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Biomedical subjects

J C Stutts

Publications and source records attributed to J C Stutts.

12 recordsLinked to original sources

The role of driver distraction in crashes: an analysis of 1995-1999 Crashworthiness Data System Data.

Five years (1995-1999) of national Crashworthiness Data System (CDS) data are analyzed to determine the role of driver distraction in traffic crashes and the specific sources of this distraction. Results show that 8.3 percent of the drivers were distracted at the time of their crash; after adjustment for the large percentage of drivers with unknown distraction status, the percentage rose to 12.9 percent. The most frequently cited sources of driver distraction were persons, objects or events outside the vehicle (29.4% of distracted drivers), adjusting the radio, tape or CD player (11.4%), and other occupants in the vehicle (10.9%). Other specific distractions (moving objects in vehicle, other objects brought into vehicle, adjusting vehicle or climate controls, eating and drinking, cell phones, and smoking) were each cited in only one to four percent of the cases. The likelihood of being distracted and the source of distraction varied by driver age but not by gender. Results are discussed in light of the limitations inherent in the CDS and other crash data, and the need for expanded data collection initiatives.

Accidents, Traffic↗

Motor vehicle and roadway factors in pedestrian and bicyclist injuries: an examination based on emergency department data.

Information on 2558 persons treated for injuries incurred while bicycling or walking was collected from eight hospital emergency departments over approximately a one-year time period. The emergency departments represented a mix of urban and suburban/rural sites in three states--California, New York, and North Carolina. The data were collected on special survey forms and included detailed information about the location of the injury event. Results show that, overall, 70% of the reported bicycle injury events and 64% of the reported pedestrian injury events did not involve a motor vehicle. In addition, 31% of the bicyclists and 53% of the pedestrians were injured in non-roadway locations such as sidewalks, parking lots, or off-road trails. Although pedestrians and bicyclists struck by motor vehicles in the roadway were generally the most seriously injured, they represented less than a third of the reported cases. Increased knowledge of non-roadway and non-motor vehicle pedestrian and bicyclist injury events can contribute to more effective program and countermeasure development to improve pedestrian and bicyclist safety.

Accidents, Traffic↗

Cognitive test performance and crash risk in an older driver population.

This paper reports on the usefulness of five brief tests of cognitive function for identifying older drivers who may be at increased risk of crash involvement; it also examines the broader issue of whether impaired cognitive function is associated with increased crash risk in the older driver population. Data for the study were collected from 3238 drivers aged 65 and older applying for renewal of their North Carolina driver's license. The specific cognitive assessments examined include the Trail Making Test parts A and B, the Short Blessed Orientation-Memory-Concentration test of cognitive impairment, a modification of the American Association of Retired Persons 'Reaction Time' test, and a timed Traffic Sign Recognition test. Information on crash involvements during the 3-year period prior to testing was obtained by linkage with the North Carolina driver history file. Although the individual tests were not found to be particularly effective screening tools for identifying subsets of high risk drivers, cognitive test performance remained significantly associated with crash risk even after controlling for driver age, race and measures of driving exposure. Drivers who scored in the lowest 10% on the cognitive tests were approx. 1.5 times more likely to be in crashes than were drivers who scored in the highest 10%. Implications for the counseling and licensing of older drivers are discussed, along with recommendations for future research.

Accidents, Traffic↗

Do older drivers with visual and cognitive impairments drive less?

OBJECTIVE: To determine whether older drivers with poorer cognitive and/or visual function drive fewer miles or avoid driving in situations that pose higher crash risks, such as at nighttime, in rush hour traffic, or when weather conditions are bad. DESIGN: A cross-sectional data analysis conducted as part of a larger prospective study. SUBJECTS: A total of 3238 drivers aged 65 and older applying for renewal of their driver's license at one of eight participating North Carolina driver's license offices. MEASUREMENTS: Subjects were administered a battery of brief tests of cognitive and visual function, which included the Trail Making Test Parts A and B, the Short Blessed Orientation-Memory-Concentration test, and measures of high and low contrast visual acuity, contrast sensitivity, and peripheral vision. Participants were also asked to complete a brief driving survey containing questions about the number of miles they drove and whether they avoided driving under certain conditions, such as after dark or on busy, multi-lane roadways. Driver age and gender were covariates in the analyses. RESULTS: Results of multivariate logistic regression models show a clear pattern of reduced driving exposure--lower annual miles and greater avoidance of high-risk driving situations--associated with lower levels of cognitive and visual function. In general, the prevalence odds of reduced driving exposure were higher for the cognitive function variables than for the visual function variables, and higher for males than for females. Men who scored in the lowest quartile of performance on one of the cognitive tests were six to seven times more likely to report driving fewer than 3000 miles a year than were men scoring in the highest quartile, and women with low scores were one-and-one-half to two times more likely to report driving less than 3000 miles than women with higher scores. CONCLUSIONS: While the findings of this study are reassuring, they do not guarantee that all drivers with cognitive and visual impairments are limiting their driving exposure appropriately, and geriatricians and other health professionals should be encouraged to evaluate their patients' cognitive and visual fitness for driving and provide counsel where indicated.

Aged↗

Nonsanction seat belt law enforcement: a modern day tale of two cities.

