Norwegian Road Research Articles

Post-mortem toxicological analyses of blood samples from 107 patients receiving opioid agonist treatment: substances detected and pooled opioid and benzodiazepine concentrations.

To present the substances and their concentrations detected post-mortem in patients receiving opioid agonist treatment (OAT) stratified by cause of death, estimate the pooled opioid and benzodiazepine concentrations using established conversion factors for blood concentrations from the Norwegian Road Traffic Act, and explore the association between drug-induced cause of death and the pooled opioid and benzodiazepine concentrations. Cross-sectional nationwide study. Norway. One hundred and seven patients who died during OAT (i.e. within 5 days after the last intake of OAT medication) between 1 January 2014 and 31 December 2015, with post-mortem femoral blood available for toxicology. Data were collected from hospital records, the Norwegian Cause of Death Registry and autopsy reports. Presence of alcohol and non-alcohol substances in the bloodstream at time of death, determined through records of toxicology of post-mortem femoral blood. A median of four substances was detected across the causes of death. At least one benzodiazepine was detected in 81 (76%) patients. The median pooled opioid concentration was significantly higher in drug-induced deaths compared with other causes of death (362 ng/mL versus 182 ng/mL, P < 0.001), in contrast to the pooled benzodiazepine concentration (5466 versus 5701 ng/mL, P = 0.353). The multivariate regression analysis showed that only increasing pooled opioid concentration (ng/ML) was associated with increased odds of a drug-induced cause of death (odds ratio, 1.003; 95% confidence interval: 1.001-1.006). In Norway, overall opioid concentration seems to play an important role in drug-induced deaths during opioid agonist treatment in patients prescribed methadone or buprenorphine. Patients prescribed buprenorphine tend to replace their agonist with full agonists, while patients prescribed methadone tend to have high opioid concentrations from methadone as the only opioid.

Serious motor vehicle collisions involving young drivers on Norwegian roads 2013–2016: Speeding and driver-related errors are the main challenge

Objective: Motor vehicle collisions (MVCs) are a leading cause of death and acute disability among young adults worldwide. We performed a prospective study of young drivers involved in severe MVCs, investigating the critical events leading up to a collision with an emphasis on driver-related factors and collision culpability. Methods: A study was conducted in southeastern Norway of all drivers younger than 25 years who were involved in high-energy MVCs resulting in immediate hospitalization during 2013–2016. Collision investigators evaluated the exterior and interior of the motor vehicle (MV) within 24 h. Complementary information was obtained from interviews of collision victims, ambulance personnel and witnesses, from police reports, and medical records.Results: There were 145 young drivers included during a 3-year study period, representing an estimated incidence of 29 per 100,000 drivers with registered driving licenses. Ninety-two percent (133/145) were considered culpable of initiating the MVC, and only 2% of the critical factors preceding the collision were not related to the driver. There were 74% (108/145) males, the median MV (motor vehicle) age age was 14 years, and 86% (125/145) of the MVs were passenger cars. The MVCs predominantly occurred on rural roads (90%, 130/145). Among the culpable drivers, speeding behavior was the main predisposing factor in 80% (106/133) of the collisions. Driving at excessive speed was associated with single-vehicle collisions (87%, 74/85) and the presence of passengers (89%, 56/63). Compared to nonculpable drivers, culpable drivers were more often younger than 21years (66% vs 33%, p = 0.031), had obtained their license less than 2 years previously (68% vs 20%, p = 0.004), and were more likely to have been drinking or using drugs (27% vs 0%, p = 0.039). The overall rate of seatbelt use was 79% (114/145).Conclusion: The vast majority of injury-causing MVCs involving young drivers are initiated by those drivers. These incidents are characterized by male drivers with little driving experience who are operating old cars on rural roads at excessive speeds. Driving under the influence of alcohol or drugs is also not uncommon. These issues should be targeted in future preventive measures.

