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February 9, 2001

General Topics

• Hypothermia-Related Deaths --- Suffolk County, New York, January 1999--March 2000, and United States, 1979--1998. WETLI CV, SMITH P, CDC-NCEH. MMWR 2001; 50(04):53-7.
  
  ABSTRACT: Hypothermia is the unintentional lowering of core body temperature to <95 F (<35 C) (1). Core body temperature normally is maintained at 97.7 F (36.5 C) (2). Most hypothermia-related deaths occur during the winter in states that have moderate to severe cold temperatures (e.g., Alaska, Illinois, New York, and Pennsylvania) (3). During 1979--1998, New York had the second highest number of hypothermia-related deaths in the United States. This report presents case reports of four hypothermia-related deaths during January 1999--March 2000 in Suffolk County (1999 population: 1,383,847), the largest county in New York excluding New York City, and summarizes hypothermia-related deaths in the United States during 1979--1998. Such deaths can be prevented by educating health-care providers and the public to identify persons at risk for hypothermia.

• Does a threat appeal moderate reckless driving? A terror management theory perspective. BEN-ARI OT, FLORIAN V, MIKULINCER M. Accident Anal Prev 2000; 32(1)
  
  ABSTRACT: A series of two studies examined the effects of threat appeals on reckless driving from a terror management theory perspective. In both studies, all the participants (N=109) reported on the relevance of driving to their self-esteem, and, then, half of them were exposed to a road trauma film and the remaining to a neutral film. In Study 1, the dependent variable was the self-report of intentions to drive recklessly in hypothetical scenarios. In Study 2, the dependent variable was actual behavior (driving speed) in a driving simulator. Findings indicated that a road trauma film led to less reported intentions of reckless driving, but to higher driving speed than a neutral film. These effects were only found among participants who perceived driving as relevant to their self-esteem. The discussion emphasized the self-enhancing mechanisms proposed by the terror management theory.



• The effects on safety, time consumption and environment of large scale use of roundabouts in an urban area: a case study. HYDEN C, VARHELYI A. Accident Anal Prev 2000; 32(1)
  
  ABSTRACT: An experiment with small roundabouts-as speed reducing measures-was carried out in a Swedish city. The purpose of the study was to test the large scale and long term effects of the roundabouts. The results showed that the roundabouts reduced the speed considerably at the junctions and on links between roundabouts. The lateral displacement the roundabout forces the driver to has a great importance for the speed of approaching cars to a roundabout. The speed-reducing effect is large already at a 2 m deflection. A larger deflection does not result in a larger effect. Conflict studies indicated an overall decrease in accident risk by 44%. Vulnerable road-users' risk was reduced significantly, while there was no reduction for car occupants. There is a relation between the reduction of approach speed and the reduction of injury accident risk. The time consumption at a time operated signal was reduced heavily by the instalment of a roundabout at a signalised intersection. On average, emissions (CO and NOx) at roundabouts replacing non-signalised junctions increased by between 4 and 6%, while a roundabout replacing a signalised intersection led to a reduction by between 20 and 29%. The noise level was reduced at junctions that were provided with roundabout. Car drivers were less positive to the roundabouts than bicyclists. In the long term, the unchanged roundabouts worked almost as good as they did shortly after the rebuilding. The study showed that details in the design are of decisive importance for road-users' safety. Special attention has to be paid to the situation of bicyclists. The transition between the cycle path/lane and the junction has to be designed with care-the bicyclists should be integrated with motorised traffic before they enter the roundabout. There should be only one car lane both on the approach, in the circulating area and on the exit. The size of the roundabout shall be as small as possible.



• Sixteen years age limit for learner drivers in Sweden - an evaluation of safety effects GREGERSEN N, BERG H-Y, ENGSTROM I, NOLEN S, NYBERG A, RIMMO PA. Accident Anal Prev 2000; 32(1)
  
  ABSTRACT: Through a reform implemented in Sweden, September 1993, the age limit for practising car driving was lowered from 1712 to 16 years while the licensing age remained 18. The purpose of lowering the age limit was to give the learner drivers an opportunity to acquire more experience as drivers before being allowed to drive on their own. The primary aim of this study was to evaluate the effect of the reform in terms of accident involvement and data were therefore obtained from the national register of police reported accidents. The results show that after the reform there was a general reduction in the accident risk (accidents per 10 million km) of novice drivers with approximately 15%. Additional analyses show that the reduction of accident risk in the group who utilised the new age limit was approximately 40%, whereas those who did not utilise the prolonged training period did not benefit at all. Between 45 and 50% of the age population were found to utilise the reform. The accident reduction does not seem to be just an initial first year effect since the results were similar over 3 years of novice drivers during their first 2 years with a licence. These results suggest that the reform has been beneficial for the safety of novice drivers in Sweden. The results also suggest a potential for additional safety improvements if more young learner drivers can be brought to utilise the low age limit.



