DISTRACTION & INJURY: HOLDING BACK THE TIDE Beth Ebel, MD, MSc, MPH Harborview Injury Prevention & Research Center University of Washington/Seattle Children s Hospital September 24, 2013 DISCLOSURE & ACCREDITATION Acknowledgement is made on behalf of the presenter that there is no commercial support for this presentation Dr. Ebel has no conflicts of interest to disclose.
DISTRACTED DRIVING: A PUBLIC HEALTH PROBLEM OUTLINE 1. Understanding distraction and injury risk 2. Distraction in the WAMI region 3. Promising strategies for reducing distracted driving Individual Enforcement Legal framework 4. Distraction and you OUTLINE 1. Understanding distraction and injury risk Drivers
RISE IN DISTRACTION More mobile phones than people in the US (2011). Up to 28% of vehicle crash risk attributable to distraction from cell phone use or text messaging. RELATIVE RISK OF TEXTING & DRIVING Risk of distraction Naturalistic study of truckers Cell phone use was more common than texting, so greater overall risk. Relative crash risk highest for texting. Text messaging had the longest duration of eyes off road (VTTI) CELL PHONE USE AT THE TIME OF THE LAST CRASH OR NEAR-CRASH, BY SEX AND AGE
NOT JUST KIDS Study design: On-line convenience survey of 2,400 mothers with children under 2 Results: 78% of moms talked on the phone while driving with their kids 26% sent texts or checked email Nearly 10% of new moms reported they been in a crash while driving with their baby DISTRACTION IN ACTION Distracted driving video OUTLINE 1. Understanding distraction and injury risk Drivers Pedestrians
DISTRACTED WALKING 60,000 pedestrians injured; 4,000 killed each year in US Law assigns pedestrians right of way. But. Actions by pedestrians account for 15% of all deaths Distracted walking, like distracted driving, is growing problem DISTRACTED WALKING DISTRACTED PEDESTRIAN STUDY Pedestrians observed at 20 high-risk intersections Observers recorded crossing behaviors, including use of mobile device
DISTRACTED WALKING Observed 1102 people crossing the street 1 in 3 people distracted by mobile devices 11% listening to music 7% texting 6% talking on the phone DISTRACTED WALKING Texting while crossing the road is most distracting and potentially most dangerous activity 1. Texters were 4 times more likely to ignore basic pedestrian safety behaviors Fail to crossing with the lights, cross at the middle of the junction, or fail to look both ways 2. Texters did not look at cars while crossing 3. Spent more time in the street Texters took 2 seconds (18%) longer to cross street OUTLINE 1. Understanding distraction and injury risk 2. Distraction in the WAMI region
DISTRACTED DRIVING FATALITIES AND SERIOUS INJURIES IN WASH. 2009-2011 DISTRACTED DRIVING IN WASHINGTON 6 Washington counties Drivers observed at controlled intersections Observed electronic distraction (texting, talking, phone position) INCIDENCE OF DISTRACTED DRIVING AT CONTROLLED INTERSECTIONS IN 6 WASHINGTON COUNTIES, 2013 N=7800 DRIVERS 3.7% 1.7% 1.7% 1.0% 8.1%
WHAT IS DISTRACTING WASHINGTON DRIVERS? OUTLINE 1. Understanding distraction and injury risk 2. Distraction in the WAMI region 3. Promising strategies for reducing distracted driving Individual Education Technology PRINCIPLES OF INJURY PREVENTION Education Enforcement Physical Environment Social Environment
HARD TO CHANGE THIS RISKY BEHAVIOR Drivers know texting and talking on a cell phone is dangerous Drivers know texting and talking on a handheld phone is illegal Drivers are irritated at the distracted driving around them Yet. They continue to talk and text while driving Separating the : Smoking kills you from the : Telling people that smoking kills you doesn t stop young people from smoking PUBLIC HEALTH FALLACY : Truth anti-smoking campaign TOBACCO AD
TRUTH ANTI-SMOKING CAMPAIGN SEAT BELT USE RATES IN WA CLASSICAL CONDITIONING
