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UW MEDICINE │ INJURY CONTROL
DISTRACTION & INJURY:
HOLDING BACK THE TIDE
Beth Ebel, MD, MSc, MPH
Harborview Injury Prevention & Research Center
University of Washington/Seattle Children’s Hospital
Nov 21, 2013
DISTRACTED DRIVING: A PUBLIC HEALTH
PROBLEM
OUTLINE
1. Understanding distraction
and injury risk
2. Distraction in Washington
3. Promising strategies for
reducing distracted driving
–
–
–
Individual
Enforcement
Legal framework
4. Distraction on the job
OUTLINE
1. Understanding distraction
and injury risk
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)
Relative Risk of Near
Crash Event
23.2
25
21.3
20
15
10
5
0
4
4
blood alcohol .08
Cell phone
Text messaging
blood alcohol 0.19
CELL PHONE USE AT THE TIME OF THE LAST CRASH
OR NEAR-CRASH, BY SEX AND AGE
NHTSA Traffic Safety
Facts April 2012
Total 13%
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
American Baby magazine,
June 2013
8
DISTRACTION IN ACTION
Distracted driving video
9
OUTLINE
1. Understanding distraction
and injury risk
2. Distraction in Washington
DISTRACTED DRIVING FATALITIES AND
SERIOUS INJURIES IN WASH. 2009-2011
Total
Distraction
Related
Distraction as
% of Total
Traffic Deaths
1,706
426
30.3%
Serious Injuries
7,249
867
12.0%
11
DISTRACTED DRIVING IN WASHINGTON
 6 Washington
counties
 Drivers observed at
controlled
intersections
 Observed electronic
distraction (texting,
talking, phone
position)
OBSERVATION RESULTS
• Observed 7930 drivers at 120 sites in 6
counties.
• At any given moment, nearly 1 in 10
were using cellular phone, either
talking or texting (9.5%).
• At any given moment, 3.7% of drivers
were texting
13
Percentage of Distracted Drivers using
electronic devices for Six Counties in WA
(2013 UW Study)
12%
A
x 10%
i 8%
s 6%
T 4%
i 2%
t
0%
l
e
9.40%
9.40%
10.60%
9.20%
7.90%
3.60%
Series1
14
Talking And Texting Among Drivers Using
An Electronic Device
Talking handsfree (bluetooth,
headset)
11%
Talking on
handheld
Texting or
phone
visible
(speaker)
manipulation
4%
of handheld
Talking on
device
cellular phone
47%
(phone to ear)
38.1%
OBSERVATION RESULTS
• Relative to males, female drivers more
commonly engaged in electronic
distraction (PR 1.23 (95% CI 1.01,
1.49))
• Females more likely to text while
driving (PR 1.31, (95% CI 1.01, 1.69).
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CITATIONS FOR CELL PHONE/TEXTING WHILE
DRIVING, 6 LARGE WASHINGTON COUNTIES
40000
36985
35000
32262
30000
25000
20848
Phone Use while Driving
20000
Texting while Driving
15000
10000
5000
757
1323
1652
0
2010
2011
2012
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CELL PHONE USE WHILE DRIVING
Charge/Law Number
2010
2011
2012
2010
CELL PHONE USE WHILE DRIVING
2011
2012
Rate per 1,000 licensed drivers
(46.61.667 / 46.61.667.1A / 46.61.667.1B/ 11.84.480)
King
7876
13383
11465
4.99
8.40
7.04
8388
15100
13554
5.32
9.47
8.32
Pierce
2208
3558
3829
3.68
5.89
6.24
Snohomish
6191
12518
9549
11.85
23.89
17.96
Spokane
2558
3101
2731
7.26
8.79
7.65
Whatcom
873
1417
1167
5.70
9.20
7.50
Yakima
630
1291
1432
3.58
7.31
8.03
King+Seattle(City
Law)*
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TEXTING WHILE DRIVING
Charge/Law Number
2010
2011
2012
2010
TEXTING WHILE DRIVING
2011
2012
Rate per 1,000 licensed drivers
(46.61.668 / 46.61.668.1A / 46.61.668.1B / 11.84.460)
King
265
534
604
0.17
0.33
0.37
281
579
683
0.18
0.36
0.42
Pierce
166
345
375
0.28
0.57
0.61
Snohomish
133
231
402
0.25
0.44
0.76
Spokane
131
101
105
0.37
0.29
0.29
Whatcom
22
48
52
0.14
0.31
0.33
Yakima
24
19
35
0.14
0.11
0.20
King+Seattle (City
Law)*
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INATTENTIVE DRIVING
Charge/Law Number
2010
2011
2012
2010
INATTENTIVE DRIVING
King
2011
2012
Rate per 1,000 licensed drivers
10128
10867
9563
6.42
6.82
5.87
1048
1161
1157
1.75
1.92
1.89
130
256
270
0.25
0.49
0.51
0
0
0
0.00
0.00
0.00
Spokane
254
257
304
1.66
1.67
1.95
Whatcom
373
394
350
2.12
2.23
1.96
11933
12935
11644
3.53
3.80
3.36
King+Seattle (City
Law)*
Pierce
Snohomish
Yakima
20
OUTLINE
1. Understanding distraction
and injury risk
2. Distraction in Washington
3. Promising strategies for
reducing distracted driving
4 “E”s OF INJURY PREVENTION
•
•
•
•
Education
Enforcement
Physical Environment
Social Environment
Changing
Behaviors
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
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
“You’ve just got to answer that
phone, you’ve got to get that next
call. It’s the same like you’ve got to
get the next hit of heroin”
[After pulling over a driver, he waved
to let me know]….”I know you’re
back there, but I’ve got to finish this
phone conversation”.
