Alcohol and illicit substances associated with fatal crashes in Queensland: An examination of the 2011 to 2015 Coroner's findings.

PROBLEM: The problem of impaired driving is well documented in the literature but is heavily dependent upon self-report studies and/or databases that do not include in-depth information about the contributing origins of fatalities. AIM: This study aimed to conduct an in-depth analysis of Coroner's findings for all fatally injured drivers in the state of Queensland in order to explore the prevalence of alcohol and different types of illicit substances (including drug combinations) in fatal crash reports. METHOD: A total of 701 Coroner's reports related to drivers or controllers of vehicles involved in traffic related fatalities for the period of 2011-2015 were analysed, revealing 306 controllers (43.6%) were detected with either alcohol or illegal drugs (e.g., methylamphetamine, Δ9-tetrahydrocannabinol, cocaine or MDMA) RESULTS: Alcohol was the most commonly detected substance identified with 223 cases (72.9% of the drug and alcohol sample). Illicit drug detections totalled 147 cases (48% of the drug and alcohol sample) with Δ9-tetrahydrocannabinol the most commonly detected illicit substance (109 cases; 35.6% of the drug and alcohol sample) followed by methylamphetamine (total of 63 cases; 20.6% of the drug and alcohol sample). An important theme to emerge was the prevalence of polysubstance use among fatally injured drivers, not just for alcohol and one drug type, but also multiple drug combinations. Fatality trends revealed a decrease in both non-substance and alcohol-related fatalities across the study period. However, road fatalities where an illicit substance was detected increased by approximately 57%. Males were overrepresented as a proportion of total fatalities (82.4%) and there were no significant sex or age differences regarding illicit substance related deaths. Drivers of passenger vehicles were most commonly identified in the data (66.2%), but motorcycle operators were disproportionately represented (28.1% of the total controller sample compared to 4% of vehicle registrations in Queensland) CONCLUSION: This case study analysis of fatal crashes not only confirms the ongoing problem of alcohol and driving, but also illuminates the emerging (and escalating) issue of illicit substances detected in fatally injured drivers.

Past behaviours and future intentions: An examination of perceptual deterrence and alcohol consumption upon a range of drink driving events.

INTRODUCTION: The threat of application of legal sanctions remains the prominent approach to reduce the prevalence of drink driving in a vast array of motoring jurisdictions. However, ongoing questions remain regarding: (a) the extent that such mechanisms impact upon offending behaviours, (b) the deleterious effect alcohol consumption has on decisions to drink and drive and (c) how best to operationalise (and measure) the concept of drink driving to enhance the accurate measurement of the dependent variable. METHOD: This paper reports on an examination of 773 Queensland motorists' (across nine local government areas) perceptions of both legal and non-legal drink driving sanctions (as well as alcohol consumption) in order to gauge the deterrent impact upon a range of measures of drink driving: the driver thinking they are over the limit, the driver knowing they are over the limit, attempts to evade random breath testing, and intentions to re-offend. The sample completed an online or paper version of the questionnaire. RESULTS: The majority of participants reported "never" engaging in "possible" (74.5 %) or "acknowledged" (83.4 %) drink driving events, although a considerable proportion of the sample reported engaging in "possible" (25.5 %) or "acknowledged" (16.6 %) drink driving and attempting to evade RBT (18 %) events, as well as possible intentions to drink and drive in the future (22 %). Males were more likely to report such events. Perceptions of both legal sanctions (certainty, severity and swiftness) as well as non-legal sanctions (fear of social, internal or physical harm) were relatively high and consistent with previous research. Interestingly, non-legal sanctions were reported as stronger deterrents than legal sanctions. However, multivariate analysis revealed that legal deterrents had limited utility predicting offending behaviours, but rather, demographic characteristics (e.g., younger motorists, males) as well as risky drinking behaviour were better predictors. In regards to intentions to offend, a past conviction for drink driving was also a predictor of re-offending. PRACTICAL APPLICATIONS: These results highlight the ongoing challenges of addressing the problem of drink driving and that some motorists: (a) have entrenched behaviour and/or (b) make the decision to drink and drive before they are under the influence of alcohol.

Drink driving engagement in women: An exploration of context, hazardous alcohol use, and behaviour.

