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Background: Driving is a primary mode of travel in many countries. It relies primarily on the function of vision to navigate roads and traffic safely. Ensuring good vision for motor vehicle drivers is important to promote safety for all road users. Lesotho is a developing country, with road transportation central to the movement of people and goods within, and across the borders of the country. The absence of clear visual function requirements for driving in Lesotho motivated this study. Aim: To assess the visual function of motor vehicle drivers in Lesotho. Setting: The study was conducted at the Traffic Department in Maseru, the main licensing centre where all drivers in the country must apply for issuance or renewal of driving licenses. Methods: This cross-sectional study recruited 460 active licensed drivers using systematic random sampling. Data were collected through a structured questionnaire, and comprehensive vision examination and was analysed using Strata version 14. Results: The mean age of participants was 42.9 ± 10.35 years. One fifth of participants had not had an eye examination before obtaining their licenses. About 70% had normal vision (6/9 or better) in the better-seeing eye. Among those with sub-normal vision, 29% had visual acuity between 6/18 and 6/48 in the better-seeing eye. About 40% had refractive error, with myopia showing the highest distribution (46.46%), followed by astigmatism (32.96%) and hyperopia (24.59%). Most participants passed colour vision (CV) (97.61%), contrast sensitivity (53.70%) testing, as well as visual field (99.6%). About 44% of participants reported having been involved in road traffic accidents. Conclusion: Some vehicle drivers in Lesotho have compromised vision, with many not undergoing eye examination before obtaining driving licenses. Absence of screening methods for drivers in Lesotho could lead to road traffic accidents and have negative socio-economic impacts. Implementing standardised screening protocols would improve safety for road users. Contribution: A significant number of motor vehicle drivers in Lesotho have some form of visual impairment, with many not undergoing an eye examination before obtaining a driver's licenses. If drivers are encouraged to have their eyes examined regularly, many visual function anomalies could be detected early and their vision would be corrected accordingly. The absence of effective screening methods for drivers in Lesotho could possibly be a contributor to the incidence of RTAs in the country, with the resultant negative socio-economic impacts. Therefore, it is recommended that visual screening of motor vehicle drivers should be included in the traffic laws in Lesotho. [ABSTRACT FROM AUTHOR]

Background Drivers suffering from epilepsy are commonly regarded as a threat to road safety. However, inability to use their own means of transport very often implies specific professional effects and lowers the quality of life. The aim of this study was to analyze the driving status of patients with epilepsy in Poland. Material and Methods The prospective study was performed using an independent questionnaire developed by the authors, consisting of 4 parts: 1) socio-demographic information, 2) clinical information, 3) driving information, and 4) opinions about patients with epilepsy as drivers. The study was conducted in November 2018–September 2019. A total of 188 patients completed this study. Results More than one-quarter of the patients have a driving license. Among them, 35 individuals (accounting for 18.62% of the whole study group) said that they had received their driving license after the diagnosis of epilepsy. In 10 cases (5.32%), seizures occurred while the patients were driving and in 72 cases (38.30%) while they were traveling as passengers. Among all socio-clinical factors, having a driving license was conditioned by the marital status (p = 0.008) and education (p = 0.007). Other factors did not affect having a driving license or the time of obtaining the license (p > 0.05 for all cases). A relationship was observed between the occurrence of side effects of antiepileptic drugs and the occurrence of seizures while traveling as a car passenger (p = 0.001). Other factors did not affect the occurrence of epileptic seizures while traveling by car, either as a driver or a passenger (p > 0.05). Conclusions A significant proportion of the respondents were of the opinion that patients with epilepsy should not be allowed to obtain a driving license, which is probably related to concerns about the occurrence of epileptic seizures while driving. It is necessary to conduct a nationwide educational and information campaign on epilepsy in various aspects. Med Pr. 2021;72(4):341–50

Regulation (EC) No 561/2006 consists of various rules regarding the working hours of drivers, breaks and resting periods for truck and bus drivers to enhance working conditions and road safety. As of 15 July 2020, several changes have been made that might endanger road safety. The objective of this study is twofold. First of all, the study aims to explore various physical and phycological factors where the impact of these regulations is assessed. Secondly, it aims to observe the reasons behind truck drivers' fatigue behaviour. To achieve these objectives, a literature review is conducted to investigate the important features impacting truck drivers while driving. The data gathering process is carried out by using GPS data, digital tachograph data and drivers' video records monitored while they are driving. Lastly, the data is evaluated in cooperation with our partners from the University of Zilina. The pilot study is conducted in Turkey, Istanbul. Firstly, the results show that ten hours of driving does not cause any serious signs of fatigue behaviour in truck drivers. Secondly, the majority of the errors are in fact due to distractions, such as phone calls or SMS messages, rather than the result of exhaustion. Future studies will focus on increasing the number of drivers and working days to explore the behaviours of drivers thoroughly. [ABSTRACT FROM AUTHOR]

