The Heavy Vehicle Study : a case-control study investigating risk factors for crash in long distance heavy vehicle drivers in Australia

Background Heavy vehicle transportation continues to grow internationally; yet crash rates are high, and the risk of injury and death extends to all road users. The work environment for the heavy vehicle driver poses many challenges; conditions such as scheduling and payment are proposed risk factors for crash, yet the precise measure of these needs quantifying. Other risk factors such as sleep disorders including obstructive sleep apnoea have been shown to increase crash risk in motor vehicle drivers however the risk of heavy vehicle crash from this and related health conditions needs detailed investigation. Methods and Design The proposed case control study will recruit 1034 long distance heavy vehicle drivers: 517 who have crashed and 517 who have not. All participants will be interviewed at length, regarding their driving and crash history, typical workloads, scheduling and payment, trip history over several days, sleep patterns, health, and substance use. All participants will have administered a nasal flow monitor for the detection of obstructive sleep apnoea. Discussion Significant attention has been paid to the enforcement of legislation aiming to deter problems such as excess loading, speeding and substance use; however, there is inconclusive evidence as to the direction and strength of associations of many other postulated risk factors for heavy vehicle crashes. The influence of factors such as remuneration and scheduling on crash risk is unclear; so too the association between sleep apnoea and the risk of heavy vehicle driver crash. Contributory factors such as sleep quality and quantity, body mass and health status will be investigated. Quantifying the measure of effect of these factors on the heavy vehicle driver will inform policy development that aims toward safer driving practices and reduction in heavy vehicle crash; protecting the lives of many on the road network.

Creating an effective prevention curriculum to reduce transport risks and injuries

Adolescent injury is a significant health concern and can be a result of the adolescents engagement in transport-related behaviours. There is however significant planning and formative research needed to inform prevention programme design. This presentation reports on the development and evaluation of a curriculum programme that was shown to be effective in reducing transport-related risks and injuries. Early adolescents report injuries resulting from a number of transport-related behaviours including those associated with riding a bicycle, a motorcycle, and as a passenger (survey of 209 Year 9 students). In focus groups, students (n=30) were able to describe the context of transport risks and injuries. Such information provided evidence of the need for an intervention and ecologically valid data on which to base programme design including insights into the language, culture and development of adolescents and their experiences with transport risks. Additional information about teaching practices and implementation issues were explored in interviews with 13 teachers. A psychological theory was selected to operationalise the design of the programmes that drew on such preparatory data. The programme, Skills for Preventing Injury in Youth was evaluated with 197 participating and 137 control students (13–14 year olds). Results showed a significant difference between the intervention and control groups from baseline to 6-month follow-up in a number of transport-related risk behaviours and transport-related injuries. The programme thus demonstrated potential in reduce early adolescents transport risk behaviours and associated harm. Discussion will involve the implications of the development research process in designing road safety interventions.

Should we be concerned about alcohol in bicycle crashes?

This paper sets out to examine from published literature and crash data analyses whether alcohol in bicycle crashes is an issue about which we should be concerned. It discusses factors that have the potential to increase the number of bicycle crashes in which alcohol is involved (such growth in the size and diversity of the cyclist population, and balance and coordination demands) and factors which may reduce the importance of alcohol in bicycle crashes (such as time of data factors and child riders). It also examines data availability issues that contribute to difficulties in determining the true magnitude of the issue. Methods: This paper reviews previous research and reports analyses of data from Queensland, Australia, that examine the role of alcohol in Police-reported road crashes. In Queensland it is an offence to ride a bicycle or drive a motor vehicle with a BAC exceeding 0.05% (or lower for novice and professional drivers). Results: In the five years 2003-2007, alcohol was reported as involved in 165 bicycle crashes (4%). The bicycle rider was coded as “under the influence” or “over the prescribed BAC limit” in 15 were single unit crashes (12%). In multi-vehicle bicycle crashes, alcohol involvement was reported for 16 cyclists (0.4%) and 110 operators of other vehicles (3%). Additional analyses including characteristics of the cyclist crashes involving alcohol and the importance of missing data will be discussed in the paper. Conclusion: The increase in participation in cycling and the vulnerability of cyclists to injuries support the need to examine the role of alcohol in bicycle crashes. Current data suggest that alcohol on the part of the vehicle driver is a larger concern than alcohol on the part of the cyclist, but improvements in data collection are needed before more precise conclusions can be drawn.

