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To determine accurately the number of serious injuries at EU level and to compare serious injury rates between different countries it is essential to use a common definition. In January 2013, the High Level Group on Road Safety established the definition of serious injuries as patients with an injury level of MAIS3+(Maximum Abbreviated Injury Scale). Whatever the method used for estimating the number or serious injuries, at some point it is always necessary to use hospital records. The aim of this paper is to understand the implications for (1) in/exclusion criteria applied to case selection and (2) a methodological approach for converting ICD (International Classification of Diseases/Injuries) to MAIS codes, when estimating the number of road traffic serious injuries from hospital data. A descriptive analysis with hospital data from Spain and the Netherlands was carried out to examine the effect of certain choices concerning in- and exclusion criteria based on codes of the ICD9-CM and ICD10. The main parameters explored were: deaths before and after 30 days, readmissions, and external injury causes. Additionally, an analysis was done to explore the impact of using different conversion tools to derive MAIS3 + using data from Austria, Belgium, France, Germany, Netherlands, and Spain. Recommendations are given regarding the in/exclusion criteria and when there is incomplete data to ascertain a road injury, weighting factors could be used to correct data deviations and make more real estimations.

Evaluation research suggests that professional driver education and training has little effect on reducing the crash involvements of young drivers. Driver education and training programs have been criticised as being unsystematically designed and lacking an empirical or theoretical basis. The Goals for Driver Education (GDE) is a theoretical framework developed to address these criticisms. The GDE defines four hierarchical levels of driving behaviours and influences on driving and three individualised Person-specific factors that should be considered in driver education and training programs. The aim of this study was to compare and contrast, in a methodologically rigorous manner, the perceptions that young drivers (n = 22; Mage = 17.80 years, SD = 6.54 months) and driver educators (n = 10; Mage = 54.5 years, SD = 9.21 years) have of a professional driver education and training course they participated in or facilitated. Eight semi-structured focus groups were conducted and the GDE was used to direct the collection and analysis of the data. Young drivers mainly discussed basic driving skills located on the lower levels of the GDE rather than higher level abstract factors that increase risk for young drivers. Driver educators tended to group particular GDE levels and Person-specific factors together when discussing the driving course and paid limited attention to Goals and contexts of driving. Results suggest that driver educators should provide direct instruction regarding the more abstract social and contextual factors that influence driving to potentially increase the efficacy of driver education and training as a safety countermeasure.

Improving the safety at passive rail crossings is an ongoing issue worldwide. These crossings have no active warning systems to assist drivers’ decision-making and are completely reliant on the road user perceiving the approach of a train to decide whether to enter a crossing or not. This study aimed to better understand drivers’ judgements regarding approaching trains and their perceptions of safe crossing. Thirty-six participants completed a field-based protocol that involved detecting and judging the speeds of fast moving trains. They were asked to report when they first detected an approaching train, when they could first perceive it as moving, as well as providing speed estimates and a decision regarding when it would not be safe to cross. Participants detected the trains ∼2 km away and were able to perceive the trains as moving when they were 1.6 km away. Large differences were observed between participants but all could detect trains within the range of the longest sighting distances required at passive level crossings. Most participants greatly underestimated travelling speed by at least 30%, despite reporting high levels of confidence in their estimates. Further, most participants would have entered the crossing at a time when the lights would have been activated if the level crossing had been protected by flashing lights. These results suggest that the underestimation of high-speed trains could have significant safety implications for road users’ crossing behaviour, particularly as it reduces the amount of time and the safety margins that the driver has to cross the rail crossing.

The ability to detect changes is crucial for safe driving. Previous research has demonstrated that drivers often experience change blindness, which refers to failed or delayed change detection. The current study explored how susceptibility to change blindness varies as a function of the driving environment, type of object changed, and safety relevance of the change. Twenty-six fully-licenced drivers completed a driving-related change detection task. Changes occurred to seven target objects (road signs, cars, motorcycles, traffic lights, pedestrians, animals, or roadside trees) across two environments (urban or rural). The contextual safety relevance of the change was systematically manipulated within each object category, ranging from high safety relevance (i.e., requiring a response by the driver) to low safety relevance (i.e., requiring no response). When viewing rural scenes, compared with urban scenes, participants were significantly faster and more accurate at detecting changes, and were less susceptible to "looked-but-failed-to-see" errors. Interestingly, safety relevance of the change differentially affected performance in urban and rural environments. In urban scenes, participants were more efficient at detecting changes with higher safety relevance, whereas in rural scenes the effect of safety relevance has marginal to no effect on change detection. Finally, even after accounting for safety relevance, change blindness varied significantly between target types. Overall the results suggest that drivers are less susceptible to change blindness for objects that are likely to change or move (e.g., traffic lights vs. road signs), and for moving objects that pose greater danger (e.g., wild animals vs. pedestrians).

Young men figure prominently in sleep-related road crashes. Non-driving studies show them to be particularly vulnerable to sleep loss, compared with older men. We assessed the effect of a normal night's sleep vs. prior sleep restricted to 5 h, in a counterbalanced design, on prolonged (2 h) afternoon simulated driving in 20 younger (av. 23 y) and 19 older (av. 67 y) healthy men. Driving was monitored for sleepiness related lane deviations, EEGs were recorded continuously and subjective ratings of sleepiness taken every 200 s. Following normal sleep there were no differences between groups for any measure. After sleep restriction younger drivers showed significantly more sleepiness-related deviations and greater 4–11 Hz EEG power, indicative of sleepiness. There was a near significant increase in subjective sleepiness. Correlations between the EEG and subjective measures were highly significant for both groups, indicating good self-insight into increasing sleepiness. We confirm the greater vulnerability of younger drivers to sleep loss under prolonged afternoon driving.

Objectives To examine the effects on monotonous driving of normal sleep versus one night of sleep restriction in continuous positive airway pressure (CPAP) treated obstructive sleep apnoea (OSA) patients compared with age matched healthy controls. Methods Nineteen CPAP treated compliant male OSA patients (OSA-treated patients (OPs)), aged 50–75 years, and 20 healthy age-matched controls underwent both a normal night’s sleep and sleep restriction to 5 h (OPs remained on CPAP) in a counterbalanced design. All participants completed a 2 h afternoon monotonous drive in a realistic car simulator. Driving was monitored for sleepiness-related minor and major lane deviations, with ‘safe’ driving time being total time driven prior to first major lane deviation. EEGs were recorded continuously, and subjective sleepiness ratings were taken at regular intervals throughout the drive. Results After a normal night’s sleep, OPs and controls did not differ in terms of driving performance or in their ability to assess the levels of their own sleepiness, with both groups driving ‘safely’ for approximately 90 min. However, after sleep restriction, OPs had a significantly shorter (65 min) safe driving time and had to apply more compensatory effort to maintain their alertness compared with controls. They also underestimated the enhanced sleepiness. Nevertheless, apart from this caveat, there were generally close associations between subjective sleepiness, likelihood of a major lane deviation and EEG changes indicative of sleepiness. Conclusions With a normal night’s sleep, effectively treated older men with OSA drive as safely as healthy men of the same age. However, after restricted sleep, driving impairment is worse than that of controls. This suggests that, although successful CPAP treatment can alleviate potential detrimental effects of OSA on monotonous driving following normal sleep, these patients remain more vulnerable to sleep restriction.