Inattention and Misjudgment in Older Drivers Involved in Automobile Collisions in Hawai'I, 1986–1991

Motor vehicle collision reports filed by police officers may be useful in investigating driver behavior and identifying potential causal attributes of accident involvement. Inattention and misjudgment were two options appearing on police reports to explain the cause of motor vehicle collisions in Hawai'i from 1986 to 1991. Examination of all crash reports (n = 218,718) revealed that inattention and misjudgment are serious problems for older drivers (65 years and older, n = 14,179). For instance, for the 75 to 84 year old drivers involved in collisions (n = 3659), 36% were classified as inattentive and 22% were identified as having misjudgment errors in driving; for the 85 and older drivers (n = 340), these percentages were 41 and 22, respectively. Of the collisions involving older drivers, 48% were at intersections. Reports of inattention and misjudgments were highest at dusk and dawn compared to other times of the day and night. Among the rear-end collisions, 65% of the older rear-enders were inattentive drivers. Strong associations of inattentive older drivers were found with being a broadsider (49%), side-swiper (45%) and headoner. Misjudgments among older drivers were most associated with being a side-swiper (41% from the opposite direction and 37% from the same direction). Regarding vehicle maneuvers prior to the crash, inattention was associated with right turns on red (61%), U-turns (57%), starting from park (56%), backing (56%), changing lanes (48%), merging (45%), and making left turns (40%). Misjudgment errors were most likely to occur when overtaking (44%), parking (41%), making left turns (39%), and changing lanes (39%). Dangerous actions common among inattentive older drivers included disregarding traffic controls (72%), following too closely (67%), going the wrong way (54%), failing to yield (52%), improper turns (48%), and speeding (45%). Older drivers classified as having misjudgments were most likely to be involved in improper overtaking (46%), failure to yield (41%), and improper turns (39%).

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Case Exercise: Biomechanics in Rearend Motor Vehicle Collisions

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2007.mayjun02 ◽

2007 ◽

Vol 12 (3) ◽

pp. 4-7

Author(s):

Charles N. Brooks ◽

Christopher R. Brigham

Keyword(s):

Motor Vehicle ◽

Body Position ◽

Motor Vehicle Collisions ◽

Time Curve ◽

Vehicle Collisions ◽

Need For Treatment ◽

Multiple Factors ◽

Bodily Injury ◽

Vehicle Collision ◽

Physical Findings

Abstract Multiple factors determine the likelihood, type, and severity of bodily injury following a motor vehicle collision and, in turn, influence the need for treatment, extent of disability, and likelihood of permanent impairment. Among the most important factors is the change in velocity due to an impact (Δv). Other factors include the individual's strength and elasticity, body position at the time of impact, awareness of the impending impact (ie, opportunity to brace, guard, or contract muscles before an impact), and effects of braking. Because Δv is the area under the acceleration vs time curve, it combines force and duration and is a useful way to quantify impact severity. The article includes a table showing the results of a literature review that concluded, “the consensus of human subject research conducted to date is that a single exposure to a rear-end impact with a Δv of 5 mph or less is unlikely to result in injury” in most healthy, restrained occupants. Because velocity incorporates direction as well as speed, a vehicular occupant is less likely to be injured in a rear impact than when struck from the side. Evaluators must consider multiple factors, including the occupant's pre-existing physical and psychosocial status, the mechanism and magnitude of the collision, and a variety of biomechanical variables. Recommendations based solely on patient history and physical findings (and, perhaps, imaging studies) may be ill-informed.

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Decreased Incidence of Rib Fractures in Pregnant Patients After Motor Vehicle Collisions

American Journal of Critical Care ◽

10.4037/ajcc2021505 ◽

2021 ◽

Vol 30 (5) ◽

pp. 385-390

Author(s):

Marissa Di Napoli ◽

William B. DeVoe ◽

Stuart Leon ◽

Bruce Crookes ◽

Alicia Privette ◽

...

