Skip to main content
Log in

Human factors in the causation of road traffic crashes

  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

Road traffic crashes (RTCs) are responsible for a substantial fraction of morbidity and mortality and are responsible for more years of life lost than most of human diseases. In this review, we have tried to delineate behavioral factors that collectively represent the principal cause of three out of five RTCs and contribute to the causation of most of the remaining. Although sharp distinctions are not always possible, a classification of behavioral factors is both necessary and feasible. Thus, behavioral factors can be distinguished as (i) those that reduce capability on a long-term basis (inexperience, aging, disease and disability, alcoholism, drug abuse), (ii) those that reduce capability on a short-term basis (drowsiness, fatigue, acute alcohol intoxication, short term drug effects, binge eating, acute psychological stress, temporary distraction), (iii) those that promote risk taking behavior with long-term impact (overestimation of capabilities, macho attitude, habitual speeding, habitual disregard of traffic regulations, indecent driving behavior, non-use of seat belt or helmet, inappropriate sitting while driving, accident proneness) and (iv) those that promote risk taking behavior with short-term impact (moderate ethanol intake, psychotropic drugs, motor vehicle crime, suicidal behavior, compulsive acts). The classification aims to assist in the conceptualization of the problem that may also contribute to behavior modification-based efforts.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. MacMahon B, Trichopoulos D. Epidemiology: Principles and Methods. 2nd edn. Boston: Little Brown and Co., 1996; 1–18.

    Google Scholar 

  2. Evans L. The dominant role of driver behavior in trafic safety. Am J Public Health 1996; 86: 784–786.

    Google Scholar 

  3. Williams AS, O'Neill B. On the road driving records of licensed race drivers. Acc Anal Prev 1974; 72: 260–272.

    Google Scholar 

  4. Shinar D. Psychology on the Road. The Human Factor in Trafic Safety. USA: John Wiley & Sons, 1978, 29–40.

    Google Scholar 

  5. Rosenberg ML, Martinez R. Graduated Licensure: A win-win proposition for teen drivers and parents. Pediatrics 1996; 98: 959.

    Google Scholar 

  6. Gregersen NP. Systematic cooperation between driving schools and parents in driver education, an experiment. Acc Anal Prev 1994; 26: 453–461.

    Google Scholar 

  7. Morgan R, King D. The older driver-a review. Postgraduate Med J 1995; 71: 525–528.

    Google Scholar 

  8. Lerner N. Giving the older driver enough perception-reaction time. Exper Aging Res 1994; 20: 25–33.

    Google Scholar 

  9. Kline DW. Optimizing the visibility of displays for older observers. Exper Aging Res 1994; 20: 11–23.

    Google Scholar 

  10. Lambert LD, Fleury M. Age, cognitive style, and trafic signs. Percep & Motor Skills 1994; 78: 611–624.

    Google Scholar 

  11. Johansson K, Bronge L, Lundberg C, Persson A, Seideman M, Viitanen M. Can a physician recognize an older driver with increased crash risk potential? J Am Geriat Soc 1996; 44: 1198–1204.

    Google Scholar 

  12. Morris DE. Medical aspects of fitness to drive. Unfit patients are a common and dificult problem. Br Med J 1995; 311: 1162.

    Google Scholar 

  13. McLellan BA, Vingilis E, Larkin E, Stoduto G, Macartney-Filgate M, Sharkey PW. Psychosocial characteristics and follow-up of drinking and non-drinking drivers in motor vehicle crashes. J Trauma 1993; 35: 245–250.

    Google Scholar 

  14. Tsahageas C. Prevention of morbidity from road trafic accidents in Greece and in other European Countries. Professional Thesis. Athens, 1984, pp. 140.

  15. Petridou E, Kouri N, Trichopoulos D, Revinthi K, Skalkidis Y, Tong J. Socioeconomic and family factors for school injuries. Epidemiol Commun Health 1994; 48: 490–491.

    Google Scholar 

  16. Simon F, Corbett C. Road trafic ofiending, stress, age, and accident history among male and female drivers. Ergonomics 1996; 39: 757–780.

    Google Scholar 

  17. Alvarez FJ, Del Rio MC. Drugs and driving. Lancet 1994; 344: 282.

    Google Scholar 

  18. Anonymous. Drivers with repeat convictions or arrests for driving while impaired-United States. MMWR 1994; 43: 759–761.

  19. Lex BW, Goldberg ME, Mendelson JH, Lawler NS, Bower T. Components of antisocial personality disorder among women convicted for drunken driving. Ann New York Acad Sci 1994; 708: 49–58.

