One night’s CPAP withdrawal in otherwise compliant OSA patients: marked driving impairment but good awareness of increased sleepiness

Purpose Obstructive sleep apnoea (OSA) patients effectively treated by and compliant with continuous positive air pressure (CPAP) occasionally miss a night’s treatment. The purpose of this study was to use a real car interactive driving simulator to assess the effects of such an occurrence on the next day’s driving, including the extent to which these drivers are aware of increased sleepiness. Methods Eleven long-term compliant CPAP-treated 50–75-year-old male OSA participants completed a 2-h afternoon, simulated, realistic monotonous drive in an instrumented car, twice, following one night: (1) normal sleep with CPAP and (2) nil CPAP. Drifting out of road lane (‘incidents’), subjective sleepiness every 200 s and continuous electroencephalogram (EEG) activities indicative of sleepiness and compensatory effort were monitored. Results Withdrawal of CPAP markedly increased sleep disturbance and led to significantly more incidents, a shorter ‘safe’ driving duration, increased alpha and theta EEG power and greater subjective sleepiness. However, increased EEG beta activity indicated that more compensatory effort was being applied. Importantly, under both conditions, there was a highly significant correlation between subjective and EEG measures of sleepiness, to the extent that participants were well aware of the effects of nil CPAP. Conclusions Patients should be aware that compliance with treatment every night is crucial for safe driving.

Assessment of police subjective workload and preference for using a voice-based interface during simulated driving

Police in-vehicle systems include a visual output mobile data terminal (MDT) with manual input via touch screen and keyboard. This study investigated the potential for voice-based input and output modalities for reducing subjective workload of police officers while driving. Nineteen experienced drivers of police vehicles (one female) from New South Wales (NSW) Police completed four simulated urban drives. Three drives included a concurrent secondary task: an imitation licence number search using an emulated MDT. Three different interface output-input modalities were examined: Visual-Manual, Visual-Voice, and Audio-Voice. Following each drive, participants rated their subjective workload using the NASA - Raw Task Load Index and completed questions on acceptability. A questionnaire on interface preferences was completed by participants at the end of their session. Engaging in secondary tasks while driving significantly increased subjective workload. The Visual-Manual interface resulted in higher time demand than either of the voice-based interfaces and greater physical demand than the Audio-Voice interface. The Visual-Voice and Audio-Voice interfaces were rated easier to use and more useful than the Visual-Manual interface, although not significantly different from each other. Findings largely echoed those deriving from the analysis of the objective driving performance data. It is acknowledged that under standard procedures, officers should not drive while performing tasks concurrently with certain invehicle policing systems; however, in practice this sometimes occurs. Taking action now to develop voice-based technology for police in-vehicle systems has potential to realise visions for potentially safer and more efficient vehicle-based police work.

On-road driving studies to understand why drivers behave as they do at regional rail level crossings

Improving safety at rail level crossings is an important part of both road and rail safety strategies. While low in number, crashes between vehicles and trains at level crossings are catastrophic events typically involving multiple fatalities and serious injuries. Advances in driving assessment methods, such as the provision of on-road instrumented test vehicles with eye and head tracking, provide researchers with the opportunity to further understand driver behaviour at such crossings in ways not previously possible. This paper describes a study conducted to further understand the factors that shape driver behaviour at rail level crossings using instrumented vehicles. Twenty-two participants drove an On-Road Test Vehicle (ORTeV) on a predefined route in regional Victoria with a mix of both active (flashing lights with/without boom barriers) and passively controlled (stop, give way) crossings. Data collected included driving performance data, head checks, and interview data to capture driver strategies. The data from an integrated suite of methods demonstrated clearly how behaviour differs at active and passive level crossings, particularly for inexperienced drivers. For example, the head check data clearly show the reliance and expectancies of inexperienced drivers for active warnings even when approaching passively controlled crossings. These studies provide very novel and unique insights into how level crossing design and warnings shape driver behaviour.

