Drivers In Motor Vehicle Crashes Research Articles

Size and age of fatal drivers by crash type, vehicle type and gender

Objective: The objective of this study was to determine the physical characteristics of fatal drivers in motor vehicle crashes with focus on rear impacts. Methods: 1998 to 2020 FARS data was analyzed for height, weight, and age of fatal drivers. The data was queried by gender, crash type and vehicle type. Results: The average fatal driver weighed 80.4 kg, was 173.4 cm tall, and was 43 years old. Females were 16.0 kg lighter and 14.2 cm shorter than males on average. The height was 151.2 cm for the 5th percentile female, 177.0 cm for the 50th male and 188.9 cm for the 95th male. The weight of fatal drivers increased linearly with calendar year. The increase rate was greater in females than in males. About 3% of fatal drivers were involved in rear crashes, 39.9% in frontal crashes and 36.8% in rollovers. The average fatal driver was 172.5 cm tall and weighed 81.0 kg in rear impacts. They were similar in height and weight to the overall sample. The average fatal driver in rear impacts was 46 years old, 3 years older than the overall average. Pickup truck drivers weighed 85.4 kg and were 176.8 cm tall on average. They were heavier and taller than passenger car drivers on average, which were 78.0 kg and 172.2 cm. Fatally injured minivan drivers were 10 years older than fatally injured passenger car drivers on average. The findings are compared with ATDs (anthropometric test devices) used in sled and crash testing. Conclusion: The average weight of fatal drivers increased with calendar year. The average size of fatal drivers was similar by crash types. Fatal drivers were older in rear impacts.

Roadway features associated with elderly drivers in motor vehicle crashes.

As the number of older US drivers has increased over the past decades, so has the number of injuries, hospitalizations, and deaths from motor vehicle crashes (MVCs) involving elderly drivers. We seek to identify personal, environmental, and roadway features associated with increased crashes involving elderly drivers. We hypothesize that elderly drivers are more likely to be involved in MVCs at intersections with more complex signage and traffic flow. This is a retrospective observational study using 2015 to 2019 police traffic crash reports and a Department of Public Health database of built-environment variables from a single urban center. Demographics and environmental/road features were compared for vehicle-only MVCs involving elderly (≥65 years) and younger drivers. χ2 and nonparametric tests were used to analyze 36,168 drivers involved in MVCs. There were 2,575 (7.1%) elderly drivers involved in MVCs during the study period. Left turns and all-way stop signs were associated with increased crash risk among elderly drivers compared with younger drivers. Elderly-involved MVCs were less likely to occur at intersections with left-turn restrictions, traffic lights, only one-way streets, and bike lanes compared with MVCs with younger drivers. Elderly drivers were more likely to be involved in MVCs on weekdays, less often intoxicated at the time of the crash, and less frequently involved in fatal MVCs compared with younger drivers. However, elderly drivers were more frequently the at-fault party, especially after the age of 75 years. Updates to roadway features have potential to decrease injury and death from MVCs involving elderly adults. Left turn restrictions or other innovative safety treatments at all-way stops or where left turns are permitted may mitigate road crashes involving older adults. Education may increase awareness of higher-risk driving tasks such as turning left, and driving alternatives including public transportation/paratransit may offer alternate means to maintain activities of daily living. Prognostic/Epidemiological, level IV.

Difficulties in Emotion Regulation and Attitudes towards Risky Driving in a Group of Pre-Licensed Drivers

Over-representation of novice drivers in motor-vehicle crashes encourages researchers to look for all possible psychological causes which might be targeted in prevention. The present study is aimed to explore the associations between difficulties in emotional regulation and attitudes towards risk-taking while driving in a group of pre-licensed drivers. The sample involved 475 driver’s licence candidates who completed the self-reported questionnaire with the Difficulties in Emotion Regulation Scale (DERS) and the Scale of Risk-Taking Attitudes to Driving. Structural equation modelling showed that difficulties in emotion regulation were statistically significant predictors of all measured risk-taking attitudes to driving (over speeding, drunk driving, showing off driving skills, violation of traffic rules, joyriding and positive attitude towards traffic flow) for both males and females. These findings add to the gap in the literature and confirm that emotion regulation difficulties might be the important target addressed in early intervention. Increased emotional competence of pre-licensed drivers might contribute to safer driving and improved road safety.

