Search

The study examines changes over time in crash risk differences between young Australian drivers born in Asia and those born in Australia.Data from the 2003 baseline survey of the DRIVE cohort of 20 806 young drivers aged 17–24 years were linked to police, hospital and death data up until 2016. The association between country of birth and crash was investigated using flexible parametric survival models adjusted for confounders.Six months after baseline, the crash risk in Asian-born drivers was less than half that of their Australian-born counterparts (mean HR, MHR 0.41; 95% CI 0.29 to 0.57), only to increase steadily over time to resemble that of Australian-born drivers 13 years later (MHR 0.94; 95% CI 0.66 to 1.36).This is likely to be associated with acculturation and the adoption by young Asian-born Australian drivers of driving behaviour patterns akin to those born locally. This needs to be considered in future road safety campaigns.

BackgroundYoung drivers of low socioeconomic status (SES) have a disproportionally high risk of crashing compared with their more affluent counterparts. Little is known if this risk persists into adulthood and if it differs between men and women.MethodsWe used data from a 2003/2004 Australian survey of young drivers (n=20 806), which included measures of drivers’ demographics and established crash risk factors. These data were linked to police-reported crash, hospital and death data up to 2016. We used negative binomial regression models to estimate the association between participants’ SES, with car crash.ResultsAfter adjusting for confounding, drivers of lowest SES had 1.30 (95% CI 1.20 to 1.42), 1.90 (95% CI 1.25 to 2.88), 3.09 (95% CI 2.41 to 3.95) and 2.28 (95% CI 1.85 to 2.82) times higher rate of crash, crash-related hospitalisation, crash in country areas and crash on streets with a speed limit of 80 km/hour or above compared with drivers of highest SES, respectively. For single-vehicle crashes, women in the lowest SES groups had 2.88 (95% CI 1.83 to 4.54) times higher rate of crash compared with those in the highest SES group, but no differences were observed for men from different SES groups.ConclusionYoung drivers who lived in areas of low SES at the time of the survey had a sustained increased risk of crash over the following 13 years compared with drivers from the most affluent areas. Our findings suggest that in addition to traditional measures, road transport injury prevention needs to consider the wider social determinants of health.

IntroductionSelf-harm and suicide are leading causes of morbidity and death for young people, worldwide. Previous research has identified self-harm is a risk factor for vehicle crashes, however, there is a lack of long-term crash data post licensing that investigates this relationship. We aimed to determine whether adolescent self-harm persists as crash risk factor in adulthood.MethodsWe followed 20 806 newly licensed adolescent and young adult drivers in the DRIVE prospective cohort for 13 years to examine whether self-harm was a risk factor for vehicle crashes. The association between self-harm and crash was analysed using cumulative incidence curves investigating time to first crash and quantified using negative binominal regression models adjusted for driver demographics and conventional crash risk factors.ResultsAdolescents who reported self-harm at baseline were at increased risk of crashes 13 years later than those reporting no self-harm (relative risk (RR) 1.29: 95% CI 1.14 to 1.47). This risk remained after controlling for driver experience, demographic characteristics and known risk factors for crashes, including alcohol use and risk taking behaviour (RR 1.23: 95% CI 1.08 to 1.39). Sensation seeking had an additive effect on the association between self-harm and single-vehicle crashes (relative excess risk due to interaction 0.87: 95% CI 0.07 to 1.67), but not for other types of crashes.DiscussionOur findings add to the growing body of evidence that self-harm during adolescence predicts a range of poorer health outcomes, including motor vehicle crash risks that warrant further investigation and consideration in road safety interventions. Complex interventions addressing self-harm in adolescence, as well as road safety and substance use, are critical for preventing health harming behaviours across the life course.

© 2017, BMJ Publishing Group. All rights reserved. Knowledge translation and exchange (KTE) can enable evidence-informed road safety policy and practice by reducing the gap between what is known to be effective and what actually occurs. A quality improvement project, undertaken within a government policy frame, was implemented in 2015 to produce an enhanced KTE framework for road safety (the framework). Information was collected from 35 road safety stakeholders in the UK, the Netherlands, Norway and Sweden. Thirteen KTE facilitators were identified that covered research funding and production, the expertise of knowledge users and dissemination practices. The framework was subsequently developed, which separated facilitators seen as essential for a KTE system, from others perceived as aspirational due to their lesser influence and the considerable time and resources required for their implementation. The framework provides a heuristic device to enable policy agencies to holistically assess and improve current KTE systems for road safety, to encourage evidence-informed policy and practice.

