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Fulltext The influence of spouses and their driving roles in self-regulation: A qualitative exploration of driving reduction and cessation practices amongst married older adults

Ang BH, Oxley JA, Chen WS, Yap MKK, Song KP, Lee SWH

PLoS One, 2020;15(5):e0232795.
PMID: 32413053 DOI: 10.1371/journal.pone.0232795

INTRODUCTION: There is growing evidence to suggest the importance of self-regulatory practices amongst older adults to sustain mobility. However, the decision to self-regulate driving is a complex interplay between an individual's preference and the influence of their social networks including spouse. To our best knowledge, the influence of an older adult's spouse on their decisions during driving transition has not been explored.
MATERIALS AND METHODS: This qualitative descriptive study was conducted amongst married older adults aged 60 years and above. All interview responses were transcribed verbatim and examined using thematic approach and interpretative description method.
RESULTS: A total of 11 married couples were interviewed. Three major themes emerged: [1] Our roles in driving; [2] Challenges to continue driving; and, [3] Our driving strategies to ensure continued driving. Older couples adopted driving strategies and regulated their driving patterns to ensure they continued to drive safely. Male partners often took the active driving role as the principal drivers, while the females adopted a more passive role, including being the passenger to accompany the principal drivers or becoming the co-driver to help in navigation. Other coping strategies include sharing the driving duties as well as using public transportation or mixed mode transportation.
DISCUSSION: Our findings suggest spouse play a significant role in their partners' decision to self-regulate driving. This underscores a need to recognise the importance of interdependency amongst couples and its impact on their driving decisions and outcomes.

Matched MeSH terms: Automobile Driving/psychology*
Lower back pain and its association with whole-body vibration and manual materials handling among commercial drivers in Sabah

Awang Lukman K, Jeffree MS, Rampal KG

Int J Occup Saf Ergon, 2019 Mar;25(1):8-16.
PMID: 28978270 DOI: 10.1080/10803548.2017.1388571

A cross-sectional study was undertaken to determine the prevalence of lower back pain (LBP) and its association with whole-body vibration (WBV) and manual materials handling (MMH). We studied 110 commercial vehicle drivers using a self-administered questionnaire and the VI-400Pro human vibration monitor. Prevalence of LBP was 66.4%. The percentage of drivers who had frequent manual handling of heavy loads was 45.5% and those who handled heavy loads in awkward postures accounted for 86.4%. Daily vibration A(8) averaged on the z axis was 0.25 (0.06) m·s-2 and at vector sum was 0.29 (0.07) m·s-2. Daily vibration exposures on the z axis, frequent manual handling of heavy loads and awkward posture during MMH were significantly associated with LBP. Drivers who are exposed to WBV and frequently handle heavy loads manually and with awkward postures probably have more LBP than drivers who are exposed to only one of these risk factors.

Matched MeSH terms: Automobile Driving*
Effects of vibration on occupant driving performance under simulated driving conditions

Azizan A, Fard M, Azari MF, Jazar R

Appl Ergon, 2017 Apr;60:348-355.
PMID: 28166895 DOI: 10.1016/j.apergo.2016.12.020

Although much research has been devoted to the characterization of the effects of whole-body vibration on seated occupants' comfort, drowsiness induced by vibration has received less attention to date. There are also little validated measurement methods available to quantify whole body vibration-induced drowsiness. Here, the effects of vibration on drowsiness were investigated. Twenty male volunteers were recruited for this experiment. Drowsiness was measured in a driving simulator, before and after 30-min exposure to vibration. Gaussian random vibration, with 1-15 Hz frequency bandwidth was used for excitation. During the driving session, volunteers were required to obey the speed limit of 100 kph and maintain a steady position on the left-hand lane. A deviation in lane position, steering angle variability, and speed deviation were recorded and analysed. Alternatively, volunteers rated their subjective drowsiness by Karolinska Sleepiness Scale (KSS) scores every 5-min. Following 30-min of exposure to vibration, a significant increase of lane deviation, steering angle variability, and KSS scores were observed in all volunteers suggesting the adverse effects of vibration on human alertness level.

