Road Safety and Health David L. Wiesenthal davidw@yorku.ca www.psych.yorku.ca/davidw 1

Road Safety Statistics World Health Organization (2005) 1.2 million die in road traffic crashes each year Approximately 50 million are injured or disabled by collisions each year Every day 3,500 die in a road crash Speed contributes to at least 30% of crashes and deaths For every 1 km/hr reduction in average speed, there’s a 2% reduction in crashes The United Nations has declared 2011-2020 as the Decade of Action for Road Safety

Road Safety Statistics 90% of road casualties are from developing countries 1.9 million road deaths forecast for 2020 Traffic injuries are the #1 cause of death for young people worldwide Economic cost to developing countries approx. $100 billion/yr. By 2015, traffic injuries will be the leading health burden for children over 5 yrs.

Road Safety Statistics Unless action is taken, by 2020, traffic injuries are predicted to be the 3rd leading health issues ahead of malaria, TB, and HIV/AIDS Economic costs: High income countries US$518 billion Low & middle income countries US$65 billion Source: Peden, M. & Sminkey, L. (2004). World Health Organization dedicates World Health Day to road safety. Injury Prevention, 10, 67.

Road Safety Statistics 2,425 fatalities (2008) Speeding was a contributing factor in 23% of the incidents 9.1% decrease in collisions from 2007 12.2% decrease in fatalities from 2007 7.9% decrease in injuries In 2007, accidents and suicide ranked first and second respectively, as leading cause of death for the young people aged 15 to 34, a trend observed since 2000 Source:http://www.statcan.gc.ca/pub/84-215-x/2010001/hl-fs-eng.htm Transport Canada (2008)

www.tc.gc.ca/eng/roadsafety/tp-tp15145-1201.htm

Road Safety Statistics Motor vehicle-related injuries are the leading cause of death among children and young adults More than 41,000 die in motor vehicle crashes each year 3.5 million suffer non-fatal injuries Motor vehicle deaths & injuries cost $230 billion each year $61 billion in lost productivity $33 billion in medical expenses Alcohol related crashes are estimated to cost $51 billion (2000) National Highway Traffic Safety Administration (NHTSA)

Road Safety Statistics 2008 National Highway Traffic Safety Administration (NHTSA) Fatal crashes = 34,172 Drivers = 19,279 Passengers = 7,441 Unknown = 71 Motorcyclists = 5,312 Pedestrians = 4,414 Bicycles = 718 Other/? = 188 _____________________ Total = 37,423

Pedestrian Injury Pedestrian-vehicle crashes responsible for > 1/3 of injuries & fatalities worldwide (Crandall, Bhalla, & Madeley, 2002) Lower limb trauma is most common injury, head injury leading cause of death (Crandall, Bhalla, & Madeley, 2002)

Pedestrian Injuries in Canada (1992-2001) Average of 416 fatalities/yr and decreased 24.1% over this period Injuries averaged 14, 252/yr and decreased 10.2% Males represented 61% of injuries, females 39% 65+ age group males = 27%, females = 39% male decrease = 12.7%, female decrease = 30.4% 95% of injuries occurred in urban areas 69.5% of fatalities occurred in urban areas Source: http://www.tc.gc.ca/eng/roadsafety/tp-tp2436-rs200401-menu-165.htm

Prevention Strategies for Pedestrians Education of road users, especially children Vehicle design changes Road/street modifications for better visibility Use of reflective clothing Prohibit play in driveways, streets, parking lots, etc. Enforcement of traffic laws

Motorcycle Injuries & Fatalities Total US traffic deaths increased by only 2% (1996-2006), motorcycle deaths doubled (from 1995) Per vehicle mile traveled, motorcyclists are about 35 more likely to die in a crash than passenger car occupants Touring motorcycles (>1000 cc engines) have lower fatality rates than sport bikes with smaller engines Data based on US Fatality Analysis Reporting System (FARS) Source:Source: Padmanaban, J. & Eyges (2009)

Source: Padmanaban, J. & Eyges (2009)

Cycling Injuries & Fatalities in Canada Estimated 7,500 seriously injured each year 40-70 fatalities per year 1,361 bicyclists hospitalized in Ontario (2002, Ontario Trauma Registry) 1,268 hospitalized in British Columbia ≈950 cyclists received ambulance calls in Montreal Transport Canada (2005) Source: Cyclingincities, UBC, www.cher.ubc.ca/cyclingincities/injuries.html

Cycling/Pedestrian Injuries & Fatalities in Canada 28 children aged 5-14 died from pedestrian injuries (2001) 13 aged 5-14 died from cycling injuries (2001) 1,681 children aged 5-14 were injured as a result of cycling crashes and 632 suffered injuries as pedestrians (1999-2000) Bicycle injuries are the most common cause of children’s brain injuries Helmets reduce serious injuries but are not mandatory in all provinces

Cycling Injuries & Fatalities in the USA 500,000 emergency rooms visits due to bicycle-related injuries 700+ deaths Children 15 yrs. & younger accounted for 59% of all bicycle- related injuries Source: Centers for Disease Control and Prevention National Center for Injury Prevention and Control www.cdc.gov/homeandrecreationalsafety/bikeinjuries.html

