Fatal Accident Reporting System Research Articles

Are Minimum Wages a Silent Killer? New Evidence on Drunk Driving Fatalities

AbstractIn volume 94 of this REVIEW, Adams, Blackburn, and Cotti (ABC), using Fatal Accident Reporting System data from 1998 to 2006, find that a 10% increase in the minimum wage is associated with a 7% to 11% increase in alcohol-related fatal traffic accidents involving teen drivers. We find this result does not hold when the analysis period is expanded to include 1991 through 2013. In addition, auxiliary analyses provide no support for income-driven increases in alcohol consumption, the primary mechanism posited by ABC. Together, our results suggest that minimum wage increases are not a silent killer.

Emergency Medical Services Response Times to Motor Vehicle Crashes Increased over the Period 1987 to 2015

Emergency Medical Services (EMS) response time to motor vehicle crashes (MVC’s) have been studied to determine if reducing the individual components of EMS response time (notification, arrival at the crash scene, and hospital arrival) may affect survival rates. It has been proposed that a reduction to 1 and 15- minute EMS notification and arrival times at the crash would result in 1.84% and 5.2% fewer fatalities. The aim of this study was to analyze the changes in EMS response times (notification, arrival at the crash scene, and hospital arrival) over the past three decades, both individually and overall. An important change in the past three decades is the increased use of cellular phones. Therefore, we hypothesized that EMSnotification time would have decreased over the timeframe, yielding an overall decrease in EMS response time. Our data are based on the Fatal Accident Reporting System (FARS) using the variables: Time of Crash, EMS Notification Time, EMS Arrival Time, EMS Hospital Arrival Time. This gives a total of 248,981 valid cases following the implementation of our inclusion criteria and truncation of the dataset to the 99th percentile to eliminate unexplainable outliers. We computed the individual and overall median EMS response times for each year from 1987 to 2015. Additionally, we analyzed the response times based on four separate crash factors: weather, total vehicles involved, time of day, and state population density. From 1987 to 2015 the individual EMS response times changed; while notification time has decreased, the arrival at both crash scene and hospital have steadily increased, resulting in overall increased total EMS response time.

IDENTIFICATION OF ROAD TRAFFIC FATAL CRASHES LEADING FACTORS USING PRINCIPAL COMPONENTS ANALYSIS

Traffic crash fatalities create primary safety concern beyond the traffic congestion and delay. Therefore, the purpose of this study is to identify the principal components/factors associated with road traffic crash in the U.S. through retrospective reviewing based on more than two million records of fatal crashes and 38 years (1975-2012) of National Highway Traffic Safety Administration official’s Fatal Accident Reporting System (FARS) database. This study portrays an integrated geographic information system and SAS application in order to find the major factors forcing traffic crashes. The resulting geospatial analysis and principal components analysis yielded critical significant factors causing fatal traffic crashes. The outcomes of this research could be used in transportation safety policy making and planning significantly.

Some Counterclaims Undermine Themselves in Observational Studies

Claims based on observational studies that a treatment has certain effects are often met with counterclaims asserting that the treatment is without effect, that associations are produced by biased treatment assignment. Some counterclaims undermine themselves in the following specific sense: presuming the counterclaim to be true may strengthen the support that the original data provide for the original claim, so that the counterclaim fails in its role as a critique of the original claim. In mathematics, a proof by contradiction supposes a proposition to be true en route to proving that the proposition is false. Analogously, the supposition that a particular counterclaim is true may justify an otherwise unjustified statistical analysis, and this added analysis may interpret the original data as providing even stronger support for the original claim. More precisely, the original study is sensitive to unmeasured biases of a particular magnitude, but an analysis that supposes the counterclaim to be true may be insensitive to much larger unmeasured biases. The issues are illustrated using data from the U.S. Fatal Accident Reporting System. Supplementary materials for this article are available online.

