Impact of alcohol driving-while-impaired license suspension duration on future alcohol-related license events and motor vehicle crash involvement in North Carolina, 2007 to 2016.

BACKGROUND/PURPOSE: License suspensions are a strategy to address alcohol-impaired driving behavior and recidivism following an alcohol driving while impaired (alcohol-DWI) conviction. Little is known about the specific impacts of conviction-related suspensions on safety outcomes and given recent fluctuations in alcohol-impaired driving behavior, crashes, and suspension trends, updated and focused assessments of this intervention are necessary. This study aimed to 1) examine the association between type of recent alcohol-DWI suspension and having a secondary alcohol-related license outcome and/or future crash event in North Carolina (NC) between 2007 and 2016; and 2) assess potential modification of these associations by race/ethnicity. METHODS: We used linked NC licensing data, NC crash data, and county-level contextual data from a variety of data sources. We compared individuals ages 21 to 64 who sustained initial (1-year) versus repeat (4-year) suspensions for alcohol-related license and crash involvement outcomes. We estimated unadjusted and adjusted hazard ratios (aHRs) using Cox proportional hazards models and produced Kaplan-Meier (KM) survival curves using a three-year follow-up period. After observing statistically significant modification by race/ethnicity, we calculated stratified aHRs for each outcome (Black and White subgroups only, as other subgroups had low numbers of outcomes). RESULTS: 122,002 individuals sustained at least one alcohol-DWI conviction suspension (117,244 initial, 4,758 repeat). Adjusted KM survival curves indicated that within three years of the index suspension, the predicted risks of having a license outcome and crash outcome were about 8 % and 15 %, respectively, among individuals with an initial suspension and 5 % and 10 %, respectively, among individuals with a repeat suspension. After adjusting for potential confounding, we found that compared to those with an initial suspension, those with repeat suspensions had a lower incidence of future license (aHR: 0.49; 95 % CI: 0.42, 0.57) and crash outcomes (aHR: 0.67; 95 % CI: 0.60, 0.75). Among Black individuals, license outcome incidence was 162 % lower among repeat versus initial index suspension groups (aHR: 0.38; 95 % CI: 0.26, 0.55), while for White individuals, the incidence was 87 % lower (aHR: 0.54; 95 % CI: 0.45, 0.64). Similarly, crash incidence for repeat versus initial suspensions among Black individuals was 56 % lower (aHR: 0.64; 95 % CI: 0.50, 0.83), while only 39 % lower among White individuals (aHR: 0.72; 95 % CI: 0.63, 0.81). CONCLUSIONS: Decreased incidence of both license and crash outcomes were observed among repeat versus initial index suspensions. The magnitude of these differences varied by race/ethnicity, with larger decreases in incidence among Black compared to White individuals. Future research should examine the underlying mechanisms leading to alcohol-impaired driving behavior, convictions, recidivism, and crashes from a holistic social-ecological perspective so that interventions are designed to both improve road safety and maximize other critical public health outcomes, such as access to essential needs and services (e.g., healthcare and employment).

Racial and ethnic disparities in motor vehicle crash-related outcomes in North Carolina surrounding the COVID-19 pandemic.

Long-term impacts of the COVID-19 pandemic on racial and ethnic disparities in motor vehicle crash (MVC) injuries and death are poorly understood. This study aimed to characterize trends and investigate the heterogeneity of MVC-related disparities in North Carolina across several data sources. Crash reports, emergency department visit records, and death certificates from 2018 to 2021 were used to calculate monthly population-rates of MVC-related public health outcomes. We estimated trendlines using joinpoint regression and compared outcomes across racial and ethnic classifications. MVC and MVC-related injury rates declined in conjunction with NC's stay-at-home order, while rates of severe outcomes remained unimpacted. By December 2021 rates of MVC-related outcomes met or exceeded pre-pandemic levels, with the highest rates observed among non-Hispanic Black individuals. Racial and ethnic disparities in MVC-related outcomes remained prevalent throughout the COVID-19 pandemic. These results highlight the importance of a holistic approach to traffic injury surveillance when assessing the impact of MVCs.

Towards safer streets: A framework for unveiling pedestrians' perceived road safety using street view imagery.

