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Resumo Objetivo Mapear evidências científicas nacionais e internacionais sobre a condução veicular por pessoas idosas. Método Revisão de escopo baseada no manual proposto pelo Joanna Briggs Institute. Para as buscas foram acessadas as bases MEDLINE, Web of Science, Scopus, SciELO e a literatura cinzenta, por meio do Google Scholar. Resultados Dos 1.194 estudos encontrados, selecionaram-se 189 artigos submetidos aos critérios de elegibilidade. Os países precursores nas publicações foram Austrália e Estados Unidos, e o ápice das pesquisas ocorreu entre 2013 e 2014. Os participantes dos estudos eram pessoas idosas saudáveis, 63,49% (120); seguidos de 17,46% (33) com doença de Alzheimer; 11,11% (21) com Transtorno Neurocognitivo Leve; 6,88% (13) com doença de Parkinson; e 19,58% (37) com outras comorbidades. Diferentes tipos de intervenções foram identificadas nos estudos, destas, 94,02% (178) avaliaram a eficácia de instrumentos que mensuram a aptidão do motorista idoso. Conclusão Houve predominância de estudos na busca de instrumentos de avaliação que mensurassem a funcionalidade do condutor idoso. Esse fato ratifica a importância de avaliação padronizada, validada e economicamente viável que colabore na identificação do motorista em risco. Evidenciou-se a necessidade de intervenções para a prática da geriatria e gerontologia, por meio de ações para formação de equipe multidisciplinar especializada em condução veicular, de modo a adequar as diretrizes de licenciamento a fim de atender às especificidades dos condutores idosos, considerando os aspectos sociais, econômicos, políticos e educacionais, especialmente nos departamentos de trânsito brasileiro.

Abstract Objective To map national and international scientific evidence regarding driving by older adults. Method Scope review based on the manual proposed by the Joanna Briggs Institute. Searches were conducted in the MEDLINE, Web of Science, Scopus, SciELO databases, and grey literature through Google Scholar. Results Out of 1,194 studies identified, 189 papers meeting eligibility criteria were selected. Pioneering countries in publications were Australia and the United States, with the peak of research occurring between 2013 and 2014. Study participants included healthy older adults (63.49%, 120), followed by those with Alzheimer's disease (17.46%, 33), Mild Neurocognitive Disorder (11.11%, 21), Parkinson's disease (6.88%, 13), and other comorbidities (19.58%, 37). Various interventions were identified, with 94.02% (178) assessing the effectiveness of instruments measuring the fitness of older drivers. Conclusion There was a prevalence of studies aimed at identifying assessment tools to measure the functionality of older drivers. This underscores the importance of standardized, validated, and economically viable assessments that contribute to identifying at-risk drivers. The need for interventions in geriatrics and gerontology was evident, emphasizing the necessity for actions to establish a specialized multidisciplinary team in vehicular driving. This approach seeks to align licensing guidelines with the specific needs of older drivers, taking into account social, economic, political, and educational aspects, particularly within the Brazilian traffic departments.

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Few studies have reported specific attention deficits in post-COVID-19 patients. Attention consists of different subdomains. Disruptions to specific attention subdomains might impair a wide range of everyday tasks, including road safety. As there are millions of COVID-19 patients with different socio-economic backgrounds, screening of attentional performance less dependent on education is needed. Here, we verified if physically recovered COVID-19 inpatients showed specific attention decrements at discharge. The Continuous Visual Attention Test (CVAT) is a Go/No-go task which is independent of participants' schooling. It detects visuomotor reaction time (RT = intrinsic alertness), variability of reaction time (VRT = sustained attention), omission (focused-attention), and commission errors (response-inhibition). Thirty physically functional COVID-19 inpatients at discharge and 30 non-infected controls underwent the CVAT. A MANCOVA was performed to examine differences between controls and patients, followed by post-hoc ANCOVAs. Then, we identified the percentile score for each patient within the distribution of the CVAT performance of 211 subjects mentally capable of driving (reference group). COVID-19 patients at discharge showed greater RT and VRT, and more omission errors than controls. Twenty-two patients (73%) had performance below the 5th percentile of the reference group in one or more subdomains. As slow visuomotor RT, deficits in focusing and difficulties in keeping visual attention are associated with traffic accidents, we concluded that most COVID-19 patients at discharge had deficits that may increase the risk of road injuries. As these deficits will probably affect other daily activities, a routine assessment with the CVAT could provide useful information on whom to send to post-COVID centers.