• Which are the relevant costs and benefits of road safety measures designed for pedestrians and cyclists? ELVIK R. Accident Anal Prev 2000; 32(1)
  
  ABSTRACT: This paper discusses the current state-of-the-art with respect to impact assessment and cost-benefit analysis of measures designed to improve safety or mobility for pedestrians and cyclists. The study concludes that a number of impacts that are likely to regarded as important for pedestrians and cyclists are not included in current impact assessments and cost-benefit analyses as these are made in Norway. Impacts that are not currently included in impact assessments and cost-benefit analyses are: (a) changes in the amount of walking and cycling; (b) changes in travel time for pedestrians and cyclists; (c) changes in road user insecurity (feeling of safety); and (d) changes in road user health state. In order to include these effects in impact assessments and cost-benefit analyses, more needs to be known about their occurrence and monetary value. Hypothetical examples of ideally designed cost-benefit analyses are given, based on highly preliminary monetary values for travel time, insecurity and generalised costs of travel for pedestrians and cyclists. These analyses indicate that inclusion of these effects in cost-benefit analyses could make a major difference for the results of those analyses.



• Hispanics, Blacks and Whites driving under the influence of alcohol: results from the 1995 National Alcohol Survey. R CAETANO R, CLARK CL. Accident Anal Prev 2000; 32(1)
  
  ABSTRACT: Objective: To report nationwide survey data on patterns of driving under the influence of alcohol among Whites, Blacks and Hispanics. Method: Data were obtained from a probability sample consisting of 1582 Blacks, 1585 Hispanics and 1636 Whites in the US household population. Interviews averaging 1 h in length were conducted in respondents' homes by trained interviewers. Results: Self-reported rates of driving a car after having drunk enough 'to be in trouble if stopped by the police' were highest among White and Hispanic men (22 and 21%, respectively), as were lifetime arrest rates for driving under the influence of alcohol (13% for White men, 19% for Hispanic men). Additionally, our analyses suggest that drinkers who drive under the influence of alcohol are more likely to be men (regardless of ethnicity), consume more alcohol, and be alcohol dependent than drinkers who do not engage in alcohol-impaired driving.



• Regional mortality from motor vehicle traffic injury: relationships among place-of-occurrence, place-of-death, and place-of-residence. LU T-H, CHU M-C, LEE M-C. Accident Anal Prev 2000; 32(1)
  
  ABSTRACT: Regional mortality data, which are compiled according to place-of-residence of the decedent, are an important reference for regional health planning and resource allocation. However, it would be inappropriate to apply these data to studies of environmental risk factors if a large proportion of fatal motor vehicle traffic injuries (MVTI) in fact occur outside the resident county. The aim of this study was to determine the proportion and characteristics of residents of a rural area of Taiwan who died from MVTIs that occurred outside the county of residence. We also explored the relationships among the place-of-occurrence, place-of-death, and place-of-residence of these decedents. The families or neighbors of residents of Huatung Area (eastern Taiwan) who died from MVTIs in 1994 or 1995 were interviewed to identify the place-of-occurrence of the MVTI. Of the 882 Huatung Area residents who died as a result of an MVTI during the study period and for whom relevant data were available, the MVTI occurred outside the resident county in 207 (23%) cases. Residents whose MVTI occurred outside the county of residence were more likely to be youths (aged 15-24) or young adults (aged 25-44) and driving automobiles or trucks. Of the 866 cases in which the exact place was known, the place-of-occurrence and the place-of-death (recorded on the death certificate) were in the same county in 849 (98%). Because a high proportion of fatal MVTIs occurred outside the resident county, the mortality rate calculated according to place-of-residence does not accurately reflect the environmental risk factors in this area. The finding that the characteristics of those whose MVTI occurred outside the county differed from those decedents whose MVTI occurred within the county indicates that there are two target groups for prevention programs. In addition, at least in Huatung Area, the place-of-death recorded on the death certificate could serve as a surrogate for the place-of-occurrence in epidemiologic studies.



• The Effects of Learner's Permit Requirements in Tennessee. PREUSSER DF, FERGUSON SA,WILLIAMS AF. J Safety Res 30(4)
  
  ABSTRACT: Sixteen and 17 year-olds were surveyed at motor-vehicle offices in Tennessee after qualifying for their first driver's license. When the survey was conducted during October and November 1995, neither a learner's permit nor completion of a driver education course was required to obtain a license at age 16 or 17. The survey was repeated during December and January 1996¯97, approximately one year after a requirement to hold a learner's permit for 90 days or complete a driver education course was implemented. Results from the 1991 drivers (ages 16 and 17) surveyed indicated Tennessee's licensing law change was associated with approximately 100 additional miles and 8 additional hours of practice driving prior to licensure for the typical 16 or 17 year-old, most often while supervised by a parent or guardian. Results are discussed in relation to the prelicense practice driving requirements of graduated licensing systems.



• Hazard and Risk Perception among Young Novice Drivers. DEERY HA. J Safety Res 30(4)
  
  ABSTRACT: Young novice drivers are overrepresented in road accidents. Although they quickly acquire the skills needed to control a motor vehicle, it takes much longer for novice drivers to develop the higher-order perceptual and cognitive skills necessary to safely interact with the driving environment. The aim of this paper is to propose a model of the processes mediating behavior around traffic hazards and to critically review the literature on novice drivers within the framework provided by the model. Compared to experienced drivers, novice drivers detect hazards less quickly and efficiently and perceived them less holistically. The detection of hazards is proposed to provide the requisite information for risk perception, the process which includes assessing both the level of risk posed by a hazard and one's ability to deal with the hazard effectively. Research indicates that young drivers underestimate the risk of an accident in a variety of hazardous situations. At the same time, they overestimate their own driving skill. Young drivers are also more willing to accept risk while driving than experienced drivers. These factors are likely to contribute to young novice drivers overrepresentation in accidents. Opportunities for further research are discussed.

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