Browsing by Subject "Motor vehicle crashes"

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    A National Survey of Motor Vehicle Crashes Among General Surgery Residents
    (Wolters Kluwer, 2021) Schlick, Cary Jo R.; Hewitt, Daniel Brock; Quinn, Christopher M.; Ellis, Ryan J.; Shapiro, Katherine E.; Jones, Andrew; Bilimoria, Karl Y.; Yang, Anthony D.; Surgery, School of Medicine
    Objectives: Evaluate the frequency of self-reported, post-call hazardous driving events in a national cohort of general surgery residents and determine the associations between duty hour policy violations, psychiatric well-being, and hazardous driving events. Summary of background data: MVCs are a leading cause of resident mortality. Extended work shifts and poor psychiatric well-being are risk factors for MVCs, placing general surgery residents at risk. Methods: General surgery residents from US programs were surveyed after the 2017 American Board of Surgery In-Training Examination. Outcomes included self-reported nodding off while driving, near-miss MVCs, and MVCs. Group-adjusted cluster Chi-square and hierarchical regression models with program-level intercepts measured associations between resident- and program-level factors and outcomes. Results: Among 7391 general surgery residents from 260 programs (response rate 99.3%), 34.7% reported nodding off while driving, 26.6% a near-miss MVC, and 5.0% an MVC over the preceding 6 months. More frequent 80-hour rule violations were associated with all hazardous driving events: nodding off while driving {59.8% with ≥5 months with violations vs 27.2% with 0, adjusted odds ratio (AOR) 2.86 [95% confidence interval (CI) 2.21-3.69]}, near-miss MVCs, [53.6% vs 19.2%, AOR 3.28 (95% CI 2.53-4.24)], and MVCs [14.0% vs 3.5%, AOR 2.46 (95% CI 1.65-3.67)]. Similarly, poor psychiatric well-being was associated with all 3 outcomes [eg, 8.0% with poor psychiatric well-being reported MVCs vs 2.6% without, odds ratio 2.55 (95% CI 2.00-3.24)]. Conclusions: Hazardous driving events are prevalent among general surgery residents and associated with frequent duty hour violations and poor psychiatric well-being. Greater adherence to duty hour standards and efforts to improve well-being may improve driving safety.
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    Impacts of confounding roadway characteristics on estimates of associations between alcohol outlet densities and alcohol-related motor vehicle crashes
    (Wiley, 2021) Lipton, Robert; Banerjee, Aniruddha; Ponicki, William R.; Gruenewald, Paul J.; Morrison, Christopher; Geography, School of Liberal Arts
    Introduction and aims: Previous research on alcohol-related motor vehicle crashes (AMVC) share a substantial limitation: sources of geographic variations in background crash risks may confound estimated spatial relationships between alcohol outlets and AMVCs. The aim of this study was to address this concern by examining, spatial-temporally, relationships between alcohol outlets and AMVCs adjusting for a set of six roadway characteristics that may be, independently, related to crash risks. While most similar studies focus on one metropolitan area, we use a unique sample of 50 cities. Design and methods: The spatial sample for this study consisted of 8726 Census 2000 block groups representing 50 mid-sized California cities. Dependent measures were counts of crashes located within Census block groups. Independent measures included socio-demographics, social disadvantage, alcohol outlets and roadway characteristics. We assessed relationships of crashes to independent measures using hierarchical generalised linear models. Results: Greater roadway length, greater percentage of highways, greater average speeds, fewer T-intersections, greater curviness and less fragmentation were related to greater numbers of crashes as was alcohol outlet density. Discussion: Above and beyond alcohol outlet type and density, we found that roadway characteristics were related to AMVC risks across a sample of 50 mid-sized cities. Measures of roadway characteristics are an essential component of any model of motor vehicle crashes that attempts to assess impacts of alcohol outlets on motor vehicle crashes risks.