Publications (19)42 Total impact
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Article: Single- versus multi-vehicle bicycle road crashes in Victoria, Australia.
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ABSTRACT: The aim of the study is to compare trends, circumstances and outcomes of single- versus multi-vehicle bicycle on-road crashes in Victoria, Australia, through the analysis of police records and hospital admissions between January 2004 and December 2008. The results show that over 80% of on-road single-vehicle bicycle crashes occurred as a result of the cyclist losing control of the bicycle with the remainder involving collisions with objects. Compared with multi-vehicle crashes, single-vehicle crashes were more likely to occur in the dark, in wet conditions and in rural areas. Over half of the cyclists hospitalised as result of on-road crashes were injured in single-vehicle crashes and this proportion seems to be increasing over time. Single-vehicle crashes were associated with hospitalised injuries as severe as those resulting from multivehicle crashes. The findings highlight the significant burden of serious injury associated with single-vehicle bicycle road crashes. Further research is needed to investigate in greater detail the risk factors of these crashes and the effectiveness of countermeasures to reduce their burden.Injury Prevention 02/2013; · 1.39 Impact Factor -
Article: Risk factors for severe injury in cyclists involved in traffic crashes in Victoria, Australia.
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ABSTRACT: This study examines the impact of cyclist, road and crash characteristics on the injury severity of cyclists involved in traffic crashes reported to the police in Victoria, Australia between 2004 and 2008. Logistic regression analysis was carried out to identify predictors of severe injury (serious injury and fatality) in cyclist crashes reported to the police. There were 6432 cyclist crashes reported to the police in Victoria between 2004 and 2008 with 2181 (33.9%) resulting in severe injury of the cyclist involved. The multivariate analysis found that factors that increase the risk of severe injury in cyclists involved in traffic crashes were age (50 years and older), not wearing a helmet, riding in the dark on unlit roads, riding on roads zoned 70km/h or above, on curved sections of the road, in rural locations and being involved in head-on collisions as well as off path crashes, which include losing control of vehicle, and on path crashes which include striking the door of a parked vehicle. While this study did not test effectiveness of preventative measures, policy makers should consider implementation of programs that address these risk factors including helmet programs and environmental modifications such as speed reduction on roads that are frequented by cyclists.Accident; analysis and prevention 11/2012; 49:404-9. · 1.65 Impact Factor -
Article: Attempts at the practical on-road driving test and the hazard perception test and the risk of traffic crashes in young drivers.
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ABSTRACT: This study separately examined the impact of the outcomes of a practical on-road driving test and a hazard perception test on the likelihood of traffic crashes among a cohort of newly licensed young drivers in New South Wales (NSW), Australia. The DRIVE study is a prospective cohort study of drivers aged 17 to 24 years holding their first-year provisional driver license in NSW. Information obtained from 20,822 participants in a detailed baseline questionnaire was linked to information on the number of attempts at a mandatory practical on-road driving test and hazard perception test as well as police-reported traffic crashes. After controlling for a number of sociodemographic and behavioral factors as well as factors related to driver learning experiences, multivariate analysis showed that those who failed the practical on-road test at least 4 times had an increased risk of involvement in a traffic crash compared to those who passed the test at first attempt (relative risk [RR]: 1.79, 95% confidence interval [CI]: 1.20-2.65). The crash risk among those who failed the practical on-road test at least 4 times was particularly high in females (RR: 2.10, 95% CI: 1.20-3.68). Similarly, those who failed the hazard perception test at least twice had an increased risk of involvement in a traffic crash (RR: 1.83, 95% CI: 1.27-2.63) compared to those who passed the test on the first attempt. The crash risk of those who failed the hazard perception test at least twice was particularly high in males (RR: 2.5, 95% CI: 1.5-4.1) and among those from rural and remote areas (RR: 5.53, 95% CI: 1.63-18.71). The findings have implications on licensing practices and suggest the need for adequate strategies to assist young drivers with multiple failures in the driving and hazard perception tests.Traffic injury prevention 10/2011; 12(5):475-82. -
Book: The Pedal Study: Factors associated with bicycle crashes and injury severity in the ACT. Final report to the NRMA ACT Road Safety Trust
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ABSTRACT: Over the last decade in many parts of Australia as in other high income countries, there has been a substantial increase in the number of people cycling. The Australian Capital Territory (ACT) has the highest cycling participation rate in Australia and a population rate for serious bicycle crash injuries that is significantly above the national rate, which may be due to higher exposure. This report summarises the findings of a study which examined the characteristics of bicycle crashes in different cycling environments in the ACT and investigated the type and severity of injuries associated with the type of clothing worn. The objective was to inform strategies to reduce bicycle crashes and the severity of the associated injury.07/2011; NRMA ACT Road Safety Trust. -
Article: Cycling crashes in children, adolescents, and adults--a comparative analysis.
