title: Factors affecting the severity of motor vehicle traffic crashes involving elderly drivers in Ontario.
abstract: A population-based cross-sectional study was conducted to examine factors affecting the severity of motor vehicle traffic crashes (MVTCs) involving elderly drivers in Ontario. The study population included drivers aged 65 and over involved in injury-producing MVTCs between 1988 and 1993 on Ontario public roads. Information was obtained from the Canadian Traffic Accident Information Databank (TRAID) compiled from police reports. The severity of MVTC was classified as fatal, major, minor or minimal. Comparisons between fatal-, major-, minor- and minimal-injury crashes were conducted. Percentage distributions of crashes at each level of severity involving elderly drivers were examined according to specific factors and tested using the X2 test. Multivariate unconditional logistic regression was used to calculate the estimated relative risk as odds ratios (ORs) while controlling for confounding factors. A number of factors were significantly related to the increased risk of fatal-injury in crashes compared with a reference category for each variable. These included age (OR = 1.4 for 70-79 and OR = 2.3 for 80 + ), sex (OR = 1.4 for males), failing to yield right-of-way/disobeying traffic signs (OR = 1.7), non-use of seat belts (OR = 4.0), ejection from vehicle (OR = 11.3), intersection without traffic controls (OR = 1.7), roads with higher speed limits (OR = 7.9 for 70-90 km/h; OR= 5.8 for 100 km/h), snowy weather (OR= 1.6), head-on collisions (OR=55.1), two-vehicle turning collisions (OR = 3.1 for left-turn, OR = 8.7 for right-turn), overtaking (OR = 5.6), and changing lanes (OR = 2.1). Adverse medical/physical conditions increased the risk of fatality by a factor of 5 for drivers 75-79 years of age and a factor of 3.5 for those 80 years and over. However, in the age group 65-74, medical/physical condition did not appear to be related to risk of fatality. Similar but weaker associations between these factors and risk of major- and minor-injury in crashes were also observed. To reduce the severity of crashes involving elderly drivers, strategies could target specific factors such as head-on collisions, single-vehicle collisions, and traffic controls at intersections. Driver conditions such as medical/physical conditions and driver actions such as failing to yield right-of-way/disobeying traffic signs should be examined further.
authors.affiliation: Environmental Risk Assessment and Case Surveillance Division, Laboratory Centre for Disease Control, Health Canada, Ottawa, Ont.
authors.forename: J
authors.initials: J
authors.lastname: Zhang
authors.forename: J
authors.initials: J
authors.lastname: Lindsay
authors.forename: K
authors.initials: K
authors.lastname: Clarke
authors.forename: G
authors.initials: G
authors.lastname: Robbins
authors.forename: Y
authors.initials: Y
authors.lastname: Mao
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D009864:Ontario / Q000453:epidemiology; D012307:Risk Factors; D014947:Wounds and Injuries / Q000453:epidemiology*