The Importance of Vehicle Rollover as a Field Triage Criterion

The objective of this article was to review the importance of vehicle rollover as a field triage criterion. In 1987, field triage criteria were developed by the American College of Surgeons Committee on Trauma that have been propagated repeatedly over the subsequent 20+ years. The field triage decision scheme is based on abnormal physiology, obvious abnormal anatomy, mechanism of injury likely to result in severe injury, and other factors (age, etc.) and was supported by available science at that time. In 2005, the triage scheme was revised by a committee, and vehicle rollover as a crash scene triage criterion was dropped in 2006. The medical literature and data from the Department of Transportation/National Highway Traffic Safety Administration (NHTSA) Fatal Accident Reporting System and the National Automotive Sampling System were analyzed to determine the contribution of rollover to morbidity and mortality. Vehicle rollovers represent a small but significant percentage of crashes; of the almost 12 million vehicle crashes reported by NHTSA in 2004, only 2.4% were rollovers, but these accounted for one-third of all crash-related occupant deaths and about 25,000 serious injuries every year. Rollovers are associated with the second highest number of vehicle occupant deaths by crash mode, three times the risk of injury when compared with other impact directions (p < 0.0001), specific types of injury such as head and spinal cord injuries, and a risk of death >15 times the risk in nonrollover crashes. The data and literature unequivocally show a strong and disproportionate association between vehicle rollover and injury severity and death. Because it is difficult to devise simple, accurate decision rules for point of wounding and vehicle crash scene triage, simple, powerful relationships should be used when possible. Thus, the exclusion of rollover as a triage criterion seems to be ill advised.

Bounds on effectiveness of driver hours-of-service regulations for freight motor carriers

Crash rates for trucks depend in part on the length of time drivers have been operating their vehicles. This paper investigates bounds on the reduction in crash rates due to the imposition of hours-of-service regulations, which limit the number of hours drivers operate their vehicles. Methods for analyzing probability distributions for trip length, and odds ratios for crashes (as a function of hours driven) are developed. We also produce bounds on the economic costs of truck-involved collisions, and estimate changes in these costs due to changes in hours-of-service rules. The study is a first step toward a broader cost/benefit analysis of regulations, based on analysis of data from the fatal accident reporting system (FARS).

Alcohol Involvement in Fatal Crashes Under Three Crash Exposure Measures

Objective. A common method of normalizing crash fatality data for comparing subgroups of drivers has been the estimated vehicle miles traveled (VMT). Unfortunately, the VMT method fails to provide for exposure to risks such as those related to alcohol consumption (among others). Recently, the “crash incidence ratio” (CIR) has been introduced to address some of these limitations. The goals of this study are first, to show that the CIR method is intrinsically similar to an increasingly popular quasi-induced method: the relative accident involvement ratio (RAIR); second, to compare the VMT-based, the CIR, and the RAIR methods when applied to the evaluation of alcohol-related crash fatalities across racial/ethnic groups. Methods. We use the 1990–1996 Fatal Accident Reporting System (FARS) with information on the drivers' race/ethnicity and alcohol involvement (BAC). Descriptive and statistical ratio tests were applied. Results. The RAIR and CIR are indeed closely related measures that, when used for comparisons against a reference group, yield exactly the same numerical estimates. Strikingly different outcomes were obtained depending on using the VMT or the CIR/RAIR. Conclusion. Choosing one measure over another should depend on the questions to be answered. The implication of this finding for researchers and policy makers is discussed.

Rural vs urban motor vehicle crash death rates: 20 years of FARS data

Objectives. Historically, motor vehicle crash (MVC)-related mortality is higher in rural areas than in urban areas. The authors evaluated whether the difference in rural and urban MVC deaths is persisting, and whether the frequency of patients being found dead at the scene, particularly in rural areas, is increasing. Methods. Fatal Accident Reporting System (FARS) data for 1-977 through 1996 were reviewed. The authors determined the frequency with which crash deaths occurred, and calculated population-based and vehicle-miles-traveled-based crash death rates. They compared rates for urban and rural areas. Results. A total of 875,405 crash deaths were included in the analysis. Both population-based and -vehicle-miles-traveled-based MVC deaths have decreased over the last 20 years, but rural rates remain significantly higher than urban rates. Dead-at-scene rates may be increasing, and the rural dead-at-scene rate is higher than the urban rate. Conclusion. While MVC death rates are declining, the rural MVC death rate is still higher than the urban rate. Although these data may indicate some positive movement in the area of MVC-related deaths, differences in the rural and urban rates and the number of patients found dead on-scene remain as issues that require attention. PREHOSPITAL EMERGENCY CARE 2000;4:7-13

