Middle-aged Male Drivers Research Articles

Characteristics and outcomes of homicidal and accidental stab wounds in emergency hospitals: A medicolegal comparative study

Differentiation between the various manner of stab cases is challenging in forensic medicine. Although the distinction between homicidal and suicidal stabbing is well defined, there is a lack of discrimination between accidental and homicidal cases. Therefore, this study aimed to assess the characteristics of and outcomes for stab patients admitted to multiple emergency hospitals to highlight the distinction between accidental and homicidal stab wounds. This prospective cohort study assessed all patients with stab wounds admitted to multiple emergency hospitals from February 2021 to October 2021. Data collected on admission were demographics, trauma circumstances, internal organ damage, and patients' outcomes. Afterward, patients were categorized into homicidal or accidental stabs. Most of the included 51 stab cases were homicidal (78.4%). Most homicidal stabs were in middle-aged male drivers; were caused by sharp weapons, such as a penknife; and occurred in fights outdoors during the summer daytime. In contrast, most accidental stabs were occupational among building carpenters. Although homicidal stab wounds were significantly associated with a regular elliptical shape, oblique orientation, and defense wounds, the existence of a regular elliptical wound shape increased the likelihood of a homicidal stab. Additionally, penetrating stab type and a higher Injury Severity Score (ISS) were the dominant predictors of complications and mortality in stab patients, respectively. For fatal vague stab cases scenarios, the presence of an elliptical wound suggests the probability of homicidal injury than accidental. The initial ISS and stab wound type should be assessed to stratify stab patients who need intensive management in emergency hospitals.

Traffic safety climate factors in explaining driving behaviours and traffic crash involvement: comparative study among male and female drivers

The study examined the explanatory power of Traffic Safety Climate factors in driving behaviours and the probability of traffic crash involvement among male and female drivers in China, taking into consideration different clusters of age. A total of 887 license drivers aged between 24 and 64 completed Chinese version of traffic climate scale, driving behaviours scale, and crash involvement. Multivariate regression analyses were conducted. The result established that male driver’s, reported high emotional engagement, driving violations and traffic crashes than female drivers. Perceived external affective demand (EAD) was more likely to be related to aberrant driving behaviours (ADB), but less likely to be related to positive driving behaviour (PDB) with young and middle-aged male drivers more affected. Perceived EAD was less likely to be associated with ADB and traffic crash involvement of female older drivers. The perceived internal requirement was positively related to PDB, but negatively related to ADB for both sexes with young females expressing high PDB and low probability of traffic crash involvement than male drivers. Perceived traffic system functionality (FUN) was negatively related to ADB, but positively related to PDB for both sexes with male drivers in all age brackets expressing more PDB. As a remedial measure, traffic authorities have to direct their attention towards the modification of traffic infrastructure designs.

Type 2 diabetes can undermine driving performance of middle-aged male drivers through its deterioration of perceptual and cognitive functions

It has been widely agreed that it is risky for patients with diabetes to drive during hypoglycemia. However, driving during non-hypoglycemia may also bring certain safety hazards for some patients with diabetes. Based on previous studies on diabetes-related to early aging effect, as well as gender differences in health belief and driving behavior, we have hypothesized that middle-aged male drivers with type 2 diabetes, compared with the control healthy ones, may experience a decline in driving performance without awareness. And the decline is caused by impaired perceptual and cognitive driving-related functions. To verify these hypotheses, we recruited 56 non-professional male drivers aged between 40 and 60 (27 patients with type 2 diabetes and 29 healthy controls) to perform a simulated car-following task and finish behavioral tests of proprioception, visual search, and working memory abilities during non-hypoglycemia. They also reported their hypoglycemia experience and perceived driving skills. We found that the patients had equal confidence in their driving skills but worse driving performance as shown in larger centerline deviation (t = 2.83, p = .006), longer brake reaction time (t = 3.77, p = .001) and shorter minimum time-to-collision (t = -3.27, p = .002). Such between-group differences in driving performance could be fully mediated by proprioception, visual search ability, and working memory capacity but not by hypoglycemia experience. Regarding the effect sizes of the mediation, the visual search ability played the most important role, and then followed the working memory and the proprioception.This initial study provides original and first-hand evidence demonstrating that the middle-aged male drivers with type 2 diabetes have deteriorated driving performance, but they are unaware of it. We will also discuss the possible measures to identify people of the highest risk and improve their safety awareness by using the findings of the current study.