Transport network improvements: The effects on wage earnings

AbstractThis paper estimates the effect of transport network improvements on wage earnings using municipality‐level data from Norway. Transport improvements are modelled to impact labour productivity, and thereby wages, through effective employment density by using travel time changes in the Norwegian road network from 2005 to 2009. Identification is achieved by using panel data estimation and by isolating the effects on employment density from those caused by transport improvements. The estimation results indicate agglomeration elasticities in the range of 0.04–0.06. The result lies in the midrange of current estimates and supports the notion that agglomeration economies in a low‐density country such as Norway are not very different from those of more densely populated countries.

Driver-related risk factors of fatal road traffic crashes associated with alcohol or drug impairment

Fatal road traffic crashes are often related to speeding, non-use of a seatbelt, and alcohol/drug-impaired driving. The aim of this study was to examine associations between driving under the influence of drugs and/or alcohol and driver-related risk factors that have been reported as significantly contributing causes of fatal road traffic crashes. The data were extracted from Norwegian road traffic crash registries and forensic toxicology databases. Drug/alcohol investigated car and van drivers and motorcycle riders fatally injured in road traffic crashes in Norway during 2005–2015 were included in this study (n = 772). Drug and alcohol concentrations corresponding to 0.5 g/kg alcohol in blood were used as the lower limits for categorising drivers/riders as impaired; 0.2 g/kg was the upper limit for being categorised as sober. Associations between driver-related risk factors and impairment from specific substance groups were calculated using multivariable logistic regression, adjusted for other substance groups, age, and sex, and were reported when the confidence intervals did not contain the value 1 or lower. Substances found in concentrations above the impairment limits were mainly alcohol (20%), medicinal drugs (10%: benzodiazepines, opioids, z-hypnotics), stimulants (5%: amphetamines, methylphenidate, and cocaine), and cannabis (4%: THC). The drug/alcohol-impaired drivers had compared to the sober drivers more often been speeding (68% versus 32%), not used a seatbelt (69% versus 30%), and been driving without a valid driver license (26% versus 1%). Logistic regression analysis showed that impairment from alcohol or stimulants (mainly amphetamines) was associated with all three risk factors, medicinal drugs with all except speeding, and impairment from cannabis (THC) with not having a valid driver license. Among motorcycle riders, drug/alcohol impairment was associated with not having a valid driver license and non-use of a helmet. At least one of the risk factors speeding, non-use of a seatbelt/helmet, and driving without a valid license were present among the vast majority of the drug/alcohol-impaired fatally injured drivers and riders, and also among more than half of the fatally injured sober drivers.

Fatally injured drivers in Norway 2005–2015—Trends in substance use and crash characteristics

Objective: Norway introduced a “Vision Zero” strategy in 2001, using multiple approaches, aiming toward a future in which no one will be killed or seriously injured in road traffic crashes (RTCs). Official statistics show that the number of fatally injured road users has declined substantially from 341 deaths in 2000 to 117 in 2015. In-depth crash investigations of all fatal RTCs started in Norway in 2005. The aim of this study was to investigate whether fatal crash characteristics, vehicle safety features, and prevalence of drugs and/or alcohol among fatally injured drivers and riders has changed during 2005–2015, accompanying the reduction in road fatalities.Methods: Data on all car/van drivers and motorcycle/moped riders fatally injured in RTCs during 2005–2015 were extracted from Norwegian road traffic crash registries and combined with forensic toxicology data.Results: The proportion of cars and motorcycles with antilock braking systems and cars with electronic stability control, increased significantly during the study period. The prevalence of nonuse of seat belts/helmets and speeding declined among both fatally injured drivers and riders. In addition, the prevalence of alcohol declined, though no significant change in the total prevalence of other substances was noted.Conclusion: The observed changes toward more safety installations in cars and motorcycles and lower prevalence of driver-related risk factors like alcohol use, speeding, and nonuse of seat belts/helmets among fatally injured drivers/riders may have contributed to the decrease in road traffic deaths.