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Thousands of lives are lost every year due to traffic accidents worldwide, and youths are the most affected. The goal of this paper is to analyze the differences in young students' perceptions about traffic safety in school surroundings in order to help in the formulation of public policies and the development of infrastructure to make school travels safer. A questionnaire was used to obtain the perception of high school students from institutions with different urban characteristics. Data modelling with fuzzy logic and statistical analysis of variance indicated that students' perceptions are influenced by the different realities these youths are exposed to daily, such as school socioeconomic category, transport mode, urban environment and gender. Traffic engineering measures, public policies and road safety education action, inciting active mobility, can be validated and supported by these results. This road safety analysis may also be a participative alternative for locations with low data access.

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The social determinants of health influence both psychosocial risks and protective factors, especially in high-demanding contexts, such as the mobility of drivers and non-drivers. Recent evidence suggests that exploring socioeconomic status (SES), health and lifestyle-related factors might contribute to a better understanding of road traffic crashes (RTCs). Thus, the aim of this study was to construct indices for the assessment of crash rates and mobility patterns among young Colombians who live in the central region of the country. The specific objectives were developing SES, health and lifestyle indices, and assessing the self-reported RTCs and mobility features depending on these indices. A sample of 561 subjects participated in this cross-sectional study. Through a reduction approach of Principal Component Analysis (PCA), three indices were constructed. Mean and frequency differences were contrasted for the self-reported mobility, crash rates, age, and gender. As a result, SES, health and lifestyle indices explained between 56.3-67.9% of the total variance. Drivers and pedestrians who suffered crashes had higher SES. A healthier lifestyle is associated with cycling, but also with suffering more bike crashes; drivers and those reporting traffic crashes have shown greater psychosocial and lifestyle-related risk factors. Regarding gender differences, men are more likely to engage in road activities, as well as to suffer more RTCs. On the other hand, women present lower healthy lifestyle-related indices and a less active implication in mobility. Protective factors such as a high SES and a healthier lifestyle are associated with RTCs suffered by young Colombian road users. Given the differences found in this regard, a gender perspective for understanding RTCs and mobility is highly suggestible, considering that socio-economic gaps seem to differentially affect mobility and crash-related patterns.

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BACKGROUND: Point-of-collection testing (POCT) devices for psychoactive substance detection through oral fluid samples are used in several countries for traffic enforcement. However, the reported reliability of such devices is quite heterogeneous among studies, and evaluating and comparing their analytical performance is of paramount importance to guide enforcement policies. AIM: To evaluate the analytical reliability of four POCT devices for the detection of cocaine and cannabinoids using oral fluid samples of Brazilian drivers. METHOD: A total of 168 drivers were recruited during standard roadblockfI procedures in Southern Brazil. Subjects were screened using one of the following POCT devices: the DDS2™, the DOA MultiScreen™, the Dräger Drug Test 5000™ and the Multi-Drug Multi-Line Twist Screen Device™ (MDML). Results of the screening tests were compared with chromatographic analyses in order to obtain the reliability parameters. RESULTS: The prevalence of confirmed positive samples for cocaine and cannabinoids were 9 % and 4.4 %, respectively. For cocaine, three POCT devices (MDML™, Dräger DrugTest 5000™, DOA MultiScreen™) showed good reliability, greater than 80 % of performance measures, using guidelines for research on drugged driving published by Walsh et al. (cutoff 10ng/mL). However, for cannabinoids, the devices had low reliability-only Dräger DrugTest 5000™ had good performance using cut-offs proposed by Walsh et al. (cutoff 2ng/mL). CONCLUSION: We observed a high prevalence of drivers testing positive for cocaine and cannabinoids. Most devices achieved good reliability performance for cocaine detection using cutoffs proposed by Walsh et al. or using the device's own cutoff. Instead, the reliability for cannabinoid detection obtained the desired parameters in just one device using cut-offs proposed by Walsh et al. and its own cutoff. Difficulties in detecting cannabinoids at the roadside should be better evaluated before the implementation of such tests.

