Papers by Judith Charlton
Safety Science, 2018
Motor vehicle crashes are a major cause of death and injury to children worldwide. Although risk ... more Motor vehicle crashes are a major cause of death and injury to children worldwide. Although risk of injury to child passengers can be reduced by using a child restraint, most restraints are incorrectly used. This greatly reduces the restraints' protective potential; however there is limited research on drivers of correct child restraint use. The aim of this study was to explore perceived barriers and motivators of correct child restraint use in experienced child restraint users, to inform interventions to promote correct use. Motivations and risk perceptions concerning incorrect child restraint use among high and low socioeconomic populations and culturally and linguistically diverse (CALD) child restraint users in Sydney, Australia were qualitatively examined. Six focus groups (N = 44 participants) were facilitated using a semi-structured discussion guide. Transcriptions were deductively analysed using QSR NVivo11 software and the COMB model of behaviour. Common perceived barriers to correct restraint use were: (a) difficulty interpreting instructions and labels, particularly among CALD participants; (b) remembering and attending to correct use information; (c) lack of information and behavioural feedback on how to correctly install and use a child restraint; and (d) low confidence in ability to install and use a child restraint correctly. The results indicate current child restraint product information is poorly understood, particularly among those whose first language is not English. Interventions to increase correct child restraint use should address access to correct use information, capability to understand and use these, and the influence of motivation, memory and attention in the process.
Injury Prevention, 2016
fatality rates with the overall increase in the number of vehicles adjusted by population during ... more fatality rates with the overall increase in the number of vehicles adjusted by population during the study period. Results The information sources differ as far as percentages were concerned (1.3%-6.5%), but they coincided in the fact that fatalities increased by around 40% (2014). 37% of the fatalities occurred in three provincial departments: Antioquia (14.4%), Valle (12.5%) and Bogotá (10.1%). The average fatality rate for 2014 was nearly 14.0/100,000 inhabitants; although it was higher in the provincial departments of Casanare (37.7), Arauca (27.9), Meta (26.6), and Cesar (25.7). There was a positive correlation between TIFs and the increase in the number of vehicles in Colombia (p < 0.001). Conclusions Road safety management in Colombia is restricted due to the lack of a leading agency to direct, control, and manage policies. Although a decree to create a National Road Safety Agency was issued in 2013, the year 2015 is now closing and such agency has not initiated operations. Poor implementation and non-compliance with traffic laws and regulations seem to be the main cause for traffic accidents.
This purpose of this study, commissioned by VicRoads, was to develop and evaluate a referral tool... more This purpose of this study, commissioned by VicRoads, was to develop and evaluate a referral tool for use by GPs and other health professionals to identify functionally impaired drivers who may have an increased risk of crashing. Two hundred drivers aged 79 years and older were assessed by a GP researcher in New Zealand. The referral tool comprised a number of tasks and observational measures of functional abilities, including items from several existing tests such as the OPS scale, the GRIMPS test and standardised screening tests for dementia. Details were then obtained from the Land Transport Safety Authority on participants' on-road test performance and crash and infringement records. Participants' confidentiality was maintained and no data that would reflect on their licensing status were provided to the NZ authorities. Preliminary findings suggest that a number of test components are strongly related to driving performance. Further analyses will be conducted to explore the relationship between specific combinations of test components and driving performance as well as the sensitivity and specificity of the test. One limitation of the study is the reliance on on-road licence test outcomes as the main measure of driving performance because of the rare occurrence of crashes and infringements. The study was also constrained by the use of a GP researcher who did not have knowledge of participants' medical histories as would their family doctor. Older drivers who voluntarily choose to stop driving were not included. This study will lead to the development of a unique pre-screening test for use by health care professionals for referral of potentially at-risk older drivers to licensing authorities.
