Objective Although second-generation antihistamines have reduced sedation-related side effects compared to first-generation antihistamines, sedation may still impair motor vehicle driving performance. Moreover, receiving/making phone calls using a hands-free function can negatively affect driving performance. Therefore, herein, driving performance was evaluated using a driving simulator to gain insights into the hazards of driving by combining second-generation antihistamines and a calling task, i.e., simulated calls using a hands-free function. Methods In this study, 20 subjects drove in a driving simulator in the absence or presence of a calling task while taking or not taking second-generation antihistamines. Driving performances for nonemergency and emergency events were determined, and a comparative analysis of intra-individual variability when taking and not taking second-generation antihistamines was conducted. Results First, when nonemergency and emergency were examined in the absence of a calling task, no significant difference in driving performance was observed between taking and not taking second-generation antihistamines. Next, when the nonemergency event was examined in the presence of a calling task, no significant difference in driving performance was observed between taking and not taking second-generation antihistamines. However, when the emergency event was examined in the presence of a calling task, a significant difference in driving performance was observed between taking and not taking second-generation antihistamines, thus resulting in reduced driving performance. Conclusions The new system with added calling tasks allowed the extraction of the potential risks of driving performance of second-generation antihistamines that may have been previously overlooked. This study suggests that pharmacists and other healthcare professionals may need to instruct people taking any second-generation antihistamine to focus on driving and not on subtasks that require cognitive load such as talking while driving.

Objectives Driving is a dynamic activity that takes place in a constantly changing environment, carrying safety implications not only for the driver but also for other road users. Despite the potentially life-threatening consequences of incorrect driving behavior, drivers often engage in activities unrelated to driving. This study aims to investigate the frequency and types of errors committed by drivers when they are distracted compared to when they are not distracted. Methods A total of 64 young male participants volunteered for the study, completing four driving trials in a driving simulator. The trials consisted of different distraction conditions: listening to researcher-selected music, driver-selected music, FM radio conversation, and driving without any auditory distractions. The simulated driving scenario resembled a semi-urban environment, with a track length of 12 km. Results The findings of the study indicate that drivers are more prone to making errors when engaged in FM radio conversations compared to listening to music. Additionally, errors related to speeding were found to be more prevalent across all experimental conditions. Conclusions These results emphasize the significance of reducing distractions while driving to improve road safety. The findings add to our understanding of the particular distractions that carry higher risks and underscore the necessity for focused interventions to reduce driver errors, especially related to FM radio conversations. Future research can delve into additional factors that contribute to driving errors and develop effective strategies to promote safer driving practices.

Objective A referendum took place in Greece on the 5th of July 2015 to decide whether the suggested bailout would be accepted. Since this was the first one since 1974, the period between the referendum and the subsequent national elections was characterized by increased uncertainty and had spillover effects in many aspects of everyday life. We take advantage of this quasi-experiment to investigate the short-term impact of the referendum on vehicle collisions casualties. Methods We use data from the daily number of injuries and fatalities caused by vehicle collisions in 2015 and employ a difference-in-differences approach, comparing trends before and after the referendum. Results We reveal that the referendum had a short-term impact on road traffic casualties (4.14 more casualties per day), compared to what would have been expected in the absence of the referendum. Conclusions The study provides evidence that negative emotions and anxiety, due to uncertainty, could promote dangerous driving behavior. Preventive and traffic control measures may need to be considered by policy makers during periods of uncertainty.

Objective The use of motorcycles in commercial transportation is increasing due to its comfortable use in congested traffic conditions and the ease of parking on narrow streets. Motorcycle couriers are among the important members of the delivery industry. The race against time and delivering on time bring along many problems. This study aims to examine the relationships between perceived organizational support, colleague value and stress in motor courier employees. Method Within the scope of the study, 151 motorcycle couriers working in the delivery sector were selected. The study was carried out in the period of June-November 2022. In addition to 15 questions including demographic characteristics with the one-to-one interview method, Spielberger’s State and Trait Anxiety Scale, The Perceived Organizational Support Scale and The Coworker Support Scale were applied with the one-to-one interview method. Results The average age of the 151 couriers included in the study was 29.10 ± 7.01; the working year was 3.26 ± 3.39; the average number of daily trips was 36.47 ± 17.37; the average delivery time was 16.54 ± 10.10 in minutes (median 15); and the average weight of the cargo was 4.94 ± 5.51 (kg) (median: 3.50). The prevalence of occupational accidents in the last year has been 43.3% (n = 61). Examining the causes of the prevalence of accident among the study population, it was found that motorcycle overturning was 20 (32.8%); vehicle hitting the motorcycle was 26 (42.6%); motorcycle hitting the vehicle was 15 (24.6%). When the factors affecting the perceived organizational support were examined, it was found that those with a colleague social support score above 18 were more likely to have an organizational perception score above 80 (95% CI 1.001-4.843) with a rate of [OR] = 2.20 times higher, and those with a status anxiety score above 40 were more likely to have an organizational perception score over 80 with a rate of [OR] = 2.49 times higher (95% CI: 1.156-5.364). In addition, it was seen that the probability of having an organizational perception score above 80 was [OR] = 0.42 times higher (95%CI: 0.200-0.889) in participants who had a work accident. Conclusions The intense pace of work and the pressure of fast delivery increase couriers’ state and trait concerns. Developing policies to improve the psychosocial working environment for a more decent and healthier working environment that improves the mental health and well-being of couriers is recommended. Commercial food ordering platforms must treat driver safety as important when determining delivery times.