Rescue performance in Norwegian road related avalanche incidents

In Norway, snow avalanches hitting roads are a considerable safety challenge for the rescue services. Previous studies have given rise to concern about the rescuers´ levels of exposure to avalanche risk during these missions. The safety of the rescuers must balance a quick and lifesaving response. The ability to meet both demands constitutes the performance of the rescue service. In the period 2010–2014 the rescue services registered 58 avalanches hitting public roads in Norway. The study reported in this article includes all those events. It explored the characteristics of the rescue missions and which risk indicators that contributed to overall risk to rescuers' health and victims' survival. 45 out of these 58 incidents were analyzed using organizational risk indicators. Risk influencing factors (RIF) and other relevant variables were then included in a Bayesian Belief Network (BBN) in order to model both the associated risk and the overall performance of the rescue service. The analyses showed that rescue management in the alert phase, professional assessment of avalanche conditions, and continuous risk assessment are the most important RIFs to control when aiming at an effective and safe rescue operation. In addition, actions to control undue haste and over-commitment, and enhance risk awareness will contribute to increased safety in this line of rescue work.

Main aspects of deformation and rock support in Norwegian road tunnels

The general geology of Norway makes most of its tunnels to be constructed mainly in strong rock intersected by weakness zones of different sizes and characteristics. The Norwegian support tradition is, to the largest degree as possible, to reinforce the rock to make it self-bearing. In weak rock, this reinforcement has been accomplished by using bolts, sprayed concrete and ribs of reinforced concrete (RRS). RRS are normally designed with 6 rebars mounted on brackets that are attached to rock bolts with a center to center distance of 1.5 m covered in sprayed concrete. The spacing between the RRS in the tunnel direction is usually 1–3 m. In recent years, the application of RRS has gradually changed from following the blasted tunnel profile that formed unarched RRS that reinforced the rock to using RRS with an arched design that supports the rock. Following this development was an increase in the use of materials, as the amount of sprayed concrete used is now considerably larger and the rebar diameter changed from 16 to 20 mm. This change has also caused an abrupt increase in the support measures used for decreasing rock quality, from simple reinforcement by bolts and sprayed concrete to load-bearing arches. The authors believe that a more gradual transition is logical and this article will discuss and evaluate the current Norwegian support strategy by reviewing international theory, performing parameter analysis and presenting data from current and previous Norwegian road tunnels, with a focus on rock mass quality and deformations. It is concluded that arched RRS is not necessary for all cases where it is used today, and that evaluation of the need for load bearing arched RRS should be based on deformation considerations. Norwegian conditions comprise the basis for the discussion, but the problem at hand is also of general interest for hard rock tunnelling conditions.

Road Planning and Route Alignment Selection Criteria in the Norwegian Context

This paper reveals the main factors that guide road alignment design process in Norway. The goal is to discover what constitutes the main priorities for road planners, how these priorities are ranked when it comes to alignment selection, and how they are related to guiding factors identified in official planning documents and government transport plans throughout the life cycle of a road. This is done through a comprehensive literature and data search, involving published academic research in the road alignment design field, and by exploring Norwegian road planning documents and guidelines. Examples from a recently implemented road project are also included as a way to illustrate alignment priorities in theory versus how alignment decisions are made in practice. Particular attention is paid to how key factors influence environmental and social dimensions and how much importance these dimensions are given in the overall decision-making process. The focus on the Norwegian case is relevant in that it will identify which knowledge gaps need to be filled based on actual practices in the Norwegian road sector. The results of this study found that the dominating factors in road planning and alignment selection are the user cost and the environmental and socio-economic as they are directly related to the main national transport strategy of developing a carbon-neutral and resilient transport system. These results can be used to reinforce and amplify existing road planning strategies and to understand where challenges for environmental and social responsible road planning and alignment selection are found.