Keyword(s):

Chest Wall ◽

Injury Severity ◽

Motor Vehicle ◽

Rib Fractures ◽

Hormonal Changes ◽

Motor Vehicle Collisions ◽

Vehicle Collisions ◽

Vehicle Collision ◽

Chest Wall Injury ◽

Wall Injury

Background Rib fractures are common after motor vehicle collisions. The hormonal changes associated with pregnancy decrease the stiffness and increase the laxity of cartilage and tendons. The effect of these changes on injury mechanics is not completely understood. Objectives To compare the incidences of chest wall injury following blunt thoracic trauma between pregnant and nonpregnant women. Methods The authors conducted a retrospective review of female patients seen at a level I trauma center from 2009 to 2017 after a motor vehicle collision. Patient characteristics were compared to determine if pregnancy affected the incidence of chest wall injury. Statistics were calculated with SPSS version 24 and are presented as mean (SD) or median (interquartile range). Results In total, 1618 patients were identified. The incidence of rib/sternal fracture was significantly lower in pregnant patients (7.9% vs 15.2%, P = .047), but the incidence of intrathoracic injury was similar between the groups. Pregnant and nonpregnant patients with rib/sternal fractures had similar Injury Severity Score results (21 [13-27] vs 17 [11-22], P = .36), but pregnant patients without fractures had significantly lower scores (1 [0-5] vs 4 [1-9], P < .001). Conclusions Pregnant patients have a lower rate of rib fracture after a motor vehicle collision than nonpregnant patients. The difference in injury mechanics may be due to hormonal changes that increase elasticity and resistance to bony injury of the ribs. In pregnant trauma patients, intrathoracic injury without rib fracture should raise concerns about injury severity. A multicenter evaluation of these findings is needed.

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Zolpidem use and motor vehicle collisions in older drivers

Sleep Medicine ◽

10.1016/j.sleep.2015.12.004 ◽

2016 ◽

Vol 20 ◽

pp. 98-102 ◽

Cited By ~ 10

Author(s):

John N. Booth ◽

Michael Behring ◽

Ryan S. Cantor ◽

Lisandro D. Colantonio ◽

Sherri Davidson ◽

...

Keyword(s):

Motor Vehicle ◽

Older Drivers ◽

Motor Vehicle Collisions ◽

Vehicle Collisions

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Older drivers’ risks of at-fault motor vehicle collisions

Accident Analysis & Prevention ◽

10.1016/j.aap.2015.05.004 ◽

2015 ◽

Vol 81 ◽

pp. 120-123 ◽

Cited By ~ 9

Author(s):

Masao Ichikawa ◽

Shinji Nakahara ◽

Ayako Taniguchi

Keyword(s):

Motor Vehicle ◽

Older Drivers ◽

Motor Vehicle Collisions ◽

Vehicle Collisions

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Driving with pets as a risk factor for motor vehicle collisions among older drivers

Accident Analysis & Prevention ◽

10.1016/j.aap.2013.04.019 ◽

2013 ◽

Vol 58 ◽

pp. 70-74 ◽

Cited By ~ 7

Author(s):

Hallie Blunck ◽

Cynthia Owsley ◽

Paul A. MacLennan ◽

Gerald McGwin

Keyword(s):

Risk Factor ◽

Motor Vehicle ◽

Older Drivers ◽

Motor Vehicle Collisions ◽

Vehicle Collisions

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Risk of motor vehicle collisions after methadone use

eLife ◽

10.7554/elife.63954 ◽

2021 ◽

Vol 10 ◽

Author(s):

Ya-Hui Yang ◽

Pei-Shan Ho ◽

Trong-Neng Wu ◽

Peng-Wei Wang ◽

Chun-Hung Richard Lin ◽

...

Keyword(s):

Motor Vehicle ◽

Methadone Maintenance ◽

Adult Population ◽

Incidence Rates ◽

Motor Vehicle Collision ◽

Motor Vehicle Collisions ◽

Vehicle Collisions ◽

Vehicle Collision ◽

Increased Risk ◽

First 90 Days

Methadone maintenance treatment (MMT) can alleviate opioid dependence. However, MMT possibly increases the risk of motor vehicle collisions. The current study investigated preliminary estimation of motor vehicle collision incidence rates. Furthermore, in this population-based retrospective cohort study with frequency-matched controls, opiate adults receiving MMT (cases) and those not receiving MMT (controls) were identified at a 1:2 ratio by linking data from several nationwide administrative registry databases. From 2009 to 2016, the crude incidence rate of motor vehicle collisions was the lowest in the general adult population, followed by that in opiate adults, and it was the highest in adults receiving MMT. The incidence rates of motor vehicle collisions were significantly higher in opiate users receiving MMT than in those not receiving MMT. Kaplan–Meier curves of the incidence of motor vehicle collisions differed significantly between groups, with a significant increased risk during the first 90 days of follow-up. In conclusion, drivers receiving MMT have higher motor vehicle collision risk than those not receiving MMT in opiate users, and it is worthy of noticing road safety in such drivers, particularly during the first 90 days of MMT.

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