The Medical Journal of Australia, Mar 1, 2008
Transport Research Forum, 2001
While relatively small in number, statistics show that older drivers are over-represented in seri... more While relatively small in number, statistics show that older drivers are over-represented in serious injury crashes per kilometre travelled. Current estimates suggest that this safety problem will grow substantially over the next 20 to 30 years. The proportion of older people in the community is expected to increase, and tomorrow's older drivers are likely to have higher licensing rates, are likely to travel greater distances, and are likely to live longer than today's older driver cohort. While a range of factors may temper this problem to some extent, such as improvements in the traffic environment, increased crashworthiness of cars, and increased driver fitness, it is anticipated that improving older driver safety represents a major challenge for road safety and the Vision Zero philosophy. A unique opportunity exists to address this road safety problem before it becomes a major safety issue. The paper analyses the likely growth in older driver mobility as the population 'greys', and discusses a range of safety initiatives and research necessary to address the older driver safety problem. (a) For the covering entry of this conference, please see ITRD abstract no. E205861.
PubMed, 2004
This study examined the performance of three rear-facing and two forward-facing child restraints ... more This study examined the performance of three rear-facing and two forward-facing child restraints (CRS) with three anchorage systems: standard seatbelt, LATCH (flexible) and ISOFIX (rigid). Frontal (64 km/h) and side impact (15 km/h) HyGe sled tests were conducted using a sedan buck. Overall, the preliminary findings suggested superior performance of rigid over seatbelt and flexible anchorages, particularly in side impacts. The results also suggest a need for design improvement for CRS with flexible anchorages to increase stability in side impacts. The findings have important implications for the proposed introduction of changes to Australian Standards for CRS to permit both flexible and rigid systems to coexist with conventional seatbelt anchorage systems.
The task of driving is complex and places high demands on cognitive, attention, decision-making, ... more The task of driving is complex and places high demands on cognitive, attention, decision-making, perceptual and motor processes. Age-related changes in these capacities present a compounding factor and place older drivers at a significant risk. It is frequently claimed that drivers self-regulate their driving behaviour as they age to minimise their risk of having a crash. Examples of such behavioural changes include using low-traffic roads, planning trips to avoid busy locations, and not driving at night. While there is evidence that older drivers do travel shorter distances on average than their younger counterparts (LTSA, 2000), the evidence of older drivers adopting more safe driving practices is less definitive. There is a suggestion, too, that the practice of self-regulation may not be consistent among all older drivers (eg. those with dementia). An important factor in determining self-regulatory driving behaviour is insight into one's own functional abilities, as well as an appreciation of the specific environment and situational context related to driving. This paper reviews existing research addressing issues of self-regulation. In addition, a preliminary investigation of self-regulatory behaviours in a small sample of Australasian drivers is reported. Older drivers participating in the study completed self-reports about their driving and underwent a series of functional assessments and an on-road driving test. Results describe the relationships among functional abilities, self-regulatory driving behaviours and on-road driving performance. Implications for safety and mobility are discussed.
CRC Press eBooks, Oct 15, 2008
This chapter addresses the issue of driver distraction within the context of the known crash risk... more This chapter addresses the issue of driver distraction within the context of the known crash risk and driving patterns of older drivers. Consideration is also given to effects of aging on functional abilities and other factors that might predispose older drivers to the effects of distraction and their propensity to engage in distracting activities. In addition, strategies for reducing the potentially negative effects of distraction on older driver performance and safety are explored.
... Jennifer Oxley, Judith Charlton, Bruce Corben & Brian Fildes Accident Research Centre, Mo... more ... Jennifer Oxley, Judith Charlton, Bruce Corben & Brian Fildes Accident Research Centre, Monash University ... Gorrie and her colleagues (2004) examined neurodegenerative change (neurofibrillary tangles [NFT], a pathological hallmark of Alzheimer's Disease) within the brains ...