Road safety has become a global concern but its impact in low- and middle-income countries is widespread mainly due to lack of appropriate crash database system and under-reporting. In this context, the primary objective of this paper is to provide a scalable framework for unveiling pedestrians' perceived road safety that can also be applied in regions where accessible crash data are limited or near-crashes are left unreported. In the first step of our methodology, a deep learning architecture-based semantic segmentation model (HRNet+OCR) is trained using labeled Google Street View (GSV) images from specific study areas in Dhaka, Bangladesh, which facilitates the identification of both man-made components (such as roads, sidewalks, buildings, and vehicles) and natural elements (including trees and sky). The developed model showed excellent performance in identifying different features in an image by achieving high precision (0.95), recall (0.97), F1-score (0.96), and intersection over union (IoU) (91.86). Secondly, a group of trained raters scored the perceived road safety on an ordinal scale from 0 to 10 (extremely unsafe to extremely safe to walk in terms of road crashes) by assessing the GSV images. Then, several regression models have been used on features extracted from GSV images, and socio-demographic factors (i.e., population density, and relative wealth index) to estimate the perceived road safety, and random forest regression model was found to perform the best. Further, Shapley Additive Explanations (SHAP), a model-agnostic technique has been used for examining feature importance by computing the contribution of each feature to the random forest regression model output. The results show that sidewalk, road, population density, wall, and relative wealth index have higher impact on determining the perceived road safety rating. Additionally, the results of t-tests between the average perceived road safety scores for crash-prone and non crash-prone areas revealed the existence of significant differences. This study also provides perceived road safety rating map on a neighborhood scale, which can be a useful visualization tool for policy-makers and practitioners to identify the road safety deficiencies at specific locations, and formulate appropriate and strategic countermeasures to improve pedestrians' road safety.

A randomized controlled pilot trial of brief online mindfulness training in young drivers.

OBJECTIVE: Driver distraction contributes to fatal and injury crashes in young drivers. Mind wandering (MW) is a covert form of distraction involving task-unrelated thoughts. Brief online mindfulness training (MT) may reduce unsafe driving by enhancing recognition (meta-awareness) of MW and reducing its occurrence. This pilot trial tested these proposed mechanisms of MT and explored its specificity of action, effects on driving behaviour in simulation, as well as intervention adherence and acceptability in young drivers. METHODS: A pre-post (T1, T2), randomized, active placebo-controlled, double-blinded design was used. Twenty-six drivers, aged 21-25, received either brief online MT (experimental) or progressive muscle relaxation (PMR, control) over 4-6 days. A custom website blindly conducted randomization, delivered interventions, administered questionnaires, and tracked adherence. At T1 and T2, a simulator measured driving behaviour while participants indicated MW whenever they recognized it, to assess meta-awareness, and when prompted by a thought-probe, to assess overall MW. RESULTS: MT reduced MW while driving in simulation. The MT group reported higher state mindfulness following sessions. Motivation did not account for MW or mindfulness results. MT and meta-awareness were associated with more focus-related steering behaviour. Intervention groups did not significantly differ in adherence or attrition. No severe adverse effects were reported, but MT participants reported more difficulty following intervention instructions. CONCLUSION: Results support a plausible mechanism of MT for reducing MW-related crash risk (i.e., reduction of MW) in young drivers. This preliminary evidence, alongside promising online adherence and acceptability results, warrants definitive efficacy and effectiveness trials of online MT.

Recent Advances in Vision-Based On-Road Behaviors Understanding: A Critical Survey.

On-road behavior analysis is a crucial and challenging problem in the autonomous driving vision-based area. Several endeavors have been proposed to deal with different related tasks and it has gained wide attention recently. Much of the excitement about on-road behavior understanding has been the labor of advancement witnessed in the fields of computer vision, machine, and deep learning. Remarkable achievements have been made in the Road Behavior Understanding area over the last years. This paper reviews 100+ papers of on-road behavior analysis related work in the light of the milestones achieved, spanning over the last 2 decades. This review paper provides the first attempt to draw smart mobility researchers' attention to the road behavior understanding field and its potential impact on road safety to the whole road agents such as: drivers, pedestrians, stuffs, etc. To push for an holistic understanding, we investigate the complementary relationships between different elementary tasks that we define as the main components of road behavior understanding to achieve a comprehensive understanding of approaches and techniques. For this, five related topics have been covered in this review, including situational awareness, driver-road interaction, road scene understanding, trajectories forecast, driving activities, and status analysis. This paper also reviews the contribution of deep learning approaches and makes an in-depth analysis of recent benchmarks as well, with a specific taxonomy that can help stakeholders in selecting their best-fit architecture. We also finally provide a comprehensive discussion leading us to identify novel research directions some of which have been implemented and validated in our current smart mobility research work. This paper presents the first survey of road behavior understanding-related work without overlap with existing reviews.

