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2007-03-05_205479453

2007-03-05_205479453

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Published by: Estrada Viva / Sobrevivência Rodoviária on Jul 10, 2008
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Epidemiology of older driver crashes \u2013 Identifying older
driver risk factors and exposure patterns
J. Langford*, S. Koppel
Monash University, Accident Research Centre, Building 70, Monash 3800, Australia
Received 13 December 2004; received in revised form 11 July 2005; accepted 4 March 2006
Abstract

The crash involvement of any road user is a function of two sets of factors: risk, which covers aspects relating to the individual road user, to his or her vehicle and to the road environment through which he or she is travelling; and exposure, the amount of travel under the di\ufb00erent combinations of risk aspects.

The ever-growing body of research covering older drivers has shown that this road user group has distinct risk factors, relative to young and middle-aged drivers. For example: frailty and hence vulnerability to injury in the event of a crash; for many, a general slow-down in physical, sensory and cognitive functioning; and for some, the onset of speci\ufb01c conditions leading to signi\ufb01cant functional impairments.

Many older drivers, perhaps more so than other road user groups, are aware of their heightened crash risk and have accordingly adjusted their exposure at least in part as a protective measure. In other words, they have attempted to min- imise any travel under conditions that are threatening and/or cause discomfort and conversely, have attempted to restrict their travel to conditions perceived as safe and/or comfortable. This self-regulation of driving has resulted in distinct driv- ing exposure patterns, often re\ufb02ected in crash circumstances.

The national fatal crash data in Australia for the period 1996\u20131999, have been analysed: to identify indicators of older driver risk; to identify indicators of older driver exposure patterns; and to indicate the extent to which and how the risk/ exposure-reduction strategies have proven ine\ufb00ective, by identifying crashes for which older drivers may be deemed responsible. Further countermeasures suggested by these analyses, have been identi\ufb01ed.

\u00d32006 Elsevier Ltd. All rights reserved.
Keywords:Older drivers; Fatal crashes; Risk factors; Crash patterns
1. Introduction
1.1. Demographic changes
Over the next four or \ufb01ve decades, there will be a substantial increase in both the number and proportion of
older people in most industrialised countries (OECD, 2001). In Australia, the proportion of persons aged 65
1369-8478/$ - see front matter\u00d3 2006 Elsevier Ltd. All rights reserved.
doi:10.1016/j.trf.2006.03.005
*Corresponding author. Tel.: +61 3 9905 1275; fax: +61 3 9905 4363.
E-mail address:Jim.Langford@general.monash.edu.au(J. Langford).
Transportation Research Part F 9 (2006) 309\u2013321
www.elsevier.com/locate/trf
years and older is predicted to increase from 11.1 per cent in 2001 to 24.2 per cent in 2051, with greatest
growth for those aged 80 years and over (Australian Bureau of Statistics, 1999).

Along with increases in the number and proportion of older people in the population, it is also anticipated that there will be an increase in older drivers\u2019 licencing rates (Hakamies-Blomqvist, 1993, 1994). Further, the private car is likely to remain the dominant form of transport for the emerging cohorts of older drivers who, it is predicted, will be undertaking longer and more frequent journeys (OECD, 2001). Demographic growth, increased licencing rates and increased car use (Australian Bureau of Statistics, 1996) will combine to produce a marked increase in the numbers of older drivers on the road.

Increased older driver numbers and increased driving exposure have led to expectations of a commensurate
increase in future crash levels. It has been predicted that by 2025, older driver fatalities in the US (Hu, Jones,
Reuscher, Schmoyer, & Truett, 2000) and Australia (Fildes, Fitzharris, Charlton, & Pronk, 2001) will broadly
triple, relative to 1995 levels.
These trends highlight the need to better understand and manage the driving behaviours, travel patterns
and crash risk of older adults in order to prevent a signi\ufb01cant problem in the years ahead.
1.2. Functional impairments and driving implications
While there are many individual di\ufb00erences in the ageing process, even relatively healthy older adults are
likely to experience some level of functional decline in sensory, physical and cognitive areas (Janke, 1994; Stel-
mach & Nahom, 1992). These changes would intuitively be expected to a\ufb00ect driving and lead to an over-

involvement in crashes as a consequence. Some principal associations between age-related impairments and driving di\ufb03culties are listed inTable 1. However, current evidence of causal relationships between declines in speci\ufb01c abilities and reduced driving performance or increased crash risk is limited (for reviews, seeCharl-

ton et al., 2003; Dobbs, 2001; Janke, 1994; Marottoli et al., 1998; Staplin, Lococo, Stewart, & Decina, 1999).
1.3. Older drivers and crash risk

Whether older drivers, as a group, represent an unacceptably high crash risk, remains a contentious issue. When their crash casualty crash involvement is considered either per licenced driver or per distance travelled, there is invariably evidence that crash rates increase from around the late middle ages onwards (seeFig. 1).