Evaluating drivers’ speed choice with and without route-based warnings on approach to black spots on a rural highway

A high percentage of crashes occur at black spots of rural highways, and it is of paramount importance to employ strategies that can significantly reduce these crashes. The use of warning systems is one of the different methods of achieving this goal, and this study evaluates the effectiveness of these systems in different classes of drivers. To analyze the effects of warning systems on driver performance, three speed measures (mean speed, speed variation and speed limit violation) were applied. Forty-eight male and female drivers were categorized into three age groups, namely young (18–35 years old), middle age (36–55 years old) and elderly (above 55 years old), and they were asked to drive on a rural two-lane two-way highway in the north-west of Iran to conduct the experiment. The results indicate that middle-aged men and elderly women had the highest and lowest recorded mean speeds at black spots respectively both in the warning and non-warning states. On the other hand, young male drivers had the highest speed variations in the warning state, and middle-aged male drivers recorded the lowest variations in the non-warning state. Concerning the violation of speed limit at the black spots, young and middle-aged men had the highest number of violations in the warning and non-warning states respectively. Elderly women were found to be the most cautious group both in the warning and non-warning states. Conclusively, strategies such as changing the type and number of warnings are proposed to improve the effectiveness of the warning systems in special groups of drivers.

Critical older driver errors in a national sample of serious U.S. crashes

ObjectiveOlder drivers are at increased risk of crash involvement per mile traveled. The purpose of this study was to examine older driver errors in serious crashes to determine which errors are most prevalent. MethodsThe National Highway Traffic Safety Administration’s National Motor Vehicle Crash Causation Survey collected in-depth, on-scene data for a nationally representative sample of 5470 U.S. police-reported passenger vehicle crashes during 2005–2007 for which emergency medical services were dispatched. There were 620 crashes involving 647 drivers aged 70 and older, representing 250,504 crash-involved older drivers. The proportion of various critical errors made by drivers aged 70 and older were compared with those made by drivers aged 35–54. ResultsDriver error was the critical reason for 97% of crashes involving older drivers. Among older drivers who made critical errors, the most common were inadequate surveillance (33%) and misjudgment of the length of a gap between vehicles or of another vehicle’s speed, illegal maneuvers, medical events, and daydreaming (6% each). Inadequate surveillance (33% vs. 22%) and gap or speed misjudgment errors (6% vs. 3%) were more prevalent among older drivers than middle-aged drivers. Seventy-one percent of older drivers’ inadequate surveillance errors were due to looking and not seeing another vehicle or failing to see a traffic control rather than failing to look, compared with 40% of inadequate surveillance errors among middle-aged drivers. About two-thirds (66%) of older drivers’ inadequate surveillance errors and 77% of their gap or speed misjudgment errors were made when turning left at intersections. When older drivers traveled off the edge of the road or traveled over the lane line, this was most commonly due to non-performance errors such as medical events (51% and 44%, respectively), whereas middle-aged drivers were involved in these crash types for other reasons. Gap or speed misjudgment errors and inadequate surveillance errors were significantly more prevalent among female older drivers than among female middle-aged drivers, but the prevalence of these errors did not differ significantly between older and middle-aged male drivers. These errors comprised 51% of errors among older female drivers but only 31% among older male drivers. ConclusionsEfforts to reduce older driver crash involvements should focus on diminishing the likelihood of the most common driver errors. Countermeasures that simplify or remove the need to make left turns across traffic such as roundabouts, protected left turn signals, and diverging diamond intersection designs could decrease the frequency of inadequate surveillance and gap or speed misjudgment errors. In the future, vehicle-to-vehicle and vehicle-to-infrastructure communications may also help protect older drivers from these errors.

Risk Factors Contributing to Taxi Involved Crashes: A Case Study in Xi’an, China

Using the 612 valid samples deriving from the original 6259 crash reports in Xi’an from 2006 to 2011, comparative statistics and systematic analysis are employed to describe the features of taxi crashes. It is found that the middle-aged male drivers with lower education background are much more likely to be involved in a crash and it indicates that 438 cases or approximate 72% of all crashes are related to those aged 26~40 years, and the taxi drivers with 3~5 years experience are at greater risk for crashes than other groups. Additionally, the statistics also presents that a big proportion among occurred with the most frequent type of sideswipe collisions (44.77%), on major segments or intersections, in two most dangerous periods (8:00~10:00 & 16:00~18:00), at weekends, and during November, December and January, but night records more fatal and serious crashes due to fatigue and poor lighting. Similarly with the motor vehicle accidents, nearly 89% are associated with drivers’ over speeding, unbelted and other types of improper or illegal behaviors. Meanwhile, the average 9.72 working hours also performs significant contribution to the frequency of crashes.