Fuel consumption and gas emissions of an automatic transmission vehicle following simple eco-driving instructions on urban roads

Following eco-driving instructions can reduce fuel consumption between 5 to 20% on urban roads with manual cars. The majority of Australian cars have an automatic transmission gear-box. It is therefore of interest to verify whether current eco-driving instructions are e cient for such vehicles. In this pilot study, participants (N=13) drove an instrumented vehicle (Toyota Camry 2007) with an automatic transmission. Fuel consumption of the participants was compared before and after they received simple eco-driving instructions. Participants drove the same vehicle on the same urban route under similar tra c conditions. We found that participants drove at similar speeds during their baseline and eco-friendly drives, and reduced the level of their accelerations and decelerations during eco-driving. Fuel consumption decreased for the complete drive by 7%, but not on the motorway and inclined sections of the study. Gas emissions were estimated with the VT-micro model, and emissions of the studied pollutants (CO2, CO, NOX and HC) were reduced, but no di erence was observed for CO2 on the motorway and inclined sections. The di erence for the complete lap is 3% for CO2. We have found evidence showing that simple eco-driving instructions are e cient in the case of automatic transmission in an urban environment, but towards the lowest values of the spectrum of fuel consumption reduction from the di erent eco-driving studies.

Alcohol-related driving offences, crashes, and traffic policing strategies in Zhejiang Province, China

Context Alcohol-related traffic offences and associated trauma have attracted attention in China in recent years, culminating in changes to national legislation in May 2011. Harsher penalties were introduced, particularly for offences where blood alcohol concentration (BAC) levels above 80mg/100mL are recorded. Deemed to be drunk under the law, this is now a criminal offence attracting penalties including large monetary fines, licence suspension for 5 years and imprisonment. Objective This paper outlines key statistics about alcohol-related road trauma in Zhejiang Province and strategies used to combat drink- and drunk-driving. Key Outcomes Zhejiang Province, in China’s south east, has a population of approximately 54, 426,000; 22.36% hold a driving licence. Rapid motorisation is occurring there. In 2011, 1,383,318 new licences were issued, representing a 16.78% increase from the previous year. In 2012, there were a total of 65,000 police officers throughout the Province, 12,307 of whom (18.9%) were traffic police. Responsibility for conducting alcohol testing is the responsibility of all traffic police. The number of alcohol breath tests conducted per year was not available. However, traffic police are actively enforcing alcohol-related laws. In 2011, 89,228 drivers were charged with drink-driving (DUI;20-80mg/100 mL) and 10,014 with the more serious drunk-driving offence (DWI;>80mg/100mL) (Zhejiang Traffic Management Department, 2012). These numbers decreased from the previous year (221,262 and 26,390 respectively). For all crashes recorded in 2011 (n=20,176), 2% involved alcohol-impaired road users. Information on the role of alcohol in crashes from previous years was not available. Discussion Various strategies are employed to detect alcohol-impaired drivers including: targeting vehicles from hotels/restaurants; using sense of smell to screen drivers for further testing; passive alcohol sensors to test drivers; and blood tests for crash-involved drivers where a fatality occurred. Although resources to promote road safety are limited, various government initiatives promote awareness of the dangers of alcohol-related driving and more are needed in future.

Promoting a more positive traffic safety culture in Australia : lessons learnt and future directions

Adopting a traffic safety culture approach, this paper identifies and discusses the ongoing challenge of promoting the road safety message in Australia. It is widely acknowledged that mass media and public education initiatives have played a critical role in the significant positive changes witnessed in community attitudes to road safety in the last three to four decades. It could be argued that mass media and education have had a direct influence on behaviours and attitudes, as well as an indirect influence through signposting and awareness raising functions in conjunction with enforcement. Great achievements have been made in reducing fatalities on Australia’s roads; a concept which is well understood among the international road safety fraternity. How well these achievements are appreciated by the general Australian community however, is not clear. This paper explores the lessons that can be learnt from successes in attitudinal and behaviour change in regard to seatbelt use and drink driving in Australia. It also identifies and discusses key challenges associated with achieving further positive changes in community attitudes and behaviours, particularly in relation to behaviours that may not be perceived by the community as dangerous, such as speeding and mobile phone use while driving. Potential strategies for future mass media and public education campaigns to target these challenges are suggested, including ways of harnessing the power of contemporary traffic law enforcement techniques, such as point-to-point speed enforcement and in-vehicle technologies, to help spread the road safety message.

