Post on 14-Jan-2016
description
Older Driver and Occupant Older Driver and Occupant SafetySafety
Gerald McGwin, Jr., M.S., Ph.D.Gerald McGwin, Jr., M.S., Ph.D.
Departments of Epidemiology, Ophthalmology Departments of Epidemiology, Ophthalmology
and Surgeryand Surgery
University of Alabama at BirminghamUniversity of Alabama at Birmingham
Crash Rate DecompositionCrash Rate Decomposition
SOURCE: Dellinger AM, et al. AJE; 2002SOURCE: Dellinger AM, et al. AJE; 2002
Crash Rate DecompositionCrash Rate Decomposition
SOURCE: Dellinger AM, et al. AJE; 2002SOURCE: Dellinger AM, et al. AJE; 2002
Prevention EffortsPrevention Efforts
• Interventions tend to focus on primary Interventions tend to focus on primary prevention.prevention.
Crash Rate DecompositionCrash Rate Decomposition
SOURCE: Dellinger AM, et al. AJE; 2002SOURCE: Dellinger AM, et al. AJE; 2002
Mean Daily Minutes and Miles Spent Mean Daily Minutes and Miles Spent Driving by Driver AgeDriving by Driver Age
National Household Travel Survey, 2001U.S. Department of Transportation
Prevention EffortsPrevention Efforts
• Interventions tend to focus on primary Interventions tend to focus on primary prevention.prevention.
• These interventions either demonstrate These interventions either demonstrate small, significant effects, lack evaluation or small, significant effects, lack evaluation or have not impacted crash involvement.have not impacted crash involvement.
• Studies evaluating secondary and tertiary Studies evaluating secondary and tertiary prevention rareprevention rare
Crash Rate DecompositionCrash Rate Decomposition
SOURCE: Dellinger AM, et al. AJE; 2002SOURCE: Dellinger AM, et al. AJE; 2002
Older Driver “Older Driver “FragilityFragility””
Opportunities for Reducing FatalitiesOpportunities for Reducing Fatalities
Older Driver FragilityOlder Driver Fragility
Increased Susceptibility to Injury
0.00
5.00
10.00
15.00
20.00
25.00
Inju
ry R
ate
(per
10,
000
Cra
sh I
nvo
lved
Occ
up
ants
)
0 - 09 10 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 - 79 80+
Older Driver FragilityOlder Driver Fragility
Who is at Risk?
Older Driver FragilityOlder Driver Fragility
Secondary Prevention Opportunities
Older Occupant ProtectionOlder Occupant Protection
•Seat belts are most effective means of reducing Seat belts are most effective means of reducing risk of injury and fatality from MVCs. risk of injury and fatality from MVCs.
•Some research suggests that seat belts may be Some research suggests that seat belts may be less effective among older drivers. less effective among older drivers.
•Air bags have been shown to offer trivial Air bags have been shown to offer trivial benefits in preventing injury and death. benefits in preventing injury and death.
•They can be harmful to small children; whether They can be harmful to small children; whether they provide equivalent protection for adults of they provide equivalent protection for adults of all ages, however, has not been addressed. all ages, however, has not been addressed.
Risk Ratios* and 95% Confidence Intervals for Risk Ratios* and 95% Confidence Intervals for Association Between Association Between Severe InjurySevere Injury and and
Seat Belt UseSeat Belt Use According to Age According to Age
*Adjusted for age, gender, delta-v, curb weight, seating position, air bag deployment*Adjusted for age, gender, delta-v, curb weight, seating position, air bag deployment
0.0
0.2
0.4
0.6
0.8
<36 36-65 >65
Ris
k R
ati
o
pphomogeneityhomogeneity=0.15=0.15
Risk Ratios* and 95% Confidence Intervals for Risk Ratios* and 95% Confidence Intervals for Association Between Association Between Moderate InjuryModerate Injury and and
Seat Belt UseSeat Belt Use According to Age According to Age
*Adjusted for age, gender, delta-v, curb weight, seating position, air bag deployment*Adjusted for age, gender, delta-v, curb weight, seating position, air bag deployment
0.0
0.2
0.4
0.6
0.8
<36 36-65 >65
Ris
k R
ati
o
pphomogeneityhomogeneity=0.23=0.23
Risk Ratios* and 95% Confidence Intervals for Risk Ratios* and 95% Confidence Intervals for Association Between Association Between Minor InjuryMinor Injury and and
Seat Belt UseSeat Belt Use According to Age According to Age
*Adjusted for age, gender, delta-v, curb weight, seating position, air bag deployment*Adjusted for age, gender, delta-v, curb weight, seating position, air bag deployment
0.0
0.2
0.4
0.6
0.8
1.0
1.2
<36 36-65 >65
Ris
k R
ati
o
pphomogeneityhomogeneity=0.26=0.26
Risk Ratios* and 95% Confidence Intervals for Risk Ratios* and 95% Confidence Intervals for Association Between Association Between Severe InjurySevere Injury and and Air Bag Deployment Air Bag Deployment According to AgeAccording to Age
*Adjusted for age, gender, delta-v, curb weight, seating position, air bag deployment*Adjusted for age, gender, delta-v, curb weight, seating position, air bag deployment
0.0
0.5
1.0
1.5
2.0
2.5
<36 36-65 >65
Ris
k R
ati
o
pphomogeneityhomogeneity=0.40=0.40
Risk Ratios* and 95% Confidence Intervals for Risk Ratios* and 95% Confidence Intervals for Association Between Association Between Moderate InjuryModerate Injury and and
Air Bag Deployment Air Bag Deployment According to AgeAccording to Age
*Adjusted for age, gender, delta-v, curb weight, seating position, air bag deployment*Adjusted for age, gender, delta-v, curb weight, seating position, air bag deployment
0.0
0.5
1.0
1.5
2.0
2.5
3.0
<36 36-65 >65
Ris
k R
ati
o
pphomogeneityhomogeneity=0.61=0.61
Risk Ratios* and 95% Confidence Intervals for Risk Ratios* and 95% Confidence Intervals for Association Between Association Between Minor InjuryMinor Injury and and Air Bag DeploymentAir Bag Deployment According to Age According to Age
*Adjusted for age, gender, delta-v, curb weight, seating position, air bag deployment*Adjusted for age, gender, delta-v, curb weight, seating position, air bag deployment
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
<36 36-65 >65
Ris
k R
ati
o
pphomogeneityhomogeneity=0.004=0.004
Older Driver FragilityOlder Driver Fragility
Long Term Consequences
SummarySummary
• Increased susceptibility to injury/death Increased susceptibility to injury/death among older drivers underscores need for among older drivers underscores need for primary prevention efforts.primary prevention efforts.
• Reduced effectiveness of air bags for Reduced effectiveness of air bags for older drivers suggests the need for older drivers suggests the need for restraint systems tailored towards aging restraint systems tailored towards aging population.population.
Older Driver and Occupant Older Driver and Occupant SafetySafety
Gerald McGwin, Jr., M.S., Ph.D.Gerald McGwin, Jr., M.S., Ph.D.
Departments of Epidemiology, Ophthalmology Departments of Epidemiology, Ophthalmology
and Surgeryand Surgery
University of Alabama at BirminghamUniversity of Alabama at Birmingham