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BACKGROUND: In May 2014, the Dominican Republic introduced the 911-emergency response system (ERS) in Santo Domingo. Before its introduction, more than 40 phone numbers were available to report emergencies. The objective of this work is to assess whether this new emergency response system was effective in reducing traffic fatalities. METHODS: Weekly numbers of traffic fatalities per population and per vehicle fleet from January 2013 to December 2015 were obtained from the Ministry of Health and the National Institute of Statistics. A hybrid time-series difference-in-difference analysis using multivariable negative binomial regression models were used to compare trends in rates of traffic fatalities in Santo Domingo to La Romana and Santiago, before and after the introduction of the 911-ERS. RESULTS: Estimates from negative binomial models suggest that the introduction of the 911-ERS in Santo Domingo relative to Santiago-La Romana was associated with a 17% reduction in the Incidence Rate Ratio (IRR) of traffic fatalities per 1 000 000 population (IRR = 0.83, 95% confidence interval [CI]: 0.67; 1.03) and with a 20% reduction in the IRR of weekly traffic fatalities per 1 000 000 vehicle fleet (IRR = 0.80, 95% CI:0.67; 0.99). DISCUSSION: Our findings suggest that transitioning from multiple to one unique emergency phone number should be considered more attentively. Furthermore, the case of the Dominican Republic calls for more theoretical and methodological research to understand how to assess these road safety policies more accurately. Since various studies suggest that 911-ERS mature in the long run, how these systems evolve over time and other related variables should be carefully considered.

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The main objective of this research was to investigate the psychometric properties of a Spanish-language version of the Attitudes toward Traffic Safety Scale (ATTS) for the assessment of risky driving attitudes among Spanish-speaking populations. Five hundred and fifty-eight drivers from Argentina participated in the study. Confirmatory factor analysis supported the ATTS three-factor structure: Attitude towards violations and speeding, attitude towards the careless driving of others and attitude towards drinking and driving, χ2(87) = 205.91, p < .001; χ2/df = 2.36; GFI = .94; CFI = .93; TLI = .91; RMSEA = .05; 90% CI [.04, .06]. A model with one higher-order factor (overall attitude toward risky driving) also fits the data. Reliability estimates were acceptable for the total scale (α = .81) and for all subscales (with α values ranging from .74 to .84), and concurrent validity was supported by theoretically expected correlations with self-reported risky driving behavior (r ranging from .27 to .45, ps < .01). Subsequent comparison between zero-order correlation and partial correlation (controlling for Driver Impression Management) between ATTS subscales and self-reported risky driving behavior revealed minor or no effects of social desirability bias. Implications for road safety intervention are discussed.

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This study aimed at identifying and comparing subjective risk perception regarding two different violent situations in urban roads: traffic accidents (i.e. crashes) and robberies. A robbery consists of subtracting something from someone, while seriously threatening the victim, or using violence. Robberies can be perpetrated either with or without the use of a weapon. This study was carried out in the city of Uberlândia, a medium size city in the state of Minas Gerais, south-east Brazil. A total of 383 people was interviewed at home in two boroughs of Uberlândia, using a questionnaire divided in five parts: a) personal information; b) description of crash involvement; c) description of robbery involvement; d) the chance of being involved in a crash and in a robbery within the next three years; e) willingness to pay for more safety in traffic or for more security against robberies; f) what causes more damage or harm to society, crashes or robberies. Descriptive figures are shown for the sample which reported 1.44 crashes/person. More than half of those involved in crashes (56%) were injured and 75% of these needed hospital care. There were 1.15 robberies/person. Only 7% of those involved in robberies were injured, none of them hospitalized. During robberies, 57.3% of the respondents were threatened with weapons. Car drivers were more subject to crashes (40%) and pedestrians were more subject to robberies (78%). Risk perception of being involved in a robbery within the next three years and when on the streets of the local borough is higher than crash risk perception. Respondents thought of dying in 25.5% of the crashes and in 46.3% of the robberies. A large group (63.7% of the sample) declared the willingness to pay for more personal security rather than for more traffic safety. Statistical analysis is presented in an attempt to study the relationship between variables. As expected, the respondents' subjective risk perception appears to contradict objective risk. Instinctively, interviewees might perceive robberies as a greater threat than crashes, perhaps reflecting lightly on the latter. In countries with high crash and violent incident statistics such results could be used to orientate traffic safety policies, education and campaigns, concentrating on the outcomes of crashes.