    Google Scholar 

  20. Buntain-Ricklefs JJ, Rivara FP, Donovan DM, Salzberg PM, Polissar NL. Difierentiating “bad drivers” with and without a DWI. J Studies Alcohol 1995; 56: 356–360.

    Google Scholar 

  21. Del Rio MD, Javier Alvarez J. Illegal drug taking and driving: Patterns of drug taking among Spanish drivers. Drug Alcohol Dependence 1995; 37: 83–86.

    Google Scholar 

  22. Soderstrom CA, Dischinger PC, Kerns TJ, Trifillis AL. Marijuana and other drug use among automobile and motorcycle drivers treated at a trauma center. Acc Anal Prev 1995; 27: 131–135.

    Google Scholar 

  23. Hingson R, Heeren T, Winter M. Lowering state legal blood alcohol limits to 0.08%: The efiect on fatal motor vehicle crashes. Am J Public Health 1996; 86: 1297–1299.

    Google Scholar 

  24. Kennedy BP, Isaac NE, Graham JD. The role of heavy drinking in the risk of trafic fatalities. Risk Anal 1996; 16: 565–569.

    Google Scholar 

  25. Ross HL, Simon S, Cleary J. License plate confiscation for persistent alcohol impaired drivers. Acc Anal Prev 1996; 28: 53–61.

    Google Scholar 

  26. Maycock G. Sleepiness and driving: The experience of U.K. car drivers. Acc Anal Prev 1997; 29: 453–462.

    Google Scholar 

  27. Brewer RD, Morris PD, Cole T, Watkins S, Patetta MJ, Popkin C. The risk of dying in alcohol related automobile crashes among habitual drunk drivers. N Engl J Med 1994; 331: 513–517.

    Google Scholar 

  28. Pack A. Drowsy driving and trafic safety. In: Building Bridges. Between Trafic Safety and Public Health. Education Development Center Inc, MA. 1997, III(3): 2–3.

    Google Scholar 

  29. Horne JA, Reyner LA. Sleep related vehicle accidents. Br Med J 1995; 310: 565–567.

    Google Scholar 

  30. Corfitsen MT. Enhanced tiredness among young impaired male nighttime drivers. Acc Anal Prev 1996; 28: 155–162.

    Google Scholar 

  31. Hanning CD, Welsh M. Sleepiness, snoring and driving habits. J Sleep Res 1996; 5: 51–54.

    Google Scholar 

  32. Maclure M. The case-crossover design: A method for studying transient efiects on the risk of acute events. Am J Epidemiol 1991; 133: 144–153.

    Google Scholar 

  33. Brown ID. Driver fatigue. Human Factors 1994; 36: 298–314.

    Google Scholar 

  34. Lamberg L. Wake-up call aimed at drowsy drivers: Message is “drive alert, arrive alive”. JAMA 1996; 276: 1209–1210.

    Google Scholar 

  35. Vogel Sprott M, Sdao Jarvie K. Learning alcohol tolerance: The contribution of response expectancies. Psychopharmocol 1989; 98: 289–296.

    Google Scholar 

  36. Howat P, Sleet D, Smith I. Alcohol and driving; is the 0.05% blood alcohol concentration limit justified? Drug Alcohol Rev 1991; 10: 151–166.

    Google Scholar 

  37. Guppy A, Adams-Guppy JR. Behavior and perceptions related to drink-driving among an international sample of company vehicle drivers. J Studies Alcohol 1995; 56: 348–355.

    Google Scholar 

  38. Hingson R, McGoven T, Howland J, Heeren T, Winter M, Zakocs R. Reducing alcohol-impaired driving in Massachusetts: The saving lives program. Am J Public Health 1996; 86: 791–797.

    Google Scholar 

  39. Alvarez FJ, Del Rio MC, Prada R. Drinking and driving in Spain. J Studies Alcohol 1995; 56: 403–407.

    Google Scholar 

  40. Finnigan F, Hammersley R, Millar K. The efiects of expectancy and alcohol on cognitive-motor performance. Addiction 1995; 90: 661–672.

    Google Scholar 

  41. MacDonald TK, Zanna MP, Fong GT. Decision making in altered states: Efiects of alcohol on attitudes toward drinking and driving. J Personal Social Psychol 1995; 68: 973–985.