Matched MeSH terms: Automobile Driving*
Characteristics of persons with spinal cord injury who drive in Malaysia and its barriers: a cross sectional study

Lee RCH, Hasnan N, Engkasan JP

Spinal Cord, 2018 04;56(4):341-346.
PMID: 29288252 DOI: 10.1038/s41393-017-0034-2

STUDY DESIGN: Cross sectional study.

OBJECTIVES: To determine the prevalence, characteristics of and barriers to driving among persons with a spinal cord injury (SCI).

SETTING: SCI Rehabilitation Clinic, University Malaya Medical Centre (UMMC).

METHODS: This is a questionnaire-based study on persons with SCI who attended the UMMC SCI Rehabilitation Clinic between June 2015 and November 2016. The questionnaire comprised demographic data, clinical characteristics, driving variables, Spinal Cord Independence Measure III, WHOQOL-BREF, and Craig Handicap Assessment and Reporting Technique Short Form. Malaysians aged greater than 18 years old with any etiology and levels of SCI, had no other physical disabilities and not suffering from progressive illness were recruited. A single investigator administered the questionnaire via face-to-face interviews.

RESULTS: A total of 160 participants were included in this study. Overall, 37% of persons with SCI drove and owned a modified vehicle. Almost half of persons with paraplegia (47%) drove, but only 12% of tetraplegia did. A majority (93%) of those who drove aged below 60 years, and had higher level of independence in activity of daily living. More drivers (81%) compared to non-drivers (24%) were employed; drivers also reported better community reintegration and quality of life. Three commonest barriers to driving included medical reasons (38%), fear and lack of confidence (17%), and inability to afford vehicle modifications (13%).

CONCLUSIONS: The percentage of persons with SCI driving post injury is low. Based on the findings of this study, more efforts are needed to motivate and facilitate persons with SCI to drive.

Study site: SCI Rehabilitation Clinic, University Malaya Medical Centre (UMMC)

Matched MeSH terms: Automobile Driving/psychology; Automobile Driving/statistics & numerical data*
Fulltext Examination Standards for Disabled Driver's Licensing

Citation: Examination Standards for Disabled Driver's Licensing. Putrajaya: Occupational Health Unit, Disease Control Division, Ministry of Health Malaysia; 2011

Matched MeSH terms: Automobile Driving
Fulltext Colour vision deficiency among failed candidates for driving license in Sabah. [Abstract]

Azmi N, Yahya AN, Gilong HCS, Anne SJ, Ting RHY, Amil Bangsa NH, et al.

Borneo Journal of Medical Sciences, 2020;3(101):11-12.
MyJurnal

Introduction: Good visual acuity (VA) coupled with the ability to discriminate colours and having a sufficiently wide field of view are factors needed for safe driving. This study aimed to determine the types of colour vision deficiency (CVD) among failed candidates for driving license and to identify the accuracy of the Road transport Department (RTD) screening tests in detecting those who have poor VA and CVD in Sabah.
Methods: A cross-sectional study on the patient’s records of all failed candidates for the driving license that were referred for further assessment by an optometrist. This study was conducted at eight hospitals in Sabah from March to June 2019. Basic demographic data, distance VA, Ishihara test and Farnsworth-Munsell D15 test were collected. Descriptive statistics were used to summarise the results. All subjects referred with best-corrected visual acuity (BCVA) 0.3 LogMAR were included.
Results: A total of 73 subjects (79% males and 21% females), age range from 16 to 61 years (mean 29±13 years) were recruited. Bajau, Dusun, Bugis and Kadazan were the major ethnic among the subjects. Mean VA on attendance was 0.1 ± 0.19 LogMAR, while BCVA was 0.0 ± 0.07 LogMAR. Thirty-six subjects (49%) were found to have CVD. The prevalence of CVD was more in males than females (45% vs 4%). Most of the CVD were deutans (25%) followed by protans (22%), no findings of tritan CVD In this study, 37 subjects (51%) passed the Ishihara test. These were the false-positive error of the RTD screening tests.
Conclusions: Hereditary red-green perceptive disorder was the commonest CVD in Sabah. The severity of CVD was not been evaluated in this study because it is best evaluated using Hardy Rand and Rittler (HRR) test. The false-positive results might be because of technical error or unfamiliar of using computerized colour vision test, especially among elderly candidates. Visual field screening might be considered in the future to ensure safe driving.
Keywords:visual acuity (VA), colour vision deficiency (CVD), driving license
NMRR Research ID: NMRR-19-1785-48811