However, the U-shaped risk curves inFig. 1 and common to most industrialised countries, cannot be
accepted as necessarily denoting reduced driving skills.
First, older drivers are more likely to \ufb01gure in casualty outcomes because of their greater frailty and
reduced tolerance to injury (Augenstein, 2001; Dejeammes & Ramet, 1996; Evans, 1991; Mackay, 1998; Pad-
manaban, 2001; Viano, Culver, Evans, Frick, & Scott, 1990). Between 60 and 95 per cent of the increase in
Table 1
Age-related impairments and associated driving problems (adapted fromSuen and Mitchell, 1998)
Age-related impairments
Driving problems
Increased reaction time. Di\ufb03culty dividing
attention between tasks
Di\ufb03culty driving in unfamiliar or congested areas
Deteriorating vision, particularly at night
Di\ufb03culty seeing pedestrians and other objects at night, reading signs.
Di\ufb03culty with wet weather driving
Di\ufb03culty judging speed and distance
Failure to perceive con\ufb02icting vehicles. Accidents at intersections
Di\ufb03culty perceiving and analysing situations
Failure to comply with Give Way signs, tra\ufb03c signals and railway
crossing signals. Slow to appreciate hazards
Di\ufb03culty turning head, reduced peripheral vision
Failure to notice obstacles while manoeuvring. Failure to observe
tra\ufb03c behind when merging and changing lanes
More prone to fatigue
Get tired on long journeys, run-o\ufb00 road single vehicle crashes
General e\ufb00ects of ageing
Worries over inability to cope with a breakdown, driving to
unfamiliar places, at night, in heavy tra\ufb03c
Some impairments vary in severity from
day to day. Tiredness, symptoms of dementia
Concern over \ufb01tness to drive
310
J. Langford, S. Koppel / Transportation Research Part F 9 (2006) 309\u2013321
death rate per distance travelled for those aged 60 and over can be accounted for by increases in fragility (Li,
Braver, & Chen, 2003).

Second, there is the low mileage bias. Independent of age, drivers travelling longer distances will typically demonstrate reduced crash rates per kilometre, compared to those driving lower mileages.Janke (1991) accordingly warned licencing administrators against becoming overly alarmed about older drivers\u2019 apparent high crash risks when based on distance driven, given their shorter driving distances. More recently

Hakamies-Blomqvist, Raitanen, and O\u2019Neill (2002)found that compared to middle-aged drivers, older drivers

had no increased crash risk per distance driven, once di\ufb00erent driving distances were controlled for. \u2018\u2018These \ufb01ndings cast serious doubt on any previous reports of age di\ufb00erences in accident risk per distance driven\u2019\u2019 (Hakamies-Blomqvist et al., p. 274).

1.4. Older drivers\u2019 driving patterns

Many older drivers are aware of some functional decline and accordingly adjust their driving patterns to avoid travel under conditions which are perceived to be threatening or which otherwise cause discomfort (Eberhard, 1996; Evans, 1988; McGwin & Brown, 1999; Preusser, Williams, Ferguson, Ulmer, & Weinstein,

1998; Smiley, 1999). For example, older adults typically choose to reduce their exposure by driving fewer
annual kilometres, making shorter trips and making fewer trips by linking di\ufb00erent trips together (Benekohal,
Michaels, Shim, & Resende, 1994; Rosenbloom, 1995, 1999). Older drivers have also been found to limit their
peak hour and night driving, restrict long distance travel, take more frequent breaks and drive only on familiar
and well lit roads (Ernst & O\u2019Connor, 1988; Smiley, 1999).

At least some of these changes, however, are counterproductive from the viewpoint of crash reduction. Older drivers\u2019 uncertainty about high-speed travel has led to greater travel on low-speed roads and minimal travel on freeways (OECD, 2001), a road type with a relatively safe record because of the limited numbers of con\ufb02ict points.

1.5. Older drivers\u2019 crash patterns
As a group, older drivers have distinct crash patterns. The OECD Working Group described older driver
crash features thus:
A larger share of older driver accidents involve collisions with another vehicle. They have a smaller share
of single-vehicle and speed-related accidents. Older drivers tend to be legally at fault in their collisions. A
02468
10
12
16-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
Age Group (Years)
NumberofCas
ualtiesper
ExposureMea
sure

Killed and injured drivers per 10 000 population
Killed and injured drivers per 10 000 licensed drivers
Killed and injured drivers per 100 million miles driven

Fig. 1. US driver fatalities and injuries for di\ufb00erent age groups relative to the population, the number of drivers\u2019 licenced and distance
travelled, 1997 (adapted fromOECD, 2001).
J. Langford, S. Koppel / Transportation Research Part F 9 (2006) 309\u2013321
311

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