P06 Varied Severity of Motor Vehicle Crash Injuries Using National Dataset in Taiwan

BackgroundInjuries by motor vehicle crashes remain the priority concern in the public-health. The aims of this study were to determine the distribution of varied severity of motor vehicle crash (MVC) injuries, and the time trend of MVC injuries by different car type between 2003 and 2010 in Taiwan. MethodsPooled data from Taiwan׳s National Traffic Accident Dataset, Taiwan׳s National Health Insurance Database, and National Register of Deaths for the year 2003 through 2010 were used. A total of 2,405,674 subjects involved in MVC events were included. The severity of MVC injuries were classified as emergency-visit only (ER-visit), hospitalization and death. Frequency counts, percentages and 95% confident interval were estimated for descriptive analyses. Mann-Kendall test was used to determine time trend of varied severity injuries by car types. ResultsIn 2010, the percentages of MVC subjects who were injured with ER-visit only, hospitalization, or death were 33.9%, 6.9% and 0.6% respectively. Vulnerable road users as cyclists and motorcyclists had highest probability of sever injury outcomes due to MVC rather than all other types of vehicle drivers. Compared with sedan drivers, cyclist had approximately 10 times more risk of ER-visit, 15 times more risk of hospitalization, 9 times more risk of death in MVC. Among motorcyclists, the risks of getting ER-visit, hospitalization, or death were 9, 11, 4 times higher than sedan drivers in MVC respectively. Over the period 2003 to 2010, the results of time trend test showed that the percentage of hospitalization or death among drivers of MVC had significantly decreased with years, however, the ER-visit utilization increased from 26.2% in 2003 to 34.0% in 2010. After stratification of car types, the ER-visit utilization among cyclist and motorcyclist of MVC remains significantly increased by years. ConclusionsThe evidences presented that the severity of MVC occurred from cyclists and motorcyclists is the major problems of motor vehicle crashes in Taiwan. Therefore, governments and health care providers to address on motorists and cyclist safety education, and to allocate an appropriate level of medical resources in order to effectively deal with different injury severity patterns.

Obesity and seatbelt use: a fatal relationship

BackgroundSeatbelts significantly reduce the risk of death in motor vehicle accidents, but a certain number of individuals from some subgroups tend not to wear their seatbelts. ObjectivesIn this study, we hypothesized that obese drivers (in fatal crashes) were less likely to wear seatbelts than their normal-weight counterparts. MethodsA retrospective study was conducted on the drivers in motor vehicle crashes entered into the Fatality Analysis Reporting System database between 2003 and 2009. A number of precrash variables were found to be significantly associated with seatbelt use. These were entered into a multivariate logistic regression model using stepwise selection. Drivers were grouped into weight categories based on the World Health Organization definitions of obesity by body mass index. Seatbelt use was then examined by body mass index, adjusted for precrash variables that were significantly associated with seatbelt use. ResultsThe odds of seatbelt use for normal-weight individuals were found to be 67% higher than the odds of seatbelt use in the morbidly obese. The relationship of seatbelt use between the different weight groups and the morbidly obese is as follows (odds ratios [ORs] for each comparison are listed with 95% confidence limits [CL]): underweight vs morbidly obese (OR, 1.62; CL, 1.47-1.79), normal weight vs morbidly obese (OR, 1.67; CL, 1.54-1.81), overweight vs morbidly obese (OR, 1.60; CL, 1.48-1.74), slightly obese vs morbidly obese (OR, 1.40; CL, 1.29-1.52), and moderately obese vs morbidly obese (OR, 1.24; CL, 1.13-1.36). ConclusionSeatbelt use is significantly less likely in obese individuals compared with their normal-weight counterparts.