A probability-based approach for assessing the relationship between crash accidents and pavement properties

Skid resistance is a condition parameter characterising the contribution that a road makes to the friction between a road surface and a vehicle tyre. Studies of traffic crash histories around the world have consistently found that a disproportionate number of crashes occur where the road surface has a low level of surface friction and/or surface texture, particularly when the road surface is wet. Various research results have been published over many years and have tried to quantify the influence of skid resistance on accident occurrence and to characterise a correlation between skid resistance and accident frequency. Most of the research studies used simple statistical correlation methods in analysing skid resistance and crash data.----- ------ Preliminary findings of a systematic and extensive literature search conclude that there is rarely a single causation factor in a crash. Findings from research projects do affirm various levels of correlation between skid resistance and accident occurrence. Studies indicate that the level of skid resistance at critical places such as intersections, curves, roundabouts, ramps and approaches to pedestrian crossings needs to be well maintained.----- ----- Management of risk is an integral aspect of the Queensland Department of Main Roads (QDMR) strategy for managing its infrastructure assets. The risk-based approach has been used in many areas of infrastructure engineering. However, very limited information is reported on using risk-based approach to mitigate crash rates related to road surface. Low skid resistance and surface texture may increase the risk of traffic crashes.----- ----- The objectives of this paper are to explore current issues of skid resistance in relation to crashes, to provide a framework of probability-based approach to be adopted by QDMR in assessing the relationship between crash accidents and pavement properties, and to explain why the probability-based approach is a suitable tool for QDMR in order to reduce accident rates due to skid resistance.

Risky driving or risky drivers? Exploring driving and crash histories of illegal street racing offenders

Illegal street racing has received increased attention in recent years from road safety professionals and the media as jurisdictions in Australia, Canada, and the United States have implemented laws to address the problem, which primarily involves young male drivers. Although some evidence suggests that the prevalence of illegal street racing is increasing, obtaining accurate estimates of the crash risk of this behavior is difficult because of limitations in official data sources. Although crash risk can be explored by examining the proportion of incidents of street racing that result in crashes, or the proportion of all crashes that involve street racing, this paper reports on the findings of a study that explored the riskiness of involved drivers. The driving histories of 183 male drivers with an illegal street racing conviction in Queensland, Australia, were compared with a random sample of 183 male Queensland drivers with the same age distribution. The offender group was found to have significantly more traffic infringements, license sanctions, and crashes than the comparison group. Drivers in the offender group were more likely than the comparison group to have committed infringements related to street racing, such as speeding, "hooning," and offenses related to vehicle defects or illegal modifications. Insufficient statistical capacity prevented full exploration of group differences in the type and nature of earlier crashes. It was concluded, however, that street racing offenders generally can be considered risky drivers who warrant attention and whose risky behavior cannot be explained by their youth alone.

Road crash proneness prediction using data mining

Developing safe and sustainable road systems is a common goal in all countries. Applications to assist with road asset management and crash minimization are sought universally. This paper presents a data mining methodology using decision trees for modeling the crash proneness of road segments using available road and crash attributes. The models quantify the concept of crash proneness and demonstrate that road segments with only a few crashes have more in common with non-crash roads than roads with higher crash counts. This paper also examines ways of dealing with highly unbalanced data sets encountered in the study.

Using data mining to predict road crash count with a focus on skid resistance values

Road crashes cost world and Australian society a significant proportion of GDP, affecting productivity and causing significant suffering for communities and individuals. This paper presents a case study that generates data mining models that contribute to understanding of road crashes by allowing examination of the role of skid resistance (F60) and other road attributes in road crashes. Predictive data mining algorithms, primarily regression trees, were used to produce road segment crash count models from the road and traffic attributes of crash scenarios. The rules derived from the regression trees provide evidence of the significance of road attributes in contributing to crash, with a focus on the evaluation of skid resistance.