Lack of efficacy of clopidogrel pretreatment in the prevention of myocardial damage after elective stent implantation

The vast literature on alcohol's effect on traffic safety does not contain even a moderately satisfactory answer to one of the most basic questions, namely “What is the fraction of all traffic fatalities attributable to alcohol use?” A published estimate of 23.7% based on an erroneous calculation has been widely quoted. This paper combines 1987 Fatal Accident Reporting System (FARS) data from 26 states that recorded blood alcohol concentrations for over 84% of fatally injured drivers with published estimates on how alcohol affects crash risk. By categorizing all traffic fatalities as either nonoccupants of vehicles, or occupants killed in single-vehicle, two-vehicle or three-or-more-vehicle crashes, and developing calculation procedures appropriate for each category, the fraction of all fatalities due to alcohol was inferred. The main finding was that eliminating alcohol would reduce traffic fatalities by (47 ± 4)%. It was also concluded that alcohol use changes from 1982 to 1987 have reduced traffic fatalities by 12% (6,400 fatalities), which helps explain the absence of the fatality increase predicted because of a buoyant economy. Reducing the fraction of fatalities due to alcohol from the 1987 value of 47% to 42% (say) would reduce all traffic fatalities by 8%.

The independent contribution of driver, crash, and vehicle characteristics to driver fatalities

Several driver, crash, and vehicle characteristics may affect the fatality risk of drivers involved in crashes. To determine the independent contribution of these variables to drivers’ fatality risk, we used data from single-vehicle crashes with fixed objects contained in the US Fatal Accident Reporting System. A multivariate logistic regression revealed that the odds ratio (OR) of a fatal injury increased with age, reaching 4.98 (99% confidence interval (CI)=2.01–12.37) for drivers aged 80+ compared with drivers aged 40–49 years. Female gender (OR=1.54, 99% CI=1.35–1.76) and blood alcohol concentration greater than 0.30 (OR=3.16, 99% CI=1.96–5.09) were also associated with higher fatality odds. In comparison with front impacts, driver-side impacts doubled the odds of a fatality (OR=2.26, 99% CI=1.92–2.65), and speeds in excess of 111 kilometers per hour (kph; 69 mph) prior to or at impact were related to higher fatality odds (OR=2.64, 99% CI=1.82–3.83) compared with speeds of less than 56 kph (35 mph). Three-point seatbelts were protective against fatal injuries (OR=0.46, 99% CI=0.39–0.53 compared with no belt). These data suggest that increasing seatbelt use, reducing speed, and reducing the number and severity of driver-side impacts may prevent fatalities. The importance of age and gender suggests that the specific safety needs of older drivers and female drivers may need to be addressed separately from those of men and younger drivers.

R URAL VS U RBAN M OTOR V EHICLE C RASH D EATH R ATES : 20 Y EARS OF F ARS D ATA

Objectives. Historically, motor vehicle crash (MVC)-related mortality is higher in rural areas than in urban areas. The authors evaluated whether the difference in rural and urban MVC deaths is persisting, and whether the frequency of patients being found dead at the scene, particularly in rural areas, is increasing. Methods. Fatal Accident Reporting System (FARS) data for 1–977 through 1996 were reviewed. The authors determined the frequency with which crash deaths occurred, and calculated population-based and vehicle-miles-traveled-based crash death rates. They compared rates for urban and rural areas. Results. A total of 875,405 crash deaths were included in the analysis. Both population-based and -vehicle-miles-traveled-based MVC deaths have decreased over the last 20 years, but rural rates remain significantly higher than urban rates. Dead-at-scene rates may be increasing, and the rural dead-at-scene rate is higher than the urban rate. Conclusion. While MVC death rates are declining, the rural MVC death rate is still higher than the urban rate. Although these data may indicate some positive movement in the area of MVC-related deaths, differences in the rural and urban rates and the number of patients found dead on-scene remain as issues that require attention.

