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At least 127 records · Page 7Linked to original sources
PubMed2006

Child passenger injury risk in motor vehicle crashes: a comparison of nighttime and daytime driving by teenage and adult drivers.

INTRODUCTION: To examine the association between child passenger injury risk, restraint use, and crash time (day vs. night) for children in crashes of vehicles driven by teenage versus adult drivers. METHODS: Cross-sectional study involving telephone interviews with insured drivers in a probability sample of 6,184 crashes involving 10,028 children. RESULTS: Child passengers in teen nighttime crashes had an increased injury risk and an increased risk of restraint nonuse compared with those in teen daytime crashes. This increased injury risk can be explained by differences in the age of child passengers, collision type, and child passenger's restraint status associated with time of day. CONCLUSIONS: In order to limit the risk of injury to child passengers driven by teens, Graduated Driver Licensing (GDL) laws should include provisions restricting nighttime driving, as well as mandates for age-appropriate restraint for child passengers. Consideration should also be given for education in child passenger safety for novice teen drivers as part of the licensing process. IMPACT ON INDUSTRY: Results of this study can be used to support advocacy efforts by the automotive industry and others to promote nighttime driving restrictions on novice drivers. In addition, given that both driver groups were more likely to be involved in a single-vehicle collision during the night, technologies such as electronic stability control may offer opportunities for protection. Further reseach on specific circumstances of teen nighttime crashes is needed to inform industry efforts to improve visibility or vehicle operation under poor lighting conditions.

Accidents, Traffic↗
PubMed1999

Cataract in traffic.

BACKGROUND: To obtain a driver's licence to drive a private passenger car, the binocular visual acuity required is 0.5 or better, and the minimum horizontal width of the visual field is 120 degrees . Persons who fulfill these requirements can obtain a driver's licence even if they have an eye disease such as cataract. However, contrast sensitivity and visual acuity in glare can be considerably decreased in eyes with cataract, and this may create a risk factor in traffic. METHODS: Examinations of the eyes, visual fields, contrast sensitivity and glare sensitivity (visual acuity in glare and macular photostress test) were performed for 35 cataract patients aged 60 to 87 years (mean 70.1 years+/-6.1 SD). They had cataract in one or both eyes. In spite of the cataract, the visual acuity was > or =0.5 in 50 of the eyes. Twenty-two control eyes of persons within the same age range were similarly tested. RESULTS: The results in the contrast sensitivity test were significantly worse in the cataract eyes than in the control eyes. Contrast sensitivity decreased significantly as the visual acuity became worse. In the glare test, none of the control eyes lost any of the lines in the visual acuity chart. In the cataract eyes, the loss of lines with the highest glare varied from 0 to 6 lines (mean 1.4+/-1.5). The recovery time in the macular photostress test was longer, but not significantly, in cataract eyes than in normal eyes. There was no significant correlation between the loss of visual chart lines and visual acuity or between the recovery time in the macular photostress test and visual acuity. CONCLUSION: It would be advisable for traffic safety if simple tests for contrast and glare sensitivity were added to the requirements for a driver's licence, at least for older drivers. The age and test result limits should be defined.

Aged↗
PubMed2002

[Cognitive functions and driving ability of older drivers].

INTRODUCTION: The aim of the study was to test older drivers applying for a renewal of their driver's license for cognitive impairment and to examine the outcome of a subsequent driving test. MATERIAL AND METHODS: Patients registered with general practitioners (GPs) in the County of Southern Jutland, who applied for a renewal of their driver's license because of age, participated in the study. Data were collected from a questionnaire sent to GPs and from driving license certificates. The test used m-mini mental state (m-MMSE) for registration of cognitive functioning was a short version of MMSE. The number of recommended driving tests and the results of the driving test were compared during a period before and after the test was used, and compared with the result of the m-MMSE. A total of 6,091 elderly participated in the study, 2,631 before and 3,460 after the introduction of the test. In addition a semi-structured telephone interview with a random sample of the participating GPs was carried out. RESULTS: The use of m-MMSE resulted in significantly more older drivers being recommended a driving test and significantly fewer having their driver's license renewed. Of the older drivers who were recommended a driving test and did not have their driver's license renewed, 83% and 60% had impaired cognitive functioning. The majority (95%) of the GPs considered the test to be a useful tool in general practice. DISCUSSION: The results show that the use of m-MMSE when older drivers apply for renewal of their driver's license because of age, led to fewer older drivers having their driver's license renewed, and that most of them have impaired cognitive functioning. The test is suitable for general practice.