Drivers aged 65 years and over are over-represented in serious injury and fatal crashes in this c... more Drivers aged 65 years and over are over-represented in serious injury and fatal crashes in this country and elsewhere and these figures are expected to increase up to threefold with the projected increase in the proportion of the elderly in the population. It is unclear, however, whether these crash data reflect over-exposure to risky situations, the frailty of the elderly, their driving behaviour, or other factors. On the whole, older drivers are considered a safe and cautious group, however, as people age, there are declines in sensory, cognitive and motor skills that can affect the ability to drive safely. The purpose of this report is to review current literature on driving reduction, restriction and cessation. It identifies and discusses factors that may influence the process of self-regulation and eventual cessation of driving, including the role of educational programs aimed to improve the effectiveness of this practice for older drivers. The review suggests that there are serious gaps in our knowledge about the incidence and process of self-regulation in this country and about the effectiveness of self-regulatory practices in reducing crashes both here and elsewhere. (a)
Kerb 63 6.3.2 Road Cross CHAPTER 7 GENERAL DISCUSSION AND CONCLUSiONS 75 7.1 DISCUSSION OF ACCIDE... more Kerb 63 6.3.2 Road Cross CHAPTER 7 GENERAL DISCUSSION AND CONCLUSiONS 75 7.1 DISCUSSION OF ACCIDENTS AT "BLACK-SPOT" SiTES 75 7.2 DISCUSSION OF FIRST OBSERVATIONAL STUDY-TWO-WAY ROADS 7.2.1 Times Spent in Completing the Road-Crossing Task 7.2.2 Directional Looking Behaviour 7.2.3 Gap Acceptance and Time-of-arrival Judgements 7.2.4 Crossing Styles/Strategies 7.3 DISCUSSION OF SECOND OBSERVATIONAL STUDY-ONE-WAY ROADS 7.3.1 Times Spent in Completing the Road-crossing Task 7.3.2 Directional Looking Behaviour.. 7.3.3 Gap Acceptance and Time-of-arrival Judgements 7.4 PERCEPTUAL AND COGNITIVE ISSUES 80 7.4.1 Ability to make appropriate gap acceptance and time-of-arrivaljudgements 81 7.4.2 Ability to react quickly 81 7.4.3 Ability to focus attention on important sources of information 82 7 4 4 AbT .-~. ffi' I' I. .. llty to process Illl0rmatlOn e Clent y In comp ex enVironments 7.5 IMPLICATIONS FOR COUNTERMEASURES 7.
This study examined the suitability of booster seats for children across a wide age range. HyGe s... more This study examined the suitability of booster seats for children across a wide age range. HyGe sled tests were conducted using a large vehicle buck with booster seats fitted in the rear seat. Four conditions were evaluated: three with booster seats with (i) standard adult seatbelt, (ii) seatbelt plus H-harness and crotch strap, and (iii) seatbelt plus H-harness with crotch strap disengaged (simulating real-world misuse); and a fourth test (iv) with the dummy restrained in an adult seatbelt only. For tests (ii) and (iii), booster seats were fixed to the vehicle with a retrofitted ISOFIX system and top-tether. This modification was consistent with proposed changes to the AS1754, which apply to forward-facing restraints (but not boosters). Results suggest that, with appropriate modifications, booster seats may provide a suitable option for children represented by 3 year old and 6 year old dummies. Head acceleration and neck injury data suggested that the boosters provided superior protection to that of an adult seatbelt. Tests with H-harnesses showed t h a t t h e c r o t c h s t r a p wa s c r i t i c a l i n e l i mi n a t i n g ' s u b-ma r i n i n g '. F i n d i n g s h i g h l i g h t e d t h e p o t e n t i a l for serious injury with H-harnesses misuse and identified areas for design improvement of booster seats.