Residence location of drivers involved in fatal crashes

Traffic safety researchers have long known that the majority of fatal crashes occur on rural roads, but it is not clear whether these crashes involve people who live in rural areas or residents of urban areas traveling on rural roads. `Geodemographic' market-research tools allow determination of the urbanization of drivers' residence locations from their postal `zip code.' Using data from the 1988–1992 files of the Fatal Accident Reporting System (FARS) maintained by the National Highway Traffic Safety Administration (NHTSA), this study determined the residence location of several subgroups of drivers involved in fatal crashes. Not only did the majority of fatal crashes occur in rural areas, but the majority of fatal crashes involved rural and small-town residents, and the majority of the rural and small-town residents involved in fatal crashes were traveling on rural roads.

Incidence of Large Truck-Passenger Vehicle Underride Crashes in Fatal Accident Reporting System and National Accident Sampling System

Between 1988 and 1993, the Fatal Accident Reporting System (FARS) coded 4 percent of all fatal large truck–passenger vehicle crashes as involving underrides (portion of passenger vehicle slides under a large truck) or overrides (truck rides over another vehicle). In contrast, the National Accident Sampling System Crashworthiness Data System (NASS/CDS) coded 27 percent of a sample of 275 fatal large truck–passenger vehicle crashes as underrides during the same years. Seven percent of these 275 fatal crashes are identified as underrides in FARS. The discrepancy between FARS and NASS coding becomes more pronounced when underrides involving sides of passenger vehicles or trucks are considered. The reason for this discrepancy is that NASS/CDS did not code underrides involving side impacts, but FARS did. When underrides involving side impacts were added, the total percentage of underrides in NASS/CDS rose from 27 percent to 50 percent of fatal truck-car crashes. The most likely explanations for the lower incidence of underride coding in FARS are that (a) the greater amounts of information available to NASS/CDS analysts enable more complete identification of underrides, (b) FARS analysts sometimes may not recognize that an underride has occurred, and (c) underride was not a separate FARS variable before 1994. On the basis of NASS/CDS data, an estimated 1,108 fatal underride crashes occurred each year between 1988 and 1993 [95 percent confidence interval (CI) = 735, 1482]. Of these 1,108 underrides, 634 involved the front (CI = 328, 942), 248 involved the rear (CI = 137, 360), and 226 involved the sides (CI = 110, 341) of large trucks.

Differentiation of Visibility and Alcohol as Contributors to Twilight Road Fatalities

Elevated road fatality rates at night involve multiple variables, each of which contributes to an unknown degree. In order to determine the relative contributions of reduced visibility and drivers' consumption of alcohol, we performed two quasi-experiments analyzing data recorded by the U.S. Fatal Accident Reporting System from 1980 through 1990. The results confirmed that both variables play a major role in nighttime road fatalities and revealed new evidence that they contribute differentially to two classes of fatal collisions: Degraded visibility in low illumination is associated primarily with collisions involving pedestrians and pedalcyclists, whereas drivers' consumption of alcohol plays a larger role in other fatal collisions.

The role of heavy drinking in the risk of traffic fatalities.

Recent studies have identified a "hard core" of drinking drivers who do not fit a "social" drinker profile and may require medical intervention. This article builds on these studies by quantifying the role of heavy drinking in motor vehicle fatalities. Data on male alcohol-involved fatally injured drivers (AIFIDs) were obtained from the U.S. Fatal Accident Reporting System (FARS) for the years 1989-1990 (n = 8876). The AIFIDs were grouped into either a "heavy" or "light" drinking category based on drinking behaviors inferred from prior driving records and blood alcohol concentrations (BAC). The majority of male AIFIDs were between the ages of 20-39 (70%). Sixty-five percent had a BAC of 150 mg/dl or greater, and 41% had a BAC in excess of 200 mg/dl. AIFIDs with high BACs were more likely to have histories of DUI convictions and license suspensions than AIFIDs with low BACs. According to the study's criteria, 73% percent of the AIFIDs could be classified as "heavy" drinkers. There were no driving variables that differentiated the heavy and light drinker groups, indicating that heavy drinking per se is the primary factor that distinguishes the groups. Male alcohol-involved fatally injured drivers are comprised mostly of heavy drinkers who may suffer from serious drinking problems or alcoholism. Successful interventions may require medical treatment as well as punitive criminal justice policies.