Accidents, Traffic↗
PubMed1997

Reporting of vestibular patients who are unfit to drive: survey of Canadian otolaryngologists.

OBJECTIVES: The objectives of this study were (1) to learn about the concerns and current practices of Canadian otolaryngologists with regard to the reporting of vestibular patients; and (2) to examine the three different reporting mandates in Canada by surveying otolaryngologists in Ontario, Alberta, and British Columbia, and to assess the level of satisfaction with reporting methods. METHOD: A survey was mailed to all members of the Canadian Society of Otolaryngology-Head and Neck Surgery in Ontario, Alberta, and British Columbia, using a modified version of the "Dillman Total Survey Design Method." RESULTS: The survey had an overall response rate of 62.8%. Although many respondents have considered reporting vestibular patients (82.2%) and have warned patients not to drive without reporting them (84.2%), only 25.3% actually have. The great majority (91.8%) felt that unfit drivers should be brought to the attention of the transportation authority. There was no consensus of opinion on the best method of reporting, but only 23.3% of those surveyed supported mandatory physician reporting. Ontario otolaryngologists were significantly less satisfied with the fitness-to-drive legislation in their province than were those from Alberta or British Columbia (chi 2 = 22.7, p = .001). Almost three times as many Ontario respondents have actually reported a vestibular patient (chi 2 = 6.7, p = .01). CONCLUSIONS: The study results suggest that mandatory physician reporting is not a satisfactory method of reporting unfit-to-drive vestibular patients. It is highly recommended that all physicians become familiar with the reporting guidelines in their province or territory and comply with their legal obligations.

Alberta↗
PubMed2001

Initial effects of graduated driver licensing on 16-year-old driver crashes in North Carolina.

CONTEXT: Since 1997, 32 states have enacted graduated driver licensing (GDL) systems to reduce crash rates among young novice drivers. OBJECTIVE: To determine the initial effect of the North Carolina GDL system on crashes among 16-year-old drivers. DESIGN, SETTING, AND SUBJECTS: Comparison of population-based North Carolina motor vehicle crash rates before (1996-1997) and after (1999) 16-year-old drivers were licensed under the GDL system. To control for other factors that might have influenced crashes, changes for 16-year-old drivers were compared with those of drivers 25 to 54 years of age. Crashes per licensed driver were also examined. INTERVENTION: The North Carolina GDL system, enacted December 1, 1997, requires beginning drivers 15 to 17 years of age to hold level 1 licenses, allowing driving only while supervised by a designated adult for a full year; followed by level 2 licensure, allowing unsupervised driving from 5 AM to 9 PM and supervised driving at any time for at least 6 months; and, finally, level 3-a full, unrestricted license. MAIN OUTCOME MEASURES: Rates of motor vehicle crashes among 16-year-old drivers in 1996-1997 vs 1999, overall and by crash severity (fatal, injury, and noninjury), time (night vs day), type (single vs multiple vehicle), driver alcohol use, and driving environment (more vs less rural counties). RESULTS: Crash rates declined sharply for all levels of severity among 16-year-old drivers after the GDL program was implemented. Following GDL, 16-year-old driver crashes were substantially less likely. Comparing 1996 with 1999, fatal crashes declined 57%, from 5 to 2 per 10 000 population (rate ratio [RR], 0.43; 95% confidence interval [CI], 0.27-0.70); crashes with no or minor injuries decreased 23%, from 1068 to 826 per 10 000 (RR, 0.77; 95% CI, 0.75-0.80). Nighttime crashes were 43% less likely (156 vs 88 per 10 000; RR, 0.57; 95% CI, 0.52-0.61) and daytime crashes decreased by 20% (951 vs 764 per 10 000; RR, 0.80; 95% CI, 0.78-0.83). Single-vehicle crashes (245 vs 175; RR, 0.71; 95% CI, 0.67-0.76) declined somewhat more than multiple-vehicle crashes (866 vs 681; RR, 0.79; 95% CI, 0.76-0.81). CONCLUSION: In its initial years, the North Carolina GDL system produced substantial declines in 16-year-old driver crashes.

Accidents, Traffic↗
PubMed2006

Neuropsychological function and driving ability in people with Parkinson's disease.