Emergency Department Charges for Evaluating Minimally Injured Alcohol-Impaired Drivers

The literature on the costs of treating alcohol-impaired motor vehicle crash victims is largely based on inpatient data. Less is known about the more frequent emergency department (ED) evaluations for those who are discharged home. Our objective is to measure the difference in charges and length of stay between alcohol-impaired and nonimpaired drivers in this population. This was a retrospective study of charts and billing data for all drivers in motor vehicle crashes, aged 21 to 65 years, treated at an urban Level I trauma center in 2005 and discharged home from the ED. Patients were divided into alcohol-positive and -negative groups according to alcohol level, documentation of recent alcohol use, or clinical intoxication. Itemized charges were tabulated and compared across groups. Of 1,618 eligible patients, median charges were higher for alcohol-positive patients by $4,538 (95% confidence interval [CI] $2,755 to $5,665). Imaging was 69% of the charge differential because of a higher frequency of imaging (91% versus 70%) and more expensive studies (median difference $2,464; 95% CI $1,507 to $3,400) for alcohol-positive patients. Median length of stay was higher for alcohol-positive patients by 3.3 hours (95% CI 2.7 to 4.1 hours). When stratified by trauma-protocoled triage destination, median charges were higher for alcohol-positive versus -negative patients in non-critical care beds by $2,229 (95% CI $1,039 to $2,693). For patients triaged to critical care beds, the difference in charges was only $132 (95% CI -$1,677 to $1,233). The presence of alcohol substantially increased charges and length of stay for ED evaluations of injured drivers discharged home, especially for patients who were triaged to non-critical care beds. The magnitudes are striking for this minimally injured population and represent an underreported burden of alcohol-impaired driving.

Are There Racial Disparities in Trauma Care?

A number of recent studies have demonstrated disparity between racial groups in both outcome and processes of trauma care. These were not controlled for the presence of shock. We used data from the National Trauma Databank (NTDB) (version 6.0) to evaluate mortality, length of hospital stay, and discharge disposition for patients who suffered gunshot wounds (GSW) or who were drivers in motor vehicle crashes (MVC). Using regression analysis to control for age, gender, first measured systolic blood pressure, geographic region, trauma center verification status, and hospital teaching status, we looked for differences in trauma care outcomes by race as represented in the NTDB. We included 235,557 MVC victims and 13,378 GSW victims in our analysis. When potential confounding variables were accounted for, there were no differences in mortality based on race in either group, with the exception that Hispanic motor vehicle drivers suffered higher mortality, OR: 1.72 (95% CI: 1.36, 2.19; p<.001). Both Blacks and Hispanics had shorter lengths of stay in linear regression models (p<.001 in both cases) than whites. Blacks and Hispanics were less likely to be discharged home when compared to white patients (OR 0.83, 95% CI 0.80-0.86 for Blacks, and OR 0.53, 95% CI 0.50-0.56 for Hispanics). Shock, as reflected by first systolic blood pressure reported, and to a lesser degree, anatomic injury, as measured by Injury Severity Score (ICISS), were much more powerful predictors of outcome than race in all analyses. We found no mortality differences based on race for GSW. Hispanics have a higher mortality rate for MVC. For both injury types, Blacks and Hispanics had shorter hospital stays and a greater likelihood of transfer to post-acute care when compared to white patients. Hypotension on admission has a much more significant impact on outcome than race and ethnicity.

Obesity and risk for death due to motor vehicle crashes.

We examined the role of body mass index (BMI) and other factors in driver deaths within 30 days after motor vehicle crashes. We collected data for 22 107 drivers aged 16 years and older who were involved in motor vehicle crashes from the Crashworthiness Data System of the National Automotive Sampling System (1997-2001). We used logistic regression and adjusted for confounding factors to analyze associations between BMI and driver fatality and the associations between BMI and gender, age, seatbelt use, type of collision, airbag deployment, and change in velocity during a crash. The fatality rate was 0.87% (95% confidence interval [CI]=0.50, 1.24) among men and 0.43% (95% CI=0.31, 0.56) among women involved as drivers in motor vehicle crashes. Risk for death increased significantly at both ends of the BMI continuum among men but not among women (P<.05). The association between BMI and male fatality increased significantly with a change in velocity and was modified by the type of collision, but it did not differ by age, seatbelt use, or airbag deployment. The increased risk for death due to motor vehicle crashes among obese men may have important implications for traffic safety and motor vehicle design.

Traumatic brain injury and automotive design: making motor vehicles safer.