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ABSTRACT: To compare rates, circumstances, and outcomes of cyclist crashes between children (aged 0-9 years), adolescents (aged 10-19 years), and adults (aged 20 years and over) in Victoria, Australia. A retrospective analysis of cyclist crashes in police records and the Victorian Admitted Episodes Dataset during the period 2004-2008. Adolescent cyclists had the highest rates, per 100 000 people, of police-reported (32.6, 95% confidence interval [CI]: 30.7-34.5) and hospitalized cyclist crashes (71.6, 95% CI: 68.7-74.4). Police-reported helmet use at the time of the crash was lowest among children (57.1%, 95% CI: 49.5-64.8) compared to 60.2 percent (95% CI: 57.3-63.1) in adolescents and 77.7 percent (95% CI: 76.5-78.8) in adults. This was reflected in the hospital data, which indicated that more than one third of cyclist hospitalizations among children (37.4%) resulted in head injuries compared to around 1 in 4 hospitalized cyclist crashes in adolescents (26.8%) and adults (23.7%). Cyclists emerging off a footpath into the path of a vehicle as well as cyclists struck by vehicles emerging form a driveway were the most frequent types of police-reported crashes involving children (73.9%) and adolescents (48.1%). In contrast, most adult cyclist crashes occurred on the roadway, mainly at intersections. Programs to improve the safety knowledge and behavior of children and adolescent cyclists, particularly focusing on helmet use, should be part of a comprehensive approach that encompasses legislative and environmental changes, including appropriate cyclist facilities and reduced speed limit in residential areas.Traffic injury prevention 06/2011; 12(3):244-50. -
Article: Prevalence rates of helmet use among motorcycle riders in a developed region in China.
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ABSTRACT: This study aimed to determine the prevalence rates of helmet use, and of correct helmet use (chinstrap firmly fastened) among motorcycle riders and their passengers in Zhongshan, Guangdong Province, China. A cross-sectional survey involving direct observation of motorcycle riders was conducted at 20 randomly selected intersections. A total of 13,410 motorcycles were observed during a 10-day period in February 2009. The overall prevalence of helmet use was 72.6% (95% CI: 71.8-73.3%) among drivers and 34.1% (95% CI: 32.7-35.5%) among pillion passengers. The prevalence of correct use was 43.2% (95% CI: 42.4-44.0%) and 20.9% (95% CI: 19.8-22.1%) for drivers and passengers respectively. The helmet wearing rate on city streets was almost 95%, however city riders were more likely than rural riders to wear non-motorcycle helmets while riding. In multivariate analyses, factors associated with increased helmet use included riding on city streets, male gender, being a driver, carrying less passengers and riding a registered motorcycle. The results indicated enforcement and education activities need to be strengthened with respect to both helmet use and helmet quality, especially in rural areas, in order to improve wearing rates.Accident; analysis and prevention 01/2011; 43(1):214-9. · 1.65 Impact Factor -
Article: Utilization of research in policymaking for graduated driver licensing.