Objective The purpose of this study was to explore various tests of impairment that could potentially be added to the Standardized Field Sobriety Test (SFST) to enhance its sensitivity to identify drivers whose abilities are adversely affected by cannabis. Methods An observational study was conducted in which participants were invited to use their own cannabis at the research facility. Once prior to cannabis use and at four times during the 150 min after cannabis use, participants performed the three tests of the Standardized Field Sobriety Test (SFST) (i.e., Horizontal Gaze Nystagmus, Walk and Turn, and One Leg Stand) as well as the Modified Romberg Balance and Finger to Nose tests. In addition, assessments were made of physiological indicators (i.e., eyelid, leg and body tremors, rebound dilation, lack of convergence) and vital signs (pulse, blood pressure and body temperature). Participants also completed a digit-symbol substitution task at each testing interval. With the exception of vital signs and the digit symbol task, all tests and assessments were administered and scored by certified Drug Recognition Experts using the standard procedures of the Drug Evaluation and Classification Program. Results Twenty minutes after vaping cannabis (mean THC concentration = 6.34 ng/mL), participants displayed performance deficits on a variety of tasks; 67% met the criterion for suspected impairment on the SFST. Addition of the Finger-to-Nose (FTN) test along with observations of head movements and jerks (HMJ) increased the percentage of participants who met the criterion for suspected impairment by 33% and improved the sensitivity of the test from 0.67 to 0.88. Conclusions The results of this study support supplementing the SFST with the Finger-to-Nose test and observations of HMJ to assist in the detection of drivers who are adversely affected by the use of cannabis. The observational study design and the use of assessors who were not blinded as to the use of cannabis by participants limits the strength of the evidence. Further research, including randomized trials and field studies of drivers, is required to confirm and validate this enhanced version of the SFST.

Objectives Few studies have examined motor function in determining the suitability of patients with stroke to resume driving a car. Patients with hemiplegia usually control car pedals with the unaffected lower limb. However, motor control on the unaffected side is also impaired in patients with stroke. This study aimed to clarify the neurophysiological characteristics of pedal switching control during emergency braking in patients with hemiplegia. Methods The study participants consisted of 10 drivers with left hemiplegia and 10 age-matched healthy drivers. An experimental pedal was used to measure muscle activity and kinematic data during braking, triggered by the light from a light-emitting diode placed in front of the drivers. Results The patient group took the same reaction time as the healthy group. However, from the visual stimulus to the release of the accelerator pedal, the patient group had higher muscle activity in the tibialis anterior and rectus femoris and had faster angular velocities of hip and knee flexion than the healthy group. In addition, the patient group had higher co-contraction activities between flexors and extensors. From the accelerator pedal release to brake contact, the patient group had slower angular velocities of hip adduction, internal rotation, ankle dorsiflexion, internal return, and internal rotation than the healthy group. Conclusions Patients with hemiplegia exhibited poor control of pedal switching using their unaffected side throughout the pedal-switching task. These results indicate that the safety related to car-pedal control should be carefully evaluated while deciding whether a patient can resume driving a car after a stroke.

Objective Two wheel motorized vehicles used in both street transportation and recreation are a common cause of severe injury in the United States (US). To date, there has been limited data describing the spinal injury patterns among these motorcycle injury patients in the US. The goal of this study is to characterize and compare differences in specific injury patterns of patients sustaining traumatic spinal injuries after motocross (off-road) and street bike (on-road) collisions in the southwestern US at a Level I Trauma Center. Methods Trauma registry data was queried for patients sustaining a spinal injury after motorcycle collision from 2010 to 2019 at a single Level I Trauma Center. Computed tomography (CT) scan and magnetic imaging resonance imaging (MRI) reports from initial trauma evaluation were reviewed and data was manually obtained regarding injury morphology and location. Results A total of 1798 injuries were identified in 549 patients who sustained a motorcycle collision, specifically 67 off-road and 482 on-road motorcycle patients. Off-road motorcycle patients were found to be significantly younger (34.75 vs. 42.66, p = 0.00015). A total of 46.2% of the off-road injuries were determined to be from compression mechanisms, compared to 32.9% in the on-road cohort (p = 0.0027). The on-road cohort was more likely to have an injury classified as insignificant, such as transverse and spinous process fractures (60.1% vs. 42.5%, p = 00.25). There was no significant difference in regards to junctional, mobile, and semirigid spine segments between the two cohorts. Conclusions Different fracture patterns were seen between the off-road and on-road motorcycle cohorts. Off road motorcyclists experienced significantly more compression and translational injuries, while on road motorcyclists experienced more frequent insignificant injury patterns. Data on the different fracture patterns may help professionals develop safety equipment for motorcyclists.