    Google Scholar 

  42. Shinar D. Drinking and driving of pub patrons in Israel. Acc Anal Prev 1995; 27: 65–71.

    Google Scholar 

  43. Gruenewald PJ, Millar AB, Treno AJ, Yang Z, Ponicki WR, Roeper P. The geography of availability and driving after drinking. Addiction 1996; 91: 967–983.

    Google Scholar 

  44. Winsten JA. Promoting designated drivers: The Harvard Alcohol Project. Am J Prev Med 1994; 10S: 11–14.

    Google Scholar 

  45. Beirness DJ, Simpson HM, Mayhew DR, Wilson RJ. Trends in drinking driver fatalities in Canada. Canad J Public Health 1994; 85: 19–22.

    Google Scholar 

  46. Ranney TA. Models of driving behavior: A review of their evolution. Acc Anal Prev 1994; 26: 733–750.

    Google Scholar 

  47. Becker K. The consequenses of drunken driving in South Africa. Med Law 1994; 13: 11–17.

    Google Scholar 

  48. Brewer RD, Sleet D. Alcohol and Injuries. Time for action. Arch Fam Med 1995; 4: 499–501.

    Google Scholar 

  49. Skurtveit S, Christophersen AS, Morland J. Female drivers suspected for drunken or drugged driving. Forensic Sci Int 1995; 75: 139–148.

    Google Scholar 

  50. Middleman AB, Faulkner AH, Woods ER, Emans SJ, DuRant RH. High-risk behaviors among risk school students in Massachusetts who use anabolic steroids. Pediatrics 1995; 96: 268–272.

    Google Scholar 

  51. Logan BK. Methamphetamine and driving impairment. J Forensic Sci 1996; 41: 457–464.

    Google Scholar 

  52. MacDonald S, Dooley S. A case-control study of driving-while-impaired ofienders. Drug Alcohol Depend 1993; 33: 61–71.

    Google Scholar 

  53. Marquet P, Delpha PA, Kerguelen S, et al. Prevalence of drugs of abuse in urine of drivers involved in road accidents in France: A collaborative study. J Forensic Sci 1998; 43: 806–811.

    Google Scholar 

  54. Brookofi D, Cook CS, Williams C, Mann CS. Testing reckless drivers for cocaine and marijuana. N Engl J Med 1994; 331: 518–522.

    Google Scholar 

  55. Stacy AW, Bentler PM, Flay BR. Attitudes and health behavior in diverse populations: Drunk driving. Alcohol use, binge eating, marijuana use, and cigarette use. Health Psychol 1994; 13: 73–85.

    Google Scholar 

  56. Escobedo LG, Chorba TL, Waxweiler R. Patterns of alcohol use and the risk of drinking and driving among US high school students. Am J Public Health 1995; 85: 976–978.

    Google Scholar 

  57. Ranney PM. Testing reckless drivers for substance abuse. N Engl J Med 1995; 332: 892–893.

    Google Scholar 

  58. Augsburger M, Rivier L. Drugs and alcohol among suspected impaired drivers in Canton de Vaud (Switzerland). Forensic Sci Int 1997; 85: 95–104.

    Google Scholar 

  59. Robertson MD, Drummer OH. Responsibility analysis: A methodology to study the efiects of drugs in driving. Acc Anal Prev 1994; 26: 243–247.

    Google Scholar 

  60. Trichopoulos D, Katsouyanni K, Zavitsanos X, Tzonou A, Dalla-Vorgia P. Psychological stress and fatal heart attach: The Athens (1981) earthquake natural experiment. Lancet 1983; 1: 441–444.

    Google Scholar 

  61. Engel GL. Sudden and rapid death during psychological stress. Folklore or folk wisdom? Ann Intern Med 1971; 74: 771–782.

    Google Scholar 

  62. McMurray L. Emotional stress and driving performance: The efiects of divorce. Behav Res Highway Safety 1970; 1: 100–114.

    Google Scholar 

  63. Alm H, Nilsson L. Changes in driver behaviour as a function of handsfree mobile phones-a simulator study. Acc Anal Prev 1994; 26: 441–451.

    Google Scholar 

  64. Shua-Haim JR, Gross JS. The “co-pilot” driver syndrome. J Am Geriat Soc 1996; 44: 815–817.

    Google Scholar 

  65. Maclure M, Mittleman MA. Cautions about car telephones and collisions. N Engl J Med 1997; 336: 501–502.

    Google Scholar 

  66. Redelmeier DA, Tibshirani RJ. Association between cellular-telephone calls and motor vehicle collisions. N Engl J Med 1997; 336: 453–458.

