Journal of Safety Research最新文献

{"title":"A two-decade analysis of trends in drowning-related deaths among the U.S. geriatric population: 1999–2020","authors":"Shree Rath ,&nbsp;Asad Ali Ahmed Cheema ,&nbsp;Abu Huraira Bin Gulzar ,&nbsp;Muzamil Khan ,&nbsp;Muhammad Raza ,&nbsp;Hammad Javaid ,&nbsp;Umama Alam ,&nbsp;Ayesha Saleem ,&nbsp;Nouman Aziz ,&nbsp;Waseem Nabi","doi":"10.1016/j.jsr.2025.10.020","DOIUrl":"10.1016/j.jsr.2025.10.020","url":null,"abstract":"<div><div><em>Introduction:</em> Drowning among geriatric individuals is of concern, particularly as rising life expectancy contributes to a growing aging population worldwide. Older adults face heightened vulnerability due to age-related neurocognitive decline, physical impairments, and often inadequate supervision or care. This study examines drowning-related deaths among older adults in the United States and highlights strategies to mitigate these preventable fatalities <em>Methods:</em> A retrospective analysis was conducted using death certificate data from the CDC-WONDER database. The study evaluated demographic and regional disparities in drowning-related death rates among individuals aged 55 and older between 1999 and 2020. Crude and age-adjusted mortality rates (AAMRs) per 100,000 individuals were determined, and temporal changes in trends were evaluated using Joinpoint v5.4. <em>Results:</em> Between 1999 and 2020, 20,466 deaths were attributed to drowning among the geriatric population in the United States, with an AAMR of 12.23 per 100,000 individuals. The average annual percent change (AAPC) in mortality rate was 1.51% (95% CI: 1.21, 1.82), indicating a significant increase over the study period. The AAMR for geriatric drowning deaths rose steadily, with notable disparities across sex, race, geographic region, and urban–rural classification. Males had higher mortality rates than females, and non-Hispanic American Indian/Alaska Natives exhibited the highest overall AAMR among racial groups. The highest mortality was observed in the Western region, while rural areas had slightly higher rates than urban regions. <em>Conclusion:</em> The rising incidence of drowning among older adults presents a significant public health challenge. Age-related declines in mobility, balance, cognition, and chronic health conditions increase vulnerability in aquatic environments. <em>Practical Applications:</em> This study highlights the need for age-specific drowning prevention strategies, including improved supervision, environmental modifications, and community-based education programs tailored for older adults. Enhancing access to water safety training and fall-prevention initiatives in high-risk populations could substantially reduce drowning-related mortality in this vulnerable age group.</div></div>","PeriodicalId":48224,"journal":{"name":"Journal of Safety Research","volume":"95 ","pages":"Pages 446-454"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145473508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of risk assessment algorithms recommended by the World Falls Guidelines (WFG) to predict fall and fall-related injury among older Chinese community-dwellers","authors":"Weiqiang Li ,&nbsp;Min Zhao ,&nbsp;Yanhong Fu ,&nbsp;David C. Schwebel ,&nbsp;Na Zhang ,&nbsp;Lei Yang ,&nbsp;Jingtao Zhou ,&nbsp;Youyou Wu ,&nbsp;Tongfei Zhang ,&nbsp;Peishan Ning ,&nbsp;Li Li ,&nbsp;Zhenzhen Rao ,&nbsp;Guoqing Hu","doi":"10.1016/j.jsr.2025.10.018","DOIUrl":"10.1016/j.jsr.2025.10.018","url":null,"abstract":"<div><div><em>Introduction:</em> The World Falls Guidelines (WFG) Task Force published a falls risk stratification algorithm in 2022, but its predictive performance was reported only in Ireland, the United States, the Netherlands, Australia, and Malaysia. Methods: Using a nationally representative dataset, the China Health and Retirement Longitudinal Study (CHARLS), we analyzed data from six follow-up cohort visits (2, 3, 4, 5, 7, 9 years). The Cochran-Armitage trend test examined trends in fall and fall-related injury rate across the WFG algorithm. Multivariable logistic regression models examined associations between the WFG algorithm and fall and fall-related injury incidence rates. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and 95% confidence intervals (95% <em>CIs</em>) were calculated to assess predictive performance of the WFG algorithm. Sensitivity analyses were performed to assess the impact of missing values on principal findings. <em>Results:</em> We included 9,735, 5,377, 4,092, 9,426, 7,776, and 3,355 eligible older adults across the six follow-up time periods, with sample sizes varying due to the study’s dynamic recruitment strategy. Fall risk categorized by WFG algorithm was significantly associated with falls and fall-related injuries at all six follow-up cohorts (<em>p</em> &lt; 0.05). However, its predictive performance for both falls and fall-related injuries was unacceptable, with sensitivity ranging from 20.2% to 32.5% for both outcomes across the six follow-up visits. Sensitivity analyses displayed highly similar results. Conclusion: The WFG algorithm is valuable for predicting future falls and fall-related injuries among older Chinese community-dwellers, but its predictive performance is unacceptable for practical use without considering other contributing factors. <em>Practical Applications:</em> Further methodological modifications of the WFG algorithm are recommended to improve its predictive performance.