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A83 Road traffic injuries and Alcohol: Double jeopardy in Pacific Island nations fuelled by inequitably distributed determinants of health
S48
Oral Abstracts / Journal of Transport & Health 2 (2015) S5–S63
A82 Road users with hearing loss and evaluation of tactile support systems Birgitta Thorslund a a
VTI, Sweden
Abstract Background:
Research regarding the effect of Hearing loss (HL) on traffic safety and mobility is limited and the empirical findings are somewhat inconsistent. HL is one of the most frequent sensory deficit in humans, which may affect behavior in traffic situations and might reduce traffic safety. The prevalence of age-related HL in Europe is roughly 30% for men and 20% for women at the age of 70 years, and 55% for men and 45% for women at the age of 80 years. The prevalence of age-related HL is increasing, and as a consequence the number of road users with HL will also increase.
Methods:
To investigate traffic safety and mobility for individuals with HL three studies have been conducted; 1) a questionnaire survey, 2) a driving simulator study, 3) a field study.
Results:
The effects of HL on traffic safety and mobility are small, often bound to workload condition, however quite consistent. Differences in transportation habits related to HL include less likelihood of having a driving license and a higher valuing of written information, with the latter sometimes prioritized before time and safety issues. Respondents with higher degree of HL were less concerned about the effect of HL, indicating that they might be using compensatory strategies. Differences related to HL in driving behavior were bound to driving condition and occurred when complexity of driving task increased. There was also an effect of HL on visual behavior, suggesting that drivers with HL have a more active visual behavior with more frequent glances in the rear view mirror and a general scanning of the environment before looking away from road. Tactile signal in the driver seat was found useful in both experimental studies, both for calling for driver attention and to facilitate navigation with a GPS. Of high relevance for traffic safety and regardless of hearing status, the tactile support lead to higher satisfaction with the navigation system, less time spent to look at the navigation display, and more focus on road and better driving performance.
Conclusions:
There are effects of HL on both traffic safety and mobility, consistently pointing towards a generally more cautious driving behavior, suggesting a difference in experienced safety. The appearance of compensatory strategies associated with HL is bound to driving condition and include driving at lower speeds, more comprehensive visual search behavior and less engagement in distracting activities. By adding a tactile modality, some driver assistance systems can be made accessible also for drivers with HL.
http://dx.doi.org/10.1016/j.jth.2015.04.570
Travel-Related Injury/Road Danger Reduction (A83-A96) A83 Road traffic injuries and Alcohol: Double jeopardy in Pacific Island nations fuelled by inequitably distributed determinants of health Shanthi Ameratunga a, Josephine Herman a, Iris Wainiqolo a, Berlin Kafoa a,b a b
University of Auckland, New Zealand Fiji National University, Fiji
Abstract Background:
Efforts to address the burden of road traffic injuries in Pacific Island countries and territories are theoretically based on initiatives identified by the global road safety community. However, common risk factors targeted, including drink driving, are poorly quantified with respect to contribution to injury-involved crashes and contextual factors that challenge preventive interventions. We investigated the contribution of alcohol to the population-based burden of serious injury-involved road crashes in Fiji (second largest Pacific Island nation). We examine the findings in light of social determinants of health and injury, and the implications for future policy initiatives.
Methods:
We undertook an analysis of the Traffic-Related Injury in the Pacific (TRIP) project funded by the Wellcome Trust and Health Research Council of New Zealand. Specifically, a case-control study of four-wheeled motor vehicles was conducted in Viti Levu, Fiji in 2004/5 involving crash vehicles (recruited through a study specific hospital surveillance system) and a representative sample of control vehicles (recruited from road side surveys). Key informants for the study (drivers of the vehicles) completed standardised self-report surveys. Logistic regression analyses examined the association between alcohol and road traffic injuries, adjusting for relevant confounders. The findings were evaluated and interpreted applying the World Health Organization’s Priority Public Health Conditions Analytical Framework.
Results:
The case control study involving 140 crash vehicles and 752 control vehicles revealed the three-fold excess in the odds of serious injuryinvolved crashes (resulting in hospital admission or death of a road user) associated with the consumption of alcohol within the 12 h prior to driving (Adjusted Odds Ratio 3.2; 95% confidence interval: 1.1-9.4). Using the Priority Public Health Conditions Analytical Framework, we identified important social parameters influencing inequities in the distribution of alcohol consumption and being a victim of road crashes in Pacific settings. In particular, we found differential distributions in socioeconomic position, exposure to alcohol, vulnerabilities to injury, and related outcomes.
