk-taking by parents or friends, and exposure to risky driving as passenger.Results: Frequent risk-taking was associated with higher crash frequency. Stepwise regression confirmed that children who more often took risks on the road were also more sensitive to peer pressure, had more often been passengers of risky drivers, had parents and friends who exhibited risky behaviors in traffic more often, and perceived hazards as less dangerous but, in contrast to expectations, did not do worse on the detection of hazards. The predictors explained 28% of the variance in total risk-taking but varied from 6 to 20% depending on the specific risk-taking behavior concerned.Conclusions: At least 20% of children sometimes or more often take risks in traffic. Children who feel peer pressure to behave in a risky manner, observe parents and friends behaving in a risky manner in traffic, and have been exposed as passengers to risky driving more often take risks in traffic themselves. These results provide support for including items on risky road behavior in health monitors and to design interventions that address the risk factors in the child's perceived social environment.

Higher-order cycling skills among 11- to 13-year-old cyclists and relationships with cycling experience, risky behavior, crashes and self-assessed skill

INTRODUCTION

In the Netherlands, young cyclists are extremely vulnerable in traffic, which may partly be due to their still underdeveloped higher-order cycling skill. So far, knowledge on their actual level of skill is lacking. Using a computerized test battery mimicking real-life risky traffic conditions, this study assessed the level of higher-order cycling skill in children 11 and 12 years of age and tested the hypothesis that these skills show caveats. Furthermore, factors potentially influencing the development and impact of these skills were studied, such as cycling experience, risky road behavior, crash involvement, and self-assessed skill.

METHOD

A total of 335 students (49% female) completed computerized tests on hazard perception, gap acceptance, blind spot strategies, and priority decisions in traffic, and completed questionnaires on cycling experience, risky cycling behavior, crashes, and self-assessment of cycling skill.

RESULTS

On the hazard perception test, one-third of the participants missed at least half of the number of hazards. They made errors in about 50% of the priority decisions, accepted critical gaps when crossing the road, and conversely rejected safe gaps; only 1% of the participants identified all blind spots of a truck correctly, while 69% made unsafe decisions when interacting with trucks in traffic scenarios. Overall, in complex traffic situations performance was worse than in simple ones. The hypothesis of lack of skills was therefore accepted. However, the study failed to demonstrate consistent relationships between subtest performance and cycling experience, risky behavior, crashes, and self-assessed skill, which weakens the theoretical assumptions concerning the subtests.

CONCLUSIONS

The results suggest that children at the end of primary school are still lacking elementary skills for safe cycling, calling for measures to accelerate skill development.

PRACTICAL APPLICATIONS

Test batteries are essential tools for systematically monitoring skill development in cyclists, evaluating education programs, and for guiding the development of effective road safety education. The next step is the validation of such batteries.

Risky driving and the persistent effect of a randomized intervention focusing on impulsivity: The role of the serotonin transporter promoter polymorphism

Road traffic accidents are a serious public health issue, and real-life traffic offences are an excellent indicator of the behavioural tendencies of impulsivity and risk-taking. We have previously reported on short-term efficacy of a brief intervention in driving schools to reduce traffic risks (Paaver et al., Accid. Anal. Prev., 2013; 50, 430-437), and have now addressed the question of whether does the impact of the intervention last for a few years, and whether traffic behaviour and the intervention effect are associated with the serotonin transporter polymorphism (5-HTTLPR) genotype as the central serotonin system is strongly associated with impulse control. Participants of the study were 1866 novice car-drivers (mean age 23.0, SD = 7.2 years). Data on traffic violations were obtained four years after intervention from the police database and on traffic collisions from the national traffic insurance database. DNA samples were available for 767 participants and 5-HTTLPR genotypes were classified using the triallelic model. For the observation period after the intervention, speeding, drunk driving and involvement in traffic accidents were significantly lower in the intervention group. 5-HTTLPR genotype was associated with traffic behaviour: The S'-allele carriers had significantly lower odds for speeding offences and traffic accidents. The lower prevalence of S'-allele carriers among those who had committed speeding offences was statistically significant in females, while the lower prevalence of having been involved in a traffic accident was rather observed in males. Statistically significant intervention effects were observed only in the L'/L' homozygotes who had higher prevalence of traffic incidents. Conclusively, the brief intervention in traffic schools had a significant impact on traffic safety within subsequent four years, and traffic behaviour was associated with the serotonin transporter genotype. These findings suggest that subjects who are less likely to self-regulate their driving habits while gaining experience would benefit from training of impulsivity recognition.