Mobile phone use and driving : the message is just not getting through

Previous research has shown that mobile phone use while driving can increase crash risk fourfold while texting results in 23 times greater crash risk for heavy vehicle drivers. However, mobile phone use has changed in recent years with the functional capabilities of smart phones to now also include a range of other common behaviours while driving such as using Facebook, emailing, the use of ‘apps’, and GPS. Research continues to show performance decrements for many such behaviours while driving, however many Australians still openly admit to illegal mobile phone use while driving despite ongoing enforcement efforts and public awareness campaigns. Of most concern are young drivers. ‘Apps’ available to restrict mobile phone use while in motion do not prevent use while a driver is stopped at traffic lights, so are therefore not a wholly viable solution. Vehicle manufacturers continue to develop in-vehicle technology to minimise distraction, however communication with the ‘outside world’ while driving is also perhaps a strong selling point for vehicles. Hence, the safety message that drivers should focus on the driving task solely and not use communication devices is unlikely to ever be internalised by many drivers. This paper reviews the available literature on the topic and argues that a better understanding of perceptions of mobile phone use while driving and motives for use are required to inform public awareness campaign development for specific road user groups. Additionally, illegal phone use while driving may be reinforced by not being apprehended (punishment avoidance), therefore stronger deterrence-focussed messages may also be beneficial.

Identifying the determinants of concealed and obvious texting while driving : are they distinct behaviours?

Concealed texting (CT) while driving involves a conscious effort to hide one’s texting while obvious texting (OT) does not involve such efforts to conceal the behaviour. Young drivers are the most frequent users of mobile phones while driving which is associated with heightened crash risk. This study investigated the extent to which CT and OT may be discrete behaviours to ascertain whether countermeasures would need to utilise distinct approaches. An extended Theory of Planned Behaviour (TPB) including moral norm, mobile phone involvement, and anticipated regret guided the research. Participants (n = 171) were aged 17 to 25 years, owned a mobile phone, had a current driver’s licence, and resided in Queensland. A repeated measures MANOVA found significant differences between CT and OT on all standard and extended TPB constructs. Hierarchical multiple regression analyses showed the standard TPB constructs accounted for 68.7% and 54.6% of the variance in intentions to engage in CT and OT, respectively. The extended predictors contributed additional variance in intentions over and above the standard TPB constructs. Further, in the final regression model, differences emerged in the significant predictors of each type of texting. These findings provide initial evidence that CT and OT are distinct behaviours. This distinction is important to the extent that it may influence the nature of advertising countermeasures aimed at reducing/preventing young drivers’ engagement in these risky behaviours.