Matched MeSH terms: Automobile Driving
Fulltext Visual problems of new malaysian drivers

Haliza A, Md Muziman Syah M, Norliza M

Malays Fam Physician, 2010;5(2):95-8.
PMID: 25606195 MyJurnal

PURPOSE: The objective of this study was to determine the prevalence of poor visual acuity, colour blindness and visual field defect of new Malaysian drivers.

METHODS: A total of 3717 new drivers (50.2% males and 49.8% females) age 19±6 years, voluntarily participated in this study. Standard optometric apparatus such as LogMAR Charts, Ishihara plates and HandHeld Bernell Perimeter were used and standard procedures were applied.

RESULTS: The visual examination showed 6.7% (n=250) of subjects achieved less than 0.3 LogMAR with better eye whilst 2.2% (n=83) had failed the Ishihara Test (2.1% males and 0.1% females). Most of the affected drivers were deutranopia. Only 2094 subjects had their visual field using a mobile Handheld Bernell Perimeter. 1.72% (n=36) subjects have less than 120 degrees of peripheral field of vision.

CONCLUSIONS: The visual status among new Malaysian drivers needs to be taken seriously to ensure safe driving. Other factors such as colour vision and visual field screening have to be considered seriously when evaluating the visual performance of a driver. Good visual performance is indispensible for safe driving.

Matched MeSH terms: Automobile Driving
Modeling of passengers' safety perception for buses on mountainous roads

Khoo HL, Ahmed M

Accid Anal Prev, 2018 Apr;113:106-116.
PMID: 29407657 DOI: 10.1016/j.aap.2018.01.025

This study had developed a passenger safety perception model specifically for buses taking into consideration the various factors, namely driver characteristics, environmental conditions, and bus characteristics using Bayesian Network. The behaviour of bus driver is observed through the bus motion profile, measured in longitudinal, lateral, and vertical accelerations. The road geometry is recorded using GPS and is computed with the aid of the Google map while the perceived bus safety is rated by the passengers in the bus in real time. A total of 13 variables were derived and used in the model development. The developed Bayesian Network model shows that the type of bus and the experience of the driver on the investigated route could have an influence on passenger's perception of their safety on buses. Road geometry is an indirect influencing factor through the driver's behavior. The findings of this model are useful for the authorities to structure an effective strategy to improve the level of perceived bus safety. A high level of bus safety will definitely boost passenger usage confidence which will subsequently increase ridership.

Matched MeSH terms: Automobile Driving
Drowsiness detection during different times of day using multiple features

Sahayadhas A, Sundaraj K, Murugappan M

Australas Phys Eng Sci Med, 2013 Jun;36(2):243-50.
PMID: 23719977 DOI: 10.1007/s13246-013-0200-6

Driver drowsiness has been one of the major causes of road accidents that lead to severe trauma, such as physical injury, death, and economic loss, which highlights the need to develop a system that can alert drivers of their drowsy state prior to accidents. Researchers have therefore attempted to develop systems that can determine driver drowsiness using the following four measures: (1) subjective ratings from drivers, (2) vehicle-based measures, (3) behavioral measures and (4) physiological measures. In this study, we analyzed the various factors that contribute towards drowsiness. A total of 15 male subjects were asked to drive for 2 h at three different times of the day (00:00-02:00, 03:00-05:00 and 15:00-17:00 h) when the circadian rhythm is low. The less intrusive physiological signal measurements, ECG and EMG, are analyzed during this driving task. Statistically significant differences in the features of ECG and sEMG signals were observed between the alert and drowsy states of the drivers during different times of day. In the future, these physiological measures can be fused with vision-based measures for the development of an efficient drowsiness detection system.