Oral Abstracts / Journal of Transport & Health 2 (2015) S5–S63
S49
Conclusions:
Alcohol imposes a substantial contribution to the burden of road traffic injury in the Pacific. However, there are several impediments to addressing this problem due to the inequitable distribution of alcohol exposure and road injury which are systemic, avoidable, unfair, and unjust. These findings highlight the imperatives to strengthen policies that address root causes of road injury embedded in inadequately regulated motorization, marketing and supply of alcohol, deficiencies in implementing drink-driving legislation and systemic improvements in transport infrastructure.
http://dx.doi.org/10.1016/j.jth.2015.04.571
A84 Collisions between pedal cyclists and heavy vehicles: an in depth analysis of fatalities in London Nicola Christie a, Rachel Talbot b, Steve Reed b, Peter Thomas b a b
UCL, London, UK Loughborough University, UK
Abstract Background:
Cycling is promoted in London to improve health and encourage more sustainable travel. However, the perceived safety of cycling is a major reason given by people not to cycle. Despites people’s concerns about the safety of cycling relatively few cyclists are injured and therefore there is limited information about the factors that contribute to their collisions. However, because of their severity, fatal collisions are subject to in-depth investigation by the police and provide an opportunity to learn more about causal factors. In London between 2007–2011 there were 79 fatal and life threatening collisions involving cyclists of which 53 were available for analysis. Over half of these fatal collisions involved heavy goods vehicles, large vans and buses. This paper presents findings of a systematic analysis of collisions involving cyclists and large, heavy vehicles focusing on the interaction between road users, infrastructure and vehicle characteristics and the implications for countermeasures.
Methods:
The study involved a case review of 53 pedal cycle fatalities in London. The method involved six stages:
Formation of the expert research group Data retrieval Protocol development (check with stakeholder group for completeness of data sources) Case collection and quality control (develop coding glossary) Case reviews and countermeasure development Linking countermeasure development to evidence of effectiveness
Results:
The most common characteristics of the infrastructure associated with fatal collisions involving bicycles and heavy vehicles were the lack of integration of cycling facilities with the wider traffic environment and road narrowing. These characteristics created conflict points between cyclists and other vehicles. The most common vehicle characteristics associated with collisions were related to the driver’s vision of the cyclist and the cyclist being dragged under the wheels of vehicle. The most common characteristics of road user behaviour associated with collisions were the positioning of the cyclist in relation to vehicle where the cyclist typically moved forward to the left side of the truck whilst it was stationary or moving into position at a junction. This placed the cyclist in a zone of potential conflict with the vehicle where it was inherently more difficult for the truck driver to see the cyclist.
Conclusions:
There is a paucity of evidence on the effectiveness on countermeasures to reduce collisions between cyclists and truck drivers. This study suggests that countermeasures should focus on reducing conflict points between road users, improving truck drivers vision of cyclists and training drivers and cyclists with regard to positioning especially at junctions.
http://dx.doi.org/10.1016/j.jth.2015.04.572
A85 Water-pipe smoking and traffic crashes: a hidden aspect of an emerging global epidemic Wafa Elias a a
SCE, College of Engineering, Israel
Abstract Background:
Over the last 20 years, the habit of Water-pipe Tobacco Smoking (WTS) has become a global epidemic. WTS is especially prevalent among youth and young adults, who often believe it is a relatively safe behavior. There is now a considerable body of evidence refuting this popular view. Yet, the health implications of WTS have still not been considered in full, and the mechanisms leading users to engage in WTS remain under-theorized. The current study examined the hypothesis that the intensity of WTS smoking, compared to cigarettes, will have both physiological and observable behavioral effects, which will be manifested in driving ability.
Methods: Over the last 20 years, the habit of Water-pipe Tobacco Smoking (WTS) has become a global epidemic. WTS is especially prevalent among youth and young adults, who often believe it is a relatively safe behavior. There is now a considerable body of evidence refuting this popular view. Yet, the health implications of WTS have still not been considered in full, and the mechanisms leading users to engage in WTS remain under-theorized. The current study examined the hypothesis that the intensity of WTS smoking, compared to cigarettes, will have both physiological and observable behavioral effects, which will be manifested in driving ability.