The accuracy of benefit-cost analyses (BCAs) in transportation: An ex-post evaluation of road projects

Ex-post evaluations of benefit-cost analyses (BCAs) of transportation projects are scarce in the literature. If conducted frequently, they could reveal the extent to which objectives are achieved and may give inputs that can improve the quality of ex-ante BCAs. We first explain the usefulness of ex-post BCA evaluations of transportation projects, depending on which planning phase a project is in. We then perform ex-post BCAs on 27 Norwegian road projects that have been in service for at least 5 years and compare the results with the ex-ante BCAs that were presented to the decision-makers. We use two different measures of aggregating the magnitudes of accuracy; the Mean Percentage Error (MPE) and Mean Absolute Percentage (MAPE). Using MPE, we find that: (1) ex-ante BCAs underestimate the actual net present value (NPV) by 50% on average and, the NPV per dollar invested by a mere 0.14% points on average; (2) the traffic level and traffic growth rates are often underestimated ex-ante, leading to an underestimation of the benefits and; (3) construction costs are underestimated by 5% on average, which is too small to offset the observed underestimation of benefits. By default, MAPE shows higher values of inaccuracies implying that one should not be indifferent as to the measure used. Overall, the Norwegian ex-ante BCAs perform fairly well. We urge that the authorities concerned must improve their traffic forecasts and construction cost estimates to assure that the ex-ante objectives are met. The upkeep of ex-ante data is essential to enable ex-post evaluation which, ceteris paribus, will enhance the transparency and credibility of BCA as an appropriate decision-making tool.

Bone health in elite Norwegian endurance cyclists and runners: a cross-sectional study

BackgroundAthletes who compete in non-weight-bearing activities such as swimming and cycling are at risk of developing low bone mineral density (BMD). Athletes in long-distance running are at risk of low...

Conversion factors for assessment of driving impairment after exposure to multiple benzodiazepines/z-hypnotics or opioids

AimsNorway has introduced legal concentration limits in blood for 28 non-alcohol drugs in driving under the influence cases. As of 2016 this legislation also regulates the assessment of combined effects of multiple benzodiazepines and opioids. We herein describe the employed methodology for the equivalence tables for concentrations of benzodiazepines/z-hypnotics and opioids implemented in the Norwegian Road Traffic Act. MethodsLegislative limits corresponding to impairment at blood alcohol concentrations (BAC) of 0.02%, 0.05% and 0.12% were established for 15 different benzodiazepines and opioids. This was based on a concept of a linear relationship between blood drug concentration and impairment in drug naïve users. Concentration ratios between these drugs were used to establish conversion factors and calculate net impairment using diazepam and morphine equivalents. ResultsConversion factors were established for 14 benzodiazepines/z-hypnotics (alprazolam, bromazepam, clobazam, clonazepam, etizolam, flunitrazepam, lorazepam, nitrazepam, nordiazepam, oxazepam, phenazepam, temazepam, zolpidem and zopiclone) and two opioids (methadone and oxycodone). ConclusionsConversion factors to calculate diazepam and morphine equivalents for benzodiazepines/z-hypnotics and selected opioids, respectively, have been operative in the Norwegian Road Traffic Act as of February 2016. Calculated equivalents can be applied by the courts to meter out sanctions.

Internationalisation in Road Transport of Goods in Norway: Safety Outcomes, Risk Factors and Policy Implications

The European Union (EU) promotes a gradual lifting of restrictions on foreign hauliers involved in domestic road transport of goods (cabotage), and liberalization of the current road cabotage rules may further increase the proportion of foreign heavy goods vehicles (HGVs) on Norwegian roads. The aims of the present study are to: (1) Examine the safety outcomes of increasing internationalisation in (Norwegian) road transport of goods; and (2) Discuss the importance of potential risk factors related to increasing proportions of foreign HGVs on Norwegian roads. We use four data sources to shed light on the aims. Results show that foreign HGVs account for 6% of the average domestic transport in Norway, and 11% of the HGVs involved in personal injury accidents. Additionally, foreign HGVs have a three times higher risk of single vehicle accidents, and twice the risk of head-on collisions. Foreign HGV drivers also seem more likely to trigger fatal accidents. We conclude that two risk factors seem to be important: (1) experience with/competence on Norwegian roads and (2) winter driving. Thus, the safety challenge is not that the drivers are foreign, but that they to some extent lack experience with, and competence on, the Norwegian road networks and the challenges that these roads may pose (e.g., narrow roads with high gradients, many curves, snow and ice). Previous research from other countries has also found that lacking experience with national road networks is an important risk factor. Given our results on risk factors, we may hypothesize that if foreign HGV drivers get more experience and education on Norwegian driving conditions, then increased internationalization could perhaps be of less concern in road safety. When discussing the higher accident risk and lower experience of foreign HGV drivers in Norway, it is important to note that the reason for foreign HGV drivers, working for foreign hauliers, to drive in Norway is that there are customers of the goods in Norway. Interviewees stressed that the foreign driver is often the last link in a long and complex chain of actors involved in the transport. Although these actors have a legal responsibility to “contribute to safety,” interviewees stated that this responsibility is vague and not clearly enforced. We therefore suggest the clarification of, and an increase in, the responsibilities of the different parties involved in goods transport, especially the transport buyers. This means to both ensure the experience and training of the drivers (e.g., preparing them properly to drive on winter roads), and to positively influence their transport safety in other ways (e.g., reducing stress and time-pressure).