BACKGROUND: While drink driving continues to be significantly more common among male drivers, there is evidence from many countries that shows a growing trend of women engaging in this risky behaviour. The aims of the current study were threefold: (i) determine to what extent a sample of women drivers reported engaging in drink driving behaviour by expanding the construct into a range of definitions, (ii) determine if there were significant differences in self-reported engagement in drink driving behaviours in accordance with hazardous drinking behaviour, and (iii) identify which situational or personal factors would increase women drivers' likelihood to engage in drink driving through presenting a range of scenarios. METHOD: Data were collected using an on-line, purpose-designed survey and promoted to reach women aged 17 years and older, living in Queensland, Australia. In addition to questions relating to demographic characteristics, participants completed items relating to engagement in seven drink driving related behaviours in the previous 12-month period, hazardous drinking as measured by the Alcohol Use Disorders Identification Test, and likelihood of driving when unsure if over the legal limit for licence type across a range of scenarios manipulating different situational factors. A total of 644 valid responses were received in the two-week period the study was advertised. RESULTS: The results demonstrate women's self-reported engagement in drink driving behaviour ranged from 12.6% (driving when they believed they were over the legal limit) to over 50.0% (driving when unsure if over the legal limit the morning after drinking alcohol) and was significantly more likely among those who reported hazardous levels of alcohol use. Circumstances in which women reported they would drive when unsure if over the legal BAC limit were when they were a few blocks from home, if they subjectively felt they were not too intoxicated, or if they needed their car to get somewhere the next morning. CONCLUSION: Examining drink driving behaviour by way of responses to nuanced definitions provided valuable insight into self-reported engagement in the behaviour and highlights the usefulness of multi-measure dependent variables in order to illuminate a more accurate acknowledgement into both the type (and extent) of drink driving behaviours.

Predicting self-reported drink driving among middle-aged women.

A substantial and sustained increase in the proportion of drink drivers that is female is observed in many parts of the motorised world. Given this trend, a better understanding of the factors that influence drink driving among women is needed. The current study investigated drink driving among middle-aged women, a relatively under-researched group of female drink drivers. A total of 781 women (age; M=51.36, SD=4.29years) completed a cross-sectional survey measuring a number of alcohol beliefs and drink driving. Among the included alcohol beliefs, viewing alcohol as a form of social enhancement as well as higher perceived heavy episodic drinking among same-aged women and greater acceptability toward this consumption pattern significantly increased the likelihood of self-reported drink driving. However, after adjusting for harmful consumption patterns, only alcohol as form of social enhancement remained significant. These results indicate that middle-aged women who engage in harmful alcohol consumption are more likely to drink drive, but also that the social aspect of drinking is a risk factor. Targeting both harmful consumption patterns as well as alcohol beliefs that are held by middle-aged women may reduce the incidence of drink driving in this group.

Crash risk perception of sleepy driving and its comparisons with drink driving and speeding: Which behavior is perceived as the riskiest?

OBJECTIVE: Driver sleepiness is a major crash risk factor but may be underrecognized as a risky driving behavior. Sleepy driving is usually rated as less of a road safety issue than more well-known risky driving behaviors, such as drink driving and speeding. The objective of this study was to compare perception of crash risk of sleepy driving, drink driving, and speeding. METHODS: Three hundred Australian drivers completed a questionnaire that assessed crash risk perceptions for sleepy driving, drink driving, and speeding. Additionally, the participants' perceptions of crash risk were assessed for 5 different contextual scenarios that included different levels of sleepiness (low, high), driving duration (short, long), and time of day/circadian influences (afternoon, nighttime) of driving. RESULTS: The analysis confirmed that sleepy driving was considered a risky driving behavior but not as risky as high levels of speeding (P < .05). Yet, the risk of crashing at 4 a.m. was considered as equally risky as low levels of speeding (10 km over the limit). The comparisons of the contextual scenarios revealed driving scenarios that would arguably be perceived as quite risky because time of day/circadian influences were not reported as high risk. CONCLUSIONS: The results suggest a lack of awareness or appreciation of circadian rhythm functioning, particularly the descending phase of circadian rhythm that promotes increased sleepiness in the afternoon and during the early hours of the morning. Yet, the results suggested an appreciation of the danger associated with long-distance driving and driver sleepiness. Further efforts are required to improve the community's awareness of the impairing effects from sleepiness and, in particular, knowledge regarding the human circadian rhythm and the increased sleep propensity during the circadian nadir.

The on-road experiences and awareness of sleepiness in a sample of Australian highway drivers: A roadside driver sleepiness study.

OBJECTIVE: Driver sleepiness contributes substantially to road crash incidents. Simulator and on-road studies clearly reveal an impairing effect from sleepiness on driving ability. However, the degree to which drivers appreciate the dangerousness of driving while sleepy is somewhat unclear. This study sought to determine drivers' on-road experiences of sleepiness, their prior sleep habits, and personal awareness of the signs of sleepiness. METHODS: Participants were a random selection of 92 drivers traveling on a major highway in the state of Queensland, Australia, who were stopped by police as part of routine drink driving operations. Participants completed a brief questionnaire that included demographic information, sleepy driving experiences (signs of sleepiness and on-road experiences of sleepiness), and prior sleep habits. A modified version of the Karolinska Sleepiness Scale (KSS) was used to assess subjective sleepiness in the 15 min prior to being stopped by police. RESULTS: Participants' ratings of subjective sleepiness were quite low, with 90% reporting being alert to extremely alert on the KSS. Participants were reasonably aware of the signs of sleepiness, with many signs of sleepiness associated with on-road experiences of sleepiness. Additionally, the number of hours spent driving was positively correlated with the drivers' level of sleep debt. CONCLUSIONS: The results suggest that participants had moderate experiences of driving while sleepy and many were aware of the signs of sleepiness. The relationship between driving long distances and increased sleep debt is a concern for road safety. Increased education regarding the dangers of sleepy driving seems warranted.