Traffic safety risks trends and patterns analysis on motorways

Crashes that occur on motorways contribute to a significant proportion (40-50%) of non-recurrent motorway congestion. Hence, reducing the frequency of crashes assist in addressing congestion issues (Meyer, 2008). Analysing traffic conditions and discovering risky traffic trends and patterns are essential basics in crash likelihood estimations studies and still require more attention and investigation. In this paper we will show, through data mining techniques, that there is a relationship between pre-crash traffic flow patterns and crash occurrence on motorways, compare them with normal traffic trends, and that this knowledge has the potentiality to improve the accuracy of existing crash likelihood estimation models, and opens the path for new development approaches. The data for the analysis was extracted from records collected between 2007 and 2009 on the Shibuya and Shinjuku lines of the Tokyo Metropolitan Expressway in Japan. The dataset includes a total of 824 rear-end and sideswipe crashes that have been matched with crashes corresponding traffic flow data using an incident detection algorithm. Traffic trends (traffic speed time series) revealed that crashes can be clustered with regards to the dominant traffic patterns prior to the crash occurrence. K-Means clustering algorithm applied to determine dominant pre-crash traffic patterns. In the first phase of this research, traffic regimes identified by analysing crashes and normal traffic situations using half an hour speed in upstream locations of crashes. Then, the second phase investigated the different combination of speed risk indicators to distinguish crashes from normal traffic situations more precisely. Five major trends have been found in the first phase of this paper for both high risk and normal conditions. The study discovered traffic regimes had differences in the speed trends. Moreover, the second phase explains that spatiotemporal difference of speed is a better risk indicator among different combinations of speed related risk indicators. Based on these findings, crash likelihood estimation models can be fine-tuned to increase accuracy of estimations and minimize false alarms.

Effective punishment experiences : the need for a more comprehensive approach to conceptualising behavioural punishers and reinforcers in a road safety context

Determining what consequences are likely to serve as effective punishment for any given behaviour is a complex task. This chapter focuses specifically on illegal road user behaviours and the mechanisms used to punish and deter them. Traffic law enforcement has traditionally used the threat and/or receipt of legal sanctions and penalties to deter illegal and risky behaviours. This process represents the use of positive punishment, one of the key behaviour modification mechanisms. Behaviour modification principles describe four types of reinforcers: positive and negative punishments and positive and negative reinforcements. The terms ‘positive’ and ‘negative’ are not used in an evaluative sense here. Rather, they represent the presence (positive) or absence (negative) of stimuli to promote behaviour change. Punishments aim to inhibit behaviour and reinforcements aim to encourage it. This chapter describes a variety of punishments and reinforcements that have been and could be used to modify illegal road user behaviours. In doing so, it draws on several theoretical perspectives that have defined behavioural reinforcement and punishment in different ways. Historically, the main theoretical approach used to deter risky road use has been classical deterrence theory which has focussed on the perceived certainty, severity and swiftness of penalties. Stafford and Warr (1993) extended the traditional deterrence principles to include the positive reinforcement concept of punishment avoidance. Evidence of the association between punishment avoidance experiences and behaviour has been established for a number of risky road user behaviours including drink driving, unlicensed driving, and speeding. We chose a novel way of assessing punishment avoidance by specifying two sub-constructs (detection evasion and punishment evasion). Another theorist, Akers, described the idea of competing reinforcers, termed differential reinforcement, within social learning theory (1977). Differential reinforcement describes a balance of reinforcements and punishments as influential on behaviour. This chapter describes comprehensive way of conceptualising a broad range of reinforcement and punishment concepts, consistent with Akers’ differential reinforcement concept, within a behaviour modification framework that incorporates deterrence principles. The efficacy of three theoretical perspectives to explain self-reported speeding among a sample of 833 Australian car drivers was examined. Results demonstrated that a broad range of variables predicted speeding including personal experiences of evading detection and punishment for speeding, intrinsic sensations, practical benefits expected from speeding, and an absence of punishing effects from being caught. Not surprisingly, being younger was also significantly related to more frequent speeding, although in a regression analysis, gender did not retain a significant influence once all punishment and reinforcement variables were entered. The implications for speed management, as well as road user behaviour modification more generally, are discussed in light of these findings. Overall, the findings reported in this chapter suggest that a more comprehensive approach is required to manage the behaviour of road users which does not rely solely on traditional legal penalties and sanctions.