This paper describes the implementation and evaluation of a nonsanction seat belt law enforcement program in two experimental communities of contrasting size in a state with a mandatory belt law. The main ingredients of the program were seat belt "salutes," public information and education, and limited use of inexpensive economic incentives. Driver shoulder belt use data collected before, during, and after the experimental programs, compared to similar data collected in a comparison community, showed the approach to be effective. While standard seat belt enforcement activities without incentives have been shown to be effective, many police departments, especially in smaller communities, are reluctant to make wholesale increases in seat belt citations. Although requiring some additional level of manpower and resources, a nonsanction approach to seat belt law enforcement can provide an alternate way of increasing belt use in these communities.

Ethnicity↗

Observed and self-reported seat belt wearing as related to prior traffic accidents and convictions.

During the summer of 1987, 10,000 color-coded mailback questionnaires that identified belted and unbelted North Carolina drivers were handed out at the 72 sites that constitute the probability sample for determining the statewide belt use rate in North Carolina. By obtaining identifying information to determine the winner of a $500 prize from among the 5,074 respondents, police-reported traffic accident and conviction records from the North Carolina driver history file were linked to the belted and unbelted respondents. Analyses found that drivers who had been observed not wearing seat belts had 35% more accidents and 69% more convictions than did belted drivers in the previous four-year period. Similar findings were obtained from self-reported belt use.

Accidents, Traffic↗

Older driver population and crash involvement trends, 1974-1988.

North Carolina motor vehicle crash data for even-numbered years 1974-1988, inclusive, are analyzed in conjunction with North Carolina population, licensed driver, and mileage data to examine trends in motor vehicle crash involvement by driver age, sex, and race. Crash rates per licensed driver are presented along with crash rates per estimated vehicle miles travelled calculated on the basis of induced exposure. Results focus particularly on older drivers. They show that older drivers' representation in the licensed driver population has increased at a greater rate than their representation in either the census or crash involvement populations. These trends are particularly strong for females and for nonwhites. Furthermore, crash rates have declined more for drivers aged 55 and older than for younger drivers. The greatest declines, both in terms of crashes per licensed driver and crashes per estimated miles travelled, have been experienced by drivers age 65 and older, particularly nonwhites. Males show higher overall crash rates per miles travelled than females, but this effect decreases with age and disappears entirely in the oldest age categories. Results are discussed in light of the changing nature of the overall driving population and the cohort of older drivers in particular.

Accidents, Traffic↗

Bicycle accidents and injuries: a pilot study comparing hospital- and police-reported data.

Bicycle accident and injury data collected by two different samples of North Carolina hospital emergency rooms during the summers of 1985 and 1986 are examined and compared with state police-reported bicycle accident data for the same time periods. Of the 649 emergency room treated bicyclists, 62% were children aged 5-14 and 70% were male. Nineteen percent of the riders suffered moderate or worse injuries (AIS greater than or equal to 2), and 6% were hospitalized. In contrast, less than half of the police-reported accidents involved riders under 15 years of age, 85% of the riders were male, and two-thirds suffered moderate or worse injury. Whereas virtually all of the police-reported accidents involved a motor vehicle, less than a fifth of the emergency room cases did. Only 10% of the emergency room cases were duplicated on the state accident files. It is estimated that 800 children ages 0-19 are hospitalized annually in North Carolina for bicycle-related injuries, and an additional 13,300 children receive emergency room treatment.

Accidents↗

Evaluating the North Carolina safety belt wearing law.

The North Carolina Seat Belt Law required an evaluation of the effectiveness of the act with a report of the findings to the Legislature three years after the law went into effect. This paper addresses changes in statewide belt usage and in occupant injury associated with that law. Observational data collected bimonthly from a probability sample of 72 sites stratified by geographic region, rural/urban location, road type, and time of day show that belt use rose from a baseline rate of 25% to a warning ticket phase rate of 45%. Belt use then reached 78% upon enforcement and is now nearly 64%. Time series analysis showed that statistically significant reductions in percentages of moderate and serious injuries occurred at the beginning of both the warning ticket and the enforcement phases. Forecasts of injuries and deaths were also developed from the time series models and were compared with observed totals. Warning tickets brought about a modest 5.4% reduction in serious injuries; fatalities among occupants covered by the law showed no change. In contrast, the subsequent enforcement phase saw a reduction of 11.6% in fatalities and 14.6% in serious or worse injuries. This represents an estimated annual savings of 131 lives and over 2,300 serious injuries in North Carolina during the 18 months following onset of enforcement.

Accidents, Traffic↗

The potentiating effects of alcohol on driver injury.

It is well established that alcohol (ethanol) is associated with increased probability of traumatic injury. This relationship has been attributed to alcohol's impairment of judgment and psychomotor performance, leading to increased probability of an injury-producing mishap. Once an accident occurs, it is widely believed that alcohol may protect against injury. However, controlled laboratory studies using animal models indicate that alcohol exacerbates the injurious effects of trauma. In this study, detailed analysis of data from more than 1 million drivers involved in motor vehicle crashes indicates that when the effects of injury-related variables such as safety belt use, vehicle deformation, vehicle speed, driver age, and vehicle weight are taken into account, the drinking driver is more likely to suffer serious injury or death compared with the nondrinking driver. These findings do not support the widespread belief that alcohol is protective against injury, but rather indicate that alcohol increases vulnerability to injury in any given crash.

Accidents, Traffic↗