The impact and outcome of elderly drivers involved in road traffic accidents: Experience in Hsinchu Regional hospital

Background: To assess the effect of visual function on the occurrence of road traffic accidents (RTA) amongst Commercial Intercity Vehicle Drivers in Jos, Plateau State, Nigeria. Methodology: A descriptive cross-sectional survey of commercial intercity vehicle drivers at the Bauchi Road Motor Park, Jos, was undertaken in November 2006. The study instrument was a semi-structured questionnaire. Information obtained included demographic data, operational route, history of involvement in road traffic accident (RTA), cause of RTA and ocular history. Each participant had a detailed ocular examination. Data from 221 subjects were collected and entered into Epi-info version 6.04d, WHO, Geneva, Switzerland. Data entry validation was done through duplicate entry. Frequency tables were then generated. Results: A total of 221 of 268 drivers were assessed (response rate was 82.5%). All the drivers were males. Their age ranged from 20-90 years (mean: 44.2, SD 9.2). Up to 58(26.2%) drivers reported involvement in RTA. The main causes of RTAs were burst tyre 10(17.2%), reckless driving 9(15.5%), sleep 8(13.8%) and pedestrians 8(13.8%). Four persons (6.9%) complained of poor visibility at night. The age group 20-29 years and >50 years had the highest proportion of drivers involved in RTA as 33.3% (3/9) and 29.2% (19/58) of drivers in this age group reported involvement in RTA respectively. Three (5.2%) drivers with history of involvement in RTA had a VA of <6/12. Conclusion: Young and elderly drivers are more at risk of involvement in RTAs. Visual impairment was an important risk factor especially among the elderly drivers. Periodic ocular examination will contribute significantly to the reduction of RTAs.Key Words Driving, road traffic accidents, visual function

As ageing population is growing faster, traffic accidents involving elderly drivers become a serious social problem in South Korea. The present study aims to examine the impact of environmental characteristics on the injury severity of accidents involving elderly drivers in Seoul, South Korea. To achieve the purpose, the study divided elderly drivers into the following two groups: young-elderly drivers aged 65–69 years and middle- and old-aged drivers over 69 years old. The study also analysed non-elderly drivers aged 30 to 64 years as the comparative group. The study used the generalised ordered logit model, which is widely used to analyse data with ordinal scales. The findings from the study draw attention to the fact that (1) the characteristics of traffic accidents by injury severity considerably differed by age group. (2) risk of accident severity involving elderly drivers increase in areas with heavy traffic volumes and facilities that may create a complex driving condition to elderly drivers, (3) since elderly drivers tend to require longer response time with impaired vision under complex driving environment, it increased the risk of traffic accidents that older drivers face a higher risk of fatal injuries than younger counterparts. Thus, in order to reduce traffic accidents involving elderly drivers, the traffic safety policies should take environmental characteristics as well as the human factor concerning elderly drivers’ difficulties because of ageing and longer cognitive response time. This study contributes to the research in traffic accidents involving elderly drivers in that not only the accident characteristics (human factors, road condition, weather), mostly used for traffic accident analysis, but also environmental factors concerning the urban characteristics of Seoul Metropolitan City were analysed to compare the risk of traffic accidents and accident severity by age groups.

239 Mortality of Motor Vehicle Accidents by Elderly Drivers: A Nationwide Hospital-Based Registry in Japan

The purpose of this study is to analyze how the spatiotemporal characteristics of traffic accidents involving the elderly population in Seoul are changing by time period. We applied kernel density estimation and hotspot analyses to analyze the spatial characteristics of elderly people’s traffic accidents, and the space-time cube, emerging hotspot, and space-time kernel density estimation analyses to analyze the spatiotemporal characteristics. In addition, we analyzed elderly people’s traffic accidents by dividing cases into those in which the drivers were elderly people and those in which elderly people were victims of traffic accidents, and used the traffic accidents data in Seoul for 2013 for analysis. The main findings were as follows: (1) the hotspots for elderly people’s traffic accidents differed according to whether they were drivers or victims. (2) The hourly analysis showed that the hotspots for elderly drivers’ traffic accidents are in specific areas north of the Han River during the period from morning to afternoon, whereas the hotspots for elderly victims are distributed over a wide area from daytime to evening. (3) Monthly analysis showed that the hotspots are weak during winter and summer, whereas they are strong in the hiking and climbing areas in Seoul during spring and fall. Further, elderly victims’ hotspots are more sporadic than elderly drivers’ hotspots. (4) The analysis for the entire period of 2013 indicates that traffic accidents involving elderly people are increasing in specific areas on the north side of the Han River. We expect the results of this study to aid in reducing the number of traffic accidents involving elderly people in the future.

