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Cited by 80Traffic and Road SafetyOlder Adults Driving StudiesOccupational Health and Safety Research

The driver's role in fatal two-car crashes: a paired “case-control” study

Perneger, Thomas, Smith, Gordon S.·1991·American Journal of Epidemiology
DOI 10.1093/oxfordjournals.aje.a116017
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Abstract

This population-based study examines drivers' characteristics associated with driving errors that resulted in fatal motor vehicle crashes. Routinely collected data from the Fatal Accident Reporting System were used to assess whether a driver initiated the crash (case) or was passively involved (control) in 6,506 two-car collisions (81% of 7,993 eligible events). A paired comparison of cases and controls avoided confounding by environmental factors, exposure to traffic, and differences in case fatality. The strongest predictor of crash initiation is alcohol (odds ratio (OR) = 11.5; 95% confidence interval (CI) 9.57-13.9). Odds ratios are elevated even at the lowest blood alcohol concentration levels and increase dramatically as alcohol levels rise. Drivers aged 40-49 years are least likely to initiate crashes; odds ratios rise in a U-shaped manner to 3.35 in teenagers (95% CI 2.72-4.13) and to 22.1 in drivers over 80 years (95% CI 14.2-34.5). Other risk factors for initiating a fatal crash are the following: not wearing a seat belt (OR = 1.54; 95% CI 1.35-1.75), driving without a valid driver's license (OR = 2.16; 95% CI 1.72-2.73), and having had a crash within the last year (OR = 1.21; 95% CI 1.07-1.38). Driving errors leading to fatal crashes do not occur at random, but are associated with specific driver characteristics. The risk factors for crash initiation among crash-involved drivers are similar to risk factors for crash involvement found in other studies. These findings suggest that driving errors often explain high rates of crash involvement, invite further use of crash initiation in traffic injury research, and underscore the value of population-based registries for analytic epidemiology.

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Crossref · 10.1093/oxfordjournals.aje.a116017

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Authors
Perneger, T., & Smith, G. S.
Affiliations
Johns Hopkins University (US)
Corresponding author
Smith, Gordon S.
ORCID
Venue
American Journal of Epidemiology
Publisher
Oxford University Press (OUP)
Published
1991-11-15
Volume
134
Issue
10
Pages
1138-1145
ISSN
  • 0002-9262 (ISSN-L)
  • 1476-6256
DOI
10.1093/oxfordjournals.aje.a116017
OpenAlex
W1898908442
Cited by
79
References
20
Citations by year
2024: 1 · 2023: 3 · 2022: 2 · 2021: 2 · 2020: 1 · 2019: 1 · 2017: 3 · 2016: 2 · 2013: 3 · 2012: 2
FWCI
11.39
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r29aa007700-05)
  • U.S. Public Health Service (R49/CCR302486-01)
  • National Institute on Alcohol Abuse and Alcoholism (R29AA07700)
Topics
  • Physical Sciences › Engineering › Safety, Risk, Reliability and Quality › Traffic and Road Safety
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Older Adults Driving Studies
  • Health Sciences › Health Professions › Radiological and Ultrasound Technology › Occupational Health and Safety Research
Keywords
fatal motor vehicle crashes, driver characteristics, alcohol impairment, blood alcohol concentration, seat belt use, driving errors, risk factors
MeSH terms
Accidents, Traffic, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Alcohol Drinking, Automobile Driving, Humans, Middle Aged, Risk Factors, Role, United States, Logistic Models, Odds Ratio, Case-Control Studies

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