Matched MeSH terms: Automobile Driving*
Factors related to seatbelt-wearing among rear-seat passengers in Malaysia

Ng CP, Law TH, Wong SV, Kulanthayan S

Accid Anal Prev, 2013 Jan;50:351-60.
PMID: 22633252 DOI: 10.1016/j.aap.2012.05.004

The benefit of wearing a rear seatbelt in reducing the risk of motor vehicle crash-related fatalities and injuries has been well documented in previous studies. Wearing a seatbelt not only reduces the risk of injury to rear-seat passengers, but also reduces the risk of injury to front-seat occupant who could be crushed by unbelted rear-seat passengers in a motor vehicle crash. Despite the benefits of wearing a rear seatbelt, its rate of use in Malaysia is generally low. The objective of this study was to identify factors that are associated with the wearing of a seatbelt among rear-seat passengers in Malaysia. Multinomial logistic regression analysis of the results of a questionnaire survey of 1651 rear-seat passengers revealed that rear-seat passengers who were younger, male, single and less educated and who had a perception of a low level of legislation enforcement, a lower risk-aversion and less driving experience (only for passengers who are also drivers) were less likely to wear a rear seatbelt. There was also a significant positive correlation between driver seatbelt and rear seatbelt-wearing behaviour. This implies that, in regards to seatbelt-wearing behaviour, drivers are more likely to adopt the same seatbelt-wearing behaviour when travelling as rear-seat passengers as they do when driving. These findings are crucial to the development of new interventions to increase the compliance rate of wearing a rear seatbelt.

Matched MeSH terms: Automobile Driving/statistics & numerical data*
Fatigue-related crashes involving express buses in Malaysia: will the proposed policy of banning the early-hour operation reduce fatigue-related crashes and benefit overall road safety?

Mohamed N, Mohd-Yusoff MF, Othman I, Zulkipli ZH, Osman MR, Voon WS

Accid Anal Prev, 2012 Mar;45 Suppl:45-9.
PMID: 22239931 DOI: 10.1016/j.aap.2011.09.025

Fatigue-related crashes have long been the topic of discussion and study worldwide. The relationship between fatigue-related crashes and time of day is well documented. In Malaysia, the possibility of banning express buses from operating during the early-hours of the morning has emerged as an important consideration for passenger safety. This paper highlights the findings of an impact assessment study. The study was conducted to determine all possible impacts prior to the government making any decision on the proposed banning. This study is an example of a simple and inexpensive approach that may influence future policy-making process. The impact assessment comprised two major steps. The first step involved profiling existing operation scenarios, gathering information on crashes involving public express buses and stakeholders' views. The second step involved a qualitative impact assessment analysis using all information gathered during the profiling stage to describe the possible impacts. Based on the assessment, the move to ban early-hour operations could possibly result in further negative impacts on the overall road safety agenda. These negative impacts may occur if the fundamental issues, such as driving and working hours, and the need for rest and sleep facilities for drivers, are not addressed. In addition, a safer and more accessible public transportation system as an alternative for those who choose to travel at night would be required. The proposed banning of early-hour operations is also not a feasible solution for sustainability of express bus operations in Malaysia, especially for those operating long journeys. The paper concludes by highlighting the need to design a more holistic approach for preventing fatigue-related crashes involving express buses in Malaysia.

Matched MeSH terms: Automobile Driving/legislation & jurisprudence*
Fulltext Low back pain and association with whole body vibration among military armoured vehicle drivers in Malaysia

Rozali A, Rampal KG, Shamsul Bahri MT, Mohd Sidik S, Shamsul Azhar S, Khairuddin H, et al.