Simulating congestion pricing policy impacts on pedestrian safety using a system dynamics approach.

Research on congestion pricing policy (CPP) impacts has generally focused on the economic and congestion-related benefits of CPPs. Few studies have examined safety effects and the interrelated factors that produce safety outcomes for vulnerable road users. We built a novel system dynamics simulation model to explore the potential mechanisms producing pedestrian injuries over time and the impacts of a CPP (and related interventions) on this trend. We found that pedestrian injury trends varied based on important decisions related to how the CPP is designed, including investments in potential safety-related supports for pedestrians. Infrastructure improvements and speed management interventions could help cities achieve both congestion-relieving goals while also improving safety. Additionally, certain CPP configurations (e.g., additional charges on for-hire vehicles) could further reduce daily vehicle trips and congestion but might lead to unintended negative safety consequences of greater pedestrian injuries. This is the first model to provide a holistic and endogenous look at how interconnected processes affecting congestion and CPP impacts also affect vulnerable road user safety. The use of system dynamics models can facilitate a holistic inspection of potential intended and unintended effects across a range of outcomes, prior to policy implementation.

Obstructive sleep apnea screening, diagnosis, and treatment in the transportation industry.

Obstructive sleep apnea (OSA) is a common, identifiable, and treatable disorder with serious health, safety, and financial implications-including sleepiness- related crashes and incidents-in workers who perform safety-sensitive functions in the transportation industry. Up to one-third of crashes of large trucks are attributable to sleepiness, and large truck crashes result in more than 4,000 deaths annually. For each occupant of a truck who is killed, 6 to 7 occupants of other vehicles are killed. Treatment of OSA is cost-effective, lowers crash rates, and improves health and well-being. A large body of scientific evidence and expert consensus supports the identification and treatment of OSA in transportation operators. An Advanced Notice of Proposed Rulemaking regarding the diagnosis and treatment of OSA in commercial truck and rail operators was issued by the Federal Motor Carrier Safety Administration and Federal Railroad Administration, but it was later withdrawn. This reversal of the agencies' position has caused confusion among some, who have questioned whether efforts to identify and treat the disorder are warranted. In response, we urge key stakeholders, including employers, operators, legislators, payers, clinicians, and patients, to engage in a collaborative, patient-centered approach to address the disorder. At a minimum, stakeholders should follow the guidelines issued by a medical review board commissioned by the Federal Motor Carrier Safety Administration in 2016 alone, or in combination with the 2006 criteria, "Sleep Apnea and Commercial Motor Vehicle Operators," a Statement from the Joint Task Force of the American College of Chest Physicians, the American College of Occupational and Environmental Medicine, and the National Sleep Foundation developed by a joint task force. As research in this area continues to evolve, waiting is no longer an option, and the current standard of care demands action to mitigate the burden of serious health and safety risks due to this common, treatable disorder. CITATION: Das AM, Chang JL, Berneking M, Hartenbaum NP, Rosekind M, Gurubhagavatula I. Obstructive sleep apnea screening, diagnosis, and treatment in the transportation industry. J Clin Sleep Med. 2022;18(10):2471-2479.

Night Vision and Carotenoids (NVC): A Randomized Placebo Controlled Clinical Trial on Effects of Carotenoid Supplementation on Night Vision in Older Adults.