Examining signs of driver sleepiness, usage of sleepiness countermeasures and the associations with sleepy driving behaviours and individual factors.

The impairing effect from sleepiness is a major contributor to road crashes. The ability of a sleepy driver to perceive their level of sleepiness is an important consideration for road safety as well as the type of sleepiness countermeasure used by drivers as some sleepiness countermeasures are more effective than others. The aims of the current study were to determine the extent that the signs of driver sleepiness were associated with sleepy driving behaviours, as well as determining which individual factors (demographic, work, driving, and sleep-related factors) were associated with using a roadside or in-vehicle sleepiness countermeasure. A sample of 1518 Australian drivers from the Australian State of New South Wales and the neighbouring Australian Capital Territory took part in the study. The participants' experiences with the signs of sleepiness were reasonably extensive. A number of the early signs of sleepiness (e.g., yawning, frequent eye blinks) were related with continuing to drive while sleepy, with the more advanced signs of sleepiness (e.g., difficulty keeping eyes open, dreamlike state of consciousness) associated with having a sleep-related close call. The individual factors associated with using a roadside sleepiness countermeasure included age (being older), education (tertiary level), difficulties getting to sleep, not continuing to drive while sleepy, and having experienced many signs of sleepiness. The results suggest that these participants have a reasonable awareness and experience with the signs of driver sleepiness. Factors related to previous experiences with sleepiness were associated with implementing a roadside countermeasure. Nonetheless, the high proportions of drivers performing sleepy driving behaviours suggest that concerted efforts are needed with road safety campaigns regarding the dangers of driving while sleepy.

Profiling contextual factors which influence safety in heavy vehicle industries.

A significant proportion of worker fatalities within Australia result from truck-related incidents. Truck drivers face a number of health and safety concerns. Safety culture, viewed here as the beliefs, attitudes and values shared by an organisation's workers, which interact with their surrounding context to influence behaviour, may provide a valuable lens for exploring safety-related behaviours in heavy vehicle operations. To date no major research has examined safety culture within heavy vehicle industries. As safety culture provides a means to interpret experiences and generate behaviour, safety culture research should be conducted with an awareness of the context surrounding safety. The current research sought to examine previous health and safety research regarding heavy vehicle operations to profile contextual factors which influence health and safety. A review of 104 peer-reviewed papers was conducted. Findings of these papers were then thematically analysed. A number of behaviours and scenarios linked with crashes and non-crash injuries were identified, along with a selection of health outcomes. Contextual factors which were found to influence these outcomes were explored. These factors were found to originate from government departments, transport organisations, customers and the road and work environment. The identified factors may provide points of interaction, whereby culture may influence health and safety outcomes.

Continuing to drive while sleepy: the influence of sleepiness countermeasures, motivation for driving sleepy, and risk perception.

Driver sleepiness is a major contributor to road crashes. The current study sought to examine the association between perceptions of effectiveness of six sleepiness countermeasures and their relationship with self-reports of continuing to drive while sleepy among 309 drivers after controlling for the influence of age, sex, motivation for driving sleepy, and risk perception of sleepy driving. The results demonstrate that the variables of age, sex, motivation, and risk perception were significantly associated with self-reports of continuing to drive while sleepy and only one countermeasure was associated with self-reports of continuing to drive while sleepy. Further, it was found that age differences in self-reports of continuing to drive while sleepy was mediated by participants' motivation and risk perception. These findings highlight modifiable factors that could be focused on with interventions that seek to modify drivers' attitudes and behaviours of driving while sleepy.

Profile of women detected drink driving via Roadside Breath Testing (RBT) in Queensland, Australia, between 2000 and 2011.

BACKGROUND: Drink driving among women is a growing problem in many motorised countries. While research has shown that male and female drink drivers differ on a number of characteristics, few studies have addressed the circumstances surrounding women's drink driving offences specifically. AIM: To add to previous research by comparing apprehension characteristics among men and women and to extend the understanding of the female drink driving problem by investigating the drink driving characteristics that are unique to women. RESULTS: The sample consisted of the 248,173 (21.5% women) drink drivers apprehended between 2000 and 2011 in Queensland, Australia. Gender comparisons showed that women were older, had lower levels of reoffending, and were more likely to be apprehended in Major Cities compared to men. Comparisons of age group and reoffending and non-reoffending among female drink drivers only revealed that higher BAC readings were more common among younger women. Moreover, a substantial minority (13.7%) of women aged 24 years or younger were apprehended with a BAC below 0.05%, reflecting a breach of the zero tolerance BAC for provisional licence holders in Australia. Older women were more likely to be charged with a 'failure to provide a test' offence as a result of refusing to provide a breath or blood sample, indicating that drink driving is associated high levels of stigma for this group. Reoffending occurred among 16.2% of the female drink drivers and these drivers were more likely than non-reoffending drivers to record a mid to high range BAC, to be aged 30-39 or below 21 years, and to be apprehended in Inner Regional or Remote locations. CONCLUSION: Findings highlight the unique circumstances and divergent needs of female drink drivers compared to male drivers and for different groups of female drivers.