Med J Malaysia, 2009 Sep;64(3):197-204.
PMID: 20527267 MyJurnal

A cross sectional study was conducted among military armoured vehicle drivers in the two largest mechanized battalions with the objective to determine the prevalence of low back pain (LBP), and its association with whole body vibration (WBV) and other associated factors. A self-administered questionnaire and Human Vibration Meter were used in this study. A total of 159 respondents participated in this study and 102 (64.2%) of them were subjected to WBV measurement. One-hundred-and-seventeen respondents complained of LBP for the past 12 months giving a prevalence of 73.6%. The prevalence of LBP among tracked armoured vehicle drivers was higher (81.7%) as compared to wheeled armoured vehicle drivers (67.0%). The mean acceleration at Z-axis in tracked armoured vehicles (1.09 +/- 0.26 ms(-2)) and wheeled armoured vehicles (0.33 +/- 0.07 ms) were the dominant vibration directions. The mean estimated vibration dose value (eVDV) for eight-hour daily exposure at Z-axis (19.86 +/- 4.72 ms(-1.75)) in tracked armoured vehicles showed the highest estimation. Based on the European Vibration Directive (2002), the mean eVDV at Z-axis in tracked armoured vehicles exceeded exposure action value (EAV) (> 9.1 ms(-1.75), but did not exceed exposure limit value (ELV) (<21.0 ms(-1.75)). Logistic regression analysis revealed that only driving in forward bending sitting posture (OR = 3.63, 95% CI 1.06-12.42) and WBV exposure at X-axis (OR = 1.94, 95% CI 1.02-3.69) were significant risk factors to LBP. Preventive measures should be implemented to minimize risk of WBV and to improve ergonomic postures among drivers.

Matched MeSH terms: Automobile Driving*
Fulltext New regression model for predicting hand-arm vibration (HAV) of Malaysian Army (MA) three-tonne truck steering wheels

Aziz SA, Nuawi MZ, Nor MJ

J Occup Health, 2015;57(6):513-20.
PMID: 26269278 DOI: 10.1539/joh.14-0206-OA

OBJECTIVE: The objective of this study was to present a new method for determination of hand-arm vibration (HAV) in Malaysian Army (MA) three-tonne truck steering wheels based on changes in vehicle speed using regression model and the statistical analysis method known as Integrated Kurtosis-Based Algorithm for Z-Notch Filter Technique Vibro (I-kaz Vibro).
METHODOLOGY: The test was conducted for two different road conditions, tarmac and dirt roads. HAV exposure was measured using a Brüel & Kjær Type 3649 vibration analyzer, which is capable of recording HAV exposures from steering wheels. The data was analyzed using I-kaz Vibro to determine the HAV values in relation to varying speeds of a truck and to determine the degree of data scattering for HAV data signals.
RESULTS: Based on the results obtained, HAV experienced by drivers can be determined using the daily vibration exposure A(8), I-kaz Vibro coefficient (Ƶ(v)(∞)), and the I-kaz Vibro display. The I-kaz Vibro displays also showed greater scatterings, indicating that the values of Ƶ(v)(∞) and A(8) were increasing. Prediction of HAV exposure was done using the developed regression model and graphical representations of Ƶ(v)(∞). The results of the regression model showed that Ƶ(v)(∞) increased when the vehicle speed and HAV exposure increased.
DISCUSSION: For model validation, predicted and measured noise exposures were compared, and high coefficient of correlation (R(2)) values were obtained, indicating that good agreement was obtained between them. By using the developed regression model, we can easily predict HAV exposure from steering wheels for HAV exposure monitoring.