Review of the under the limit drink driving rehabilitation program

The combination of alcohol and driving is a major health and economic burden to most communities in industrialised countries. The total cost of crashes for Australia in 1996 was estimated at approximately 15 billion dollars and the costs for fatal crashes were about 3 billion dollars (BTE, 2000). According to the Bureau of Infrastructure, Transport and Regional Development and Local Government (2009; BITRDLG) the overall cost of road fatality crashes for 2006 $3.87 billion, with a single fatal crash costing an estimated $2.67 million. A major contributing factor to crashes involving serious injury is alcohol intoxication while driving. It is a well documented fact that consumption of liquor impairs judgment of speed, distance and increases involvement in higher risk behaviours (Waller, Hansen, Stutts, & Popkin, 1986a; Waller et al., 1986b). Waller et al. (1986a; b) asserts that liquor impairs psychomotor function and therefore renders the driver impaired in a crisis situation. This impairment includes; vision (degraded), information processing (slowed), steering, and performing two tasks at once in congested traffic (Moskowitz & Burns, 1990). As BAC levels increase the risk of crashing and fatality increase exponentially (Department of Transport and Main Roads, 2009; DTMR). According to Compton et al. (2002) as cited in the Department of Transport and Main Roads (2009), crash risk based on probability, is five times higher when the BAC is 0.10 compared to a BAC of 0.00. The type of injury patterns sustained also tends to be more severe when liquor is involved, especially with injuries to the brain (Waller et al., 1986b). Single and Rohl (1997) reported that 30% of all fatal crashes in Australia where alcohol involvement was known were associated with Breadth Analysis Content (BAC) above the legal limit of 0.05gms/100ml. Alcohol related crashes therefore contributes to a third of the total cost of fatal crashes (i.e. $1 billion annually) and crashes where alcohol is involved are more likely to result in death or serious injury (ARRB Transport Research, 1999). It is a major concern that a drug capable of impairment such as is the most available and popular drug in Australia (Australian Institute of Health and Welfare, 2007; AIHW). According to the AIHW (2007) 89.9% of the approximately 25,000 Australians over the age of 14 surveyed had consumed at some point in time, and 82.9% had consumed liquor in the previous year. This study found that 12.1% of individuals admitted to driving a motor vehicle whilst intoxicated. In general males consumed more liquor in all age groups. In Queensland there were 21503 road crashes in 2001, involving 324 fatalities and the largest contributing factor was alcohol and or drugs (Road Traffic Report, 2001). 23438 road crashes in 2004, involving 289 fatalities and the largest contributing factor was alcohol and or drugs (DTMR, 2009). Although a number of measures such as random breath testing have been effective in reducing the road toll (Watson, Fraine & Mitchell, 1995) the recidivist drink driver remains a serious problem. These findings were later supported with research by Leal, King, and Lewis (2006). This Queensland study found that of the 24661 drink drivers intercepted in 2004, 3679 (14.9%) were recidivists with multiple drink driving convictions in the previous three years covered (Leal et al., 2006). The legal definition of the term “recidivist” is consistent with the Transport Operations (Road Use Management) Act (1995) and is assigned to individuals who have been charged with multiple drink driving offences in the previous five years. In Australia relatively little attention has been given to prevention programs that target high-risk repeat drink drivers. However, over the last ten years a rehabilitation program specifically designed to reduce recidivism among repeat drink drivers has been operating in Queensland. The program, formally known as the “Under the Limit” drink driving rehabilitation program (UTL) was designed and implemented by the research team at the Centre for Accident Research and Road Safety in Queensland with funding from the Federal Office of Road Safety and the Institute of Criminology (see Sheehan, Schonfeld & Davey, 1995). By 2009 over 8500 drink-drivering offenders had been referred to the program (Australian Institute of Crime, 2009).

Bicycle helmet research : CARRS-Q monograph 5

Recent research on bicycle helmets and concerns about how public bicycle hire schemes will function in the context of compulsory helmet wearing laws have drawn media attention. This monograph presents the results of research commissioned by the Queensland Department of Transport and Main Roads to review the national and international literature regarding the health outcomes of cycling and bicycle helmets and examine crash and hospital data. It also includes critical examinations of the methodology used by Voukelatos and Rissel (2010), and estimates the likely effects of possible segmented approaches to bicycle helmet wearing legislation. The research concludes that current bicycle helmet wearing rates are halving the number of head injuries experienced by Queensland cyclists. Helmet wearing legislation discouraged people from cycling when it was first introduced but there is little evidence that it continues to do so. Cycling has significant health benefits and should be encouraged in ways that reduce the risk of the most serious injuries. Infrastructure and speed management approaches to improving the safety of cycling should be undertaken as part of a Safe System approach, but protection of the individual by simple and cost-effective methods such as bicycle helmets should also be part of an overall package of measures.

The impact of school connectedness on violent behavior, transport risk taking behavior and associated injuries in adolescence

Adolescents engage in many risk-taking behaviors that have the potential to lead to injury. The school environment has a significant role in shaping adolescent behavior, and this study aimed to provide additional information about the benefits associated with connectedness to school. Early adolescents aged 13 to 15 years (N = 509, 49% boys) were surveyed about school connectedness, engagement in transport and violence risk-taking, and injury experiences. Significant relations were found between school connectedness and reduced engagement in both transport and violence risk-taking, as well as fewer associated injuries. This study has implications for the area of risk-taking and injury prevention, as it suggests the potential for reducing adolescents' injury through school based interventions targeting school connectedness.