The association of measures of the serotonin system, personality, alcohol use, and smoking with risk-taking traffic behavior in adolescents in a longitudinal study

Studies on the neurobiological basis of risk-taking behavior have most often focused on the serotonin system. The promoter region of the gene encoding the serotonin transporter contains a polymorphic site (5-HTTLPR) that is important for the transcriptional activity, and studies have demonstrated its association with brain activity and behavior. Another molecular mechanism that reflects the capacity of the central serotonin system is the activity of the enzyme monoamine oxidase (MAO) as measured in platelets. The purpose of the present study was to examine how measures of the serotonin system (platelet MAO activity and the 5-HTTLPR polymorphism), personality variables, alcohol use and smoking are associated with risk-taking traffic behavior in schoolchildren through late adolescence. The younger cohort of the longitudinal Estonian Children Personality Behaviour and Health Study (originally n = 583) filled in questionnaires about personality traits, smoking status, alcohol use and traffic behavior at age 15 and 18 years. From venous blood samples, platelet MAO activity was measured radioenzymatically and 5-HTTLPR was genotyped. During late adolescence, subjects with lower platelet MAO activity were more likely to belong to the high-risk traffic behavior group. Male 5-HTTLPRs'-allele carriers were more likely to belong to the high-risk traffic behavior group compared to the l'/l' homozygotes. Other variables predicting risk group were alcohol use, smoking and Maladaptive impulsivity.The results suggest that lower capacity of the serotoninergic system is associated with more risky traffic behavior during late adolescence, but possibly by different mechanisms in boys and girls.

Road injuries, health burden, but not fatalities make 12- to 17-year olds a high risk group in the Netherlands

Background

To explore the impact of road injuries for different age groups, this study compares the health burden of road injuries in young adolescents-12 to 17 years of age-to those for older age groups. Young adolescents are underrepresented in road fatalities. However, their inexperience, developmental stage and use of bicycles may expose them to high levels of road risk, but their physical resilience may help them survive injuries which in older age groups would be fatal.

Methods

To assess the impact of injuries compared with death, this study assessed by age group the health burden expressed in disability adjusted life years; years of life lost plus years lived with disability. Its analyses make use of existing data bases on road fatalities, serious injuries (maximum abbreviated injury score 2 or more), travel, life expectancy and disability weights.

Results

For young adolescents, seriously injuries per distance travelled (injury risk) were higher than for any other age group, except for the elderly (75+). This was further amplified when health burden was taken into account, showing these young adolescents to be responsible for 15% of the total health burden associated with road crashes.

Conclusions

These results justify extra efforts to improve the understanding and prevention of injury-only crashes among young adolescents.

Risky Driving Behaviours among Medical Students in Erbil, Iraq

OBJECTIVES

This study aimed to assess risky driving behaviours among medical students in Erbil, Iraq, and to explore the relationship between risky driving behaviours and perceptions of risky driving.

METHODS

This self-administered questionnaire-based survey was conducted from January to May 2014 among a random sample of 400 medical students at Hawler Medical University in Erbil. The questionnaire was designed to assess the frequency of engagement in 21 risky driving behaviours, the perceived risk of each behaviour and the preference for each behaviour as ranked on a 5-point scale.

RESULTS

A total of 386 students responded to the survey (response rate: 96.5%). Of these, 211 reported that they currently drove a vehicle (54.7%). Drivers most frequently engaged in the following behaviours: playing loud music (35.9%), speeding (30.4%), allowing front seat passengers to not wear seat belts (27.9%) and using mobile phones (27.7%). Least frequent driving behaviours included not stopping at a red light (3.9%), driving while sleepy (4.4%), driving after a mild to moderate intake of alcohol (4.5%) and drunk driving (6.4%). Mean risky driving behaviour scores were significantly higher among males (P <0.001) and those who owned a car (P = 0.002). The mean risk perception score was higher among >20-year-olds (P = 0.028). There was a significant positive relationship between the preference for risky behaviours and risky driving behaviours (beta = 0.44; P <0.001).

CONCLUSION

Medical students in Erbil reported high frequencies of several serious risky driving behaviours. The preference for risky behaviours was found to be an important predictor of risky driving behaviours among medical students in Erbil.