In this study the association between cognitive symptoms of PD and driving performance was investigated by examining the correlation between neuropsychological test performance and driving simulator behavior. Eighteen participants with PD and 18 healthy participants in a matched comparison group completed a range of neuropsychological measures. These data were correlated with driving simulator performance results from an earlier study. Significant correlations were found between several measures of neuropsychological test performance and driving behavior in participants with PD. In contrast, few significant correlations were obtained in the comparison group. Results suggest that executive difficulties in people with PD such as working memory, planning and set shifting are associated with reduced tactical level driving performance such as speed adaptation and complex curve navigation. Impaired information processing, visual attention and visual perception in people with PD appears associated with reduced operational level driving performance, such as reacting to road obstacles and maintaining constant lane position. Few correlations were found between measures of physical mobility and psychomotor speed with driving measures. Overall, this study highlights the important role of cognitive function in driving performance within the PD population. Comprehensive assessment of cognitive function should be included when assessing driving competency in people with PD.

Aged↗
PubMed1990

Driving safety after brain damage: follow-up of twenty-two patients with matched controls.

Driving after brain damage is a vital issue, considering the large number of patients who suffer from cerebrovascular and traumatic encephalopathy. The ability to operate a motor vehicle is an integral part of independence for most adults and so should be preserved whenever possible. The physician may estimate a patient's ability to drive safely based on his own examination, the evaluation of a neuropsychologist, and a comprehensive driving evaluation--testing, driving simulation, behind-the-wheel observation--with a driving specialist. This study sought to evaluate the ability of brain-damaged individuals to operate a motor vehicle safely at follow-up. These patients had been evaluated (by a physician, a neuropsychologist, and a driving specialist) and were judged able to operate a motor vehicle safely after their cognitive insult. Twenty-two brain-damaged patients who were evaluated at our institution were successfully followed up to five years (mean interval of 2.67 years). Patients were interviewed by telephone. Their driving safely was compared with a control group consisting of a close friend or spouse of each patient. Statistical analysis revealed no difference between patient and control groups in the type of driving, the incidence of speeding tickets, near accidents, and accidents, and the cost of vehicle damage when accidents occurred. The patient group was further divided into those who had, and those who had not experienced driving difficulties so that initial neuropsychologic testing could be compared. No significant differences were noted in any aspect of the neuropsychologic test battery. We conclude that selected brain-damaged patients who have passed a comprehensive driving assessment as outlined were as fit to drive as were their normal matched controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Traffic↗
PubMed1983

Bioptic telescopic spectacle is a hazard for operating a motor vehicle.

The primary purpose of the bioptic telescopic spectacle is to permit the driver to pass the visual requirement to operate a motor vehicle. It is paradoxical that a driver can pass the vision test only by the use of a telescope but that he cannot drive while looking through the telescope. Rather, he must drive with his limited vision (sometimes legal blindness) while looking through the carrier lens. He can use the telescope only for reading a sign or for distinguishing an object, and even then he must lower his head to look through it. This is hazardous: he becomes thus "blind" to the traffic while reading the sign through the telescope. Such a driver could never pass a peripheral vision test due to the blind areas created in the peripheral field. It is more humane and reasonable to grant a waiver for the impaired vision than to compel a handicapped person to purchase a bioptic telescopic spectacle to pass the visual requirement.

Automobile Driver Examination↗
PubMed1993

Evaluation of driving performance in patients with juvenile macular dystrophies.

The driving performance of 20 subjects with central vision impairment due to either Stargardt disease or cone-rod dystrophy (visual acuity, 20/40 to 20/70) was compared with that of 29 control subjects with normal vision who had similar driving histories. Driving performance was defined by accident involvement based on self-report and state records and by an evaluation of performance on an interactive driving simulator. The proportion of individuals involved in accidents in the central vision loss group was comparable to that of the control group. For 13 of the 20 subjects with central vision loss who did not restrict their driving to daylight hours, there was a greater likelihood of involvement in nighttime accidents than in the control group. Visual function measures and simulator indexes did not predict accident involvement for the central visual loss group, although these subjects showed longer braking response times and a greater number of lane boundary crossings than the control group. These findings are in contrast to our previously published report of subjects with retinitis pigmentosa, who were more likely to have been involved in both daytime and nighttime accidents than a control group and for whom visual field extent was significantly related to accident involvement.

Accidents, Traffic↗
PubMed2001

Graduated driver licensing in Michigan: early impact on motor vehicle crashes among 16-year-old drivers.