Background The authors were commissioned to develop education curricula for a new motorcyclist graduated licensing system in Victoria, Australia. A review of published literature identified several promising models internationally, but no single best-practice framework. The objective of this research was to determine whether a best-practice framework implemented for new drivers, the Finnish Goals for Driver Education (GDE; Keskinen, 1996), could be adapted and applied for new motorcyclists. The model comprises four levels: basic, tactical, strategic and general. Methods An adapted framework was drafted by replacing driver-specific content to motorcyclist-equivalent content where applicable (e.g. seatbelts to helmets). Curriculum materials were drafted using the framework as a guide, focusing on the five most frequent novice motorcyclist crash types in Victoria and particularly enhancing the roadcraft content of the tactical and strategic levels. Train-the-trainer pilots were offered to experienced motorcycle trainers with one medium-sized provider in Victoria, and the option to undertake the pilot programs offered to their learner permit and licence candidates on selected weeks in March to October 2015. Student pilots were conducted to saturation, that is, until no new feedback was obtained. University Ethics approval was obtained. Results In total, 10 trainers and 53 students took part in the pilots. Saturation was achieved in 6 pilots each for pre-learner course, and combined learner and licence course components. Feedback from participants showed strong support for the curriculum and suggested that all levels of the model had been addressed. Conclusions The results suggested that the GDE model had been readily adapted into a promising framework for improving novice motorcyclist education. The Victorian Government has commenced plans to conduct a pre-post outcome evaluation of the new curriculum, which is due to commence rollout across the state in March 2016.

Background Typologies have been defined previously for pedestrian-vehicle interactions and are primarily based on retrospective analysis of crash data. The naturalistic driving study currently underway in Australia makes it possible to study pedestrian-vehicle interaction events that would not otherwise be identified in the crash data. This work evaluates the feasibility of using automated, manual, and semi-automated methods to identify pedestrian-vehicle interaction events. Methods Sensors and cameras were installed on the vehicles of volunteers in and around two major Australian cities which recorded their natural driving behaviour for 4 months. Forward video from select vehicles was reviewed independently by two reviewers to identify potential pedestrian-vehicle interaction events from which a typology of behaviours was formulated. These events served as the gold standard against which select automated and semi-automated methods of identification were assessed. Results A prototype typology of pedestrian-vehicle interaction events was formulated using naturalistic driving data and categorised in terms of risk of being struck. Some case scenarios will be discussed. The feasibility of using select automated, semi-automated, and manual methods to identify these events was also evaluated. Conclusions This work provides a first look at using Australian naturalistic driving data to study the interactions between vehicles and pedestrians. These findings will assist in the development of methods that can be used to most effectively answer research questions pertaining to interactions between vehicles and pedestrians as well as other vulnerable road users in the future.

Background Driver licensing is essential to effective road safety management systems however strengthened graduated driver licensing systems may make licensing less accessible. The impact of barriers to licensing can be far reaching, particularly for already marginalised groups. We aimed to describe licensing rates and factors associated with driver licensing for Aboriginal and Torres Strait Islander people in Australia. Methods Interviewer administered surveys were conducted with 625 people 16 years or older in 4 Aboriginal Community Controlled Health Services in New South Wales and South Australia over a 2 week period in 2012–2013. Results Licensing rates varied from 51% to 77%. A high proportion of participants reported licensing was important for independence and to meet work needs and opportunities, especially those from regional or remote locations. Employment was strongly associated with holding a current driver licence, with 64% of employed people holding a licence compared to only 36% of those who were unemployed (p Conclusions Substantial variation in driver licensing rates across settings suggests different barriers to access. There is a strong association between driver licensing, education and employment. Licensing inequality has far-reaching impacts on the broader health and well-being of Aboriginal and Torres Strait Islander people in Australia. This study reinforces the need for appropriate and accessible pathways to achieving and maintaining driver licensing.