Firearms and Fatalities

<h3>To the Editor.</h3> —The highly charged political debate over firearms and violence in America continues. As noted by Teret,¹there is little agreement about specific actions necessary to reduce violence in America, but there appears to be some agreement that more data are needed. The Fatal Accident Reporting System (FARS) has been proposed as a model for data collection.²During this controversial debate, it is especially important for health care professionals to discuss what can reasonably be concluded from proposed data collection and to carefully consider such data prior to making recommendations. Since most automobile-related deaths are unintentional and most firearm-related deaths are intentional, it is likely that the 2 situations will be different. The interesting data in the article by Dr Hargarten and colleagues³fall short of supporting some of the authors' conclusions. Table 2 clearly shows that the most common firearm caliber associated with gun

Analysis of fatal motorcycle crashes: crash typing

There were 2074 crashes fatal to a motorcycle driver in the United States during 1992. A computer program was developed to convert Fatal Accident Reporting System (FARS) data for these crashes into standard format English language “crash reports.” The computer generated reports were analyzed and crash type categories were defined. Five defined crash type categories accounted for 1785 (86%) of the 2074 crash events: Ran off-road (41%); ran traffic control (18%); oncoming or head-on (11%); left-turn oncoming (8%); and motorcyclist down (7%). Alcohol and excessive speed were common factors associated with motorcyclist crash involvement. Left turns and failure to yield were common factors associated with the involvement of other motorists. Suggested countermeasures include helmet use and enforcement of speed and impaired driving laws.

Relationship Between Driver's License Renewal Policies and Fatal Crashes Involving Drivers 70 Years or Older

To assess the relationship between state driver's license renewal policies and fatal crashes involving drivers aged 70 years or older (seniors). Poisson regression methods were used to isolate the relationship between different state policies mandating vision tests, knowledge tests, or road tests for driver's license renewal and fatal crashes involving senior drivers. The analysis controlled for differences among states, other than their renewal policies, likely to influence senior motor vehicle crashes. United States, 1985 through 1989. All fatal crashes identified in the National Highway Traffic Safety Administration Fatal Accident Reporting System involving at least one driver aged 70 years or older. The number of fatal crashes per state in which at least one of the drivers was aged 70 years or older. When a single fatal crash involved more than one senior driver, each was included. State-mandated tests of visual acuity, adjusted for license renewal period, were associated with lower fatal crash risk for senior drivers (relative risk, 0.93; 95% confidence interval, 0.89 to 0.97). Knowledge tests, when added to vision tests and applied only to seniors, provided a nonsignificant reduction in the senior fatal crash risk (relative risk, 0.91; 95% confidence interval, 0.79 to 1.05). Tests of vision and knowledge for senior drivers at license renewal merit further attention as a means of improving senior traffic safety.

Field effectiveness of two restraint systems: The 3-point manual belt versus the 2-point motorized-shoulder/ manual lap belt

The research question addressed in this paper is whether or not occupant death, injury, and ejection outcomes differ between vehicles equipped with 3-point manual belts versus 2-point motorizedshoulder/manual-lap (motorized/manual) belt systems. Census crash data sets for the states of Washington and Texas, and the Fatal Accident Reporting System (FARS) were subset to provide data on front-outboard occupants of Ford Escorts involved in crashes in calendar years 1981–1991. Logistic regression analyses showed that occupants of vehicles equipped with the motorized/manual system experienced 11.7% to 26.4% fewer K- or A-level injuries than occupants of vehicles equipped with the 3-point system. Similar analyses of FARS data showed lower ejection rates for occupants of vehicles with the motorized/manual system in both rollover and nonrollover crashes. The installation of the motorized/manual system provided a substantial safety benefit over the manual 3-point system in the time periods examined.

Who's in the car? Passengers as potential interveners in alcohol-involved fatal crashes

This article assesses the promise of motor vehicle passengers as interveners to prevent drinking and driving. It describes data from the U.S. Fatal Accident Reporting System (FARS), which indicate that most alcohol-involved fatally injured drivers (70% of males, 66% of females) were not accompanied by “adult” passengers (16 or older), and alcohol involvement among those passengers present appears to be high (80%). Nonetheless, in approximately 5% to 10% of cases it appears that sober or relatively “unimpaired” passengers could have served as interveners in alcohol-involved driving incidents. Passenger interveners may hold the most promise among teenagers, where passengers in general and unimpaired passengers in particular appear to be most prevalent.