Traumatic brain injury (TBI) remains a major public health problem in the United States. Identifying and modifying vehicle designs associated with TBI will have a significant impact on the frequency and severity of TBI in motor vehicle crashes (MVCs). Our objective, therefore, was to identify interior vehicle contact points associated with severe TBI (head Abbreviated Injury Scale score > 3) among drivers and determine the extent to which modifications of these contact points impact the likelihood of severe TBI. We analyzed drivers in MVCs from the 1993 to 2001 National Automotive Sampling System database. The odds of severe TBI with respect to various vehicle contact points were estimated using multivariate logistic regression. Using computer simulation software, the magnitude of driver head deceleration was modeled while manipulating vehicle design features. The potential impact of this design modification on the frequency and hospital charges of TBI cases was estimated. There were 18,313 drivers involved who were victims of TBI, equating to a national sample size of 3,275,472 cases. The most frequent contact point associated with severe TBI was the roof rail (odds ratio, 2.0; 95% confidence interval, 1.2-3.3). Increasing roof rail padding thickness to 5.0 cm reduced the peak acceleration from 700 g to 218 g, which would potentially reduce the attributable number of severe TBI cases per year from 2,730 to 210, thereby reducing annual acute care charges from $136.5 million to $10.5 million US dollars. Contact with the roof rail significantly increases the likelihood of TBI in MVCs. Minor increases in padding at these points may reduce the frequency of severe TBI, which would have a substantial effect on health care costs.

How Does Octogenarian Status Affect Morbidity, Mortality, and Functional Outcomes of Elderly Drivers in Motor Vehicle Crashes in Pennsylvania, 1988 to 2001?

How Does Octogenarian Status Affect Morbidity, Mortality, and Functional Outcomes of Elderly Drivers in Motor Vehicle Crashes in Pennsylvania, 1988 to 2001?

Trends of behavioral risk factors in motor vehicle crashes in Utah, 1992–1997

Objective: Measure changes in the prevalence of behavioral factors including police-reported fatigue and alcohol intoxication, as well as self-reported seatbelt use, and assess their effect on hospitalization or death after a motor vehicle crash. Methods: Probabilistic linkage was used to match drivers in motor vehicle crashes with hospital discharge records for the years 1992–1997. Frequencies of specific behavioral factors were evaluated using the Cochran–Armitage test for trend. Odds ratios and corresponding 95% confidence intervals were calculated using generalized estimating equations (GEEs) with crash and driver characteristics as independent variables and hospitalization or death as the dependent variable. Results: The analysis database consisted of 450,286 crash driver records, which linked to 4219 (0.9%) hospitalizations or deaths. There was an increasing trend for self-reported seatbelt use among crash-involved drivers from 80.5% in 1992 to 89.3% in 1997 ( P<0.001). Police-reported alcohol intoxication among crash-involved drivers showed a decreasing trend from 2.4% in 1992 to 1.5% in 1997 ( P<0.001). There was no trend for police-reported fatigue-related crashes. Odds ratios of hospitalization or death for seatbelt use, alcohol involvement, and fatigue were significant and did not fluctuate considerably between 1992 and 1997. Seatbelt use offered a protective effect from hospitalization or death, while alcohol intoxication and fatigue contributed to increased likelihood of hospitalization or death. Conclusions: These results suggest that while some improvement has been made in decreasing seatbelt non-use and driver alcohol intoxication among crash-involved drivers, no improvement has been made in reducing fatigue-related crashes.

How Does Older Age Affect Morbidity and Mortality of Drivers in Motor Vehicle Crashes in Pennsylvania, 1988 to 2001?

How Does Older Age Affect Morbidity and Mortality of Drivers in Motor Vehicle Crashes in Pennsylvania, 1988 to 2001?

Prospective confirmation of low arrest rates among intoxicated drivers in motor vehicle crashes.