Cycling Injuries & Fatalities in Canada Injury risk is greater for Canadian cyclists than Europeans Cyclists are 7-70 times more likely to be injured/trip or per kilometer traveled than car occupants Cyclists in North America are 2 times more likely to be killed and 8 times more likely to be seriously injured than German cyclists 3 times more likely to be killed and 30 times more likely to be seriously injured than Dutch cyclists

Research Topics: Driving & Health Impaired driving Fatigue, sleep deprivation, sleep apnea Alcohol Cannabis OTC medications Elderly drivers dementia vision problems, cataracts Distracted drivers/Attention issues Cell phone usage Informatics

Research Topics: Driving & Health ADHD Stress Aggressive driving Epidemiological studies of driver, passenger, and pedestrian injuries/fatalities

Main Findings Trait X State stress interaction: congestion does not affect everyone the same since high trait stress drivers reacted more strongly to high congestion situations No gender differences No difference in coping responses across congestion conditions Drivers preferred direct coping responses, but used both direct and indirect behaviours equally Compared to other responses, aggressive behaviours dramatically increased as traffic congestion increased

Frequency of Individual Violent Driving Behaviours (Hennessy, Ph Frequency of Individual Violent Driving Behaviours (Hennessy, Ph. D dissertation) Behaviour Frequency Chasing another driver/vehicle 40% (58) Verbal roadside confrontation 23% (33) Vandalizing another vehicle 14% (20) Throwing objects at another vehicle 11% (16) Physical roadside confrontation 7% (10) Purposeful contact with another vehicle 4% (6) Drive-by shootings 1% (2)

Suggestions for Reducing Stress & Highway Aggression Tension reduction strategies: Use cell phones to inform others of delays Listen to traffic reports and use alternative routes where possible Listen to self-selected music, books-on-tape in cars while driving Use deep breathing exercises Physical exercise Anger management Screen all drivers When a given demerit point level is reached, provide anger management workshops Enforcement of Highway Traffic Act Tailgating Signaling of lane changes Use of left lane as passing lane

Suggestions for Reducing Stress & Highway Aggression Promotion of mass transportation Deindividuation reduction: Paint driver’s names/towns on doors and backs of vehicles Ban deep tints Promote vanity licence plates

Safety/Health Promoting Interventions Mandated safety equipment in vehicles (ESC standard in 2011 Canadian automobiles) Graduated licencing Improved driver training Better designed highways/clear signage Mandatory bicycle & motorcycle helmets for all cyclists (not just children) Encouragement of carpooling & mass transportation

Psychological Strategies for Reducing Mishaps: Behaviour Modification To discourage one behaviour, encourage another Examine the rewards and costs of engaging in various behaviours

Encouraging & Discouraging Behaviours: Examples Provision of free nonalcoholic beverages and pub food to designated driver Free public transportation all night during celebration evenings Free pub buses from university residences Coupon distribution for taxi rides Promotion of coffee houses rather than alcohol culture on campus We need to consider the role of alcohol in society, particularly its effect upon young males. We need to examine the marketing of an alcohol culture that equates alcohol with fun, companionship, pleasure, sexuality, etc.

Psychological Strategies for Reducing Mishaps Complex behaviour may have a variety of motivating factors, so no approach targeting a single factor is likely to eliminate all forms of risky driver behaviour. Changing the balance between rewards and costs in risky driving. What is the value of risk for those drivers?

Risky Driving Rewards: Fun, excitement, exhilaration Self definition as an adventurous person Display of competence

Risky Driving Costs: Injury, death Arrest/punishment--the perception of the likelihood of apprehension rather than the severity of penalties may be more of a deterrent Property damage Higher insurance costs Loss of driver licence Seizure of vehicle

Psychological Strategies for Reducing Mishaps Change attitudes towards unsafe and aggressive driving Encourage stress reduction techniques towards unacceptable behaviour Role of the media in the modelling of both positive and negative driving Broaden the notion of the “problem driver”

Intervention Strategies Varied response may be necessary Community level approach Identify nature and extent of the problem Interventions based upon the assessment of the problem Evaluate costs & benefits of the intervention strategy Design a programme evaluation prior to implementation

Intervention Strategies & Evaluation Research Analysis of the exact nature of the problem Development of interventions/initiatives Community involvement in the process Defining the assessment measures Cost/benefit analysis of the intervention Publicizing the results of the intervention Documenting the intervention

Enhanced Enforcement of Highway Traffic Act Stricter alcohol bans/reduction in BAC levels Year ‘round enforcement of alcohol checks

Discourage Media Glorification of Speed Speeding vehicles are commonly depicted in both automobile commercials & advertisements with dominance and intimidation as themes Frequent depictions of car chases and illegal racing in recent motion pictures. Hero is often portrayed as initiating the chases, engaging in reckless driving or pursuing others Ever since Bullitt (1968), the car chase has become a Hollywood standard Will public opinion influence the media? Ontario’s new stunt driving legislation with harsh penalties for excessive speed

Media Effects on Driver Behaviour Media might emphasize the role of alcohol in the causation of collisions and the failure to wear seatbelts Media has the power to influence attitudes and make drunk driving socially unacceptable Bulllitt, the French Connection, Gone in 60 Seconds, Fast and Furious

Acknowledgements & Thanks Dwight Hennessy Christine Wickens James Roseborough Sara Howard Chris Mesquida Michèle Lustman Deanna Singhal