Twilight and low luminance levels are visually challenging environments for the elderly, especially when driving at night. Carotenoid rich diets are known to increase macular pigment optical density (MPOD), which in turn leads to an improvement in visual function. It is not known whether augmenting MPOD can lead to a decrease in vision related night driving difficulties. Additionally, it is unknown if carotenoid supplementation provides additional measurable benefits to one's useful field of view (UFOV) along with a decreased composite crash risk score. The aim of the study was to evaluate changes in night vision function and UFOV in individuals that took carotenoid vitamin supplements for a six-month period compared to a placebo group. METHODS: A prospective, randomized, double-blind, six-month trial of a 14 mg zeaxanthin/7 mg lutein-based supplement was carried out. Participants were randomized into active or placebo group (approx 2:1). RESULTS: n = 33 participants (26 males/7 females) participated with 93% capsule intake compliance in the supplemented group (n = 24) and placebo group (n = 9). MPOD (mean/standard error SE) in the active group increased in the Right eye from 0.35 density units (du)/0.04 SE to 0.41 du/0.05 SE; p < 0.001 and in the Left eye from 0.35 du/0.05 SE to 0.37 du, p > 0.05). The supplemented group showed significant improvements in contrast sensitivity with glare in both eyes with improvements in LogMAR scores of 0.147 and 0.149, respectively (p = 0.02 and 0.01, respectively), monocularly tested glare recovery time improved 2.76 and 2.54 s, respectively, (p = 0.008 and p = 0.02), and we also noted a decreased preferred luminance required to complete visual tasks (p = 0.02 and 0.03). Improvements in UFOV scores of divided attention (p < 0.001) and improved composite crash risk score (p = 0.004) were seen in the supplemented group. The placebo group remained unchanged. CONCLUSIONS: The NVC demonstrates that augmenting MPOD in individuals with difficulty in night vision showed measurable benefits in numerous visual functions that are important for night vision driving in this small sample RCT. Additionally, we observed an improvement in UFOV divided attention test scores and decreased composite risk scores.

Hazard Perception and Prediction test for walking, riding a bike and driving a car: "Understanding of the global traffic situation".

To "put oneself in the place of other road users" may improve understanding of the global traffic situation. It should be useful enabling drivers to anticipate and detect obstacles in time to prevent accidents to other road users, especially those most vulnerable. We created a pioneering Hazard Perception and Prediction test to explore this skill in different road users (pedestrians, cyclists and drivers), with videos recorded in naturalistic scenarios: walking, riding a bicycle and driving a car. There were 79 participants (30 pedestrians, 14 cyclists, 13 novice drivers and 22 experienced drivers). Sixty videos of hazardous traffic situations were presented, divided into 2 blocks of 30 videos each: 10 walking, 10 riding a bicycle, 10 driving a car. In each situation presented, we evaluated the performance of the participants carrying out the task of predicting the hazard and estimating the risk. In the second block, after they had carried out the task, we gave them feedback on their performance and let them see the whole video (i.e., checking what happened next). The results showed that the holistic test had acceptable psychometric properties (Cronbach's alpha = .846). The test was able to discriminate between the different conditions manipulated: a) between traffic hazards recorded from different perspectives: walking, riding a bicycle and driving a car; b) between participants with different user profiles: pedestrians, cyclists and drivers; c) between the two test blocks: the first evaluation only and the second combining evaluation with this complex intervention. We found modal bias effects in both Hazard Perception and Prediction; and in Risk Estimation.

An examination of the intersection environment associated with perceived crash risk among school-aged children: using street-level imagery and computer vision.

While computer vision techniques and big data of street-level imagery are getting increasing attention, a "black-box" model of deep learning hinders the active application of these techniques to the field of traffic safety research. To address this issue, we presented a semantic scene labeling approach that leverages wide-coverage street-level imagery for the purpose of exploring the association between built environment characteristics and perceived crash risk at 533 intersections. The environmental attributes were measured at eye-level using scene segmentation and object detection algorithms, and they were classified as one of four intersection typologies using the k-means clustering method. Data on perceived crash risk were collected from a questionnaire conducted on 799 children 10 to 12 years old. Our results showed that environmental features derived from deep learning algorithms were significantly associated with perceived crash risk among school-aged children. The results have revealed that some of the intersection characteristics including the proportional area of sky and roadway were significantly associated with the perceived crash risk among school-aged children. In particular, road width had dominant influence on risk perception. The findings provide information useful to providing appropriate and proactive interventions that may reduce the risk of crashes at intersections.

