Age-based medical screening of drivers in Switzerland: an ecological study comparing accident rates with Austria and Germany.

BACKGROUND: In Switzerland, as in various other countries throughout the world, elderly drivers have to pass a medical screening assessment every two years to keep their driver's licence. The scientific literature shows no clear evidence that these policies improve road safety. This study evaluated the effects of the Swiss screening policy by comparing the accident and injury rates of elderly road users in Switzerland with those in Austria and Germany, two neighbouring countries without systematic age-based screening policies. The aims of this study were to examine if the screening policy is associated with a reduced risk of elderly car drivers causing serious accidents (research question 1) or with an increased risk of elderly pedestrians or (e-)cyclists being seriously or fatally injured (research question 2). METHODS: In all three countries, data on accidents were taken from official statistics based on police reports and mileage data from national mobility surveys. An accident was defined as serious if at least one person is seriously or fatally injured in it. Accident and injury rates were calculated using distances driven and population size as measurement of exposure. Multiple Poisson regression models were used to examine the association between the Swiss policy and the accident or injury risk of elderly persons. RESULTS: We found no association between the screening policy for elderly drivers in Switzerland and their risk of causing a serious accident (incidence rate ratio [IRR] 1.24, 95% confidence interval [CI] 0.79-1.94). Contrary to other studies, however, the Swiss policy was not associated with an increased risk of elderly pedestrians (IRR 1.16, 95% CI 0.80-1.68) and (e-)cyclists (IRR 0.79, 95% CI 0.56-1.12) being seriously or fatally injured. CONCLUSIONS: The intended positive effect of the Swiss screening policy on accident rates of elderly drivers could not be demonstrated in this study. These findings serve as a basis for discussion on how to proceed with the policy in the future.

Change of risk behaviour in young people - the effectiveness of the trauma prevention programme P.A.R.T.Y. considering the effect of fear appeals and cognitive processes.

BACKGROUND: The purpose of the present study was to examine the effectiveness of the injury awareness and prevention programme P.A.R.T.Y. (Prevent Alcohol and Risk-Related Trauma in Youth) in Germany. On a designated P.A R.T.Y. day, school classes spend a day in a trauma hospital experiencing the various wards through which a seriously injured person goes. A further goal of the study was to reveal indications of the programme's mechanism of action by testing theory-based impact models of fear appeals and cognitive beliefs. METHODS: In a quasi-experimental longitudinal study with three measurement times the participants of 19 P.A.R.T.Y. days (n = 330), as well as pupils who did not attend the programme (n = 244), were interviewed with a standardised questionnaire. They reported risk behaviour, feelings of threat and cognitive beliefs about road traffic. The data were analysed using a meta-analytical approach to estimate an average effect size across the different P.A.R.T.Y. days. Path models were used to identify possible mechanisms of action. RESULTS: For most of the parameters, small positive effects could be proven immediately after the P.A.R.T.Y. INTERVENTION: However, after four to 5 months only one statistically significant effect was found. Using path analytical models, important predictors for behavioural changes (e.g. self-efficacy) could be identified. But for these predictors no or only short-term effects were observed in the meta-analysis. CONCLUSIONS: Fear appeals as used primarily in the P.A.R.T.Y. programme appear to cause behavioural changes only to a limited extent and only in the short-term, especially if the strengthening of psychosocial resources is not given sufficient consideration. The participants must also cognitively process the experiences in the hospital. Accordingly, consideration should be given to how the P.A.R.T.Y. program could be adapted to complement the fear appeal with cognitive components.

(E-)Cyclists running the red light - The influence of bicycle type and infrastructure characteristics on red light violations.

Red light running is one of the most common traffic violations among cyclists. From different surveys, we know that about 40% of all cyclists run a red light at least occasionally. However, specific data on red light running of e-bike riders (pedelec and S-pedelec riders), a population of cyclists that has been growing steadily in the past few years in Germany and elsewhere, is largely missing. Similarly unclear is the role of the used infrastructure (e.g., carriageway or bike path) or the intersection type on the riders' propensity to run the red light. The goal of this study was to investigate the red light running behaviour of three different bicycle types (bicycle, pedelec, S-pedelec) in Germany, with specific focus on various infrastructure characteristics. We reanalysed data obtained in a naturalistic cycling study, in which we observed 90 participants riding their own bicycles (conventional bicycles, pedelecs, S-pedelecs) on their daily trips over four weeks each. The video material of these trips was annotated and analysed with regard to red light running. Overall, our participants experienced nearly 8000 red light situations. In 16.3% of these situations, they ran the red light, with nearly identical rates for cyclists, pedelec and S-pedelec riders. Red light running rates were lowest when cyclists rode on the carriageway, while the complexity of the intersection appeared to play a role as well. In general, red light running was more common when riders were about to turn right instead of turning left or riding straight through the intersection. Interestingly, we also observed a considerable number of cases in which the riders changed their used infrastructure (e.g., from the carriageway onto the pavement) to avoid a red light.