An Estimator for Traffic Breakdown Probability Based on Classification of Transitional Breakdown Events

In this paper we propose a new estimator for calculating the probability of traffic breakdown as a function of traffic demand. Traffic breakdown is a well-studied phenomena within previous literature and is of great importance to traffic planners and controllers. The proposed estimator has an appealing intuition and is able to overcome several of the problems associated with previously proposed methodology. The input to the estimator is a set of aggregated (typically five minute) traffic observations classified to either a breakdown or nonbreakdown state, and a customized and fast algorithm for this purpose is proposed. Last, we apply the classification algorithm and breakdown probability estimator to a large data set consisting of several observation sites on the Norwegian road network, and we compare our estimator to a previously defined estimator.

Talking Doping: A Frame Analysis of Communication About Doping Among Talented, Young, Norwegian Road Cyclists

In everyday communication, participants can critically explore their understanding of morally complex phenomena. There has been little effort within the social sciences to provide insight into whether and how athletes communicate among themselves about morally contested topics. This study attempts to fill this gap in the literature. Through focus group interviews and with the help of Goffman’s frame analysis, we explore how a group of young, Norwegian road cyclists communicates about doping. The article demonstrates that this communication is strongly norm-regulated and often appears as brief, assertive, and evasive. We show how the communication reflects a hegemonic discourse of doping as immoral and inexcusable. We conclude that this discourse limits explorative communication and may limit young athletes’ preparation for doping-related dilemmas and social pressures.

Cost escalations in the front-end of projects – empirical evidence from Norwegian road projects

ABSTRACTThis paper investigates an issue largely ignored in the transport literature on cost overruns, namely, cost increases in the early project phase, long before the decision to build is made. This is the phase of project planning that is referred to as the front-end phase in the literature. The rationale of the study is that unless cost estimates during the front-end phase are relatively accurate, the wrong projects may be selected for further development. We first argue for why it is important to address cost escalation during the front-end phase of project planning. We then use Norwegian data to demonstrate the magnitude of cost escalations during the front-end phase of projects and in comparison to the implementation phase. We find that even in a sample of projects with relatively small cost overruns as in the case of Norway, there are substantial cost increases before the formal decision to build was made. This raises the issue of whether decisions and priorities taken at the early stages of project development are based on false information and whether this may lead to the wrong project concepts being selected.

Managing the Room of Maneuver in Design Build Contracts – A Comparative Study of Norwegian Road Projects

Most public infrastructure projects in Norway are conducted with design-bid-build contract form. However, the traditional design-bid-build contract seems to be both time consuming and demand a lot of resources. And at the same time contribute to a high level of conflict between the project owner and the contractor. Because of this, and an increased amount of big and complex infrastructure projects, public project owners are boosting their use of design-build contracts. Use of design-build contracts can potentially shorten project time, and reduce cost. In addition, the use of this contract form can release the project owner's resources and make use of the contractor's competence. Within the design-build contract form and delivery method there is a certain room of maneuver. This can be utilized and potentially contribute to achieve the mentioned benefits. The problem occurs when the public project owner's laws and regulations limits this room of maneuver, and puts too many restrictions on the contractor's choice of technical solutions and ways of construction. To explore this a literature review and multiple case studies were conducted. Four public road projects were explored through semi-structured in depth interviews and document studies. This identified the room of maneuver in the studied projects, as well as the potential room of maneuver for the projects. The level of detail set in the contract by the project owner, through deployment of the laws and regulations, seems to be the most critical factor. This decides whether the contractor has a satisfying room of maneuver or is too restricted and not able to propose and execute alternative solutions.