Injuries across adolescence : an investigation using the Extended Adolescent Injury Checklist (E-AIC)

Injury is the leading cause of death among adolescents, and in many countries, accounts for more deaths than all other causes combined. Rates of death due to injury also increase dramatically across adolescence. The Australian Institute of Health and Welfare reported that, in 2005, there were 954 deaths of young Australians due to injury, which is a rate of 26 deaths per 100,000 young people. Of these deaths, 4% were adolescents aged 12-14, 17% were aged 15-17, and 80% were aged 18-24 years. Issues addressed: Injuries are the leading cause of death among adolescents. The current research examined a measure of adolescent injury in terms of whether it encompasses the diverse injury experiences of Australian adolescents, including high-risk and normative adolescents, and thus determine its utility as a tool for health promotion research. Grade 9 students from two Brisbane high schools (n=202, aged 13-14 years) and adolescents recruited from the Emergency Department waiting rooms of four Brisbane hospitals (n=98, aged 16-18 years) completed the Extended Adolescent Injury Checklist (E-AIC). The most common cause of injury among adolescents was a sports activity, followed by fights for all participants except schoolbased males, who experienced more bicycle injuries. Alcohol use was most frequently reported in association with interpersonal violence injuries. A broad variety of injuries, occurring in context of multiple risk as well as normative behaviours, were reported by adolescents in both school and ED settings, and were captured by the E-AIC. Findings suggest that the E-AIC is a useful measure that captures the injury experiences of adolescents in different contexts. The high occurrence of injuries that do not result in formal medical treatment also indicates scope for interventions to be based around lessons in first aid, while also incorporating injury prevention components.

Impact of traffic oscillations on freeway crash occurrences

Traffic oscillations are typical features of congested traffic flow that are characterized by recurring decelerations followed by accelerations (stop-and-go driving). The negative environmental impacts of these oscillations are widely accepted, but their impact on traffic safety has been debated. This paper describes the impact of freeway traffic oscillations on traffic safety. This study employs a matched case-control design using high-resolution traffic and crash data from a freeway segment. Traffic conditions prior to each crash were taken as cases, while traffic conditions during the same periods on days without crashes were taken as controls. These were also matched by presence of congestion, geometry and weather. A total of 82 cases and about 80,000 candidate controls were extracted from more than three years of data from 2004 to 2007. Conditional logistic regression models were developed based on the case-control samples. To verify consistency in the results, 20 different sets of controls were randomly extracted from the candidate pool for varying control-case ratios. The results reveal that the standard deviation of speed (thus, oscillations) is a significant variable, with an average odds ratio of about 1.08. This implies that the likelihood of a (rear-end) crash increases by about 8% with an additional unit increase in the standard deviation of speed. The average traffic states prior to crashes were less significant than the speed variations in congestion.

Risk of falls, injurious falls, and other injuries resulting from visual impairment among older adults with age-related macular degeneration

Purpose: Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment among older adults. This study explored the relationship between AMD, falls risk and other injuries and identified visual risk factors for these adverse events. Methods: Participants included 76 community-dwelling individuals with a range of severity of AMD (mean age, 77.0±6.9 years). Baseline assessment included binocular visual acuity, contrast sensitivity and merged visual fields. Participants completed monthly falls and injury diaries for one year following the baseline assessment. Results: Overall, 74% of participants reported having either a fall, injurious fall or other injury. Fifty-four percent of participants reported a fall and 30% reported more than one fall; of the 102 falls reported, 63% resulted in an injury. Most occurred outdoors (52%), between late morning and late afternoon (61%) and when navigating on level ground (62%). The most common non-fall injuries were lacerations (36%) and collisions with an object (35%). Reduced contrast sensitivity and visual acuity were associated with increased fall rate, after controlling for age, gender, cognitive function, cataract severity and self-reported physical function. Reduced contrast sensitivity was the only significant predictor of falls and other injuries. Conclusion: Among older adults with AMD, increased visual impairment was significantly associated with an increased incidence of falls and other injuries. Reduced contrast sensitivity was significantly associated with increased rates of falls, injurious falls and injuries, while reduced visual acuity was only associated with increased falls risk. These findings have important implications for the assessment of visually impaired older adults.