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ABSTRACT: Young drivers are overrepresented in road trauma and vehicle-related deaths, and there is substantial evidence for the effectiveness of graduated driver licensing (GDL) policies that minimize young drivers' exposure to high-risk driving situations. However, it is unclear what role research plays in the process of making GDL policies. To understand how research is utilized in this context, we interviewed influential GDL policy actors in Australia and the United States. We found that GDL policy actors generally believed that research evidence informed GDL policy development, but they also believed that research was used to justify politically determined policy positions that were not based on evidence. Further efforts, including more effective research dissemination strategies, are required to increase research utilization in policy.American Journal of Public Health 11/2010; 100(11):2052-8. · 3.93 Impact Factor -
Article: Does psychological distress increase the risk for motor vehicle crashes in young people? findings from the DRIVE study.
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ABSTRACT: Earlier research demonstrates increased and decreased risk of crash related to psychological distress; however, previous literature has almost entirely used retrospective study designs and has not been able to adequately control for important confounders such as exposure to driving, alcohol and drug use, or having had a previous crash. This study aimed to assess the relationship between psychological distress and risk of motor vehicle crashes. The DRIVE study is a prospective cohort study of 20,822 novice drivers aged 17-24 years in Australia. Information on risk factors for motor vehicle crash was collected through online questionnaire and subsequently linked to police-reported crashes. Poisson regression was used to analyze risk of various crash types by low, moderate, high, and very high levels of psychological distress, taking into account other known risk factors for crash. Compared to the referent group with low or no distress, a protective effect against crash was observed for young people who reported a moderate amount of psychological distress in unadjusted (RR = .87; 95% CI = .76-1.00) and multivariable analyses (RR = .85; 95% CI = .74-.97). Severe psychological distress was not significantly associated with an increase or decrease in the risk of crash. Psychological distress was not significantly associated with an increased risk of single vehicle crash. Earlier studies may have overestimated risk for motor vehicle crashes associated with psychological distress. This study found little convincing evidence to support a strong risk relationship for higher levels of distress and indeed found a modest protective association for low levels of distress.Journal of Adolescent Health 11/2010; 47(5):488-95. · 3.33 Impact Factor -
Article: Short sleep duration in prevalent and persistent psychological distress in young adults: the DRIVE study.
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ABSTRACT: Young people are sleeping less. Short sleep duration has a range of negative consequences including a hypothesized link with psychological distress, which has yet to be studied Prospective cohort study Community-based sample from Australia Twenty thousand (20,822) young adults (aged 17-24) identified through the state vehicle licensing authority. A random sample (n = 5000) was approached for follow-up 12-18 months later, with 2837 providing full data. Psychological distress, determined by a Kessler 10 score > 21, at baseline; and as both onset and persistence of distress at follow-up. Shorter sleep duration was linearly associated with prevalent psychological distress: relative risk (RR) 1.14 (95% CI 1.12 to 1.15). Only the very short (< 5 h) sleepers among those not distressed at baseline had an increased risk for onset of psychological distress (RR 3.25 [95% CI 1.84, 5.75]). Of 945 cohort participants reporting psychological distress at baseline, 419 (44%) were distressed at follow-up. Each hour less of sleep increased the risk of psychological distress persisting after adjustment for potential confounding variables: RR 1.05 (95% CI 1.01 to 1.10). Long sleep duration showed no association with distress at any time point. Self-reported shorter sleep duration is linearly associated with prevalent and persistent psychological distress in young adults. In contrast, only the very short sleepers had a raised risk of new onset of distress. Different approaches to sleep duration measurement yield different results and should guide any interventions to improve subjective sleep duration in young adults.Sleep 09/2010; 33(9):1139-45. · 5.05 Impact Factor -
Article: Accuracy of self-report of on-road crashes and traffic offences in a cohort of young drivers: the DRIVE study.