    Google Scholar 

  67. Violanti JM, Marshall JR. Cellular phones and trafic accidents: An epidemiological approach. Acc Anal Prev 1996; 28: 265–270.

    Google Scholar 

  68. Agostinelli G, Miller WR. Drinking and thinking: How does personal drinking afiect judgments of prevalence and risk? J Studies Alcohol 1994; 55: 327–337.

    Google Scholar 

  69. Brindis C, Wolfe AL, McCarter V, Ball S, Starbuck-Morales S. The association between immigrant status and risk-behavior patterns in Latino adolescents. J Adolescent Health 1995; 17: 99–105.

    Google Scholar 

  70. Petridou E, Zavitsanos X, Dessypris N, Mandyla M, Doxiadis S, Trichopoulos D. Adolescents in high risk trajectory: Clustering of risky behavior and the origins of socioeconomic health difierentials. Prev Med 1997; 26: 215–219.

    Google Scholar 

  71. Parker D, West R, Stradling S, Manstead AS. Behavioral characteristics and involvement in difierent types of trafic accident. Acc Anal Prev 1995; 27: 571–581.

    Google Scholar 

  72. Redeker NS, Smeltzer SC, Kirkpatrick J, Parchment S. Risk factors of adolescent and young adult trauma victims. Am J Critical Care 1995; 4: 370–378.

    Google Scholar 

  73. Rajalin S. The connection between risky driving and involvement in fatal accidents. Acc Anal Prev 1994; 26: 555–562.

    Google Scholar 

  74. Anonymous. Risky driving behaviors among teenagers-Gwinnett County, Georgia, 1993. MMWR 1994; 43: 405–409.

  75. Assum T. Attitudes and road accident risk Institute of Transport Economics, Oslo, Norway. Acc Anal Prev 1997; 29: 153–159.

    Google Scholar 

  76. Gregersen NP. Young drivers' overestimation of their own skill-an experiment on the relation between training strategy and skill. Acc Anal Prev 1996; 28: 243–250.

    Google Scholar 

  77. Moore VM, Dolinis J, Woodward AJ. Vehicle speed and risk of a severe crash. Epidemiology 1995; 6: 258–262.

    Google Scholar 

  78. Adams-Guppy JR, Guppy A. Speeding in relation to perceptions of risk, utility and driving style by British company car drivers. Ergonomics 1995; 38: 2525–2535.

    Google Scholar 

  79. Lajunen T, Karola J, Summala H. Speed and acceleration as measures of driving style in young male drivers. Percept mot Skills 1997; 85: 3–16.

    Google Scholar 

  80. Hemenway D, Solnick SJ. Fuzzy dice, dream cars, and indecent gestures: Correlates of driver behavior? Acc Anal Prev 1993; 25: 161–170.

    Google Scholar 

  81. Blockey PN, Hartley LR. Aberrant driving behaviour: Errors and violations. Ergonomics 1995; 38: 1759–1771.

    Google Scholar 

  82. Delk EW, Meilman PW. Alcohol use among college students in Scotland compared with norms from the United States. J Am College Health 1996; 44: 274–281.

    Google Scholar 

  83. Peck RC. Comment on Hemenway's and Solnick's “Fuzzy dice, dream cars, and indecent gestures: correlates of driver behavior?”. Acc Anal Prev 1994; 26: 127–129.

    Google Scholar 

  84. Evans L. Restraint efiectiveness, occupant ejection from cars, and fatality reductions. Accid Anal Prev 1990; 22: 167–175.

    Google Scholar 

  85. Evans L. Motorized two point safety belt efiectiveness in preventing fatalities. Acc Anal Prev 1991; 23: 165–174.

    Google Scholar 

  86. Viano DC. Restraint efiectiveness, availability and use in fatal crashes: Implications to injury control. J Trauma 1995; 38: 538–546.

    Google Scholar 

  87. Evans L. Safety belt efiectiveness: The influence of crash severity and selective recruitment. Acc Anal Prev 1996; 28: 423–433.

    Google Scholar 

  88. Martinez R, Levine DW, Martin R, Altman DG. Efiect of integration of injury control information into a high school physics course. Ann Emerg Med 1996; 27: 216–224.

    Google Scholar 

  89. Stewart JR. Seat belt use and accident involvement: A comparison of driving behavior before and after a seat belt law. Acc Anal Prev 1993; 25: 757–763.