Matched MeSH terms: Automobile Driving/standards*
Exploring the economics of motorcycle helmet laws--implications for low and middle-income countries

Hyder AA, Waters H, Phillips T, Rehwinkel J

Asia Pac J Public Health, 2007;19(2):16-22.
PMID: 18050559

This paper reviews economic evaluations of motorcycle helmet interventions in preventing injuries. A comprehensive literature review focusing on the effectiveness of motorcycle helmet use, and on mandatory helmet laws and their enforcement was done. When helmet laws were lifted between 1976-80, 48 states within the U.S.A. experienced a cost of $342,047 per excess fatality of annual net savings. Helmet laws in the USA had a benefit-cost ratio of 1.33 to 5.07. Taiwan witnessed a 14% decline in motorcycle fatalities and a 22% reduction of head injury fatalities with the introduction of a helmet law. In Thailand, where 70-90% of all crashes involve motorcycle, after enforcement of a helmet law, helmet-use increased five-fold, the number of injured motorcyclists decreased by 33.5%, head injuries decreased by 41.4%, and deaths decreased by 20.8%. There is considerable evidence that mandatory helmet laws with enforcement alleviate the burden of traffic injuries greatly. For low and middle-income countries with high rates of motorcycle injuries, enforced, mandatory motorcycle helmet laws are potentially one of the most cost-effective interventions available.

Matched MeSH terms: Automobile Driving/legislation & jurisprudence*
Obstructive sleep apnea among express bus drivers in Malaysia: important indicators for screening

Yusoff MF, Baki MM, Mohamed N, Mohamed AS, Yunus MR, Ami M, et al.

Traffic Inj Prev, 2010 Dec;11(6):594-9.
PMID: 21128189 DOI: 10.1080/15389588.2010.505255

Obstructive sleep apnea (OSA) has been identified as one of the significant risk factors for motor vehicle crashes (MVCs). In the interest of public safety, this study was conducted to determine the prevalence of OSA and its associated factors among express bus drivers in Malaysia. Identifying factors or conditions related with OSA is very important because they can be used as indicators to subject a person to a confirmatory diagnosis using polysomnography testing.

Matched MeSH terms: Automobile Driving*
Application of theory-based evaluation for the critical analysis of national biofuel policy: A case study in Malaysia

Abdul-Manan AF, Baharuddin A, Chang LW

Eval Program Plann, 2015 Oct;52:39-49.
PMID: 25898073 DOI: 10.1016/j.evalprogplan.2015.03.007

Theory-based evaluation (TBE) is an effectiveness assessment technique that critically analyses the theory underlying an intervention. Whilst its use has been widely reported in the area of social programmes, it is less applied in the field of energy and climate change policy evaluations. This paper reports a recent study that has evaluated the effectiveness of the national biofuel policy (NBP) for the transport sector in Malaysia by adapting a TBE approach. Three evaluation criteria were derived from the official goals of the NBP, those are (i) improve sustainability and environmental friendliness, (ii) reduce fossil fuel dependency, and (iii) enhance stakeholders' welfare. The policy theory underlying the NBP has been reconstructed through critical examination of the policy and regulatory documents followed by a rigorous appraisal of the causal link within the policy theory through the application of scientific knowledge. This study has identified several weaknesses in the policy framework that may engender the policy to be ineffective. Experiences with the use of a TBE approach for policy evaluations are also shared in this report.

Matched MeSH terms: Automobile Driving/statistics & numerical data
Truck driver fatigue risk assessment and management: a multinational survey

Adams-Guppy J, Guppy A

Ergonomics, 2003 Jun 20;46(8):763-79.
PMID: 12745978 DOI: 10.1080/0014013021000056980

As part of an organizational review of safety, interviews and questionnaire surveys were performed on over 700 commercial goods drivers and their managers within a series of related companies operating across 17 countries. The results examine the reported incidence of fatigue-related problems in drivers and their associations with near miss and accident experience as well as work and organizational factors. Experience of fatigue problems while driving was linked to time of day and rotation of shifts, though most associations were small. There were significant associations found between fatigue experiences and driver and management systems of break taking and route scheduling. The quantitative combined with qualitative information suggested that, where feasible, more flexible approaches to managing the scheduling and sequencing of deliveries assisted drivers in managing their own fatigue problems through appropriate break-taking. The results are interpreted within the overarching principles of risk assessment and risk control.

Matched MeSH terms: Automobile Driving/statistics & numerical data*

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