</div></div>","PeriodicalId":48224,"journal":{"name":"Journal of Safety Research","volume":"95 ","pages":"Pages 338-344"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the safety effectiveness of advanced driver assistance systems","authors":"Shengxuan Ding,&nbsp;Mohamed Abdel-Aty,&nbsp;Samgyu Yang,&nbsp;Chenzhu Wang","doi":"10.1016/j.jsr.2025.10.014","DOIUrl":"10.1016/j.jsr.2025.10.014","url":null,"abstract":"<div><div><em>Introduction</em>: Advanced Driver Assistance Systems (ADAS) have been increasingly integrated into modern vehicles to enhance safety and reduce crash risk, however, a comprehensive evaluation of their safety effectiveness across various traffic conditions is still needed. <em>Method:</em> This study assesses the real-world safety impact of ADAS using data from 3,549 ADAS-equipped vehicles and 3.76 million non-ADAS vehicles involved in two-vehicle crashes covering 34 models and 41 brands from 2017 to 2023. These ADASs are associated with specific driving maneuvers, including lane-changing with Blind Spot Warning (BSW), backing with Rear Cross Traffic Alert (RCTA), and straight-ahead driving with Forward Collision Warning (FCW), and are assumed to be activated during their respective maneuvers. The Quasi-Induced Exposure (QIE) method is applied to compare ADAS-equipped and non-ADAS-equipped vehicles across various conditions, analyzing key variables such as crash outcome, road condition, weather pattern, and driver behavior. <em>Results:</em> Results show that most ADAS-equipped vehicles are effective in reducing crashes under various traffic conditions when compared to non-ADAS-equipped vehicles. Additionally, this research compared a series of Bayesian hierarchical models and selected the best-fitting Bayesian Hierarchical Random-Parameter Model (BHRPM) considering unobserved heterogeneity to investigate the determinants influencing the crash responsibility for ADAS-equipped vehicle. Results reveal that intersections, dark unlit conditions, and higher speeds increase the likelihood of ADAS-equipped vehicle responsibility in a crash, while daylight, rural roads, and lower speeds decrease it. The interaction between vehicle type and ADAS is particularly critical. <em>Practical applications:</em> The analysis highlights both the strengths and limitations of current ADAS, providing a detailed examination of specific ADAS safety functions in the contexts where they are most commonly deployed.</div></div>","PeriodicalId":48224,"journal":{"name":"Journal of Safety Research","volume":"95 ","pages":"Pages 345-361"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The protective effect of pedestrian reflective devices: A combined micro- and macro-level study","authors":"Rune Elvik","doi":"10.1016/j.jsr.2025.11.004","DOIUrl":"10.1016/j.jsr.2025.11.004","url":null,"abstract":"<div><div><em>Introduction:</em> From 2003 to 2022 pedestrian use of reflective devices in darkness on lit roads in urban areas in Norway increased from 11% to 43%. This paper reports a study evaluating: (a) the protective effect of reflective devices for each pedestrian and (b) the effect on the number of injured pedestrians of an increase in the use of reflective devices. <em>Method:</em> To evaluate the protective effect of reflective devices for each pedestrian a case-control study was made, using injured pedestrians as cases, and pedestrians observed in traffic as controls. To evaluate the effects of increased use of reflective devices, ARIMA time series models and Poisson regression models for panel data were applied. <em>Results:</em> Use of reflective devices was associated with a reduction of 84% (odds ratio 0.16) of the chance of getting injured on lit roads in urban areas. The estimated effect is large, but not inconsistent with estimates of the increased safety margin as indicated by the increase in recognition distance to pedestrians using reflective devices. ARIMA time series models and Poisson regression models for panel data consistently indicated that increased use of reflective devices was associated with a reduction of the number of injured pedestrians. The negative sign was consistent, but the values of the coefficient varied substantially between models and was in most cases not statistically significant. A conservative estimate is that the increased use of reflective devices may have reduced the number of pedestrians injured in darkness on lit roads in urban areas by about 10–15%. <em>Conclusions:</em> Use of reflective devices in darkness is likely to protect pedestrians from traffic injury. <em>Practical applications:</em> Reflective devices are a cheap and effective method of reducing pedestrian injury in darkness which remains underutilized. Measures promoting the use of reflective devices are likely to be very cost-effective.