Jennifer Oxley

It Cannot Be All about Safety: The Benefits of Prolonged Mobility

Objectives. While there is much emphasis on managing the safety of older road users, there is limited understanding and recognition of the significance of mobility and transportation needs, mobility changes in later life, and the impact of reduced mobility on quality of life. Moreover, there is little information about the measures that can be taken to increase or at least maintain mobility in older age. Method. A systematic literature review was undertaken to address the issues associated with the transportation and mobility needs of older road users. Articles and publications were selected for relevance and research strength and strategies and measures aimed to manage the safe mobility of older road users were reviewed. Results and Discussion. The review provides clear evidence that, for older adults who cease driving, quality of life is reduced and that there are a number of adverse consequences of poor mobility. The misconceptions regarding the risks that older drivers pose on the road and how their safe mobility should be managed are discussed, particularly the implications of current licensing procedures on mobility. Evidence is also presented showing there are subgroups of older adults who are more likely to suffer more pronounced mobility consequences including women and financially disadvantaged groups. Moreover, “best-practice” strategies for maintaining at least some level of mobility for older adults are highlighted in four broad categories: safer road users, safer vehicles, safer roads and infrastructure, and provision of new and innovative alternative transport options that are specifically tailored to older adults. Conclusions. Provision of safe travel options that allow easy access to services and amenities is a vital factor in maintaining mobility amongst older road users. An understanding that continued mobility means access to a private vehicle, either as a driver (for as long as possible as it is safe to drive) or as a passenger, and easy and practical access to other forms of transport is essential in the management of health, well-being, and the safe mobility of older road users.

Attitudes to and Mobility Impacts of Driving Cessation: Differences Between Current and Former Drivers

Safe travel remains an essential goal for any society, however, recognition of the benefits of continued mobility and, conversely, serious consequences of loss of mobility must also be considered. Driving affords the greatest mobility for many older adults and this often means access to a private vehicle for as long as it is safe to drive. Unfortunately, it is inevitable that, at some point, most individuals need to consider retiring from driving and this is often described as a traumatic experience. However, this is not necessarily the case for all drivers—how and when this decision is made can make a significant difference to the outcome. This study examined differences in attitudes toward driving cessation, life satisfaction, and mobility between current and former drivers. Surveys of adults 60 years and older were conducted in 3 Australian jurisdictions. The study highlights some of the factors that are associated with a more acceptable transition to nondriving and those that have a more favorable mobility outcome. These findings have implications for road safety professionals, clinicians, and geriatric specialists, particularly developing and using resources, information, and training programs to assist a smooth transition from driving to nondriving.

An Australasian model license reassessment procedure for identifying potentially unsafe drivers

Most licensing jurisdictions in Australia currently employ age-based assessment programs as a means to manage older driver safety, yet available evidence suggests that these programs have no safety benefits. This paper describes a community referral-based model license re assessment procedure for identifying and assessing potentially unsafe drivers. While the model was primarily developed for assessing older driver fitness to drive, it could be applicable to other forms of driver impairment associated with increased crash risk. It includes a three-tier process of assessment, involving the use of validated and relevant assessment instruments. A case is argued that this process is a more systematic, transparent and effective process for managing older driver safety and thus more likely to be widely acceptable to the target community and licensing authorities than age-based practices.

Cyclist exposure to the risk of car door collisions in mixed function activity centers: A study in Melbourne, Australia

ABSTRACT Objective: The objective of this study is to describe key risks related to dooring collisions on roads in mixed function activity centers by examining video footage recorded onboard the bicycles of cyclists riding through this road environment. The study aims to enhance our understanding of the risk associated with cyclist door collisions on these roads and to provide a focus for future studies that aim to identify measures that enhance cyclist safety. Method: The study measured 4 key risk exposures (per hour and kilometer), namely, on-street parked cars and 3 conditions associated with parked cars being accessed or egressed: door opened (a) after the cyclist passes (give-way event); (b) in the path of the cyclist without collision (obstruction event); and (c) in the path of the cyclist with collision (collision event). Exposure to the risk factors was measured using video footage recorded onboard the bicycles of adult cyclists (n = 25) as they rode through this road environment. The average speed of cyclists was also estimated from these video data and related to the measures of exposure. Results: The cycling experiences of the participants were observed over 3 h 58 min and 84.0 km. On average, the sample was exposed to 1,166 parked car events per hour (55 per kilometer), 6.9 give-way events per hour (0.3 per kilometer), 2.3 obstruction events per hour (0.1 per kilometer), and no collision events. There were 9 instances of obstruction events. In most cases, the cyclist was clearly visible (n = 7; 77.8%) and modified his or her position to avoid the door (n = 8; 88.9%). Moreover, the door was opened by the driver in nearly all cases (n = 8; 88.9%), primarily to exit the vehicle (n = 4; 44.4%) or enter the vehicle (n = 3; 33.3%). The average speed of cyclists was 22.7 km/h (SD = 4.1 km/h), and average speed tended to reduce as exposure to parked car events increased. Conclusion: Cyclists seldom interact with a vehicle occupant accessing or egressing a parked car, yet a concerning proportion of these interactions involve the occupant opening the door in the path of the cyclist, rather than waiting for the cyclist to pass. This suggests that there is still considerable need to identify measures that increase the likelihood that a vehicle occupant will look for cyclists before opening the car door, particularly in road environments where longer-term solutions such as physical separation are not readily achieved.

Emotional Distress as a Predictor of Work-Related Musculoskeletal Disorders in Malaysian Nursing Professionals

Background: Emotional distress is becoming a great concern and is more common in both developed and developing countries. It is associated with several disease conditions. Objective: To determine the prevalence of self-perceived emotional distress and its relation to work-related musculoskeletal disorders (WRMSDs) in nurses. Methods: A self-administered questionnaire survey was carried out on 660 female nurses working in public hospitals in the Klang Valley, Malaysia. The validated Malay version of the standardized Nordic musculoskeletal questionnaire (M-SNMQ) was used to identify the annual prevalence of WRMSDs; perceived emotional distress was assessed using the validated Malay short version, depression, anxiety, and stress (M-DASS) instrument. In addition, socio-demographic and occupational profiles of the participants were considered. Factors associated with WRMSDs were identified using logistic regression analysis. Results: A total of 376 nurses completed the survey (response rate 83.3%). 73.1% of the nursing staffs experienced WRMSDs in at least one anatomical site 12 months prior to the study. 75% of nurses expressed emotional distress. Of these, over half also reported anxiety and stress. Multiple logistic regression analysis showed that stress and anxiety significantly increased the risk of WRMSDs by approximately twofold. Conclusion: There were significant associations between emotional distress and WRMSDs. Future longitudinal studies are therefore needed to investigate and identify the sources of emotional distress (non-occupational and occupational) to be used to establish preventive strategies to reduce the risk of WRMSDs.