A large body of research has established that cellphone use while driving (CUWD) is common and dangerous. However, little research has been conducted about how people react psychologically to various distraction-reduction strategies and, ultimately, support or do not support them. Understanding support for reduction is important for predicting use of technological solutions and compliance with laws and for improving communication and education about the risks of CUWD. We measured support for a variety of legislative, technological, and organizational strategies to reduce CUWD in an online sample of American drivers (N = 648). We also developed evidence-based communication techniques, describing strategies in terms of benefits vs. costs or using freedom-invoking vs. freedom-reducing language to assess what would influence support. Support for CUWD reduction was generally high. It was predicted by driver characteristics and beliefs. For example, drivers who supported reducing CUWD more also had lower CUWD reactance, greater anti-CUWD beliefs, higher personal risk perceptions of CUWD, and greater self-reported distracted driving. Age and perceived ability to drive distracted did not predict overall support. However, two strategies that allow for handsfree phone use were supported more by people who engaged in more CUWD, perceived they had greater ability to CUWD, perceived more benefits to CUWD, had more positive affect to cellphones, and were younger. Communication techniques also influenced support. Specifically, the same strategy was supported more when described using benefits and permissive language instead of costs and restrictive language. Most respondents supported strategies to reduce CUWD, and beliefs about risks and benefits predicted this snupport. Reactance to CUWD messaging emerged as a key predictor of lower support (and of greater self-reported distracted driving), indicating that it could be an important variable to consider when designing strategies to reduce CUWD. When targeting people resistant to quitting CUWD entirely, communicators could recommend a switch to handsfree use. Communicators who emphasize benefits and use permissive language also may increase support for CUWD reduction. [ABSTRACT FROM AUTHOR]

Background: Driving is one of the most important issues for patients with seizures. The 2009 European directive provides a framework for evaluating standard situations in assessing the ability to drive. Such a framework may not be sufficient for individual scenarios. Aims of the Study: To analyse current data on seizure recurrence risks (RcRs) focusing on their potential implications for car driving issues (group 1). Methods: We evaluated current studies and meta‐analyses on RcR. Results: A meta‐analysis of seizure‐free patients who withdrew their medication (Lamberink et al Lancet Neurology 2017;16:523) created a nomogram and a web‐based tool that allow estimating RcR in individual patients and thus to identify those in whom medication withdrawal is possible without the common driving ban during withdrawal. The 2‐year prediction model of that meta‐analysis has been recently externally tested and confirmed. A meta‐analysis of patients with a first unprovoked seizure (Bonnett et al PloS ONE 2014;9:e99063) determined to which extent RcRs depend on established risk factors. The seizure‐free period required to restart driving could be tailored according to the individual RcR. Conclusion: These current studies allow estimating individual RcR more precisely and thus modifying periods of driving bans beyond the existing guidelines. [ABSTRACT FROM AUTHOR]

Purpose: Epilepsy patients consider driving issues to be one of their most serious concerns. Ideally, decisions regarding fitness to drive should be based upon thorough evaluations by specialists in epilepsy care. In 2009, an EU directive was published aiming to harmonize evaluation practices within European countries, but, despite these recommendations, whether all epileptologists use the same criteria is unclear. We therefore conducted this study to investigate routine practices on how epileptologists at European epilepsy centers evaluate fitness to drive.Methods: A questionnaire was sent to 63 contact persons identified through the European Epi-Care and the E-pilepsy network. The questionnaire addressed how fitness-to-drive evaluations were conducted, the involvement of different professionals, the use and interpretation of EEG, and opinions on existing regulations and guidelines.Results: The questionnaire was completed by 35 participants (56 % response rate). Results showed considerable variation regarding test routines and the emphasis placed on the occurrence and extent of epileptiform discharges revealed by EEG. 82 % of the responders agreed that there was a need for more research on how to better evaluate fitness-to-drive in people with epilepsy, and 89 % agreed that regulations on fitness to drive evaluations should be internationally coordinated.Conclusion: Our survey showed considerable variations among European epileptologists regarding use of EEG and how findings of EEG pathology should be assessed in fitness-to-drive evaluations. There is a clear need for more research on this issue and international guidelines on how such evaluations should be carried out would be of value. [ABSTRACT FROM AUTHOR]

The use of cell phones while driving is ubiquitous, particularly in countries where the practice is legal. However, surveys indicate that most drivers favor legislation to limit the use of mobile devices during the operation of a vehicle. A study was conducted to understand this inconsistency between what drivers do and what they advocate for others. Participants completed a survey about their driving attitudes, abilities, and behaviors. Following previous research, drivers reported using cell phones for benefits such as getting work done. The hypocrisy of using cell phones while advocating restrictions appears to stem from differences in the perceived safety risks of self vs. others’ use of cell phones. Many if not most drivers believe they can drive safely while using mobile devices. However, they lack confidence in others’ ability to drive safely while distracted and believe that others’ use of cell phones is dangerous. The threat to public safety of others’ usage of mobile devices was one of the strongest independent predictors of support for legislation to restrict cell phone use. [ABSTRACT FROM AUTHOR]