This study explores risk factors influencing the at-fault party in traffic accidents and analyzes their impact on traffic accident severity. Based on the traffic accident data of Shenyang City, Liaoning Province, China, from 2018 to 2020, 19 attribute variables including road attributes, time attributes, environmental attributes, and characteristics of the at-fault parties with either full responsibility, primary responsibility, or equal responsibility of the traffic accidents were extracted and analyzed in conjunction with the built environment attributes, such as road network density and POI (points of interest) density at the sites of traffic accidents. Using the RF-SHAP method to determine the relative importance of risk factors influencing the severity of traffic accidents with either motor vehicles or vulnerable groups at-fault, the top ten risk factors influencing the severity of traffic accidents with vulnerable road users as the at-fault parties are: functional zone, density of shopping POI, density of services POI, cause of accident, travel mode, collision type, season, road type, age of driver, and physical isolation. Travel mode, season, and road speed limit are more important risk factors for traffic accidents, with motor vehicle drivers as the at-fault parties. The density of service POI and cause of the accident are less critical for traffic accidents with motor vehicle drivers than traffic accidents with vulnerable road users who are at-fault. Subsequently, the Apriori algorithm based on association rules is used to analyze the important causal factors of traffic accidents, so as to explore the influence mechanism of multiple causal factors and their implied strong association rules. Our results show that most combined factors are associated with the matched Service and Shopping POI features. This study provides valuable information on the perceived risk of fatal accidents and highlights the built environment’s significant influence on fatal traffic accidents. Management strategies targeting the most typical combinations of accident risk factors are proposed for preventing fatalities and injuries in serious traffic accidents.

Motor vehicle accidents (MVAs) are one of the major public health burdens worldwide. In particular, MVAs by elderly drivers have been significantly increasing in recent years in industrialized countries. This study aimed to assess the MVA characteristics and outcomes caused by elderly drivers in Japan.Japan Trauma Data Bank (JTDB) is a prospective, nationwide, hospital-based registry for trauma patients from 256 institutions in Japan. This study enrolled all MVA drivers older than the legal age for driving between 2004 and 2015. The included patients were divided into the following 3 groups: adults (aged ≤64 years), young-old (aged 65-74 years), and old-old (aged ≥75 years). The primary outcome was in-hospital mortality. The trend in the proportion of MVAs caused by the young-old or the old-old group was evaluated using the Cochran-Armitage trend test. To assess the association of the old-old group with in-hospital mortality, compared with the adult group, we used multivariable logistic regression analysis.During the study period, a total of 236,698 trauma patients were registered, and 39,691 patients (16.8%) were eligible for our analysis. The proportion of MVAs caused by elderly drivers aged ≥65 years significantly increased from 11.7% in 2004 to 23.8% in 2015 (P < .001). As for the primary outcome, unadjusted in-hospital mortality increased with age, but decreased year-by-year irrespective of the age group. In multivariable logistic regression analysis, in-hospital mortality was significantly higher in the old-old group than in the adult group [17.3% (584/3372) vs 8.0% (2556/31,985); adjusted odds ratio 4.80; 95% confidence interval 4.06-5.67].In the super-aging society of Japan, the proportion of MVAs by elderly drivers increased year-by-year, and the mortality rate was highest in those aged above 75 years.

Motor vehicle is the backbone of the modern transportation system worldwide. However, the excessive number of motor vehicles tend to cause traffic accidents leading to numerous casualties. Analyzing existing works on this area, this study has identified prime reasons behind traffic accidents and casualties. They include driving over the speed limit, Age of drivers and pedestrians, environmental condition, location and road types. It has also reviewed and identified several data visualization methods and visualization techniques that have been proposed by many researchers. The objective of this research endeavour is to identify the factors behind traffic accidents, determine the techniques that are used to visualize data, develop a dashboard using data visualization tools to visualize traffic accident trend and to evaluate the functionality of the dashboard which is developed on United Kingdom’s (UK) traffic accident dataset from 2014 to 2016. Upon performing data cleaning, pre-processing and filtering, the raw data has been converted into cleaned, filtered and processed data to create a coherent and properly linked data model. Then, using the Power BI visualization tool, various interactive visualizations have been produced that illustrated several significant trends in accident and casualties. The visualization trend revealed that between 2014 to 2016, majority of the accidents in the UK occurred in the urban area, in the single carriageway, on the dry road surface, under the daylight with fine weather, and when the speed limit was below 30 mph. This research may assist UK’s traffic management authority to identify the underlying factors behind the traffic accident and to detect the traffic accident and casualty trend in order to take necessary steps to reduce casualties in traffic accidents.