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Problema: Se analizó la incidencia del factor humano en la accidentalidad vial en el territorio colombiano, y se identificó evidencia empírica para la formulación de política pública del tránsito. Metodología: El diseño es descriptivo-correlacional. Instrumentos: cuestionario de comportamiento para conductores y motociclistas (D.B.Q.) y encuesta tipo Likert. Muestra no probabilística intencional: 16.322 personas (8.631 conductores de automotores, 5.133 motociclistas y 2.558 peatones, pasajeros y acompañantes). Resultados: a) conductores con nivel educativo superior inciden en menos accidentes; b) peatones con menor nivel educativo inciden en mayores conductas riesgosas; c) las mujeres tienen actitud positiva y perciben eficacia de campañas en prevencion; d) estilos de conducción iracundo, ansioso, riesgoso y de alta velocidad cometen más infracciones y accidentes; e) desobedecer señales de tránsito, la principal causa de accidentalidad; f) agresividad, hostilidad y estrés en el tránsito son factores que aumentan la probabilidad de accidente; g) campañas de prevención no están siendo captadas por la población más afectada. Conclusiones y recomendaciones: Los factores de accidentalidad vial guardan correspondencia con el Triángulo de Seguridad Vial establecido por la Organización de las Naciones Unidas –factor humano preponderante en la accidentalidad–. Lineamientos de política pública fundamentados en procesos educativos y corporativos tendientes a disminuir la accidentalidad por lo general no se concibe aplicada a la seguridad pública. Por ello, se presenta la inteligencia criminal como una disciplina que se ocupa de anticipar los riesgos criminales contra la seguridad pública. Esto permitiría disminuir la incertidumbre durante la toma de decisiones y calcular los daños contra la seguridad pública, que se pretende prevenir.

Problem: The influence of the human factor on accident rates in the Colombian territory was analyzed, and empirical evidence was identified for the formulation of public traffic policy. Methodology: The design is descriptive-correlational. Instruments: A behavior questionnaire (the D.B.Q.) for car drivers and motorcyclists, and a Likert-type survey. An intentional non-probabilistic sample: 16,322 individuals (8,631 vehicle drivers, 5,133 motorcyclists and 2,558 pedestrians, passengers, and accompanying persons). Results: a) drivers with a higher educational level have a lower impact on the accident rate; b) pedestrians with a lower educational level exhibit more risky behaviors: c) women have a poenfusitive attitude and perceive the effectiveness of prevention campaigns; d) angry, anxious, risky and high-speed driving result in more traffic offenses and accidents; e) disobeying traffic signs is the main cause of accidents; f) aggressiveness, hostility and stress are factors tending to increase the likelihood of traffic accidents; g) prevention campaigns are not being heard by the more affected population. Conclusions and recommendations: The accident rate factors correspond to the Road Safety Triangle established by the UNO –human factor prominent in accident levels–. Public policy guidelines based on educational and corporative processes leading to reduce the accident rate.