Oral Abstracts / Journal of Transport & Health 2 (2015) S5–S63
A82 Road users with hearing loss and evaluation of tactile support systems Birgitta Thorslund a a
VTI, Sweden
Abstract Background:
Research regarding the effect of Hearing loss (HL) on traffic safety and mobility is limited and the empirical findings are somewhat inconsistent. HL is one of the most frequent sensory deficit in humans, which may affect behavior in traffic situations and might reduce traffic safety. The prevalence of age-related HL in Europe is roughly 30% for men and 20% for women at the age of 70 years, and 55% for men and 45% for women at the age of 80 years. The prevalence of age-related HL is increasing, and as a consequence the number of road users with HL will also increase.
Methods:
To investigate traffic safety and mobility for individuals with HL three studies have been conducted; 1) a questionnaire survey, 2) a driving simulator study, 3) a field study.
Results:
The effects of HL on traffic safety and mobility are small, often bound to workload condition, however quite consistent. Differences in transportation habits related to HL include less likelihood of having a driving license and a higher valuing of written information, with the latter sometimes prioritized before time and safety issues. Respondents with higher degree of HL were less concerned about the effect of HL, indicating that they might be using compensatory strategies. Differences related to HL in driving behavior were bound to driving condition and occurred when complexity of driving task increased. There was also an effect of HL on visual behavior, suggesting that drivers with HL have a more active visual behavior with more frequent glances in the rear view mirror and a general scanning of the environment before looking away from road. Tactile signal in the driver seat was found useful in both experimental studies, both for calling for driver attention and to facilitate navigation with a GPS. Of high relevance for traffic safety and regardless of hearing status, the tactile support lead to higher satisfaction with the navigation system, less time spent to look at the navigation display, and more focus on road and better driving performance.
Conclusions:
There are effects of HL on both traffic safety and mobility, consistently pointing towards a generally more cautious driving behavior, suggesting a difference in experienced safety. The appearance of compensatory strategies associated with HL is bound to driving condition and include driving at lower speeds, more comprehensive visual search behavior and less engagement in distracting activities. By adding a tactile modality, some driver assistance systems can be made accessible also for drivers with HL.
http://dx.doi.org/10.1016/j.jth.2015.04.570
Travel-Related Injury/Road Danger Reduction (A83-A96) A83 Road traffic injuries and Alcohol: Double jeopardy in Pacific Island nations fuelled by inequitably distributed determinants of health Shanthi Ameratunga a, Josephine Herman a, Iris Wainiqolo a, Berlin Kafoa a,b a b
University of Auckland, New Zealand Fiji National University, Fiji
Abstract Background:
Efforts to address the burden of road traffic injuries in Pacific Island countries and territories are theoretically based on initiatives identified by the global road safety community. However, common risk factors targeted, including drink driving, are poorly quantified with respect to contribution to injury-involved crashes and contextual factors that challenge preventive interventions. We investigated the contribution of alcohol to the population-based burden of serious injury-involved road crashes in Fiji (second largest Pacific Island nation). We examine the findings in light of social determinants of health and injury, and the implications for future policy initiatives.
Methods:
We undertook an analysis of the Traffic-Related Injury in the Pacific (TRIP) project funded by the Wellcome Trust and Health Research Council of New Zealand. Specifically, a case-control study of four-wheeled motor vehicles was conducted in Viti Levu, Fiji in 2004/5 involving crash vehicles (recruited through a study specific hospital surveillance system) and a representative sample of control vehicles (recruited from road side surveys). Key informants for the study (drivers of the vehicles) completed standardised self-report surveys. Logistic regression analyses examined the association between alcohol and road traffic injuries, adjusting for relevant confounders. The findings were evaluated and interpreted applying the World Health Organization’s Priority Public Health Conditions Analytical Framework.
Results:
The case control study involving 140 crash vehicles and 752 control vehicles revealed the three-fold excess in the odds of serious injuryinvolved crashes (resulting in hospital admission or death of a road user) associated with the consumption of alcohol within the 12 h prior to driving (Adjusted Odds Ratio 3.2; 95% confidence interval: 1.1-9.4). Using the Priority Public Health Conditions Analytical Framework, we identified important social parameters influencing inequities in the distribution of alcohol consumption and being a victim of road crashes in Pacific settings. In particular, we found differential distributions in socioeconomic position, exposure to alcohol, vulnerabilities to injury, and related outcomes.