Background There is community demand for investment in motorcycle rider training programs but little evidence of its effectiveness in preventing crashes. This randomised trial of an on-road rider coaching program commissioned by VicRoads, the road authority for the State of Victoria, Australia, aimed to determine its effectiveness in reducing crashes in novice motorcycle riders. Methods Between May 2010 and October 2012 2399 newly-licensed provisional riders were recruited in Victoria, Australia and completed a telephone interview before randomisation to intervention or control groups. Riders in the intervention group were offered an on-road motorcycle rider coaching program which involved pre-program activities, 4 hours riding and facilitated discussion in small groups with a riding coach. Outcome measures were collected for all participants via telephone interviews at 3 and 12 months after program delivery (or equivalent for controls), and via linkage to police-recorded crash and offence data. The primary outcome was a composite measure of police-recorded and self-reported crashes; secondary outcomes included traffic offences, near crashes, riding exposure, and riding behaviours and motivations. Results Follow-up was 89% at 3 months and 88% at 12 months; 60% of the intervention group completed the program. Intention-to-treat analyses conducted in 2014 indicated no effect on crash risk at 3 months (adjusted OR 0.90, 95% CI: 0.65–1.27) or 12 months (adjusted OR 1.00, 95% CI: 0.78–1.29). Riders in the intervention group reported increased riding exposure, speeding behaviours and rider confidence. Conclusions There was no evidence that this on-road motorcycle rider coaching program reduced the risk of crash, and we found an increase in crash-related risk factors. Given the absence of road safety benefits such programs should be considered a less promising strategy than other aspects of a safe system approach.

Background Despite increasing popularity of off-road cycling, data on injury in off-road riders are rarely reported. This study aimed to describe characteristics of a sample of injured off-road cyclists. Aims/Objectives/Purpose Phone interviews were conducted with adults presenting to Canberra or Calvary Hospitals in Canberra with a cycle related injury between November 2009 and May 2010; medical records were accessed to verify patient data. Results Of 372 eligible cyclists, 84.1% (n=313) participated; 111 (35.5%) were riding off-road. Of off-road riders, most were riding mountain bikes (76%), 93 (84%) were male, compared to 74% overall and more were aged 17–25 (28% vs 22%). Most (63%) were riding on designated off-road trails, 22% in BMX- or skate–parks; 33% of cyclists involved in off-road crashes reported ‘riding for thrills’ compared to 5% in other cyclists, with the most common risk behaviour being downhill speeding. More off-road incidents involved a fall (93% vs 65% of all riders) but fewer involved collisions (6% vs 25%); more off-road riders were recreational riders (73% vs 43%) and more reported previous crashes (72% vs 60%). Most common injuries were bruises, abrasions and sprains; 36% had fractures. Most common injury sites were shoulder, elbow and hand. Helmet usage was higher for off-road riders (89%) compared to those riding on footpaths (71%) or cycle lanes (68%). Significance/Contribution to the Field A high proportion of injured cyclists were recreational, off-road riders. Although more research is needed, injury prevention programmes for off-road riders might focus on management of risky riding behaviours and hazards in the riding environment.

Background Young drivers who drive their own vehicle are at an increased risk of crash, which is hypothesised to be explained by more driving exposure or risky driving. Purpose This study examined this hypothesis among a young driver cohort in Australia. Methods The DRIVE Study collected information on crash risk factors from 20 822 newly licensed drivers aged 17–24 years in New South Wales between 2003 and 2004, and prospectively linked responses to police-recorded crashes, licensing details, and traffic offences. Based on self report, young driver access to a vehicle was categorised as: family vehicle, own vehicle, other vehicle, and no access. Poisson regression was used to model crash risk (average follow-up=2 years) by type of vehicle access, controlling for confounders including driving exposure and risky driving behaviours. Results/Outcomes Drivers with their own vehicle were more likely to report high weekly driving hours, more risky driving behaviours and hazardous drinking. After controlling for demographics and confounders including risky driving behaviours, they had a 30% higher crash risk (RR 1.3, 95% CI 1.2 to 1.5) compared with those with access to a family vehicle, and dropping to 20% (RR 1.2, 95% CI 1.1 to 1.4) when further controlling for driving exposure. Significance/Contribution to the Field This study affirms that, compared with those who have access to a shared family vehicle, young drivers with access to their own vehicle have an increased crash risk, regardless of their longer driving exposure and frequent risky driving behaviours. Further research is required to understand whether restricting car ownership is an effective intervention to reduce young driver crashes.

