Many health problems, especially those associated with older age, can have an impact on an individual’s mobility. This paper addresses how specific functional limitations and medical conditions may be associated with driving status, while controlling for age and gender. This paper uses baseline data (N=2025) from a longitudinal survey of adults, ages 55 and older, the Study of Physical Performance and Age-Related Changes in Sonomans (SPPARCS). For the 35 selected medical conditions and functional limitations, this report presents the prevalence, the relative “risk” ratio (i.e., the risk that an individual with that condition no longer drives), and the attributable risk (i.e., the percent of ex-drivers with each condition). Compared to current drivers, ex-drivers had higher rates of physical limitations (ability to ascend one flight of stairs or walk three blocks), cognitive impairment, vision problems and stroke. The conditions with the highest relative risk included personal mobility limitations (such as the ability to transfer onto or from bed and the ability to use the lavatory) and decreased peripheral vision. The relative risks of medical conditions’ effects on driving status offer a perspective on individuals’ mobility choices, and the attributable risks offer a perspective on the most important causes of driving cessation in the elderly population.

Rail crossing crashes have declined in the past 30 years, both nationally and in California. This is largely attributed to the closing of a large number of crossings as well as the deployment of a wide range of countermeasures, including signal systems, gating and grade separation programs. However, the number of crashes and subsequent injuries and deaths is still unacceptably high. Rail crossings provide different levels of warnings from four-quadrant gates down to stop signs. To understand how the state of California can best utilize state and federal funding available through SAFETEA-LU for making the state’s 7,719 at-grade rail-highway crossings safer, this report presents an analysis of the effectiveness of different types of railroad crossing warning devices with a cost-benefit comparison.

Motor vehicle injuries are a leading cause of injury and fatality to children. Child restraint systems can reduce injury, and their use has been a long-time focus of policy and programmatic work. During this time, there has been a marked increase in the number of children restrained in vehicles and a steady decline in vehicle-related injuries and fatalities to children. However, data reveal that children of color, compared to white children, are at greater risk of injury in motor vehicle crashes. To address needs of “the children left behind” from safety advances, the California Child Passenger Safety Initiative (CPSI) was launched in 2002 for 18 months. The CPSI was an innovative program designed to increase use and decrease misuse of child restraint systems among the most vulnerable children in California; i.e., children of color and children living in poverty. The CPSI was designed to: increase use of child safety seats among families who use public medical services at selected sites; decrease the rate of child safety seat misuse among these families; and increase knowledge of the then-new California child passenger safety seat law. This study compared survey and observation data for two samples of families with children age six and younger: a pre-intervention sample, and a post-intervention sample. Although the results of this study were mixed, dramatic increases in the use of certain child restraints and decreases in the misuse of others were observed. Implications for program replication are discussed.

Objective

Methods

Results

Discussion

Proper use of child passenger safety (CPS) systems is highly effective in reducing injury and fatality in traffic crashes. While use of CPS systems is increasing, use is not universal, and there is a high level of improper use. The Child Passenger Safety Initiative is an innovative program to provide education and training in proper CPS system use to adults with children attending public hospitals and clinics. The initiative will provide education and resources to these adults. A pre-intervention baseline study with a sample of adults and children at four participating hospitals and clinics has found that (i) the percent of participants who report that they always use a CPS system is only about 80%, (ii) over 30% of children are not appropriately restrained for the age and weight, and (iii) there is a very high level of misuse in terms of improper fastening the child to the CPS system, or in terms of fastening the CPS system to the vehicle seat. Implications for the CPS Initiative intervention include education, training, and resources to (i) encourage universal use of CPS systems for children, (ii) appropriate chose of CPS systems for the child?s age and weight, and (iii) proper fastening and securing of the child and the CPS systems itself. It is anticipated that the CPS Initiative will develop models for providing education, training, and resources, which are applicable to the large population of adults who have responsibility for transporting children in motor vehicles.