Charging strategies – implications on the interaction between an electrified road infrastructure and the stationary electricity system

This study uses a vehicle model together with detailed traffic data of the European route 39 in western Norway to estimate how the electricity demand for an electric road system varies with time and location. The aim is to better understand the impact of an electric road system on the stationary electricity system. The results show that the electricity demand for an E39 electric road system is comparable to a larger industry, potentially increasing the peak power demand in the regional electricity system with only a few percent. Yet, if all main Norwegian roads are electrified, or if vehicles can also charge their batteries while driving, there will be a significant (&gt;10%) addition of electricity demand to the current load.

The emperor's new clothes - opportunities and limitations applying AEM to geotechnical design work

In summer 2015, we acquired close to 6.000 km of Helicopter, time-domain airborne electromagnetic (AEM) data for regional geotechnical mapping for the Norwegian National Rail Administration. This survey and further experience from related Norwegian road planning projects demonstrated the unprecedented accuracy of modern AEM data. The extent of geotechnical site investigations can be drastically reduced, both in terms of time schedule, and costs if AEM derived bedrock models are included when soil investigations are planned. Geotechnical projects demand high resolution (meter scale) and AEM data is to some extent capable of delivering that. Some of our data matched the resolution of corresponding ground geophysics data. Here we present the way in which AEM can be used as bedrock models, sensitive clay delineation and to determine bedrock types. Our discussion leads us to the missing link between high vertical resolution in the first tens of meters for geotechnical work and the focus on simple, sub-vertical structures in exploration AEM. Ultimately, we should strive for the best of both worlds, shouldn't we?

Why don’t cost-benefit results count for more? The case of Norwegian road investment priorities

The starting point is that the benefit/cost ratio is virtually uncorrelated to the likelihood of a Norwegian classified road project entering the list of investments selected for the National Transport Plan. The purpose of the article is to explain what pushes cost-benefit results into the background in the prioritization process. The reasons for their downgrading point to mechanisms that are at work not only in Norway. Explanatory factors are searched for in incentives for cost-ineffective action among planners, bureaucrats and national politicians, respectively, as well as in features of the planning process and the political system. New data are used to show that the road experts’ list of prioritized projects changes little after submission to the national politicians, suggesting that the Norwegian Public Roads Administration puts little emphasis on its own cost-benefit calculations. Besides, it is shown that the petroleum revenues of the state do not provide a strong reason for neglecting cost-benefit accounts. The overall contribution of the article is to offer a comprehensive explanation why professional and political authorities in Norway set road-building priorities diverging massively from those suggested by cost-benefit analysis.

Pathways for GHG emission reduction in Norwegian road transport sector: Perspective on consumption of passenger car transport and electricity mix

Electrification of the transport sector is considered as a solution to reduce greenhouse gases (GHGs) emissions and achieve sustainable mobility. Specifically in the case of electrification of passenger vehicles, various industrial and policy initiatives have been introduced. In this article, we present and assess three approaches – pro-technology, pro-simplicity and mix (of the aforementioned approaches) – to achieve target emission reductions in the Norwegian road transport sector. We also assess the influence of including ‘Guarantee of Origin’ certification for the electricity production in accounting for typical consumption electricity mix in Norway.Results show that for the same reductions in tail-pipe GHG emissions, pro-technology, pro-simplicity, and the mix scenario offer 22%, 29% and 28% reduction in the life cycle GHG emissions respectively, compared to the reference scenario in year 2020. However, the pro-simplicity scenario requires 25% reduction in vehicle-km driven compared to the pro-technology scenario, which provides the same passenger car mobility as in the reference case. When the GHG intensity of the electricity mix used to power EVs is corrected to account for actual consumption mix in Norway, a 13% reduction in the net GHG benefit of pro-technology scenario is observed.