Several states have legally sanctioned or mandated physician reporting of drivers who were driving while intoxicated (DWI). Valid prospective evidence demonstrating extremely poor performance of the criminal justice system seems ethically and scientifically essential if overriding public health considerations are to abrogate the fundamental principles of patient-physician confidentiality. No such evidence is available. The authors reasoned that poor performance of the judicial system would be most evident if drivers who were DWI were not arrested under conditions selected to optimize legal intervention. The authors therefore wished to estimate the unbiased proportion of DWI drivers brought to an emergency department (ED) under these optimized conditions who escape detection by law enforcement officials. Prospective, consecutive cohort of drivers transported to an urban ED following a motor vehicle crash (MVC). Conditions selected to optimize legal intervention included: police at scene; inebriation of driver clinically evident to out-of-hospital personnel; and confirmatory blood ethanol level > or =100 mg/dL (> or =22 mmol/L). Main outcome measure was arrest for DWI. Of 294 drivers in MVCs, 270 had ethanol levels, of whom 18 met criteria for optimum likelihood of legal intervention. Of these, 22% were arrested for DWI (95% CI = 6% to 48%). Adjustment for missing data, under assumptions designed to maximize arrest frequency for DWI, did not materially alter these findings. No patients were lost to follow-up. These findings prospectively confirm that, even under conditions selected to optimize detection by law enforcement officials, only about one of every five drivers who were DWI and were brought to an ED following an MVC-and almost certainly no more than a minority-comes to the attention of the criminal justice system.

Psychosocial characteristics and followup of drinking and non-drinking drivers in motor vehicle crashes

Psychosocial characteristics and followup of drinking and non-drinking drivers in motor vehicle crashes

Psychosocial characteristics and follow-up of drinking and non-drinking drivers in motor vehicle crashes.

Eight hundred fifty-four consecutive motor vehicle crash (MVC) victims admitted from August 1, 1986, through August 31, 1989, were prospectively assessed including measurement of blood alcohol concentration (BAC). One hundred six in-hospital interviews were conducted on competent consenting drivers > or = 18 years old; 22.9% (n = 22) of those who were BAC tested (n = 96) were positive for alcohol on admission. The blood alcohol concentration positive [BAC(+)] and the BAC negative (-) drivers differed significantly on the following variables; driver education [BAC(-) > BAC(+): p < 0.01], license suspension < or = 2 years before admission [BAC(+) > BAC(-): p < 0.01], frequency of self-reported intoxication in month before crash [BAC(+) > BAC(-): p < 0.05], driving within 2 hours of drinking < or = 1 month before admission [BAC(+) > BAC(-): p = 0.01] and self-reported driving with BAC > 17 mmol/L < or = 1 month before admission [BAC(+) > BAC(-): p < 0.01]. Follow-up interviews (n = 106) were conducted 1 year after discharge; drivers originally testing BAC(+) were more likely to drive within 2 hours of drinking (p < 0.05), and were more likely to admit to driving with a BAC > 17 mmol/L (p < 0.01). Original BAC(+) drivers were also more likely to report a subsequent MVC in the year following discharge (not statistically significant). There is a need to develop an assessment system to identify high crash-risk drivers and establish rehabilitation programs to reduce crash recidivism.

Death and injury from motor vehicle crashes in Israel: epidemiology, prevention and control.

Death and motor vehicle crash (MVC) rates per 1000 vehicles and kilometres travelled in Israel (1977) exceed those of all western countries, despite low numbers of young and intoxicated drivers. Increased casualties have resulted from expansion of driver and vehicle populations offsetting a decline in crash risk. Time data indicate casualty crash trends reflect trends in traffic volume, and that night time case fatality rates (CFR) are high. Place data indicate that more than three quarters of all crashes occur in cities, mostly involving pedestrians, but the majority of deaths result from higher speed inter-urban crashes, mostly of 2-vehicle type, and not as intersections. The rates for deaths per 100 crashes are 4- and 8-fold higher in inter-urban than urban crashes for occupants and pedestrians, respectively. Vehicle data indicate high MVC risk from careless driving, probably speeding in taxis, and point to the need for occupant protection standards in light weight trucks and pick up vans. Human data indicate that 92% of drivers in MVCs are male. The risk of involvement is high for drivers aged 18 and drops at aged 55. Pedestrian accidents resulted in 48.1% of all dead, and included large numbers of young and elderly. Reduction in inter-urban private motor vehicle travel and in speeds at which crashes occur are suggested as swift and effective measures to reduce death and injury. Low cost strategies include air bags and other occupant protection standards and more seat belts. Prevention of pedestrian accidents requires a variety of measures to reduce vehicle-pedestrian conflicts.