Introduction Road traffic injuries are a leading cause of death and disability worldwide, particularly among young adults. While surveys are widely used to measure the incidence of on-road crashes and offences, little is known about the validity of self-reports of these events, particularly among young drivers. This study examines the accuracy of self-report of on-road crashes and traffic offences among participants in the DRIVE study: a cohort study of 20 822 drivers aged 17–24 year-old, recently licensed in New South Wales, Australia. Methods A total of 2991 DRIVE study participants who completed the follow-up questionnaire, approximately 2 years after joining the study, were asked whether they had been involved in an on-road crash or were convicted for a traffic offence during the year prior to the survey. This information was subsequently linked to police recorded crash and offence data to determine the level of accuracy of these self-reports. Results Young drivers reported more crashes and traffic offences than those recorded in the police database during the 1-year study period. The findings showed a high level of accuracy in young drivers9 self-report of police recorded crashes (85.1%; 95% CI 78.2% to 92.1%) and of police recorded traffic offences (83.0%; 95% CI 79.4% to 86.6%). Conclusions The results suggest that surveys may be useful tools for estimating the incidence of traffic crashes and offences in young drivers. The findings are particularly relevant to countries and jurisdictions where access to administrative data are limited.

Background Little research has examined associations between traffic offences and risk of crash in novice drivers. Methods 20 822 NSW drivers aged 17–24 years holding a provisional licence completed a detailed questionnaire; data were linked to driving offences, and police recorded crashes 2 years following participation. Poisson regression models were adjusted for multiple risk factors including driving exposure, risky driving, and previous crash and offences. Results During follow-up, 9.0% of drivers had one crash, 0.6% had two crashes and 0.04% had three crashes; 35.3% of males had offences recorded compared to 21.3% of females and 41.1% of those reporting high levels of risky driving behaviours had offences compared to 16.3% of people reporting lower levels. In multivariable models, drivers who had any offence had a reduced risk of crash compared to those who had no offences (relative risk (RR) 0.47, 95%CI 0.41 to 0.54). The relationship was sustained for speeding and other offences, but not for reckless driving (RR 0.96, 95%CI 0.61 to 1.49) or alcohol related offences (RR 0.57, 95%CI 0.31 to 1.08). Having any driving offence was associated with increased time to crash (RR 1.21 95%CI 1.1 to 1.27 to 0.86). Conclusion Traffic offences, particularly speeding related offences, are associated with reduced risk of crash for novice drivers. These results suggest that enforcement based approaches are an important component of crash prevention programs for novice drivers.

This paper describes how some crashes, particularly single vehicle crashes, may result from intentional self-harm behavior but research on this topic is very limited. Self-harm is the deliberate injuring of oneself and includes actions such as cutting, attempted hanging and poisoning. This study aimed to assess the risk that intentional self-harm poses for prospective motor vehicle crashes among novice drivers. Questionnaire responses from 20,822 newly licensed drivers aged 17 to 24 were prospectively linked to licensing and police-reported crash data and the mean follow-up was 2 years. Multivariable Poisson regression models were used to investigate the role of recent self-harm on the risk of crash, which takes into account potential confounders including driving exposure, duration of sleep, remoteness of residence, socio-economic status, psychological symptoms and substance abuse. A total of 871 drivers reported engaging in self-harm in the year before the survey. Self-harm was more common among youth who were women, Australian-born, living in rural areas, driving more per week, sleeping less and using drugs and alcohol. Young people who reported engaging in self-harm behavior were at significantly increased risk of crash. This first and largest ever study of the relationship between self-harm and crash in young drivers found self-harm to be a predictor of subsequent motor vehicle crash, with most crashes involving multiple vehicles.