11th International Conference on Mobility and Transport for Elderly and Disabled Persons (TRANSED)Transport CanadaTransportation Research Board, 2007
This paper describes how older drivers are over-involved in serious injury and fatal crashes per ... more This paper describes how older drivers are over-involved in serious injury and fatal crashes per licensed driver compared with younger drivers. The safe mobility of older female drivers is of particular concern because the fatality rate of this group is increasing more rapidly than that of older men and is likely to increase in the years ahead. Moreover, it seems that older women are more likely than older men to retire from driving prematurely, with the potential for compromised mobility. An understanding of the driving behaviors, risk factors and travel needs of this group is required to develop strategies to ensure their continued safe mobility. Using data from a self-administered survey of 673 older female drivers, and a case-control study of 48 crash-involved and 44 non crash-involved older female drivers, the impacts of driving experience, practices and confidence, functional performance and health-related factors were examined. The findings revealed a number of differences between driving experiences and functional performance of crash-involved drivers compared to non crash-involved drivers. The likelihood of being involved in a crash was associated with lower attention, cognitive and motor skills and presence of multiple medical conditions. Driving characteristics, such as being the main driver in the household are not highly confident of being a safe driver and experiencing difficulty in some driving situations were also associated with crash risk. There are obvious mobility benefits of continuing to drive, particularly for older female drivers, who, in the event of their partner being unable to drive, may be forced into principal driver status after years of reduced driving and therefore little up-to-date driving experience and confidence. This study has enhanced our understanding of ‘at risk’ older female drivers by identifying predictors of crash involvement and factors that may impact on their safe mobility. This information has led to further studies to develop educational and training packages aimed at improving driving experiences and driving practices.
Despite substantial research on visual function among older drivers, there is a paucity of resear... more Despite substantial research on visual function among older drivers, there is a paucity of research on how age-related changes in visual search patterns and other functional abilities impact on driver behaviour. This study investigated visual search, cognitive performance and driving performance of younger (25-35 years) and older drivers (65-75 years) in a high-level driving simulator. Participants completed two simulated test drives, incorporating complex and hazardous events. Driving measures included speed and braking and steering responses. Data from a FaceLAB eye tracking system was linked with the driving scenario to provide information on time to fixation and fixation duration for critical stimuli and events in the driving environment. Overall, the findings indicated that older drivers travelled at slower speeds and were more variable in their travel speed than younger drivers. Older drivers detected hazards later than younger drivers and differed in the proportion of time looking at hazards, the road ahead, peripheral areas and the speedometer. The relationship between visual search strategies, driving performance and a range of cognitive measures was also explored. The study provided a useful model for evaluating visual strategies and potential interventions for drivers with vision impairment. Research on older driver crashes indicates that this group is over-represented in serious and fatal crashes per kilometre driven (Diamantopoulou, Skalova, Dyte, & Cameron, 1996). However, some caution is needed in interpreting conventional
Older drivers are over-involved in serious injury and fatal crashes per licensed driver compared ... more Older drivers are over-involved in serious injury and fatal crashes per licensed driver compared to younger drivers. This may be due to age-related changes in functional performance and health status as well as changes in driving factors. Moreover, there may be some gender-specific factors that may place older female drivers at increased risk of crash involvement. Indeed, crash statistics show that their fatality rate is increasing more rapidly than that of older men and is likely to increase markedly in the years ahead as the population ages. Using data from i) a self-administered survey of 673 older female drivers, and ii) a case-control study of 48 crash-involved and 44 non crash-involved older female drivers, some factors that may predict crash involvement were identified. Poor attentional, cognitive, executive and motor skills as well as the presence of multiple medical conditions were associated with crash involvement, suggesting that women with more pronounced functional changes were at highest crash risk. Low confidence, difficulty in some driving situations and principal driver status were also related to increased risk of crash involvement. These findings suggest that older female drivers who become principal drivers, perhaps due to illness or death of a partner, may lack the up-to-date driving experience and associated confidence to drive safely. The findings have enhanced our understanding of which female drivers are at increased risk, particularly through identifying a more precisely defined target group for road safety countermeasures.
Data from 244 older drivers in New Zealand have been used to demonstrate that older drivers who t... more Data from 244 older drivers in New Zealand have been used to demonstrate that older drivers who travel low mileages are liable to have more crashes per distance driven than older drivers who travel higher mileages. The results showed that drivers travelling 50 km or less per week had a considerably higher per-distance crash rate than drivers travelling 100 km or more per week. Low mileage drivers also performed significantly worse on both a screening test of fitness to drive (the GRIMPS screening test) and on the New Zealand Older Driver Relicensing Test (NZODORT). With reduced driving performance likely to be a major factor in explaining the association between extent of driving and crash involvement, the findings presented in this paper are valuable in identifying a small, more precisely defined target group for road safety countermeasures, while excluding most older drivers from any special safety scrutiny.