    Google Scholar 

  90. Janssen W. Seat-belt wearing and driving behavior: An instrumented-vehicle study. Acc Anal Prev 1994; 26: 249–261.

    Google Scholar 

  91. Hunter WW, Stewart JR, Stutts JC, Rodgman EA. Observed and self-reported seat belt wearing as related to prior trafic accidents and convictions. Acc Anal Prev 1993; 25: 545–554.

    Google Scholar 

  92. Foss RD, Beirness DJ, Sprattler K. Seat belt use among drinking drivers in Minnesota. Am J Public Health 1994; 84: 1732–1737.

    Google Scholar 

  93. Grifiths M. Pregnant women should wear seat belts. Br Med J 1995; 311: 1501.

    Google Scholar 

  94. Wyatt JP, Richardson JM. The use of seat belts on British motorways. J Royal Soc Med 1994; 87: 206–207.

    Google Scholar 

  95. European Transport Safety Council. Seat belts and child restraints: Increasing use and optimising performance. Brussels: Experts Report, 1996.

    Google Scholar 

  96. Viano DC, Gargan MF. Headrest position during normal driving: Implication to neck injury risk in rear crashes. Acc Anal Prev 1996; 28: 665–674.

    Google Scholar 

  97. Parkin S, MacKay GM, Cooper A. How drivers sit in cars. Acc Anal Prev 1995; 27: 777–783.

    Google Scholar 

  98. Johnston C, Rivara FP, Soderberg R. Children in car crashes: Analysis of data for injury and use of restraints. Pediatrics 1994; 93: 960–965.

    Google Scholar 

  99. Augustyn M, Simons-Morton BG. Adolescent drinking and driving: Etiology and interpretation. J Drug Edu 1995; 25: 41–59.

    Google Scholar 

  100. Alvarez FJ, Del Rio MC. Alcohol and driving. Lancet 1996; 347: 985–986.

    Google Scholar 

  101. Homel R. Drink-driving law enforcement and the legal blood alcohol limit in New South Wales. Acc Anal Prev 1994; 26: 147–155.

    Google Scholar 

  102. Marks P. Drink driving legislation: Medicine and the law. Medico-Legal J 1995; 63: 119–127.

    Google Scholar 

  103. Sorock GS, Ranney TA, Lehto MR. Motor vehicle crashes in roadway construction workzones: An analysis using narrative text from insurance claims. Acc Anal Prev 1996; 28: 131–138.

    Google Scholar 

  104. Marshall C, Boyd KT, Moran CG. Injuries related to car crime: The joy-riding epidemic. Injury 1996; 27: 79–80.

    Google Scholar 

  105. Peck DL, Wamer K. Accident or suicide? Single vehicle car accidents and the intent hypothesis. Adolescence 1995; 30: 43–72.

    Google Scholar 

  106. Aberg L. Drinking and driving: Intentions, attitudes and social norms of Swedish male drivers. Acc Anal Prev 1993; 25: 289–296.

    Google Scholar 

  107. Donovan JE. Young adult drinking-driving: Behavioral and psychosocial correlates. J Studies Alcohol 1993; 54: 600–613.

    Google Scholar 

  108. Kidd PS, Holton C. Driving practices, risk-taking motivations, and alcohol use among adolescents drivers: A pilot study. J Emerg Nursing 1993; 19: 292–296.

    Google Scholar 

  109. Klein JL, Anthenelli RM, Bacon NM, Smith TL, Schuckit MA. Predictors of drinking and driving in healthy young men: A prospective study. Am J Drug Alcohol Abuse 1994; 20: 223–235.

    Google Scholar 

  110. Kuthy S, Grap MJ, Penn L, Henderson V. After the party's over: Evaluation of a drinking and driving prevention program. J Neurosci Nursing 1995; 27: 273–277.

    Google Scholar 

  111. Nau PA, Van Houten R, Rolider A, Jonah BA. The failure of feedback on alcohol impairment to reduce impaired driving. J Appl Behav Anal 1993; 26: 361–367.

    Google Scholar 

  112. Gardner JW, Sanborn JS. Years of potential life lost (YPLL)-what does it measure? Epidemiology 1990; 1: 222–228.

    Google Scholar 

  113. European Transport Safety Council. Transport accident costs and the value of safety. Brussels: Experts Report, 1997.

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Petridou, E., Moustaki, M. Human factors in the causation of road traffic crashes. Eur J Epidemiol 16, 819–826 (2000). https://doi.org/10.1023/A:1007649804201

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1007649804201

Navigation