CELL PHONE/TEXTING CAN BE COMPULSIVE 1. Habit of picking up the device to answer is hard to suppress 2. Holding phone is physical (eyes off the road, hand off the wheel) and cognitive distraction DEVELOPING MARKETING STRATEGIES FOR REDUCING DISTRACTED DRIVING WHAT WORKS TO CURB DISTRACTED DRIVING? 1. Learn from what has worked Drunk driving Seat belt use 2. Barriers Lake Woebegone phenomenon But it s important! Pavlov s dog 3. Individual strategies General education Role model and family commitment Technological solutions Risk of citation
OUTLINE 1. Understanding distraction and injury risk 2. Distraction in the WAMI region 3. Promising strategies for reducing distracted driving Individual Education Technology Enforcement IMPROVE ENFORCEMENT Goal: Identify strategies for improving implementation and enforcement of distracted driving legislation CELL PHONE DISTRACTION ENFORCEMENT Survey of WA law enforcement found significant variability in enforcement practices Significant variation in prosecution of distraction driving
CELL PHONE DISTRACTION ENFORCEMENT OFFICER FOCUS GROUP STUDY Three focus groups held with law enforcement officers in King, Whatcom, and Spokane counties in 2013 Various levels of enforcement within & between agencies To ear language in state law Proof of texting (drivers throw the phone) Citation outcomes ENFORCEMENT CHALLENGES Lack of extra patrol funds Law enforcement users of in-vehicle technology
THEME: CELL PHONE/TEXTING IS COMPULSIVE AND RISKY BEHAVIOR 1. Habit of picking up the device to answer is hard to suppress 2. Holding phone is physical (eyes off the road, hand off the wheel) and cognitive distraction THEME: DRIVERS KNOW LAWS BUT CONTINUE THEIR DISTRACTING PRACTICES THEME : ENFORCEMENT CHANGES DRIVER BEHAVIOR Behavior change happens when law enforcement and public education go hand in hand. Ex: stigma of DUI Ex: seat belt enforcement Most effective enforcement is writing a ticket. Traffic school viewed as positive learning experience
OUTLINE 1. Understanding distraction and injury risk 2. Distraction in the WAMI region 3. Promising strategies for reducing distracted driving Individual Education Technology Enforcement Legislative TEXTING LEGISLATION WASHINGTON DISTRACTION LAW Cell use: A person operating a moving motor vehicle while holding a wireless communications device to his or her ear is guilty of a traffic infraction. (exempts hands-free) (RCW 46.61.667) Texting: A person operating a moving motor vehicle who, by means of an electronic wireless communications device, sends, reads or writes a text message, is guilty of a traffic infraction. (RCW 46.61.668) Holders of Instruction Permit or Intermediate License: Cannot use any wireless communication device (regardless if hand-held or hands-free) while driving unless in an emergency situation. (RCW 46.20.055; RCW 46.20.075)
LOCAL ORDINANCES 2 COUNTIES, 44 CITIES Local ordinances address inattention Fines vary between $25-$1000 (many limit fine to >$250) Fines levied under local ordinances stay local Primary enforcement HOW COULD THE LAW BE STRENGTHENED? 1. Drop phone to ear ; include any talking on handheld device 2. Change texting to manipulating handheld device 3. Drop stop sign/signal exemption 4. Escalating fine ($124 -> $250) 5. Consider points on license for 2 nd offense 6. Decal to identify provisional license-holders, so laws pertaining to inexperienced drivers can be enforced OUTLINE 1. Understanding distraction and injury risk 2. Distraction in the WAMI region 3. Promising strategies for reducing distracted driving 4. Distraction and you
HOW MIGHT THIS IMPACT YOU? Benefits mobile device use Efficient communication of information Theoretically always easy to find Take care of issues without having to talk with someone Stay in touch with family and friends DISTRACTION ON THE JOB OTHER DISTRACTIONS
AUDIENCE SURVEY HOW MIGHT THIS IMPACT YOU? You are at high risk of a crash You may drive while fatigued Texting is illegal. You will get a $124 ticket Hands free solutions There s an app for that Explicit time management 1. Distraction is a growing public health hazard CONCLUSIONS 2. Information on risk doesn t change behavior. Need creative solutions 3. Detection and enforcement is one important approach 4. Consider your own practices and safety (at work, personal)
QUESTIONS?