Increased traffic injuries among older unprotected road users following the introduction of an age-based cognitive test to the driver's license renewal procedure in Japan

Effect of Fitness-To-Drive and Metacognition on Road Traffic Injury Among Older Taxi Drivers: Hierarchical Modeling

Age-related cognitive and somatic motor skills changes have been linked to impaired driving abilities. Taxi drivers play an important role in providing public transportation services and security. This study aimed to examine the level of fitness-to-drive (FTD) and identify the predictors of self-reported traffic injury among the older taxi drivers. Taxi drivers 60 years and older in Bangkok and the metropolitan area were enrolled. Hierarchical regression models were carried out to examine the effects of demographics, FTD, and metacognition towards self-reported road traffic injury. Totally, 46.1% of the respondents were classified as at-risk drivers. Drivers with alcohol consumption and low risk perception toward road safety were more likely to experience road traffic injury. Regular assessment of physical and psychometric capacity among older taxi drivers could provide another empirical basis to improve public safety transport.

Analysis of road traffic accidents and casualties associated with electric bikes and bicycles in Guangzhou, China: A retrospective descriptive analysis

Introduction

Electric bicycles (e-bikes) and bicycles in large Chinese cities have recently witnessed substantial growth in ridership. According to related accident trends, this study analyzed characteristics and spatial distribution in the period when e-bike-related accidents rapidly increased to propose priority measures to reduce accident casualties.

Methods

For e-bike- and bicycle-related accident data from the Guangzhou Public Security Traffic Management Integrated System, linear regression was used to examine the trends in the number of accidents and age-adjusted road traffic casualties from 2011 to 2021. Then, for the period when e-bike-related accidents rapidly increased, descriptive statistics were computed regarding rider characteristics, illegal behaviors, road types, collision objects and their accident liability. One-way analysis of variance (ANOVA) followed by Bonferroni's multiple comparison test. P < 0.05 was considered statistically significant. Finally, the density distribution of accidents was presented, and Moran's I (MI) was used for assessing spatial autocorrelation. Hotspots were identified based on an optimized hotspot analysis tool.

Results

Between 2011 and 2021, the number of accidents and casualty rate (per 100,000 population) increased for e-bikes but decreased for bicycles. After 2018, e-bike-related accidents increased rapidly, and bicycle-related accidents plateaued. Accident hotspots were concentrated in central city areas and suburban areas close to the former. Three-quarters of accidents occurred in motorized vehicle lanes. Most occurred on roads without physically segregated nonmotorized vehicle lanes. More than three-fifths of the accidents involved motor vehicles with at least four wheels. The prevalence (per 100 people) of casualties among e-bike rider victims and cyclist victims accounted for 92.0 % and 96.5 %, respectively. A total of 71.6 % of e-bike-related accidents involved migrant workers. Riding in motorized vehicle lanes was the most common illegal behavior.

Conclusions

Although e-bike-related and bicycle-related accidents presented similar characteristics, the sharp increase in e-bike-related accidents requires attention. To improve e-bike safety, governments should develop appropriate countermeasures to prevent riders from riding on motorways, such as improving road infrastructure, adjusting the driver's license system and addressing priority control areas.

Mandatory Vision Test for Driver License Renewal in Association With Traffic Fatality and Injury Among Older Road Users in Utah

In 2011, Utah began requiring that drivers aged 65 years and older pass a vision test at each license renewal. This study aims to investigate if the mandatory vision test associated with motor vehicle fatality and injury rates in older road users. We fit controlled interrupted time series analysis models to compare fatality and injury rates for older adults (65+) affected by the law to younger adults (45-64) unaffected by the law. The models yielded estimates of differential level and slope changes in fatality and injury rates, which we used to estimate policy associations. We did not find evidence that implementing an accelerated vision test for older adults in Utah was associated with a reduction in injury or fatality rates among older (65+) drivers and non-drivers relative to those aged 45-64. Other strategies might be considered to prevent fatal motor vehicle crashes (MVCs) in older adults.

Association between mandatory cognitive testing for license renewal and motor vehicle collisions and road injuries

BACKGROUND

We examined whether the policy amendment from March 2017 for a cognitive screening test for older drivers at driver's license renewal was associated with the decreased risk of motor vehicle collisions for drivers and the increased risk of injuries for pedestrians and cyclists among older people.

METHODS

This was a controlled interrupted time-series study. We used police-reported data on the number of collisions as drivers and injuries as pedestrians and cyclists among people aged 70 years or older in Japan from July 2012 to December 2019. As the outcome measures, we used the ratio of the monthly number of collisions per population among drivers of three groups aged 75 years or older (75-79, 80-84, and ≥85 years), who were targeted or exposed by the policy, to that among drivers aged 70 to 74 years, who were unaffected or unexposed by the policy and would serve as controls. The ratio of pedestrian and cyclist injuries was also calculated, as previous studies have shown a concomitant increase in these injuries after the introduction of cognitive screening for driver's licenses.

RESULTS

During the study period, there were 602,885 collisions as drivers and 196,889 injuries as pedestrians and cyclists among people aged 70 years or older. After the policy amendment in March 2017, collisions decreased among male drivers, and injuries increased among some age subgroups in both sexes. Cumulative estimated changes in the numbers of collisions and injuries from March 2017 to December 2019 were -3670 (95% confidence interval: -5125, -2104) and 959 (95% confidence interval: 24, 1834), respectively.

CONCLUSIONS

Following the policy amendment, there was a decrease in motor vehicle collisions as drivers and an increase in road injuries as pedestrians and cyclists among older people.

Global, Regional, and National Burden of Road Injuries from 1990 to 2019

(1) Background: Understanding occurrence can help formulate effective preventative laws and regulations. However, the most recent global burden and road injuries (RIs) trends have not been reported. This study reports the burden of RIs globally from 1990 to 2019. (2) Methods: RIs data were downloaded from the Global Burden of Disease 2019. Incidence, deaths, and disability-adjusted life years (DALYs) described the trend and burden of RIs. We calculated age-standardized rates (ASRs) and estimated annual percentage change (EAPC) for the above indexes to evaluate the temporal trend of RIs. We evaluated the social-demographic index (SDI) with epidemiological RI parameters and reported proportions of age-standardized rates due to RI. (3) Results: In 2019, the global incidence of RIs reached 103.2 million. The EAPC of RI incidence increased, whereas deaths and DALYs decreased. Age-standardized incident rate (ASIR) was highest in low-middle SDI regions, age-standardized death rate (ASDR) was high in middle SDI regions, and age-standardized DALYs increased in low SDI regions. The highest accident rates were found in those aged 20-24 years old. Cyclist injuries were the leading RIs (34%), though pedestrian and motor vehicle accidents were the leading cause of death (37.4%, 37.6%) and DALYs (35.7%, 32.3%), respectively. (4) Conclusions: Over the past 30 years, RIs incidence increased annually, though death and DALY rates decreased. RIs places a considerable burden on public health in low SDI countries. Data should be used to develop and implement effective measures to reduce the burden of RIs.