Risk Factors for Collisions and Near-Miss Incidents Caused by Drowsy Bus Drivers.

Serious accidents have been caused by drowsy bus drivers and have necessitated an examination of the risk factors involved. A questionnaire survey among employees of a bus company was conducted in Ibaraki Prefecture, Japan in September 2014. Respondents were asked to report details of their work and life over the preceding month. The 301 valid responses by bus drivers (295 men and 6 women) with a mean age of 51.6 years (range: 24-73 years) were used for analysis. Univariable logistic regression showed that factors affecting the incidence of collisions and near-miss incidents by drowsy drivers were continued driving when feeling sick, reporting a physical condition, number of sleep hours, time spent with family, working hours, and nutritional balance. According to a multiple regression analysis, continued driving when feeling sick (odds ratio: 3.421, 95% confidence interval: 1.618-7.231) was the only significant risk for the event. Managers should encourage drivers to voluntarily report poor health and should provide opportunities to stop driving if drivers experience physical discomfort or sleepiness. To improve road safety, educational measures are required for both drivers and managers to prevent driving under poor health conditions, although the decision to stop driving depends on drivers' subjective judgment.

Influence of workplace environment, working conditions and health status of taxi drivers on vehicle collisions or near-miss events.

Sudden illness while driving has been identified as a major cause of vehicle collisions, particularly among taxi drivers. However, no previous studies have examined the factors contributing to the occurrence of health-related vehicle collisions. The current study aimed to identify the risk factors causing health-related vehicle collisions among taxi drivers, and to inform preventative interventions. A cross-sectional survey involving a written anonymous questionnaire was conducted for company-employed taxi drivers in Chiba Prefecture, Japan. A total of 1,739 drivers returned questionnaires. Drivers were classified into those who had experienced collisions or near-miss incidents caused by health problems (Event group), and those who had not (Non-event group). According to a multivariable logistic regression analysis, being unable to take vacation time (odds ratio [OR] 4.59, 95% confidence interval [CI] 2.2-9.58), having chronic diseases (OR 1.52, 95% CI 1.02-2.27), taking insufficient vacation time (OR 1.81, 95% CI 1.19-2.79), and difficulty reporting poor health conditions (OR 2.29, 95% CI 1.36-3.87) were significant factors for the likelihood of an event. Support for drivers to maintain well-balanced control of illnesses and improvement of working environments could prevent health-related events while driving.

Comparison of the injury severity and medical history of disease-related versus trauma-related bicyclist fatalities.

The objective of this study was to clarify the relationship between injury severity and mechanism of death in bicycle fatalities resulting from trauma compared with those resulting from disease, to propose effective measures to prevent fatal bicyclist accidents. Autopsy and accident records were reviewed for bicyclist fatalities who had undergone forensic autopsy at the Dokkyo Medical University School of Medicine between September 1999 and March 2014. Victims' health histories, blood alcohol levels, causes of death, mechanisms of injury, Abbreviated Injury Scale (AIS) scores and Injury Severity Scores (ISSs) were determined. Fifty-five bicyclists (43 male and 12 female) with a mean age of 62.5±17.3 years were included in this study. Sixteen victims had driven under the influence of alcohol (mean blood concentration of 1.8±0.7 mg/ml). Mean ISS was 32.4 and the chest had the highest mean AIS score (2.6), followed by the head (2.1) and the neck (1.8). Thirty-nine victims (70.9%) had died of trauma and 16 had died of disease. The disease-death victims had significantly higher prevalence of having diabetes mellitus, hyperlipidemia, hypertension, heart disease or cerebrovascular diseases (50.0% vs. 22.2%, p=0.03) and a lower rate of drunk driving (6.3% vs. 41.0%, p=0.01) than the trauma-death group. All victims who were affected by disease, and 33.3% of trauma-death victims, had fallen on the road without a vehicle collision (p<0.001). The mean ISS of the trauma-death group was significantly higher than that of the disease-death group (44.0 vs. 4.2, p<0.001). Except for facial injuries, the AIS scores were significantly higher in trauma-death victims than in the disease-death group (p<0.005). To effectively reduce bicyclist fatalities, the authors strongly advocate efforts that will increase compliance with drunk driving prohibitions. For victims of fatal bicycle accidents with a medical history of diseases, a forensic autopsy should be performed to establish a disease-related death while bicycle riding. We must also put into effect preventative safety measures, which take into consideration the physical condition of bicyclists, to reduce the incidence of these types of accidents.