Cardiovascular Disease Risk of Bus Drivers in a City of Korea

ObjectiveTo prevent the occurrence of CV events such as MI and stroke among professional drivers in Korea, bus drivers were compared to other occupations through the Framingham risk scoring system (FRS) or metabolic syndrome (MS) of cardiovascular disease (CVD) risk assessment methods.MethodsIn October 2012, a health examination survey was conducted for 443 male bus drivers in a big city. Their CVD risk factors were compared to those of a ‘total employed’ (A group) and ‘crafts and machine operators’ (B group) extracted from Fifth Korea National Health and Nutrition Examination Survey (KNHANES, 2010) data by using FRS and MS. We calculated proportions of the CVD risk factors distribution between bus drivers and the A, B groups by the bootstrapping method. The Odds ratio (OR) between CV event risk combining MS with CHD equivalent risk of FRS and occupational factors like shift patterns and professional driving duration/age ratios (PDAR) of bus drivers was calculated through multinominal logistic regression.ResultsThe proportion of BMI ≥ 25 kg/m2 was 53.9% and waist circumference ≥ 90cm was 40.9% among bus drivers. Hypertension and MS prevalence of bus drivers was 53.3%, 49.9% which is higher than 17.6%, 22.6% in the A group and 19.7%, 23.8% in the B group respectively. OR of high CV event risk in alternate shift was 2.58 (95% CI 1.33~5.00) in comparison with double shift pattern and OR in PDAR ≥ 0.5 was 2.18 (95% CI 1.15~4.14).ConclusionMiddle aged male drivers in a big city of Korea stand a higher chance of developing CV event than other professions of the same age.

Effects of environment, vehicle and driver characteristics on risky driving behavior at work zones

This study aims to analyze the effects of environment, vehicle and driver characteristics on the risky driving behavior at work zones. A decision tree is developed using the classification and regression tree (CART) algorithm to graphically display the relationship between the risky driving behavior and its influencing factors. This approach could avoid the inherent problems occurred in the conventional logistic regression models and further improve the model prediction accuracy. Based on the Michigan M-94/I-94/I-94BL/I-94BR highway work zone driving behavior data, the decision tree comprising 33 leaf nodes is built. Bad weather, poor road and light conditions, partial/no access control, no traffic control devices, turning left/right and driving in an old vehicle are found to be associated with the risky driving behavior at work zones. The middle-aged drivers, who are going straight ahead in their vehicles with medium service time and equipped with an airbag system, are more likely to take risky behavior at lower work zone speed limits. Further, the middle-aged male drivers engage in risky driving behavior more frequently than the middle-aged female drivers. The number of lanes exhibits opposing effects on risky behavior under different traveling conditions. More specifically, the risky driving behavior is associated with the single-lane road under bad light or weather conditions while drivers are more likely to engage in risky behavior on the multi-lane road under good light conditions.

Self-Reported Incidences of Moving Vehicle Collisions and Citations Among Drivers With ADHD: A Cross-Sectional Survey Across the Lifespan