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ABSTRACT: In order to determine the accuracy of self-report of on-road crashes and traffic offences among participants in the DRIVE study, 2991 young drivers in New South Wales, Australia who completed the follow-up questionnaire were asked whether they had been involved in an on-road crash or were convicted for a traffic offence while driving during the year prior to the survey. This information was linked to police crash data to determine the level of accuracy of self-report of on-road crashes. There was a high level of accuracy in young drivers' self-report of police recorded crashes (85.1%; 95% CI 78.2% to 92.1%) and of police recorded traffic offences (83.0%; 95% CI 79.4% to 86.6%). Results suggest that surveys may be useful tools for estimating the incidence of on-road crashes and traffic offences in young drivers. The findings are particularly relevant to jurisdictions where access to administrative data is limited.Injury Prevention 08/2010; 16(4):275-7. · 1.39 Impact Factor -
Article: Risky driving behavior and road traffic crashes among young Asian Australian drivers: findings from the DRIVE study.
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ABSTRACT: To examine differences in risky driving behavior and likelihood of traffic crash according to the country of birth of recently licensed young drivers. The groups examined include those born in Australia, those born in Asia, and those born in other countries. The DRIVE study is a prospective cohort study of drivers aged 17-24 years holding their first-year provisional driver license in New South Wales, Australia. Information obtained from 20,822 participants who completed a baseline questionnaire was linked to police-reported traffic crashes. Self-reported risky driving behaviors and police-reported traffic crashes in young drivers. Young drivers who were born in Asian countries were less likely to report engaging in risky driving behaviors than their Australian-born counterparts. The proportion of participants reporting a high level of risky driving was 31.5 percent (95% confidence intervale [CI], 30.8-32.1) among Australian-born drivers compared to 25.6 percent (95% CI, 23.1-28.2) among Asian-born drivers and 30.4 percent (95% CI, 28.4-32.5) among those born in other regions. Asian-born participants had half the risk of a crash as a driver than their Australian-born counterparts (relative risk [RR] 0.55; 95% CI, 0.41-0.75) after adjusting for a number of demographic factors and driving and risk-taking behaviors. The comparative risk was even lower among those aged 17 years (RR 0.29; 95% CI, 0.29-0.75). Risk estimates for people born in other regions did not differ to those for Australian-born respondents. The study highlights the lower level of risky driving and significantly reduced crash risk for Australian drivers born in Asian countries relative to those born locally. Further research is needed to examine factors underlying this reduced risk and the impact of the length of residence in the host country.Traffic injury prevention 06/2010; 11(3):222-7. -
Article: Association between Supervisory Driver Offences and Novice Driver Crashes Post-Licensure.
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ABSTRACT: This research explore associations between driving offences of learner supervisory drivers and subsequent crashes as novice independent drivers in a prospective cohort of 20,822 drivers aged 17-24 in New South Wales, Australia, on their first independent driver licence. Information on demographics, primary supervisory drivers, and various risk factors was collected via an online questionnaire and subsequently linked to police-reported crashes two years later. Poisson regression determined that the unadjusted relative risk of crash was 1.35 (CI 1.14-1.60) for novices whose supervisors had offences, with this association remaining when adjusting for supervisor age, gender and relationship to the novice (RR=1.37, CI 1.16-1.63), but not when additionally controlling for novice driver demographics and characteristics (RR=1.50, CI 0.83-2.70). These findings suggest newly-licensed drivers previously supervised by drivers with recent traffic offences have a one-third higher risk of crashing. This risk is independent of the supervisor demographics, but mitigated by the young drivers' personal characteristics. Careful consideration should be given to policy developments regarding supervised driving requirements that rely heavily on parents to adopt this role.Annals of advances in automotive medicine 01/2010; 54:309-12. -
Article: Self-harm and risk of motor vehicle crashes among young drivers: findings from the DRIVE Study.