Risk compensation? The relationship between helmet use and cycling speed under naturalistic conditions.

INTRODUCTION: An argument against mandatory helmet use is based on the idea of risk compensation, which means that cyclists might ride faster when wearing a helmet (Lardelli-Claret et al., 2003). However, questionnaire and experimental studies were unable to find evidence for this assumption (Fyhri et al., 2012; Fyhri & Philipps, 2013). Simultaneously, other factors with a potential role in helmet use and cycling speed, such as trip length and rider characteristics have been neglected in such considerations. The goal of the analysis presented in this paper was therefore to investigate the relationship between helmet use and cycling speed under naturalistic conditions while taking characteristics of cyclists and bicycles into account. METHOD: As part of a naturalistic cycling study, we equipped the bicycles of conventional and e-bike riders with data acquisition systems to record speed and trip distance. It included two cameras (one for the face of the participant, another one for the forward scenery). For the analysis presented in this paper, we used the data of 76 participants (28 conventional bicycles, 48 e-bikes). RESULTS: In total, participants used their helmet for 56% of all trips. Helmets were used more frequently for longer trips. A linear mixed model, in which trip length, helmet use, bicycle type, age, and gender were used as predictors showed that helmet use did not play a significant role for cycling speed. Instead, all other factors that were analyzed, with the exception of gender, had a significant relationship to cycling speed. DISCUSSION: The assumption of risk compensation as a result of the use of a helmet could not be confirmed. Instead, the findings seem to support the suggestion that cyclists who undertake trips at potentially higher speed levels are aware of their increased risk, and actively try to reduce it through the use of a helmet.

The influence of speed, cyclists' age, pedaling frequency, and observer age on observers' time to arrival judgments of approaching bicycles and e-bikes.

Given their potential to reach higher speed levels than conventional bicycles, the growing market share of e-bikes has been the reason for increased concerns regarding road safety. Previous studies have shown a clear relationship between object approach speed and an observers' judgment of when the object would reach a predefined position (i.e., time to arrival, TTA), with higher speed resulting in longer TTA estimates. Since TTA estimates have been linked to road users' decisions of whether or not to cross or turn in front of approaching vehicles, the higher potential speeds of e-bikes might result in an increased risk for traffic conflicts. The goal of the two experiments presented in this paper was to examine the influence of speed and a variety of other factors on TTA estimation for conventional bicycles and for e-bikes. In both experiments, participants from two age groups (20-45 years old and 65 years or older) watched video sequences of bicycles approaching at different speeds (15-25km/h) and were asked to judge the TTA at the moment the video was stopped. The results of both experiments showed that an increase in bicycle approach speed resulted in longer TTA estimates (measured as the proportion of estimated TTA relative to actual TTA) for both bicycle types (ηp(2)Exp.1=.489, ηp(2)Exp.2=.705). Compared to younger observers, older observers provided shorter estimates throughout (Exp. I: MDiff=0.35, CI [0.197, 0.509], ηp(2)=.332, Exp. II: MDiff=0.50, CI [.317, 0.682], ηp(2)=.420). In Experiment I, TTA estimates for the conventional bicycle were significantly shorter than for the e-bike (MDiff=0.03, CI [.007, 0.044], ηp(2)=.154), as were the estimates for the elder cyclist compared to the younger one (MDiff=0.05, CI [.025, 0.066], ηp(2)=.323). We hypothesized that the cause for this effect might lie in the seemingly reduced pedaling effort for the e-bike as a result of the motor assistance it provides. Experiment II was able to show that a high pedaling frequency indeed resulted in shorter TTA estimates compared to a low one (MDiff=0.07, CI [0.044, 0.092], ηp(2)=.438). Our findings suggest that both the e-bikes' potential to reach higher speeds and the fact that they reduce the perceived cycling effort increase the risk of TTA misjudgments by other road users.