Back to table of contents Previous article Next article Communications and UpdatesFull AccessSelf-Reported Incidences of Moving Vehicle Collisions and Citations Among Drivers With ADHD: A Cross-Sectional Survey Across the LifespanDaniel J. Cox, Ph.D., Brian S. Cox, B.S., and Jennifer Cox, M.S.Daniel J. CoxCharlottesville, Va.Search for more papers by this author, Ph.D., Brian S. CoxCollege Station, Tex.Search for more papers by this author, B.S., and Jennifer CoxCollege Station, Tex.Search for more papers by this author, M.S.Published Online:1 Mar 2011https://doi.org/10.1176/appi.ajp.2010.10091355AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: Vehicular collisions are a major public health problem and the leading cause of death for individuals 15–20 years old (1). Adolescent and young adult drivers with attention deficit hyperactivity disorder (ADHD) are at higher risk, with two to eight times more collisions, citations, and suspended licenses than their non-ADHD counterparts (2). Collision-related costs are also more expensive for drivers with ADHD (2). However, it is unclear whether collision and citation rates decline with maturation for middle-age drivers with ADHD as with the general population. To address this issue, an “ADHD and Driving Safety” survey was placed on five ADHD-related web sites inquiring about the type of ADHD and frequency of citations and collisions in the previous 12 months.Over 6 months, 156 male and 283 female licensed drivers with ADHD completed the survey. The sample was divided into three age groups: adolescents (16–18 years old, N=142), young adults (19–24 years old, N=161), and middle-aged adults (25–62 years old, N=136).For citations, analyses of variance (age by sex [3×2]) indicated an age effect for adolescents, young adults, and middle-aged adults, respectively, as follows: mean=0.34 (SEM=0.06), mean=0.55 (SEM=0.08), and mean=0.53 (SEM=0.10) (p=0.05 in all cases). Male drivers had more citations than female drivers (p=0.03, respective means: 0.59 [SEM=0.10] and 0.41 [SEM=0.05]). There was no interaction effect.For collisions, there were no age or sex effects, but there was an interaction effect (p=0.008). Collision rates for men increased with age while women experienced fewer collisions during middle age, similar to the general population (Figure 1). Adolescent girls reported more collisions than adolescent boys (p=0.01), while middle-aged men reported more collisions than women (p=0.05).FIGURE 1. Citation and Collision Rates by Gender and Age GroupaaFor citations, age effect: F=3.09, df=2, 433, p=0.05; gender effect: F=4.67, df=1, 433, p=0.03. For collisions, interaction effect: F=4.89, df=2, 433, p=0.008.*p=0.05. **p=0.01Although most (60%) middle-aged male drivers reported no collisions, these findings suggest that vehicular collisions and citations do not decrease with maturation for male drivers with ADHD. Additional research is needed for replication and to explore causal factors. For example, higher collision rates among young women may in part be due to greater cell phone use and text messaging (3). This study design was limited by its cross-sectional, self-report, and nonrandomized nature. For example, there may be a cross-sectional cohort effect, where older men might be more reckless drivers in general and less likely to use ADHD medication. However, this sample is unique in its size, age range, number of women, and geographic scope.To the extent that long-acting stimulants improve driving performance of drivers with ADHD (4), it would be prudent for clinicians to ask about recent collisions, near collisions, and citations when considering whether medication is indicated.Charlottesville, Va.College Station, Tex.The project described was supported by a grant from Shire Pharmaceuticals.This letter was accepted for publication in December 2010.

Fatal Drink-Driving Accidents of Young Adult and Middle-Aged Males—A Risky Driving Style or Risky Lifestyle?

Objective. A range of situational and lifestyle-related factors in drink-driving fatal accidents were studied involving young adult and middle-aged male drivers in Finland. Methods. Fatal drink-driving accidents were compared to fatal accidents in which the driver had been sober. The study included all 18-to 59-year-old male drivers' fatal car and van accidents investigated by the Road Accident Investigation Teams in Finland between 2000 and 2002 (n = 366 accidents). The variables describing the situation included the time of the accident, the road condition, the speed, possession of a valid licence, seat-belt usage, and the presence of passengers. Results. The study found that among young adult males most of the studied situational factors bore no relation to the state of the driver (sober or drink driver). Only the time of day, seat-belt, usage, and possession of a valid licence were related to the state of the driver. Among middle-aged male drivers, drink-driving and sober driving accidents differed more clearly. Further, when the social situation in the car was examined, it was found that accidents of sober and drink drivers differed from each other within the group of middle-aged drivers but not within the group of young adult drivers. Heavy alcohol usage was found to characterize the lifestyle of the studied middle-aged drink drivers. Conclusions. It was concluded that for young adult males drink-driving was a part of a more general risky driving style. Among middle-aged males drink-driving was more related to a risky lifestyle with drinking problems. Possible countermeasures are discussed with regard to drink-driving among young adult and middle-aged males.

Older drivers fail in intersections: Speed discrepancies between older and younger male drivers

A high percentage of older drivers' accidents occur in intersections when entering the traffic or crossing a main road. The problems may be in perception or attention, motor performance or inadequate interaction with other road users. Attempts to explain older drivers' problems have mostly focused on the properties and behaviour of the older drivers only, without considering the interaction between older and younger road users. The descriptions of older drivers' problems in intersections are usually based on accident data. This study aimed to describe the normal behaviour of older drivers, including driving habits, attention patterns and interaction with younger drivers. The driving behaviour of young, old and middle-aged male drivers was studied using video cameras and observers in three T-shaped intersections in Sendai, Japan. The results showed no differences in attention behaviour between the age groups as measured with head movements. The age groups had different acceleration habits and thus different turning time, which also varied depending on whether the vehicle on the main road came from the left or the right. Also the outcome of the turning manoeuvre was dependent on age. The time margins to the vehicles on the main road were shortest when an old driver was turning and a young driver approached on the main road. The time margin between the turning driver and the vehicle approaching on the main road was clearly shorter when the latter vehicle was a motorcycle than if it was a car. The results are discussed in relation to the literature on the risk behaviour of old drivers.