Objectives This study sought to examine whether young adults who sustain concussions have different driving histories and pre-injury driving styles than uninjured peers. In addition, we assessed whether modifications were made to driving behavior in the acute period following concussion. Methods Self-reported driving and demographic information was collected from 102 16- to 25-year-old drivers. Half of the sample had recently sustained concussions and the other half comprised a matched comparison group. Results The groups reported similar pre-injury driving behaviors and styles. However, the recently injured group had more driving citations, higher rates of psychiatric disorders, and greater likelihood of having sustained a prior concussion. Self-reported driving habits postconcussion suggested that most drivers did not modify their driving behavior following concussion, though they were less likely to drive at night or with others in the car. Conclusion Results highlight the need for postconcussion driving guidelines and support for returning to driving safely.

Objective: Autonomous driving technology eliminates human errors, and thus it is a promising solution for reducing road traffic fatalities and injuries. While future autonomous driving technology may be able to reduce the number of collision accidents, it will not be able to avoid all collision accidents. This study is aimed to demonstrate why some accidents will still be unavoidable even with advanced perceiving and controlling capabilities. Methods: Because fully autonomous vehicles are currently in the laboratory stage, we used the prospective method to study the unavoidable accident of autonomous vehicles. Suitable traffic accident cases were screened from the China In-Depth Accident Study (CIDAS). Videos of the accidents were analyzed and the accidents were reconstructed using PC-Crash software. We assumed that target vehicle possesses near-perfect autonomous driving capabilities. Unavoidable accidents were determined based on vehicle dynamics and traffic constraints. The time from perceiving hazard to collision was calculated for each accident. Results: Among the 112 accidents screened, 15 cases of unavoidable accidents were identified. Three typical cases are presented in detail in this study. Based on the reasons why the target vehicles cannot avoid the collisions, we classified the unavoidable accidents into time-limit type and space-limit type. Time-limit means that vehicle cannot stop or steer out of danger in time, and space-limit means that the traffic environment does not have sufficient space for vehicle to avoid collision. Conclusions: Collision accidents will still occur even with perfect autonomous driving technology. We used the prospective method to investigate scenarios and characteristics of unavoidable accidents of autonomous vehicles. The time-limit type and the space-limit type were identified as two categories of unavoidable accidents. For the time-limit unavoidable accidents, the time from perceiving hazard to collision is typically not longer than 1.5s. The characteristics of unavoidable accidents and the estimated pre-crash warning time can provide some reference for establishing future occupant protection strategies. This study also showed the limitations of active safety and the necessity of passive safety.

Objective: The division of responsibility in vehicle-two-wheelers accidents reflects the extent to which different fault parties contributed to the occurrence of the accident, with significant differences in the injuries sustained by the riders in accidents where diverse parties were primarily responsible. We want to explore the difference in the severity of injury of riders in different fault parties of accidents so that we can make targeted protection improvements. Methods: In this study, three generalized ordered logit models were established for the total sample (n = 1204), the sample with drivers as the primary fault party (n = 607), and the sample with riders as the primary fault party (n = 597), respectively, to explore the differential impact factors on rider injury severity in vehicle-two-wheelers accidents involving different fault parties. Inter-group difference tests were conducted on the mean rider injury severity caused by differential factors in different accidents. Combining the impact effect trends and mean differences in the model, the differences in rider injury severity in accidents involving different fault parties were analyzed from the standpoints of human, vehicle, and road factors. Results: It was found that the effects of curve on injury severity was sheerly opposite in accidents with different fault parties and that factors, such as visual obstruction, road surface condition, gender, and helmet wearing differed in their effects on rider injury severity under different fault parties accidents. This reveals the driving tendencies and states of both parties in different environments. Conclusion: Based on the differential impact factor analysis and rider injury characteristics in accidents involving different fault parties, suggestions for improvement were made from the perspectives of road facilities, and safety awareness of drivers and riders, which are beneficial for improving rider safety and providing a theoretical reference for future regulations on liability allocation.