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ABSTRACT: Some motor vehicle crashes, particularly single-vehicle crashes, may result from intentional self-harm. We conducted a prospective cohort study to assess the risk that intentional self-harm poses for motor vehicle crashes among young drivers. We prospectively linked survey data from newly licensed drivers aged 17-24 years to data on licensing attempts and police-reported motor vehicle crashes during the follow-up period. We investigated the role of recent engagement in self-harm on the risk of a crash. We took into account potential confounders, including number of hours of driving per week, psychological symptoms and substance abuse. We included 18 871 drivers who participated in the DRIVE Study for whom data on self-harm and motor vehicle crashes were available. The mean follow-up was 2 years. Overall, 1495 drivers had 1 or more crashes during the follow-up period. A total of 871 drivers (4.6%) reported that they had engaged in self-harm in the year before the survey. These drivers were at significantly increased risk of a motor vehicle crash compared with drivers who reported no self-harm (relative risk [RR] 1.42, 95% confidence interval [CI] 1.15-1.76). The risk remained significant, even after adjustment for age, sex, average hours of driving per week, previous crash, psychological distress, duration of sleep, risky driving behaviour, substance use, remoteness of residence and socio-economic status (RR 1.37, 95% CI 1.09-1.72). Most of the drivers who reported self-harm and had a subsequent crash were involved in a multiple-vehicle crash (84.1% [74/88]). Engagement in self-harm behaviour was an independent risk factor for subsequent motor vehicle crash among young drivers, with most crashes involving multiple vehicles.Canadian Medical Association Journal 11/2009; 181(11):807-12. · 8.22 Impact Factor -
Article: Young driver education programs that build resilience have potential to reduce road crashes.
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ABSTRACT: The research aimed to explore associations between participation in 2 education programs for school-based learner drivers and subsequent road traffic offenses and crashes among a large cohort of newly licensed drivers. DRIVE is a prospective cohort study of 20822 first-year drivers aged 17 to 24 in New South Wales (NSW), Australia. Participants completed a detailed questionnaire and consented to data linkage in 2003-2004. Questionnaire items included year of participation in 2 specific education programs: a 1-day workshop-only program focusing on driving risks ("driver-focused") and a whole-of-community program also including a 1-day workshop but also longer term follow-up activities and a broader focus on reducing risk-taking and building resilience ("resilience-focused"). Survey data were subsequently linked to police-reported crash and offense data for 1996-2005. Poisson regression models that adjusted for multiple confounders were created to explore offenses and crashes as a driver (dichotomized as 0 vs >or=1) after program participation. Offenses did not differ between groups; however, whereas the driver-focused program was not associated with reduced crash risk, the resilience-focused program was associated with a 44% reduced relative risk for crash (0.56 [95% confidence interval: 0.34-0.93]). The large effect size observed and complementary findings from a comparable randomized, controlled trial in the United States suggest programs that focus more generally on reducing risks and building resilience have the potential to reduce crashes. A large, representative, randomized, controlled trial is urgently needed to confirm road safety benefits and ensure evidence-based spending and practitioner recommendations in this field.PEDIATRICS 10/2009; 124(5):1287-92. · 4.47 Impact Factor -
Article: Socioeconomic status and risk of car crash injury, independent of place of residence and driving exposure: results from the DRIVE Study.
