title: Road traffic accidents and self-reported Portuguese car driver's attitudes, behaviors, and opinions: Are they related?
abstract: This study aims to characterize Portuguese car drivers in terms of demographic characteristics, driving experience, and attitudes, opinions, and behaviors concerning road traffic safety. Furthermore, associations between these characteristics and self-reported involvement in a road traffic accident as a driver in the last 3 years were analyzed. A final goal was to develop a final predictive model of the risk of suffering a road traffic accident.
  
  
  
  A cross-sectional analytic study was developed, based on a convenience sample of 612 car drivers. A questionnaire was applied by trained interviewers, embracing various topics related to road safety such as driving under the influence of alcohol or drugs, phone use while driving, speeding, use of advanced driver assistance systems, and the transport infrastructure and environment (European Project SARTRE 4, Portuguese version). From the 52 initial questions, 19 variables were selected through principal component analysis. Then, and in addition to the usual descriptive measures, logistic binary regression models were used in order to describe associations and to develop a predictive model of being involved in a road traffic accident.
  
  
  
  Of the 612 car drivers, 37.3% (228) reported being involved in a road traffic accident with damage or injury in the past 3 years. In this group, the majority were male, older than 65, with no children, not employed, and living in an urban area. In the multivariate model, several factors were identified: being widowed (vs. single; odds ratio [OR] = 3.478, 95% confidence interval [95% CI], 1.159-10.434); living in a suburban area (vs. a rural area; OR = 5.023, 95% CI, 2.260-11.166); having been checked for alcohol once in the last 3 years (vs. not checked; OR = 3.124, 95% CI, 2.040-4,783); and seldom drinking an energetic beverage such as coffee when tired (vs. always do; OR = 6.822, 95% CI, 2.619-17.769) all suffered a higher risk of being involved in a car accident.
  
  
  
  The results obtained with regard to behavioral factors meet the majority of the risk factors associated with car accidents referred to in the literature. This study highlights the relation of relatively minor accidents (the majority with no injuries) with an urban (or semi-urban) context and involving older drivers. These accidents are not usually the focus of road safety literature (mainly death and serious health loss) but, in addition to the economic costs involved, they can have a huge impact on road safety (e.g., pedestrian). Specifically, the following interventions can be proposed: more detailed clinical examinations to identify real competencies to drive especially in older drivers (active aging can constitute a new challenge in road safety and new paradigms can arise) and education campaigns on how to cope with fatigue. Future studies in large samples and not based on self-reported behaviors should be developed.
authors.affiliation: a Escola Nacional de Saúde Pública, Universidade Nova de Lisboa , Lisbon , Portugal.
authors.forename: Teresa
authors.initials: T
authors.lastname: Bon de Sousa
authors.affiliation: a Escola Nacional de Saúde Pública, Universidade Nova de Lisboa , Lisbon , Portugal.
authors.forename: Carolina
authors.initials: C
authors.lastname: Santos
authors.affiliation: b Division of Health Research, Lancaster University , Lancaster , UK.
authors.forename: Ceu
authors.initials: C
authors.lastname: Mateus
authors.affiliation: c Prevenção Rodoviária Portuguesa , Lisbon , Portugal.
authors.forename: Alain
authors.initials: A
authors.lastname: Areal
authors.affiliation: c Prevenção Rodoviária Portuguesa , Lisbon , Portugal.
authors.forename: Jose
authors.initials: J
authors.lastname: Trigoso
authors.affiliation: d Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa , Portugal.
authors.forename: Carla
authors.initials: C
authors.lastname: Nunes
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001290:Attitude; D001334:Automobile Driving / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011174:Portugal; D012307:Risk Factors; D012449:Safety; D057566:Self Report; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: attitudes and opinions; behavior; car drivers; road traffic accident