Pedestrian estimation of their crossing time on multi-lane roads.

Estimation of one's own crossing time is an important process in making road-crossing decisions. This study evaluated the pedestrian's (esp. the elderly) ability to estimate crossing time in a field experiment. The estimated crossing time was measured by an interval production method (participants produced an interval to represent their estimated crossing time) and an imagined crossing method. The results showed that while young pedestrians generally had an accurate estimation of their crossing time, old pedestrians consistently underestimated the crossing time in both methods, especially at a wider road. What's worse, even fast walking cannot compensate for the large underestimation. Further analysis showed that although old pedestrians had the declined motor imagery ability and the worse general timing accuracy, none of them can account for the inaccuracy of estimation. These findings suggest that underestimation of crossing time may be one of the important reasons for the acknowledged risky road crossing decision-making in old pedestrians. It also calls for studies on assistive roadway designs and intervention programs targeting old pedestrians.

Self-reported mindfulness, cyclist anger and aggression.

Anger is a common behaviour exhibited by road users when one's goals are perceived to have been blocked by another. Recent research has demonstrated that, generally, cyclists tend to deal with anger in constructive ways. However, when anger does manifest, it can result in behaviours that increase their crash risk. Amongst motor vehicle drivers, mindfulness levels have been associated with less anger and appear to mediate anger and associated aggression. The current study sought to understand whether mindfulness has similar associations with anger and aggression in a sample of cyclists. A total of 583 cyclists (males = 68 %) completed an online questionnaire that sought information on their levels of mindfulness, current mindfulness practices and tendencies for anger and aggression while cycling. The relationships between these were then examined using structural equation modelling. The results showed that cyclists with higher mindfulness levels tended to report less anger across a range of situations (e.g., interactions with pedestrians, cyclists, motor vehicle drivers and police). Both direct and indirect (through anger) relationships were found between mindfulness and aggression, again showing that more mindful cyclists tended to engage in less frequent aggression. These findings align with recent research investigating this relationship amongst motor vehicle drivers and suggest that mindfulness may be a promising strategy to reduce or avoid anger and aggression in cyclists.

Creating a hazard-based training and assessment tool for emergency response drivers.

Emergency response drivers (ERDs) are often required to engage in high-risk driving manoeuvres on their way to a reported incident. Such risk requires that these drivers receive a high-level of training and continued development. The aim of this paper was to investigate an innovative format for a new potential tool that could support the training and assessment of these drivers: a single-clip Holistic Hazard Test, containing multiple hazards in a single route. In study one, we created a proof-of-concept 15-minute clip containing hazards, multiple-choice questions and probes to collect self-reported safety ratings. ERDs were more accurate on the multiple-choice questions (MCQs) than a control group, though response time scores to hazards did not reach the threshold for significance. In study two, we refined the development process and created a series of new holistic hazard tests across four counties of the East Midlands, UK. Each test contained many hazards and MCQs that assessed situation awareness and decision-making, based on the results of study 1. Participants were recruited across the four counties and were presented with both the test that was specific to their county and one of the unfamiliar-location tests, in order to assess the generalisability of the tests across different locales. The results showed no differences regarding location familiarity, suggesting that tests filmed in one area of the country can be viewed by drivers elsewhere without detriment to performance. ERDs once again responded to MCQs more accurately, and also scored more hazard points on the basis of faster responses to hazards compared to control participants. These results suggest such tests can successfully tap into ERD-specific skills with regard to spotting, predicting and responding to hazards on the road. We recommend refinement of this tool for assessment of emergency response drivers, and further development to extend the materials to create a training tool.

Differences between males and females in the prediction of smartphone use while driving: Mindfulness and income.