</div></div>","PeriodicalId":48224,"journal":{"name":"Journal of Safety Research","volume":"95 ","pages":"Pages 522-529"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public perspectives on the 20 mph speed reduction in Wales: A Latent Dirichlet Allocation Approach","authors":"Burcu Tekeş ,&nbsp;Tuğba Uyar Suiçmez ,&nbsp;Charles Musselwhite ,&nbsp;Rıfat Can Telci","doi":"10.1016/j.jsr.2025.11.003","DOIUrl":"10.1016/j.jsr.2025.11.003","url":null,"abstract":"<div><div><em>Introduction</em>: This study investigates public attitudes toward the Welsh Government’s implementation of a 20 mph default speed limit on all non-unrestricted roads, for example those in urban environments, residential neighborhoods, and areas with high pedestrian activity, that previously were 30 mph, aimed at reducing traffic crashes, emissions, and improving quality of life. <em>Method:</em> Using a Latent Dirichlet Allocation (LDA) approach and VADER sentiment analysis to assess emotional tone, posts on <em>X</em> (formerly Twitter) with hashtags #20 mph and #20 mya (Welsh language for mph) were analyzed during two periods: one-month post-implementation (September–October 2023) and six months later (February–March 2024). <em>Results:</em> The results indicate that public opposition to the 20 mph default speed limit decreased slightly six months after its implementation but remained high. However, since opposition declined while positive sentiment increased, results suggest a positive trend, aligning with psychological theories on social influence and attitude change. <em>Conclusions</em>: The study underscores the value of a qualitative-quantitative approach in capturing nuanced public perspectives, offering insights beyond traditional survey methods. These findings provide actionable guidance for policymakers and practitioners seeking to implement and communicate public safety policies effectively. <em>Practical Applications:</em> This research uniquely contributes to the literature by examining the 20 mph speed limit in Wales, combining computational and psychological methods to explore public opinion dynamics over time.</div></div>","PeriodicalId":48224,"journal":{"name":"Journal of Safety Research","volume":"95 ","pages":"Pages 495-504"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of automatic emergency braking on the benefits of red-light safety cameras","authors":"Wen Hu,&nbsp;Jessica Cicchino","doi":"10.1016/j.jsr.2025.09.008","DOIUrl":"10.1016/j.jsr.2025.09.008","url":null,"abstract":"<div><div><em>Introduction:</em> With the increasing prevalence of crash avoidance technologies, well-established effects of traditional safety countermeasures may change. This study examines the impact of automatic emergency braking (AEB) systems on the effects of red-light safety cameras on real-world crashes at signalized intersections. <em>Method:</em> Effects of AEB systems alone on rear-end crashes and rear-end injury crashes at signalized intersections were estimated using crash data from 19 states and Poisson regression models. Effects of red-light safety cameras alone on rear-end crashes, rear-end injury crashes, all crashes, and all injury crashes were evaluated by <em>meta</em>-analysis of 35 previous studies. Based on these two analyses, effects of red-light safety cameras on crashes were calculated assuming that 28%, 51%, 95%, and 100% of vehicles on the road were equipped with AEB systems. <em>Results:</em> As the percentage of vehicles equipped with AEB grows, the increases in rear-end crashes and rear-end injury crashes associated with red-light safety cameras decline, and the reductions in all crashes and all injury crashes grow. With no AEB impact, red-light safety cameras are associated with a 21% increase in rear-end crashes, a 10% increase in rear-end injury crashes, a 7% reduction in all crashes, and a 19% reduction in all injury crashes. Those figures improve in tandem as more vehicles are equipped with AEB. Assuming all vehicles have AEB, the increases in rear-end crashes and rear-end injury crashes decline to 13.5% and 5.9%, respectively, and the reductions in all crashes and all injury crashes grow to 9.7% and 20.2%, accordingly. <em>Conclusions:</em> The growing prevalence of AEB systems will extend the benefits of red-light safety cameras by mitigating associated increases in rear-end crashes. Estimates of the benefits of other proven safety countermeasures should also be reevaluated to account for the growing impact of crash avoidance technologies.