Road safety in Australia : successes, challenges for the future, and possibilities for the USA

Overview - Role of CARRS-Q - Australia’s road safety performance - Key features of Australia’s approach to road safety: - Strong reliance on traffic law enforcement, supported by mass media public education - Adoption of the Safe Systems approach - Ambitious road trauma reduction targets? - Ongoing challenges - Possibilities for the USA

Determinants of drink-driving and association between drink-driving and road traffic fatalities in Ghana

Background Drink-driving has been implicated in many road traffic crashes in the world. Consequently, the developed countries have prioritized drink-driving research. Contrary, drink-driving research has not attained any meaningful consideration in many developing countries. It is therefore imperative to intensify drink-driving research so as to provide research driven solutions to the menace. Aims The objective is to establish determinants of drink-driving and its association with traffic crashes in Ghana. Methods A randomized roadside breathalyzer survey was conducted. A multivariable logistic regression was used to establish significant determinants of drink-driving and a bivariate logistic regression to establish the association between drink–driving and road traffic crashes in Ghana. Results In total, 2,736 motorists were randomly stopped for breath testing of whom 8.7% tested positive for alcohol. Among the total participants, 5.5% exceeded the legal BAC limit of 0.08%. Formal education is associated with a reduced likelihood of drink-driving compared with drivers without formal education. The propensity to drink-drive is 1.8 times higher among illiterate drivers compared with drivers with basic education. Young adult drivers also recorded elevated likelihoods for driving under alcohol impairment compared with adult drivers. The odds of drink-driving among truck drivers is OR=1.81, (95% CI=1.16 to 2.82) and two wheeler riders is OR=1.41, (95% CI=0.47 to 4.28) compared with car drivers. Contrary to general perception, commercial car drivers have a significant reduced likelihood of 41%, OR=0.59, (95% CI=0.38 to 0.92) compared with the private car driver. Bivariate analysis conducted showed a significant association between the proportion of drivers exceeding the legal BAC limit and road traffic fatalities, p<0.001. The model predicts a 1% increase in the proportion of drivers exceeding the legal BAC to be associated with a 4% increase in road traffic fatalities, 95% CI= 3% to 5% and vice versa. Discussion and conclusion A positive and significant association between roadside alcohol prevalence and road traffic fatality has been established. Scaling up roadside breath test, determining standard drink and disseminating to the populace and formulating policies targeting the youth such as increasing minimum legal drinking age and reduced legal BAC limit for the youth and novice drivers might improve drink-driving related crashes in Ghana.

Using GPS and accelerometry to assess older adults' driving behaviours and performance : challenges and future directions

With the projected increase in older adults, the older driver population is estimated to be the fastest growing cohort of drivers among many developed countries. The increased physical fragility associated with the aging process make older adults who drive private automobiles a vulnerable road user group. Much of the current research on older drivers’ behaviours and practices rely on self-report data. This paper explores the utility of in-vehicle devices (Global Positioning Systems and recording accelerometers) in assessing older drivers’ habitual driving behaviours. Seventy-eight older drivers (above 65 years of age), from the Australian Capital Territory, Australia, participated in the current study. The driving behaviours and practices of these participants were prospectively assessed over a two-week period. The use of combined GPS and recording accelerometers to improve understanding of older drivers’ driving behaviours show promise within the current study. The challenges of using multiple in-vehicle devices in assessing driving beahaviours and performances within this cohort will be discussed. Based on the current findings, recommendations for future research regarding the use of in-vehicle devices among the older driver cohort are proposed.

Exploring the influences of country-level factors on mid-age women’s drink driving attitudes

Drink driving remains a major cause of serious and fatal car crashes in Australia and internationally. While this problem is more prevalent among male drivers, the rates of female intoxicated drivers have increased steadily over the past decades in many motorised countries. A combination of police enforcement, media awareness campaigns, and community initiatives has played a key role in reducing incidents of illegal drink driving by targeting public drink driving attitudes. However, important cultural differences in regards to the tolerance towards drink driving have been noted. While many countries, including Australia, have a legal Blood Alcohol Concentration (BAC) limit of .05 or higher, some countries have moved towards a zero –or low tolerance approach to drink driving; several European countries, including Sweden, Hungary, Slovakia, and Estonia currently enforce .00 or .02 BAC limits.