Oral Abstracts / Journal of Transport & Health 2 (2015) S5–S63
S49
Conclusions:
Alcohol imposes a substantial contribution to the burden of road traffic injury in the Pacific. However, there are several impediments to addressing this problem due to the inequitable distribution of alcohol exposure and road injury which are systemic, avoidable, unfair, and unjust. These findings highlight the imperatives to strengthen policies that address root causes of road injury embedded in inadequately regulated motorization, marketing and supply of alcohol, deficiencies in implementing drink-driving legislation and systemic improvements in transport infrastructure.
http://dx.doi.org/10.1016/j.jth.2015.04.571
A84 Collisions between pedal cyclists and heavy vehicles: an in depth analysis of fatalities in London Nicola Christie a, Rachel Talbot b, Steve Reed b, Peter Thomas b a b
UCL, London, UK Loughborough University, UK
Abstract Background:
Cycling is promoted in London to improve health and encourage more sustainable travel. However, the perceived safety of cycling is a major reason given by people not to cycle. Despites people’s concerns about the safety of cycling relatively few cyclists are injured and therefore there is limited information about the factors that contribute to their collisions. However, because of their severity, fatal collisions are subject to in-depth investigation by the police and provide an opportunity to learn more about causal factors. In London between 2007–2011 there were 79 fatal and life threatening collisions involving cyclists of which 53 were available for analysis. Over half of these fatal collisions involved heavy goods vehicles, large vans and buses. This paper presents findings of a systematic analysis of collisions involving cyclists and large, heavy vehicles focusing on the interaction between road users, infrastructure and vehicle characteristics and the implications for countermeasures.
Methods:
The study involved a case review of 53 pedal cycle fatalities in London. The method involved six stages:
Formation of the expert research group Data retrieval Protocol development (check with stakeholder group for completeness of data sources) Case collection and quality control (develop coding glossary) Case reviews and countermeasure development Linking countermeasure development to evidence of effectiveness
Results:
The most common characteristics of the infrastructure associated with fatal collisions involving bicycles and heavy vehicles were the lack of integration of cycling facilities with the wider traffic environment and road narrowing. These characteristics created conflict points between cyclists and other vehicles. The most common vehicle characteristics associated with collisions were related to the driver’s vision of the cyclist and the cyclist being dragged under the wheels of vehicle. The most common characteristics of road user behaviour associated with collisions were the positioning of the cyclist in relation to vehicle where the cyclist typically moved forward to the left side of the truck whilst it was stationary or moving into position at a junction. This placed the cyclist in a zone of potential conflict with the vehicle where it was inherently more difficult for the truck driver to see the cyclist.
Conclusions:
There is a paucity of evidence on the effectiveness on countermeasures to reduce collisions between cyclists and truck drivers. This study suggests that countermeasures should focus on reducing conflict points between road users, improving truck drivers vision of cyclists and training drivers and cyclists with regard to positioning especially at junctions.
http://dx.doi.org/10.1016/j.jth.2015.04.572
A85 Water-pipe smoking and traffic crashes: a hidden aspect of an emerging global epidemic Wafa Elias a a
SCE, College of Engineering, Israel
Abstract Background:
Over the last 20 years, the habit of Water-pipe Tobacco Smoking (WTS) has become a global epidemic. WTS is especially prevalent among youth and young adults, who often believe it is a relatively safe behavior. There is now a considerable body of evidence refuting this popular view. Yet, the health implications of WTS have still not been considered in full, and the mechanisms leading users to engage in WTS remain under-theorized. The current study examined the hypothesis that the intensity of WTS smoking, compared to cigarettes, will have both physiological and observable behavioral effects, which will be manifested in driving ability.
Methods: Over the last 20 years, the habit of Water-pipe Tobacco Smoking (WTS) has become a global epidemic. WTS is especially prevalent among youth and young adults, who often believe it is a relatively safe behavior. There is now a considerable body of evidence refuting this popular view. Yet, the health implications of WTS have still not been considered in full, and the mechanisms leading users to engage in WTS remain under-theorized. The current study examined the hypothesis that the intensity of WTS smoking, compared to cigarettes, will have both physiological and observable behavioral effects, which will be manifested in driving ability.