CONTEXT: Graduated driver licensing (GDL) programs are being adopted in many states to address the high rate of motor vehicle fatalities among teens by requiring teenaged drivers to gain experience and maturity under conditions of relatively low crash risk before gaining full driving privileges. OBJECTIVE: To evaluate the early impact of Michigan's GDL program on traffic crashes among 16-year-old drivers. DESIGN, SETTING, AND SUBJECTS: Analysis of Michigan motor vehicle crash data from 1996 (before GDL program implementation) vs 1998 and 1999 (after GDL program implementation) for 16-year-olds, adjusting for trends among persons 25 years or older. INTERVENTION: Michigan's GDL program, instituted April 1, 1997, for teens younger than 18 years entering the driver license system, includes 3 licensure levels, each with driving restrictions and requirements to progress to the next level. Requirements include extended, supervised practice in the learning level, 2-phase driver education, and night driving restrictions in the intermediate level. MAIN OUTCOME MEASURES: Rates in 1996 vs 1998 and 1999 for all police-reported crashes; for fatal injury, nonfatal injury, and fatal/nonfatal injury combined crashes; for day, evening, and night crashes; for single-vehicle and multivehicle crashes; and for alcohol-related crashes. RESULTS: Overall, the rate of 16-year-old drivers (per 1000 population) involved in crashes declined from 154 in 1996 to 111 in 1999 (relative risk [RR], 0.72; 95% confidence interval [CI], 0.71-0.73). After adjusting for populationwide trends, the overall crash risk for 16-year-olds was significantly reduced in 1999 from 1996 by 25% (adjusted RR, 0.75; 95% CI, 0.74-0.77). There were also significant reductions for nonfatal injury and combined fatal and nonfatal crashes; for day, evening, and night crashes; and for single-vehicle and multivehicle crashes. Fatal crashes declined from 1996 to 1999, but not significantly (RR, 0.74; 95% CI, 0.49-1.14), and alcohol-related crashes continued at a low rate (RR, 1.01; 95% CI, 0.80-1.29). CONCLUSIONS: Analysis of the first 2 full calendar years following Michigan's GDL program implementation indicates substantial crash reductions among 16-year-olds. Future research is necessary to determine if these reductions are maintained and if other jurisdictions achieve similar results.

Accidents, Traffic↗
PubMedDate not supplied

Medication and fitness to drive.

PURPOSE: The aim of this study is to analyze the consumption patterns of medicaments among motor vehicle drivers who attend 'Medical Driving Test Centres' and the relation between habitual consumption of medicaments and fitness to drive. METHODS: The study was carried out on 8043 drivers who attended 25 Medical Driving Test Centres. RESULTS: 24.7% of drivers chronically consume medicaments while 6.8% consume medicaments along with alcohol every day. Of those who chronically consume medicaments with a warning about the medications on driving, 65.8% were considered 'fit' to drive, 27.3% 'fit with restrictions', 5.1% 'suspended' and 0.4% 'unfit'. CONCLUSIONS: The results show how frequent the consumption of medicaments along with alcohol is and that the great majority of drivers who take medicaments are considered fit to drive.

Adolescent↗
PubMed1995

Evaluation of neuropsychological function in patients with liver cirrhosis with special reference to their driving ability.

Ability to drive an automobile was evaluated in 16 patients with well compensated liver cirrhosis. Four tests were performed, namely the emergency reaction test, the continuous emergency reaction test, the signal confirmation test and the accelerator reaction test. Test scores were compared to those of a group of age-matched healthy volunteers. 31% of patients were found to be unfit to drive. Alcoholic cirrhotics fared as poorly as non-alcoholic cirrhotics. In patients with subclinical hepatic encephalopathy (defined by neuropsychologic testing), 44% were unfit to drive. Routine testing of cirrhotic patients for ability to drive could have a major impact on motor vehicle accident rates.

Adult↗
PubMed1999

['Methadone substitution therapy and driving'. Results of an experimental study].

The aim of our experimental study was to gain informations and data on the driving ability of patients undergoing a methadone substitution programme as well as to explore the influence of an HIV infection. 28 patients, five of them HIV-positive, were compared to a control group equal in age, sex and education. For the traffic relevant tests the methadone patients showed significantly reduced performance. Six of the methadone patients passed the tests in a way regarded to have sufficient driving skills. We were unable to prove an influence of HIV infection on driving skills when lacking relevant somatic and neuropsychiatric symptoms. There was no significant correlation between the test results and patients age or dose of medication. We conclude that in general methadone substitution does not implicate driving inability although the majority of our patients showed some reduction of their psychomotoric skills.

Adult↗