Acculturation and risk of traffic crashes in young Asian-born Australian drivers

The study examines changes over time in crash risk differences between young Australian drivers born in Asia and those born in Australia.Data from the 2003 baseline survey of the DRIVE cohort of 20 806 young drivers aged 17-24 years were linked to police, hospital and death data up until 2016. The association between country of birth and crash was investigated using flexible parametric survival models adjusted for confounders.Six months after baseline, the crash risk in Asian-born drivers was less than half that of their Australian-born counterparts (mean HR, MHR 0.41; 95% CI 0.29 to 0.57), only to increase steadily over time to resemble that of Australian-born drivers 13 years later (MHR 0.94; 95% CI 0.66 to 1.36).This is likely to be associated with acculturation and the adoption by young Asian-born Australian drivers of driving behaviour patterns akin to those born locally. This needs to be considered in future road safety campaigns.

Driving offences and risk of subsequent crash in novice drivers: the DRIVE cohort study 12-year follow-up

Background

Penalties are a key component to improve road user safety, but previous studies suggested that they might not be successful in reducing crashing in offending drivers. However, these studies were not able to consider important crash risk factors in the analysis that might confound the results. Using data from a large prospective cohort study of young drivers in New South Wales, Australia, we explored if novice drivers with driving offences have a higher rates of car crash and if these differences are explained by established crash risk factors.

Methods

We used data from a 2003/2004 Australian survey of young drivers, linked to police reported offence and crash data, hospital data and deaths data up to 2016. We used Poisson regression models adjusted for confounders to estimate the association between driving offences during 2003–2006 with car crash during 2007–2016.

Results

The study cohort comprised 20 781 young drivers of whom 7860 drivers (37.8%) had at least one driving offence and 2487 (12.0%) were involved in at least one crash. After adjusting for confounders in the regression model, drivers with three or more driving offences had 2.25 (95% CI 1.98 to 2.57), 2.87 (95% CI 1.60 to 5.17) and 3.28 (95% CI 2.28 to 4.72) times higher rates of any crash, crashes that resulted in hospital admission or death and single vehicle crashes compared with drivers with no driving offences.

Conclusion

Measures that successfully mitigate the underlying risk factors for both, crashes and offences, have the potential to improve road safety.

Evaluation of the efficacy of an intersection conflict warning system at two-way stop-controlled rural intersections: difference-in-differences and triple-difference analytical approaches

OBJECTIVE

Intersection conflict warning systems (ICWSs) have been implemented at high-risk two-way stop-controlled intersections to prevent right-angle crashes and associated injuries. This study involved investigation of the impacts of ICWSs on crash reductions.

METHODS

The study used a quasi-experimental design to analyse the potential causal relations between Minnesota's ICWSs and various crash rate outcomes (including total, injury, non-injury, targeted right-angle and non-right-angle crashes) in pre-post analyses. A restricted randomisation method enabled identification of three controls to each ICWS treatment intersection, and included as many comparable intersection characteristics as possible. Annual crash rates (per year per intersection) were analysed over the same periods before and after system activation for treatment and control intersections in each matched group. Pre-crash data for 3 years and post-crash data for up to 5 years were included, ranging from 2010 to 2018. Negative binomial regression models with generalised estimating equations were applied to estimate the average, immediate and continuing treatment effects of ICWSs, through the difference-in-differences and difference-in-difference-in-difference approaches, respectively.

RESULTS

The ICWS treatment was significantly associated with a decreasing trend for targeted right-angle crash rates posttreatment. Although not statistically significant, most crash rate outcomes appeared to be elevated immediately after treatment (statistically significant for sideswipe crashes only). Pre-post differences in average crash rates (over entire periods), except for incapacitating injury-related crashes, were not statistically significant between treatment and control intersections.

CONCLUSIONS

The study provided important insight into potential causal associations between intersection safety countermeasures and crashes at high-risk rural two-way stop-controlled intersections.

Trends and disparities in American Indian/Alaska Native unintentional injury mortality from 1999 to 2016

INTRODUCTION

Alcohol and drug use are significant problems in the US, and American Indian/Alaska Native (AI/AN) communities and individuals are known to be among the most affected. This study evaluates disparities in unintentional injury mortality causes since 1999.

METHODS

Analyses in 2020 of unintentional injury mortality rate disparities between AI/ANs and white population over the 1999-2016 period with attention to motor vehicle crashes, alcohol poisoning, drug poisoning and all other cause types. Rates in each of the 10 states with the largest AI/AN populations were also investigated to account for geographical concentration.

RESULTS

Motor vehicle mortality rates declined for both AI/AN and white groups, but a large racial disparity was maintained. Conversely, poisoning mortality rates rose substantially in both groups, with a jump in rates in 2007 due to a coding change, resulting in a large disparity that was maintained through 2016. Comparison of alcohol and drug poisonings showed that the AI/AN alcohol poisoning rate was about eight times the white rate, whereas drug poisoning rates were similar. For 'all other' unintentional injuries, the highest rates were seen for AI/AN men, with rates generally rising over the study period. State-specific analyses found substantial variation in AI/AN rates, with few or no disparities in New York and Texas.