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ABSTRACT: Previous studies that found increased crash risks for young drivers of low socioeconomic status (SES) have failed to adjust for factors such as driving exposure and rural residence. This aim of this study is to examine the independent effect of SES on crash risk, adjusting for such factors, and to examine the relationship between injury severity following a crash and SES. Information on risk factors for crash collected from 20,822 newly licenced drivers aged 17-24 years in New South Wales, Australia, as part of the DRIVE Study was prospectively linked to hospitalisation data. SES was classified as high, moderate or low based on the Australia 2001 Socio-Economic Index for Areas. Poisson regression was used to model risk of crash-related hospitalisation by SES, adjusting for confounders. Two measures of injury severity--urgency of treatment and length of hospital stay--were examined by SES. Results of multivariable analysis showed that drivers from low SES areas had increased relative risk (RR 1.8, 95% CI 1.1 to 3.1) of crash-related hospitalisation compared to drivers from high SES areas. This increased risk remained when adjusting for confounders including driving exposure and rurality (RR 1.9, 95% CI 1.1 to 3.2). No significant association was found between injury severity and SES. The higher risk of crash-related hospitalisation for young drivers from low SES areas is independent of driving exposure and rural-urban differences. This finding may help improve and better target interventions for youth of low SES.Journal of epidemiology and community health 10/2009; 64(11):998-1003. · 3.04 Impact Factor -
Article: Novice drivers' risky driving behavior, risk perception, and crash risk: findings from the DRIVE study.
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ABSTRACT: We explored the risky driving behaviors and risk perceptions of a cohort of young novice drivers and sought to determine their associations with crash risk. Provisional drivers aged 17 to 24 (n = 20 822) completed a detailed questionnaire that included measures of risk perception and behaviors; 2 years following recruitment, survey data were linked to licensing and police-reported crash data. Poisson regression models that adjusted for multiple confounders were created to explore crash risk. High scores on questionnaire items for risky driving were associated with a 50% increased crash risk (adjusted relative risk = 1.51; 95% confidence interval = 1.25, 1.81). High scores for risk perception (poorer perceptions of safety) were also associated with increased crash risk in univariate and multivariate models; however, significance was not sustained after adjustment for risky driving. The overrepresentation of youths in crashes involving casualties is a significant public health issue. Risky driving behavior is strongly linked to crash risk among young drivers and overrides the importance of risk perceptions. Systemwide intervention, including licensing reform, is warranted.American Journal of Public Health 08/2009; 99(9):1638-44. · 3.93 Impact Factor -
Article: Injury prevention in Australian Indigenous communities.
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ABSTRACT: Injury prevention in Indigenous communities in Australia is a continuing national challenge, with Indigenous fatality rates due to injury three times higher than the general population. Suicide and transport are the leading causes of injury mortality, and assault, transport and falls the primary causes of injury morbidity. Addressing the complex range of injury problems in disadvantaged Indigenous communities requires considerable work in building or enhancing existing capacity of communities to address local safety issues. Poor data, lack of funding and absence of targeted programs are some of the issues that impede injury prevention activities. Traditional approaches to injury prevention can be used to highlight key areas of need, however adaptations are needed in keeping with Indigenous peoples' holistic approach to health, linked to land and linked to community in order to address the complex spiritual, emotional and social determinants of Indigenous injury.Injury 01/2009; 39 Suppl 5:S61-7. · 1.98 Impact Factor -
Article: Understanding the extent and impact of Indigenous road trauma.
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ABSTRACT: While transport-related injuries represent a leading cause of death for all Australians, several disparities exist between Indigenous and non-Indigenous populations. Compared to non-Indigenous Australians, Indigenous Australians are more than twice as likely to have a transport-related fatal injury, with fatality risk remaining high with age while declining among the non-Indigenous community. Few studies and appropriate databases exist to elucidate the causes and solutions to this over-representation. This paper presents a summary of known risk factors, discusses the impact of road injury at multiple levels and suggests steps towards addressing this significant public health problem.Injury 01/2009; 39 Suppl 5:S19-23. · 1.98 Impact Factor -
Article: What is the role of researcher media advocacy within the Australian road safety policy process?
Proceedings of the Australasian Road Safety Research, Policing and Education Conference. November 10-12, Adelaide. 01/2008;
Top co-authors
Top Journals
Institutions
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2009–2012
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The George Institute for Global Health
Sydney, New South Wales, Australia -
University of Wollongong
- Woolyungah Indigenous Centre
Wollongong, New South Wales, Australia
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2009–2010
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University of Sydney
Sydney, New South Wales, Australia
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