</div></div>","PeriodicalId":48224,"journal":{"name":"Journal of Safety Research","volume":"95 ","pages":"Pages 160-170"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of research on influencing factors of safety performance: A grounded theory approach","authors":"Daojian Yang,&nbsp;Beibei Liu,&nbsp;Suxia Liu","doi":"10.1016/j.jsr.2025.10.022","DOIUrl":"10.1016/j.jsr.2025.10.022","url":null,"abstract":"<div><div><em>Introduction:</em> Effective safety management is essential for achieving high safety performance, which is foundational to both employee health and safety and the sustainable development of enterprises. Although substantial research has been conducted on the factors influencing safety performance, current comprehensive understanding remains insufficient. <em>Methods:</em> This study employed the grounded theory approach to identify and code antecedents and moderators of safety performance at four levels: individual, job characteristic, organizational, and social. Based on this analysis, it also developed influencing frameworks for each level, as well as a comprehensive influencing framework. <em>Results:</em> A total of 235 antecedents influencing safety performance were distilled into 47 primary categories, which were ultimately condensed into 19 core categories. At the individual level, these include individual traits, professional quality, psychosomatic health, job behavior, and safety literacy. At the job characteristic level, categories comprise job features, job conditions, organizational climate, and job stress. The organizational level encompasses leadership traits, team traits, safety climate, safety culture, safety commitment and support, safety guidelines, safety management practices, and work management practices. Finally, at the social level, categories consist of socio-economic and technological environments, as well as social safety governance. Similarly, 25 moderators of safety performance were distilled into 14 main categories, which were summarized into 9 core categories. These include personality traits, psychological status, and professional quality at the individual level; job risk at the job characteristic level; and leadership style, safety climate, safety culture, safety support, and safety campaigns at the organizational level. <em>Conclusion:</em> Each level exerts a distinct influence on various dimensions of safety performance, with complex interactions among the influencing factors across different levels. <em>Practical application:</em> The findings of this study can help enterprises identify the root causes of safety performance issues and offer valuable insights for improving safety performance across various levels.</div></div>","PeriodicalId":48224,"journal":{"name":"Journal of Safety Research","volume":"95 ","pages":"Pages 373-395"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk awareness assessment of construction workers wearing AR head-mounted displays using EEG signals","authors":"Hanwen Ju ,&nbsp;Tanyel Bulbul ,&nbsp;Xiaoying Yang ,&nbsp;Jeremy Withers","doi":"10.1016/j.jsr.2025.10.011","DOIUrl":"10.1016/j.jsr.2025.10.011","url":null,"abstract":"<div><div><em>Introduction:</em> Augmented reality (AR) head-mounted displays have gained attention in the construction industry for enhancing information visualization and operational efficiency. However, their impact on workers’ risk awareness remains underexplored. <em>Method:</em> This study proposes a novel EEG-based framework to evaluate the risk awareness of construction workers performing tasks in an AR-enhanced environment. Forty participants equipped with AR headsets and EEG devices completed a series of tasks—standing, walking, and measuring—on a simulated elevated steel frame. EEG signals were processed using wavelet transforms to extract real-time power in theta, alpha, beta, and gamma bands, from which engagement (<em>ENI</em>) and vigilance indices were derived. <em>Results:</em> The result shows that cognitive engagement increases while vigilance decreases during high workload tasks such as measuring, indicating reduced risk awareness. Statistical analyses confirm that task type significantly affects both ENI and vigilance, while repeated exposure improves overall vigilance but has limited effect on high-load tasks. <em>Practical applications:</em> These findings provide a neurocognitive perspective on how AR affects worker safety and highlight the importance of task-specific design and training in AR-integrated construction work.</div></div>","PeriodicalId":48224,"journal":{"name":"Journal of Safety Research","volume":"95 ","pages":"Pages 237-250"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145320950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect mechanism of construction workers’ emotion on unsafe behavior: Mediating role of safety attitude and moderating role of emotional intelligence","authors":"Feilian Zhang ,&nbsp;Zhe Wu ,&nbsp;Yanchun Zhang ,&nbsp;Yu Wang","doi":"10.1016/j.jsr.2025.10.015","DOIUrl":"10.1016/j.jsr.2025.10.015","url":null,"abstract":"<div><div><em>Introduction</em>: Construction workers’ unsafe behavior has been recognized as a primary cause of workplace safety accidents. Emotion, as an important psychological factor for construction workers, has been studied in a relatively limited way regarding its effect on unsafe behavior. This study aims to reveal the effects of construction workers’ positive and negative emotions on unsafe behavior, as well as the mediating role of safety attitude and the moderating role of emotional intelligence from a multi-theoretical integration perspective. <em>Method</em>: This study conducted an anonymous questionnaire of 568 construction workers in stages using the Hash-based anonymous unique identifier generation technique, and analyzed the data using structural equation modeling, bias-corrected percentile bootstrapping, and hierarchical linear regression, so as to validate the multi-theoretical integration framework of the emotion-attitude-behavior that was proposed. <em>Results:</em> The results indicated that positive emotion can reduce unsafe behavior directly or indirectly by enhancing safety attitude, while negative emotion can increase unsafe behavior directly or indirectly by weakening safety attitude. In addition, emotional intelligence can moderate the relationship between emotions and safety attitude, which means that high emotional intelligence can amplify the beneficial effect of positive emotion on safety attitude while attenuating the detrimental effect of negative emotion on safety attitude. <em>Conclusions:</em> Positive and negative emotions have a dual role in construction workers’ unsafe behavior, in which safety attitude plays a mediating role and emotional intelligence plays a moderating role. <em>Practical Applications:</em> These findings provide novel insights into the relationship between construction workers’ emotion and unsafe behavior, offering practical implications for the development of safety management strategies in the construction industry from an emotion management perspective.</div></div>","PeriodicalId":48224,"journal":{"name":"Journal of Safety Research","volume":"95 ","pages":"Pages 318-329"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding cannabis use and car crashes: Insights from a randomized trial using a driving simulator on THC blood levels and subjective measures of sleepiness and performance","authors":"Bibiana Cardozo ,&nbsp;Sarah Hartley ,&nbsp;Nicolas Simon ,&nbsp;Jean Claude Alvarez","doi":"10.1016/j.jsr.2025.09.005","DOIUrl":"10.1016/j.jsr.2025.09.005","url":null,"abstract":"<div><div><em>Introduction:</em> To investigate whether THC inhalation increases driving collisions, and to explore the relationship between car crashes and self-assessed driving ability as measured by Visual Analog Scales (VAS) and the Karolinska Sleepiness Scale, 30 male volunteers aged 18–30 years old, with a BMI of 18.5–26.2 Kg/m², moderate tobacco and caffeine consumption, and at least one year of cannabis use either chronically (1–2 joints per day) or occasionally (1–2 joints per week) participated in a randomized, double-blind, crossover study comparing three doses of THC (placebo, 10 mg, and 30 mg). <em>Method:</em> Participants received one cigarette with a different THC dose in three randomized sequences, separated by a seven-day washout period. Following each cigarette, participants were hospitalized for 24 h, during which blood samples were taken and driving performance was assessed using the York driving simulator. Additionally, self-assessment scales were completed to measure subjective feelings of awareness, calmness, confusion, adroitness, mental sharpness, and driving confidence. <em>Results:</em> The number of car crashes on driving simulator increased from one hour, showing a significant increased and delayed effect observed 4 h post-inhalation of THC at 10 mg and 30 mg (Beta = 0.65, 95% CI = [0.45, 0.86], p &lt; 0.001 and IRR = 1.9, p &lt; 0.001), indicating this period as critical for assessing cannabis impairment and its implications for traffic safety. Although some crashes occur earlier, this delayed four hour-peak effect may suggests that the highest car crash risk on the simulator does not coincide with the period of maximum THC levels, which typically occur within 5 to 15 min of cigarette completion. Furthermore, blood THC-C_max, was strongly associated with increased risk of car collisions at 4 h, (Beta = 3.63, 95% CI = [2.56, 4.70], p &lt; 0.001 and IRR = 37.7, p &lt; 0.001). The increase in sleepiness following cannabis consumption, measured by the Karolinska Sleepiness Scale, correlated with higher car crashes on simulator rates (Beta = 0.10, 95% CI = [0.05, 0.15], p &lt; 0.001 and IRR = 1.1, p &lt; 0.001). <em>Conclusions:</em> This study also found that driving collisions were positively associated with VAS adroitness (Beta = 0.010, 95% CI = [7.89e-03, 0.01], p &lt; 0.001) and IRR = 1.0, p &lt; 0.001. Remarkably, no significant difference in car collisions between occasional and chronic users was found, opposing the notion that chronic users are less impaired. Both chronic and occasional cannabis users have a similar car crash risk on simulator testing, with younger participants showing a higher risk, highlighting the need for targeted road safety campaigns. <em>Practical Applications:</em> The direct link between subjective perceptions of driving proficiency and actual performance suggests that interventions aimed at improving self-awareness could be beneficial.</div></div>","PeriodicalId":48224,"journal":{"name":"Journal of Safety Research","volume":"95 ","pages":"Pages 109-116"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}