CONCLUSIONS

Results indicate substantial and persisting disparities in unintentional injury mortality, with especially large differences in alcohol poisoning. The absence of disparities in New York and Texas suggest the importance of situational factors.

Do healthcare providers assess for risk factors and talk to patients about return to driving after a mild traumatic brain injury (mTBI)? Findings from the 2020 DocStyles Survey

BACKGROUND

There is a dearth of information and guidance for healthcare providers on how to manage a patient's return to driving following a mild traumatic brain injury (mTBI).

METHODS

Using the 2020 DocStyles survey, 958 healthcare providers were surveyed about their diagnosis and management practices related to driving after an mTBI.

RESULTS

Approximately half (52.0%) of respondents reported routinely (more than 75% of the time) talking with patients with mTBI about how to safely return to driving after their injury. When asked about how many days they recommend their patients with mTBI wait before returning to driving after their injury: 1.0% recommended 1 day or less; 11.7% recommended 2-3 days; 24.5% recommended 4-7 days and 45.9% recommended more than 7 days. Many respondents did not consistently screen patients with mTBI for risk factors that may affect their driving ability or provide them with written instructions on how to safely return to driving (59.7% and 62.6%, respectively). Approximately 16.8% of respondents reported they do not usually make a recommendation regarding how long patients should wait after their injury to return to driving.

CONCLUSIONS

Many healthcare providers in this study reported that they do not consistently screen nor educate patients with mTBI about driving after their injury. In order to develop interventions, future studies are needed to assess factors that influence healthcare providers behaviours on this topic.

Evaluating the impact of penalising the use of mobile phones while driving on road traffic fatalities, serious injuries and mobile phone use: a systematic review

BACKGROUND

A vast literature has demonstrated that using mobile phones while driving increases the risk of road traffic crashes. In response, policy-makers have introduced bans and harsher penalties on using mobile phones while driving. Even though emerging evidence suggests that such measures may reduce mobile phone use and crashes, the literature has not been systematically reviewed and synthesised.

OBJECTIVE

To evaluate the impact of penalising mobile phone use while driving on road traffic fatalities, serious injuries and the prevalence of mobile phone use while driving.

METHODS

We employed a comprehensive search strategy using electronic databases, websites, handsearching and other sources to locate studies evaluating legislation on mobile phone use while driving. Randomised controlled trials, interrupted time series', controlled before-after studies with control(s) not exposed to harsher sanctions and panel data designs were included if they measured the outcomes of fatalities, serious injuries or the prevalence of mobile phone use while driving. Eligible studies were critically appraised. Due to substantial heterogeneity, the results were synthesised narratively. The synthesis structured studies according to the type of legislation and outcome measure.

RESULTS

Of the 7420 studies retrieved, 32 were included. The evidence on the effects of penalising mobile phone use while driving was weak, and somewhat inconsistent, but pointed to a potential decrease in the prevalence of mobile phone use and fatalities for all-driver primary enforcement hand-held bans and texting bans.

CONCLUSIONS

Preventing fatalities from risky driving practices may be helped by implementing harsher laws that penalise mobile phone use while driving.

Can child restraint product information developed using consumer testing sustain correct use 6 months after child restraint purchase? Study protocol for a cluster randomised controlled trial

BACKGROUND

With long-standing and widespread high rates of errors in child restraint use, there is a need to identify effective methods to address this problem. Information supplied with products at the point of sale may be a potentially efficient delivery point for such a countermeasure. The aim of this study is to establish whether product materials developed using a consumer-driven approach reduce errors in restraint use among purchasers of new child restraint systems.

METHODS

A cluster randomised controlled trial (cRCT) will be conducted. Retail stores (n=22) in the greater Sydney area will be randomised into intervention sites (n=11) and control sites (n=11), stratified by geographical and socioeconomic indicators. Participants (n=836) will enter the study on purchase of a restraint. Outcome measures are errors in installation of the restraint as observed by a trained researcher during a 6-month follow-up home assessment, and adjustment checks made by the parent when the child is placed into the restraint (observed using naturalistic methods). Process evaluation measures will also be collected during the home visit. An intention-to-treat approach will be used for all analyses. Correct use and adjustment checks made by the parent will be compared between control and intervention groups using a logistic regression model. The number of installation errors between groups will be compared using Poisson regression.

DISCUSSION

This cRCT will determine the effectiveness of targeted, consumer-driven information on actual error rates in use of restraints. More broadly, it may provide a best practice model for developing safety product information.

TRIAL REGISTRATION NUMBER

ACTRN12617001252303p; Pre-results.