Effect of Age on Severity of Injuries in Traffic Accidents Involving Elderly Drivers

Road traffic accident (RTA)-related trauma remains a public health issue. The aim of this study was to determine the frequency, causes and human impact of motor vehicle-related RTA in Lubumbashi, Democratic Republic of Congo. A prospective cross-sectional study was conducted in the first semester of the year 2015 in which 288 drivers (144 RTA-causing drivers and 144 control drivers who have been declared not guilty by road safety agents) involved in 144 motor vehicle-related RTA were interviewed, and only data on all RTA involving two motor vehicles with at least four wheels were recorded and analyzed. Results showed a total of 144 RTA that involved two motor vehicles with four wheels occurring during the study period which affected 104 people, including 93 injury and 11 fatality cases. The mean age of RTA-causing drivers was 33.8±7.4, whereas it was 35±8.8 for control drivers. The majority of RTA-causing drivers (53.4%) did not attend a driving school. Over speeding (32%), distracted driving (22%), overtaking (16%) and careless driving/risky maneuver (15%) and driving under the influence of alcohol (9%) were the main causes of RTA occurrence. In addition, the absence of a valid driving license [aOR=12.74 (±2.71); 95% CI 3.877-41.916; p=0.015], unfastened seat belt for the RTA-causing driver [aOR=1.85 (±0.62); 95% CI 1.306-6.661; p=0.048] and presence of damages on RTA-causing vehicle [aOR=33.56 (24.01); 95% CI 1.429-78.352; p=0.029] were associated with the occurrence of RTA-related fatality. This study showed a relatively high frequency of RTA occurring in Lubumbashi and suggests the necessity to reinforce road traffic regulation.

본 연구의 목적은 노인운전자의 교통사고 유형과 특성 등을 분석하여 교통사고 저감방안을 도출하고, 향후 노인을 위한 실제적인 교통안전정책의 방향 수립에 있다. 노인운전자의 교통사고 실태를 분석한 결과, 노인운전자에 의한 교통사고는 조명시설 등 교통안전시설물 설치가 열악한 도시 외곽지역인 지방도에서 빈번하게 발생하고 있으며, 가장 많이 발생하는 시간대는 18~20시 사이로 태양빛이 사라지고 어둠이 드리우는 일몰시간대로 나타났다. 안전운전의무 불이행과 같은 주의력 부족에 의한 교통사고가 많이 발생하였다. 노인운전자에 의한 교통사고 감소뿐만 아니라 우리 사회 전체의 안전을 위해서는 교통약자인 노인을 배려하는 법제도의 개선과 지역특성을 고려한 도로안전시설물 등의 정비가 필요하며, 신체적 능력이 저하된 노인운전자는 자신 스스로가 자신의 운전능력을 의심하고 테스트할 수 있는 신뢰 기재인 면허갱신제도 등에 의한 테스트와 대체교통수단 이용을 통한 직접 운전수요를 감소시키려는 노력이 필요하다. The purpose of this study is to deduce improvement plan through analysis of the type and characteristics of traffic accidents caused by elderly drivers, and to establish the traffic safety policies for the elderly drivers. The analyzed result of road traffic accident situation are as follows. Firstly, Traffic accidents caused by elderly drivers were frequent on local roads of poor traffic safety facilities such as lighting. Secondly, The most frequent time zone of Traffic accidents caused by elderly drivers was 18:00 to 20:00, this time zone was mainly darkened. Thirdly, Traffic accidents are often caused by lack of attention occurred by no implementation of safe driving. Institutional Improvement of cosideration for elderly drivers and Traffic Safety Facilities maintenance considering regional particularities is needed for reducing traffic accidents and the safety of our society. Their driving skills of elderly drivers should test themselves constantly, and elderly drivers must hold down driving yourself using the alternative transportation.