Problema: A incidência do fator humano na acidentalidade rodoviária no território colombiano foi analisada e a evidência empírica para a formulação da política pública do tráfego foi identificada. Metodologia: O projeto é descritivo-correlacional. Instrumentos: questionário do comportamento para os motoristas e os motoqueiros (D.B.Q.) e pesquisa tipo Likert. Amostra intencional não-probabilística: 16.322 pessoas (8.631 condutores de automotores, 5.133 motoqueiros e 2.558 pedestres, passageiros e companheiros). Resultados: a) os condutores com nível educativo superior incidem em menos acidentes; b) os pedestres com nível educativo menor incidem em maiores condutas de risco; c) as mulheres têm uma atitude positiva e percebem a eficácia das campanhas na prevenção; d) os estilos de dirigir enfurecido, ansioso, riscoso e da alta velocidade contribuem a cometer mais infrações e acidentes; e) para desobedecer sinalizações rodoviárias, a causa principal da acidentalidade; f) a agressividade, a hostilidade e o stress no tráfego são os fatores que aumentam a probabilidade do acidente; g) as campanhas da prevenção não são captadas pela população afetada. Conclusões e recomendações: Os fatores da acidentalidade rodoviária correspondem ao Triângulo da Segurança Rodoviária estabelecido pelas Nações Unidas – fator humano preponderante na acidentalidade–. Diretrizes da política pública baseadas em processos educativos e corporativos tendentes a diminuir a acidentalidade.

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OBJECTIVE: To assess the association between bicycle helmet legislation and bicycle-related deaths sustained by children involved in bicycle-motor vehicle collisions. STUDY DESIGN: We conducted a cross-sectional study of all bicyclists aged 0-16 years included in the Fatality Analysis Reporting System who died between January 1999 and December 2010. We compared fatality rates in age-specific state populations between states with helmet laws and those without helmet laws. We used a clustered Poisson multivariate regression model to adjust for factors previously associated with rates of motor vehicle fatalities: elderly driver licensure laws, legal blood alcohol limit (<0.08% vs ≥ 0.08%), and household income. RESULTS: A total of 1612 bicycle-related fatalities sustained by children aged <16 years were evaluated. There were no statistically significant differences in median household income, the proportion of states with elderly licensure laws, or the proportion of states with a blood alcohol limit of >0.08% between states with helmet laws and those without helmet laws. The mean unadjusted fatality rate was lower in states with helmet laws (2.0/1,000,000 vs 2.5/1,000,000; P = .03). After adjusting for potential confounding factors, lower fatality rates persisted in states with mandatory helmet laws (adjusted incidence rate ratio, 0.84; 95% CI, 0.70-0.98). CONCLUSION: Bicycle helmet safety laws are associated with a lower incidence of fatalities in child cyclists involved in bicycle-motor vehicle collisions.

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OBJECTIVE: To understand the critical factors that are likely to influence road traffic fatality rates in large cities around the world in the next few decades. MATERIAL AND METHODS: Road traffic fatality data for 56 cities around the world and for cities with a population of greater than 100 000 in the USA were collected and analysed to understand factors affecting differences in fatality rates. RESULTS: There are wide variations in fatality rates across income levels and within similar incomes levels. The risk varies by a factor of about 20 between the best and the worst cities. CONCLUSIONS: These patterns appear to indicate that it is not enough to have the safest vehicle and road technology to ensure low road traffic fatality rates. City structure, modal share split, and exposure of motorists and pedestrians may have a significant role in determining fatality rates, in addition to enforcement, vehicle crashworthiness and road design.

OBJETIVO: Entender los factores críticos con probabilidad de influir en las tasas de fatalidad por tránsito en las grandes ciudades del mundo durante las próximas décadas. MATERIAL Y MÉTODOS: Se recolectaron y analizaron datos de fatalidad por tránsito de 56 ciudades del mundo y de las ciudades en Estados Unidos con más de 100 000 habitantes para entender aquellos factores que determinan diferencias en las tasas de fatalidad. RESULTADOS: Hay grandes variaciones en las tasas de fatalidad entre diferentes niveles de ingreso y dentro de niveles de ingreso similares. El riesgo varía por un factor de alrededor de 20 entre las mejores y las peores ciudades. CONCLUSIÓN: Estos patrones parecen indicar que no es suficiente tener vehículos y tecnologías viales más seguros para asegurar tasas bajas de fatalidad por tránsito. La estructura de la ciudad, el reparto modal del transporte y la exposición de los automovilistas y peatones pueden tener un papel significativo en la determinación de las tasas de fatalidad, además de la aplicación de los reglamentos, la protección de los vehículos contra impacto y el diseño de las vialidades.

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