INTRODUCTION: This study examines the relationship between two variables-mindfulness and income-with regards to their relationship to the use of smartphones by young drivers, which has been known to increase the likelihood of car accidents, endangering young drivers and other road users. The study focuses on the relationship between these variables and the use of smartphones while driving, and how this relationship differs between males and females. METHOD: The study sample included 221 young drivers who were legally permitted to drive without supervision. The subjects were first asked to complete questionnaires on mindfulness and income. Next, their smartphone use while driving was monitored over a one-month period. This study is unique as it used an objective smartphone monitoring application (rather than self-reporting) to count the number of times the young participants actually touched their smartphones while driving. RESULTS: The findings show that the effects of social and personal factors (i.e., income and mindfulness) on the use of smartphones while driving are significant for males but not for females. CONCLUSIONS: Most studies that investigate differences between males and females with respect to safety focus on differences in the averages of safety-related variables (such as safety performance and outcomes). In the current study, however, we identified differences in relationships between variables and demonstrated that what predicts safety-related behavior in males may not be a good predictor for females. PRACTICAL APPLICATIONS: Mindfulness and income can be used to identify male populations that are at risk of using smartphones while driving. Interventions that improve mindfulness can be used to reduce the use of smartphones by male drivers.

Building Road Safety Institutions in Low- and Middle-Income Countries: The Case of Argentina.

Traffic injuries remain a leading health concern in most low- and middle-income countries (LMICs). However, most LMICs have not established institutions that have the legislative mandate and financial resources necessary to coordinate large-scale interventions. Argentina provides a counterexample. Argentina is a federal country where the decentralization of authority to provincial governments was a key barrier to effective national interventions. In 2008, Argentina passed a law establishing a national road safety agency and subsequently received a World Bank loan to build the agency's capacity to coordinate actions. Although traffic injuries in Argentina have not yet begun to decline, these developments raise important questions:Why did Argentina come to view road safety as aproblem?Why was institutional reform the chosen solution? What was the political process for achieving reform? What are the broader implications for institutional reform in LMICs?We explore these questions using a descriptive case study (single-case, holistic design) of Argentina. The case illustrates that focusing events, like the Santa Fe tragedy that killed nine children, and advocacy groups are important for raising political attention and creating an opportunity for legislative reform. It highlights the importance of policy entrepreneurs who used the opportunity to push through new legislation. Though the political dynamic was predominantly local, international actors worked with local advocates to build demand for safety and develop solutions that could be deployed when the opportunity arose. Most important, the case emphasizes the importance of developing institutions with the resources and authority necessary for managing national road safety programs.

Do mindfulness interventions improve road safety? A systematic review.

Mindfulness has been identified as a potentially effective intervention for reducing road trauma. In this paper, we report on the results of a systematic review which examined the evidence regarding the relationship between mindfulness and road safety. The review was conducted following PRISMA guidelines (PROSPERO 2017: CRD42017075704). The primary outcomes measured were crash or near-crash rates and the secondary outcomes were driving violations (including speeding and texting while driving) and driving performance (i.e., errors in driving simulator, etc.). This review was registered with PROSPERO 2017: CRD42017075704. A systematic search of databases from the disciplines of public health, psychology and transport safety (Ovid Cochrane Library, Ovid PsycINFO, Ovid EMBASE, CINAHL PLUS, Ovid TRANSPORT and TRID: TRIS and ITRD database) was conducted on February 7th 2018. Seventeen studies (12 cross-sectional and 5 case-control) published between 2011 and 2017 met the inclusion criteria. These all focused on the association between mindfulness or mind-wandering on road safety measures including driving performance (vehicle control, reaction time), compliance with speed zones and traffic signals, near-crash and crash rates, as well as propensity to engage in distracted driving behaviours. The results of the review suggest that mindfulness may be particularly useful for preventing distracted driving. However, a number of limitations in the existing research are noted. It is clear that more research is warranted to specifically investigate the effectiveness of mindfulness as an intervention for reducing road trauma.

Evolution of a holistic systems approach to planning and managing road safety: the Victorian case study, 1970-2015.