Road traffic accidents are the eighth leading cause of death globally, and the leading cause of death for young people aged 15-29 (productive age group). The objective of the thesis is to examine the causes of road traffic accidents in Hargeisa City. Both primary and secondary data sources were used. Primary data was collected from a sample of pedestrians and drivers by using a questionnaire and field observation. Also, archival documents and interviews with key informants from the Hargeisa traffic police. About 144 sample pedestrians and 80 sample drivers were drawn from a sampling frame of pedestrians and drivers using a purposive sampling technique. The data was analyzed through both descriptive and inferential statistics and narration for quantitative and qualitative information, respectively . According to the findings of the chi-square test, the following factors are associated with road traffic accidents in Hargeisa city: drivers age (0.001), driver′s speed (0.003), failure to give pedestrians priority to pass first as required by law (0.027), use of mobile phones (0.008), and non-use of seat belts (0.009), drivers violating traffic rules and regulations (0.015). As the main contributing factors to road traffic accidents in the city. The study recommended that unless immediate actions to revert the problem are taken, it will worsen in the future as motorization and the population of the city grow altogether. Keywords: Causes, Road Traffic Accidents, Pedestrians, Drivers, Hargeisa, Somaliland DOI: 10.7176/RHSS/12-3-03 Publication date: February 28 th 2022

Road traffic accidents (RTA) are a public health concern worldwide, resulting in numerous medical emergencies. Well-prepared health systems and hospitals with sufficient human and material resources are essential for the management of road traffic injuries (RTI). The aim of this study was to assess preparedness of health facilities to provide adequate care to patients suffering from RTI. This was a descriptive cross-sectional study targeting all hospitals located along the road axes most involved in RTAs in Cameroon (Yaoundé- Douala-Bafoussam axes) and in South Kivu province in Democratic Republic of Congo (DR Congo) (Uvira-Bukavu-Goma axes). Data were collected using a questionnaire administered face-to-face to hospital managers on the existence of an RTA management policy, human and material resources, infrastructure and staff training needs. A total of 53 hospitals were covered, including 30 (56.6%) in Cameroon and 23 (43.4%) in South Kivu - DR Congo. Of these 53 facilities, 46 (86.8%) were district hospitals. Twenty-nine hospitals (54.7%) had a RTA response plan, 38 (71.7%) had a strategy for managing indigent patients, 40 (97.6%) had a RTA communication plan, and 9 (17.0) had a staff training plan on RTA accident management. Regarding facility capacity, only 24 of the 53 hospitals surveyed (45.3%) met the minimum service requirements for managing RTAs cases. These essential services were disproportionately concentrated in higher-level facilities, being available in all national hospitals (100%) and in 40% of regional hospitals. Similarly, only seven hospitals (13.2%) met the minimum human resource requirements necessary for appropriate RTA care. This workforce capacity was more common in national hospitals, where half (50.0%) met these criteria. Hospitals are inadequately prepared to respond to road traffic accidents due to deficiencies in response planning and the insufficient availability of both material and human resources required for effective accident management.

The DVLA allows driving in early dementia contingent on regular medical assessment. GPs and psychiatrists require validated and accessible assessments. Some studies have suggested that cognitive testing has utility in the assessment of driving capacity in elderly drivers. One study raises the possibility of using a highway-code questionnaire as an adjunct to these tests. Two hundred drivers over the age of 65 were randomly selected from two GP surgeries. Baseline assessment comprised completion of a Highway Code questionnaire (DPHC-98), the Mini Mental State Examination (MMSE) and an abbreviated version of the Alzheimer's Disease Assessment Scale Cognitive Subsection (EURO-ADAS). A history of road traffic accidents (RTAs) over the preceding 5 years was obtained. At 12-month follow-up interview driving status of the subject and occurrence of RTAs were recorded. Predictive power of DPHC-98 and cognitive testing with regards RTAs were examined through logistic regression analysis. Performance on the Highway Code questionnaire was identified as the only significant regression factor in the prediction of prospective RTAs. However, none of the logistic regression models were able to identify any drivers involved in RTAs either retrospectively or prospectively. Cognitive tests are not linked with risk of driving accidents in older adults in any useful way.

This paper attempts to calculate the social cost of fatal road traffic accidents (RTA) in Singapore where, both private and external costs taken into account. The human capital approach is employed in the calculation of income loss. The social cost of fatal RTAs is about $42,551,046 for the year 1997 or $172,271 per fatal RTA. Loss of future income forms the largest share (50%) followed by congestion cost (33%). The remainder is made up of cost related to damage to properties (both private motor vehicles and public streetlights), cost of ambulances sent to accident scene, hospital and funeral costs, pain and suffering and loss of social services provided. Some of the possible ways of reducing the fatal RTAs are through education, raising the speed limits and having more and clearer road signs. Better education of young and elderly drivers in driving skills is important as they make up about 66% of all drivers involved in fatal accidents.

Association of road-traffic accidents with benzodiazepine use