Speeds are affected by several variables such as driver characteristics, vehicle performance, road geometrics, environmental conditions and driving regulations. It is therefore important to study the relationships between speed and such variables in order to facilitate conscious speed management on existing and planned roads, and to induce drivers to select a speed consistent with the posted limit. This relationship is of great interest to those who wish to achieve roadway functionality and improve overall road safety. A small number of studies have focused on this objective; however, few of them concern urban roads and they are limited to specific road types and recently built-up areas. These studies often refer to the 85th percentile of the speed distribution and are relevant to locations which are homogeneous in terms of geometry, environment, driving regulations and vehicle type. This paper presents results obtained from a study carried out on urban arterials and collectors characterized by dissimilar geometric features which facilitated the inclusion of a fully representative range of variables. A general model able to predict operating speed for a generic percentile was calibrated using three different strategies: (a) a simple multiple regression analysis in which the variables were selected using the Bayesian Information Criterion (BIC); (b) the analysis of covariance method including random effects on the same set of variables as in (a); and, finally, (c) the analysis of covariance method with random effects and a new selection of variables (again using BIC). The analysis shows a dramatic variation in results depending on the method selected. In particular, when random effects are considered, almost all the variables are found to be statistically significant. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: A state by year panel is analyzed to simultaneously explore the statistical correlation between state level traffic fatality rates and state level behavioral regulations regarding teen licensing, seat belt use, and driving under the influence (DUI) in a model that also controls for other correlates. Method: By including measures of all three of these policies, the estimated policy effects should not be overstated due to underspecification bias. The panel includes the 48 contiguous U.S. states for the time period from 1999 through 2003. State fatality rates are measured as fatalities per million miles traveled. Measures of state policies regarding traffic safety related behavior are based on information gathered by the Insurance Institute for Highway Safety. Estimates are calculated via a time fixed effects model that uses the double-log form to allow for interaction effects between the independent variables. Results: Least squares estimates indicate that, on average, more restrictive graduated teen licensing and DUI policies significantly reduce traffic fatality rates, while stricter seat belt enforcement policies have a statistically insignificant negative impact on fatality rates. [Copyright &y& Elsevier]

Abstract: Driving for the person with epilepsy (PWE) remains an important issue. Requirements for reporting PWE to driving authorities vary across the United States. We studied the prior experiences of PWE regarding counseling for driving in a reporting state (37% in New Jersey) and a nonreporting state (52% in Arizona). A prospective voluntary anonymous survey was conducted among patients with new-onset epilepsy at two epilepsy referral centers. Subjects were queried about prior interactions with health care professionals regarding attitudes toward and knowledge of driving regulations. Practitioners caring for PWE are in the position to provide advice and counsel regarding driving regulations. Fifty percent or fewer subjects were appropriately counseled, regardless of residence requirements. PWE felt they were honest with their physician and 10% of subjects have driven against medical advice. A performance gap exists in the appropriate counseling regarding driving for PWE that has potentially significant safety and legal implications. [ABSTRACT FROM AUTHOR]

Sleepiness accounts for approximately 20% of major highway motor vehicle accidents (MVAs) and the most common medical disorder associated with sleepiness is obstructive sleep apnea (OSA). OSA patients are 2 to 3 times more likely to have an MVA than the general population, although continuous positive airway pressure therapy can remove this excess risk. Several jurisdictions have introduced regulations to limit driving in patients with moderate or severe OSA associated with sleepiness until the disorder is effectively treated. Successful implementation of such regulations requires education regarding risk-benefit relationships of relevant stakeholders, including patients, clinicians, and employers in the transportation industry., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objective: To calculate the chance of a seizure in the next year (COSY) for seizures with impaired awareness in those experiencing auras only, those with no seizures and those with continuing seizures. Epilepsy surgery is an effective treatment for refractory focal epilepsy. Driving is an important factor affecting quality of life. In the UK, driving is not permitted if focal seizures with no impairment of awareness (auras, simple partial seizures) continue, if there is a prior history of seizures with impaired awareness, as will invariably be the case in those having epilepsy surgery. Current UK driving regulations allow driving if COSY is less than 20%., Method: We calculated COSY in 819 epilepsy surgery patients with up to 25 years follow-up. Each patient year was graded on the The International League against Epilepsy surgery outcome scale., Results: Patients who were entirely seizure-free for 1, 2 and 3 years had COSY of 4.9%, 3.5% and 2.4% respectively. Patients with only auras within the last 1, 2 or 3 years had a COSY of 11.3%, 9.2% and 7.8% respectively., Conclusions: Individuals with auras only after epilepsy surgery had a higher COSY than those who were seizure-free. If a COSY of below 20% is regarded as an acceptable risk, it may be suggested that those with auras only in a given year be allowed to drive. The relative risk of these patients causing accidents is lower than population groups such as those aged <25 or >75 years, who are permitted to drive., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)