Over the past year, the San Francisco Department of Parking and Traffic (DPT) conducted an intensive pedestrian-safety engineering study, the PedSafe Study. PedSafe was funded by the Federal Highway Administration (FHWA)*, which also funded companion studies in Las Vegas and Miami. The study was designed to analyze pedestrian injuries by zones (i.e., neighborhoods or districts) and to identify those most amenable to prevention efforts. The DPT expects to utilize the methodology and information from the PedSafe study to help shape a citywide pedestrian master plan. This paper describes the technical procedures and the pedestrian countermeasure plan that resulted. The paper analyzes pedestrian injury problems both citywide and in study zones, using crash data and field observations. It also compares two software packages that can be used to analyze crash patterns: PBCAT1 (Pedestrian and Bicycle Crash Analysis Tool), which is available for no charge, and the CrossroadsTM2 package, available commercially. The countermeasure plan is described for multiple funding levels, and a plan is outlined for evaluation and public outreach. The countermeasure plan proposes basic traffic engineering countermeasures including advance limit lines, curb bulbs, impactable YIELD TO PEDESTRIAN signs, median refuge island improvements, modified signal timing, pavement stencils, pedestrian head start, pedestrian scramble, and vehicle left-turn phases. In addition, Intelligent Transportation Systems (ITS) countermeasures are recommended that include animated eyes signals, automated detection of pedestrians to adjust signal timing, modern flashing beacons, pedestrian countdown signals, radar speed display signs, roadway lighting improvements and smart lighting, and signal visibility improvements.

In 2002, the City of Oakland, California implemented a scramble signal, at the intersection of 8th Street and Webster Street. Scrambles are a type of traffic signal that give pedestrians exclusive access to an intersection by stopping vehicular traffic on all approaches, allowing pedestrians to cross diagonally or conventionally. The primary objective of this evaluation was to determine whether the installation of the pedestrian scramble at this location increased pedestrian safety.

An analysis was conducted of pedestrian-vehicle conflicts and pedestrian violations occurring at the intersection before and after the signal was modified, and pedestrians were surveyed to ascertain public attitude toward and comprehension of the change. The modification to scramble signal phasing at the intersection resulted in a statistically significant decrease in conflicts between pedestrians and vehicles, and a statistically significant increase in pedestrian violations. In general, pedestrians understood the change in the way the intersection operated, and were accepting of the change to scramble signalization.

These results suggest that the scramble has been effective overall in improving safety conditions at the site. The increased number of violations occurring despite decreased conflicts is in part due to a proportion of pedestrians who cross illegally on the "safe side" crosswalk (i.e. the crosswalk parallel to moving traffic where there are no opportunities for conflicts). It is important that the scramble signal be monitored over time in order to quantify the extent to which reduced vehicle-pedestrian conflicts associated with the scramble translate into measurable reductions in pedestrian injuries and fatalities.

Because hit-and-run crashes account for a significant share of pedestrian fatalities, a better understanding of these crashes will assist efforts to reduce pedestrian fatalities. Of the more than 48,000 pedestrian deaths that were recorded in the United States between 1998 and 2007 (Fatality Accident Reporting System [FARS]), 18.1% of them were the victims of hit-and-run crashes, and the percentage of fatal pedestrian hit-and-runs has been rising as the number of all pedestrian fatalities has decreased. Using FARS data on single pedestrian fatal victim crashes between 1998-2007, logistic regression analyses were conducted to identify factors related to hit-and-run and to identify factors related to the identification of the hit-and-run driver. Results indicate an increased risk of hit-and-run in the early morning, during non-daylight, and on the weekend. Results also indicate that certain driver demographic characteristics (young, male), behavior (notably alcohol use), and history (e.g., suspended license or history of DWI/DUI convictions) are associated with hit-and-run. There also appears to be an association between the type of victim and the likelihood of the driver being identified. Alcohol use and early morning, the time frame when persons may be leaving bars, were among the leading factors that increased the risk of hit-and-run. Reducing alcohol-related crashes could substantially reduce pedestrian fatalities as a result of hit-and-run. Driver characteristics will assist in the development of countermeasures, however, more information about this population may be necessary.