Crashes involving pedestrians are severe in nature and constitute a substantial proportion of ser... more Crashes involving pedestrians are severe in nature and constitute a substantial proportion of serious injuries and deaths on the road. Moreover, many involve older adults. This paper discusses the contributing factors to increased crash and injury risk for older pedestrians including behavioural, vehicle and environmental factors. Walking is an essential part of many trips, however, the road environment is becoming more complex. The dominance of vehicles, high speed and traffic volumes on many roads used by pedestrians, places high demands on an older person's adaptability, whilst ageing can diminish the capacity to cope with many traffic situations. Older adults, therefore, experience many problems using the transport system, largely because it does not adequately accommodate their special needs and capabilities. Further, the design features of frontal structures of vehicles can greatly affect pedestrian injury outcome. In this paper, world 'best-practice' strategies and initiatives for managing the safe mobility of older pedestrians are identified and described, including the principles of road safety strategies in countries that are world leaders in road safety. Costeffective initiatives are discussed such as programs that promote safe walking practices, improvements to vehicle frontal design to optimise the protective capabilities of vehicles, and innovative engineering treatments that aim to improve the 'crashworthiness' of the road transport system and be more forgiving of vulnerable road users. Several examples are described including measures to moderate vehicle speeds in high pedestrian activity areas, measures to separate or restrict vehicular and non-vehicular traffic, and measures to reduce the complexity of the road environment. Recommendations for a system-wide approach for the management of older pedestrian safe mobility are provided.
ln Australia, the presence of a visual field deficit condition requires assessment by an optometr... more ln Australia, the presence of a visual field deficit condition requires assessment by an optometrist or ophthalmologist before an individual can be considered fit-to-drive. However, there are currently limitations in the validity of tests and criteria used for assessing vision for safe driving. This paper examines the scope of the problem in one Australian jurisdiction by identiñ7ing the prevalence of visual field loss (VFL) amongst drivers referred for medical review and describing the current practices for managing their licence review. A random sample of medical review cases was extracted from the VicRoads Medical Review database to identify cases involving VFL conditions: glaucoma, age-related macular degeneration, diabetic retinopathy, hemianopia/ quadrantanopia and retinitis pigmentosa. Data on demographic information, visual field loss conditions and the referral process were collected for all identified cases. A total of 170 cases (2.0% of 8295 total medical review cases) with visual field deficits were identified. Of these, 23 (14.7o/o) were involved in crashes and referred to VicRoads on this basis. Of these cases, 124 (72.9Vo) were assessed by either an optometrist or ophthalmologist. The most commonly used ophthalmological tools for assessing field loss included the Humphrey Field Analyzer (n=42,260/o); Esterman (n=16, 10%) and Goldman (n=7,4o/o) visual field tests. ln 89 (55%) cases, licences were continued unconditionally,42 (260/o) were discontinued, 14 (9o/o) were made conditional, and in 18 (1 1%) the decision was pending further review. Drivers with visual field loss tended to be older and the majority had co-morbid conditions. There was considerable variation in the methods for assessing visual deficits. Despite the Austroads Fitness to Drive recommendations, 27 .1o/o of cases were not referred for further assessment by an optometrist or ophthalmologist. Though some of these drivers may have surrendered their licences or had them discontinued on the basis of other reasons,22 (13.9%) of these drivers had their private car licences continued and one driver had a commercial licence continued on a conditional basis without specialist vision assessment. Five cases had their private licences discontinued based on static perimetry alone. ln two of these flve cases, the drivers were contesting the decision made by VicRoads. These findings are discussed in the context of the current medical review guidelines in Australia.
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Papers by Judith Charlton