Subjective and predicted sleepiness while driving in young adults

Sleepiness is a significant contributor to car crashes and sleepiness related crashes have higher mortality and morbidity than other crashes. Young adult drivers are at particular risk for sleepiness related car crashes. It has been suggested that this is because young adults are typically sleepier than older adults because of chronic sleep loss, and more often drive at times of increased risk of acute sleepiness. This prospective study aimed to determine the relationship between predicted and perceived sleepiness while driving in 47 young-adult drivers over a 4-week period. Sleepiness levels were predicted by a model incorporating known circadian and sleep factors influencing alertness, and compared to subjective ratings of sleepiness during 25 18 driving episodes. Results suggested that young drivers frequently drive while at risk of crashing, at times of predicted sleepiness (>7% of episodes) and at times they felt themselves to be sleepy (>23% of episodes). A significant relationship was found between perceived and predicted estimates of sleepiness. However, the participants nonetheless drove at these times. The results of this study may help preventative programs to specifically target factors leading to increased sleepiness when driving (particularly time of day), and to focus interventions to stop young adults from driving when they feel sleepy. (c) 2005 Elsevier Ltd. All rights reserved.

The economic costs of road traffic crashes: Australia, states and territories

In this paper, we obtain detailed data on road traffic crash (RTC) casualties, by severity, for each of the eight state and territory jurisdictions for Australia and use these to estimate and compare the economic impact of RTCs across these regions. We show that the annual cost of RTCs in Australia, in 2003, was approximately $17b, which is approximately 2.3% of the Gross Domestic Product (GDP). Importantly, though, there is remarkable intra-national variation in the incident rates of RTCs in Australia and costs range from approximately 0.62 to 3.63% of Gross State Product (GSP). The paper makes two fundamental contributions: (i) it provides a detailed breakdown of estimated RTC casualties, by state and territory regions in Australia, and (ii) it presents the first sub-national breakdown of RTC costs for Australia. We trust that these contributions will assist policy-makers to understand sub-national variations in the road toll better and will encourage further research on the causes of the marked differences between RTC outcomes across the states and territories of Australia. (c) 2006 Elsevier Ltd. All rights reserved.

Acute alcohol consumption and mechanism of injury

Objective: The purpose of this study was to determine whether injury mechanism among injured patients is differentially distributed as a function of acute alcohol consumption (quantity, type, and drinking setting). Method: A cross-sectional study was conducted between October 2000 and October 2001 in the Gold Coast Hospital Emergency Department, Queensland, Australia. Data were collected quarterly over a 12-month period. Every injured patient who presented to the emergency department during the study period for treatment of an injury sustained less than 24 hours prior to presentation was approached for interview. The final sample comprised 593 injured patients (males = 377). Three measures of alcohol consumption in the 6 hours prior to injury were obtained from self-report: quantity, beverage type, and drinking setting. The main outcome measure was mechanism of injury which was categorized into six groups: road traffic crash (RTC), being hit by or against something, fall, cut/piercing, overdose/poisoning, and miscellaneous. Injury intent was also measured (intentional vs unintentional). Results: After controlling for relevant confounding variables, neither quantity nor type of alcohol was significantly associated with injury mechanism. However, drinking setting (i.e., licensed premise) was significantly associated with increased odds of sustaining an intentional versus unintentional injury (odds ratio [OR] = 2.79, 95% confidence interval [CI] = 1.4-5.6); injury through being hit by/against something versus other injury types (OR = 2.59, 95% CI = 1.4-4.9); and reduced odds of sustaining an injury through RTC versus non-RTC (OR = 0.02, 95% CI = 0.004-0.9), compared with not drinking alcohol prior to injury. Conclusions: No previous analytical studies have examined the relationship between injury mechanism and acute alcohol consumption (quantity, type, and setting) across all types of injury and all injury severities while controlling for potentially important confounders (demographic and situational confounders, risk-taking behavior, substance use, and usual drinking patterns). These data suggest that among injured patients, mechanism of injury is not differentially distributed as a function of quantity or type of acute alcohol consumption but may be differentially distributed as a function of drinking setting (i.e., RTC, intentional injury, being hit). Therefore, prevention strategies that focus primarily on the quantity and type of alcohol consumed should be directed generically across injury mechanisms and not limited to particular cause of injury campaigns.

Reflexive OKN with partial and full field stimulation: Effects of age and light level

We recorded reflexive OKN in ten younger (32.3±5.98 years) and older (65.6±6.53) visually normal subjects under viewing conditions designed to differentiate M-pathway functioning from other pathways. Subjects were required to gaze straight ahead while viewing vertical gratings of either 0.43 or 1.08 cpd, drifting at either 5 or 20°/sec and presented at either 8 or 80% contrast. Gratings were presented as full field stimulation, central stimulation or peripheral (>15°) stimulation. The order of presentation of conditions was pseudo-randomised at two blocked light levels: ‘mesopic’ or twilight conditions (1.8 cdm-2) and ‘photopic’ or full light conditions (71.5 cdm-2). For the partial fields, central stimulation, mesopic light level, lower temporal frequencies (i.e. number of stripes passing per second) each contributed to greater OKN strength as measured by slow-phase velocity (SPV). For full field stimulation, and especially for higher temporal frequencies and low contrast, there was a significant interaction between age group × light level (p = 0.017): SPV diminished much more among the older than the younger group for the twilight condition compared to full light. Such a clear diminution in M-pathway sensitivity revealed by OKN response has important implications for everyday situations like crash avoidance under twilight driving conditions.

The effect of reduced contrast on drivers' speed perception

It has been demonstrated, using abstract psychophysical stimuli, that speeds appear slower when contrast is reduced under certain conditions. Does this effect have any real life consequences? One previous study has found, using a low fidelity driving simulator, that participants perceived vehicle speeds to be slower in foggy conditions. We replicated this finding with a more realistic video-based simulator using the Method of Constant Stimuli. We also found that lowering contrast reduced participants’ ability to discriminate speeds. We argue that these reduced contrast effects could partly explain the higher crash rate of drivers with cataracts (this is a substantial societal problem and the crash relationship variance can be accounted for by reduced contrast). Note that even if people with cataracts can calibrate for the shift in their perception of speed using their speedometers (given that cataracts are experienced over long periods), they may still have an increased chance of making errors in speed estimation due to poor speed discrimination. This could result in individuals misjudging vehicle trajectories and thereby inflating their crash risk. We propose interventions that may help address this problem.