BACKGROUND: The Victorian Safe System approach to road safety slowly evolved from a combination of the Swedish Vision Zero philosophy and the Sustainable Safety model developed by the Dutch. The Safe System approach reframes the way in which road safety is viewed and managed. METHODS: This paper presents a case study of the institutional change required to underpin the transformation to a holistic approach to planning and managing road safety in Victoria, Australia. RESULTS: The adoption and implementation of a Safe System approach require strong institutional leadership and close cooperation among all the key agencies involved, and Victoria was fortunate in that it had a long history of strong interagency mechanisms in place. However, the challenges in the implementation of the Safe System strategy in Victoria are generally neither technical nor scientific; they are predominantly social and political. While many governments purport to develop strategies based on Safe System thinking, on-the-ground action still very much depends on what politicians perceive to be publicly acceptable, and Victoria is no exception. CONCLUSIONS: This is a case study of the complexity of institutional change and is presented in the hope that the lessons may prove useful for others seeking to adopt more holistic planning and management of road safety. There is still much work to be done in Victoria, but the institutional cultural shift has taken root. Ongoing efforts must be continued to achieve alert and compliant road users; however, major underpinning benefits will be achieved through focusing on road network safety improvements (achieving forgiving infrastructure, such as wire rope barriers) in conjunction with reviews of posted speed limits (to be set in response to the level of protection offered by the road infrastructure) and by the progressive introduction into the fleet of modern vehicle safety features.

Qing-Qi Rickshaw : A Boon Or Bane For Public Transportation? A Study Of Road Traffic Injury Patterns Involving Qing-Qi Rickshaws In Karachi Pakistan.

BACKGROUND: The three-wheeler Qing-qi and Compressed Natural Gas (CNG) auto-rickshaws were introduced in Karachi to meet the transportation demand of the growing population. These vehicles have directly or indirectly been implicated in a number of road traffic violations as well as road accidents. This study aims to describe the crash characteristics and injury patterns for Qing-qi rickshaw occupants and other road users hit by Qing-qi rickshaw in Karachi, Pakistan. METHODS: An Observational/ Descriptive study was conducted at Accident & Emergency and Orthopaedic Surgery Department, Jinnah Post Graduate Medical Centre, Karachi Pakistan from July 2014 to June 2015.All patients who came with Qing-qi rickshaw accident in Accident & Emergency (A&E) of JPMC were included. Crash characteristics, details of injuries, injury severity parameters and outcome were documented in detailed interviews. RESULTS: Four hundred and eighty-six rickshaw related injuries were noted in road traffic accidents by Qing-gi rickshaw. Age range was 2-85 (43.5±58.68). 350 injured victims were males and 136 were females. By occupation most victims were laborers and daily wage workers (45%) and students (21%). Overloading of vehicle with more than two passengers was found in (28.5%). The most common cause of injury was collision with a moving vehicle (56%), followed by fall from rickshaw. The most common contributing factor was the overloading of rickshaw and roll over on turning (61%). Injury severity on arrival were mild (49%), moderate were (32%), and severe were (19%). Injuries related to head and neck (26%), face (14%), thorax and abdomen (5%), lower extremity and pelvic girdle (31%) and upper extremity (23%) were observed. CONCLUSIONS: Qing-qi rickshaw injuries are common and these vehicles are vulnerable to road traffic accidents. Occupants and road users are both at risk of injuries.

Driving home from the night shift: a bright light intervention study.

Sleep deprivation (SD) impairs vigilance and increases the risk of driving accidents during the commute home after night work. Bright light (BL) can enhance alertness and cognitive performance. We examined the effects of BL (5600 lux) versus dim light (DL, 35 lux) at the end of a night awake on driving performance. METHODS: Subjects (N = 19, 22.8 ± 4 ya) completed three conditions, counterbalanced for order at >1 week intervals. The two overnight SD conditions began in the lab at usual bedtime. After six hours in DL, subjects were exposed to 45 min BL or continued DL, and then completed a 44 min driving test (two lap circuit) in a high fidelity simulator. In the rested condition, subjects slept at home until habitual wakeup time, were transported to the lab and ∼45 min after wakeup, received BL and then the driving test. RESULTS: Oral temperature decreased while reaction time and sleepiness increased across both SD nights. BL suppressed salivary melatonin but had little or no effect on sleepiness or reaction time. SD markedly increased incidents and accidents. Five subjects (26%) sustained a terminal accident (eg, car flip) in the SD-DL condition, but none did so in the SD-BL or rested-BL conditions. Compared to SD-DL, SD-BL was associated with fewer incidents and accidents overall, and with better performance on the second lap of the circuit on several performance measures. CONCLUSION: BL at the end of a night shift may have potential as a countermeasure to improve driving following night work.