“When is it a big enough deal to
realize that we need to draw a line in
the sand? We can either stop
[texting/talking] in the hopes that
we’ll have fewer crashes, or we just
have to agree that we all might lose
some family members because it’s so
important that we text.”
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CLASSICAL CONDITIONING
DEVELOPING MARKETING STRATEGIES FOR
REDUCING DISTRACTED DRIVING
Big Fat Tobacco Wants to Control You
26
WHAT WORKS TO CURB DISTRACTED
DRIVING?
• Learn from what has worked
•
Drunk driving
•
Seat belt use
• Barriers
•
I’m a better/safer driver than others
•
My calls are “important”
•
Compulsive habit
27
4 “E’s” OF INJURY PREVENTION
Education
Enforcement
Physical Environment
Social Environment
EDUCATING INDIVIDUALS
•
General education on why reducing
distraction is an important public health
problem
•
Opportunities for parent role-model; review
family commitment to distraction-free driving
•
There’s an app for that: technological
solutions
•
Education on risk of citation (not crash)
•
Traffic court for distraction?
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4 “E’s” OF INJURY PREVENTION
Education
Enforcement
Physical Environment
Social Environment
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
Washington Case Filings for 'Hand Held Cell Phone Use' Violation
4,980
5,000
3,728
3,000
2,817
Primary law effective June 10,
2,561
2,000
1,000
642
0
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Number of Case Filings
4,182
4,000
2008
2009
2010
2011
2012
Data source: Adminstrative Offices of the Courts (AOC). Number of cases filed under RCW 46.61.667 (using wireless telecommunications device
while driving) for violations identified by WSP and local law enforcement. Does not include cases filed in Seattle Municpal Court (SMC).
33
OFFICER FOCUS GROUP STUDY
• Three focus groups held with law
enforcement officers in King, Whatcom, and
Spokane counties in 2013
THEME: DRIVERS KNOW LAWS BUT
CONTINUE THEIR DISTRACTING PRACTICES
“If you don’t know that there’s a cell phone law in this state you shouldn’t be
driving. Because it’s out there... They know it’s a big deal. So give them a
ticket.”
– WA Officer
“Short of calling 911, there is no excuse. [for using a cell phone while driving].
If you need to be on the phone all day, get a blue tooth.”
– WA Officer
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
“We need to change the way the
public sees the importance of
traffic enforcement as a whole.
Criminals drive cars; normal
people drive cars. It is easier to
give a criminal a ticket, than a
normal person. But normal
people kill people because
they’re distracted.”
- WA officer
“If you give somebody a warning,
it’s not going to change their
behavior. They’re driving away
with an “I got away with it” kind
of attitude.
- WA officer
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ENFORCEMENT CHALLENGES
• Various levels of
enforcement within &
between agencies
• “To ear” language in state
law
• Proof of texting (drivers
“throw” the phone)
• Citation outcomes
• Lack of extra patrol funds
• Law enforcement ‘users’ of
in-vehicle technology
HOW COULD ENFORCEMENT BE IMPROVED?
1. Each law enforcement
office adopt policy on
distracted driving
2. Track citations and
convictions locally
3. Emphasis patrols
4. Inform public that laws
are enforced
5. Motorcycle
enforcement
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4 “E’s” OF INJURY PREVENTION
Education
Enforcement
Physical Environment
Social Environment
TEXTING LEGISLATION
2001
2012
By 2012, forty-five states had a law that bans texting for
any group of drivers defined by age or driving experience, up from zero in
2001.
LawAtlasSM
40
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 2nd offense
6. Decal to identify provisional
license-holders, so laws
pertaining to inexperienced
drivers can be enforced
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OUTLINE
1. Understanding distraction
and injury risk
2. Distraction in Washington
3. Strategies for reducing
distracted driving
4. Distraction at work
OFFICER DISTRACTED DRIVING
• Minn. Study found distracted
driving contributed to 14% of
all claims; 17% of all costs.
• One half of all crashes that
involved distraction from
technology involved the use of
Mobile Data Terminals
(MDT’s).
• MDT claims were most
expensive, averaging about
$10,000 per claim.
Distracted Driving: Law
Enforcement’s Achilles’ Heel
45
DISTRACTION ON THE JOB
46
ACTION STEPS FOR LEADERSHIP
1.
Distracted Driving is Impaired Driving
•
•
•
2.
Adopt distraction policy for officers
•
•
•
•
3.
Make distracted driving a priority area
for law enforcement
There are no “safe” distracted drivers
Current law, while not perfect, is
enforceable and prosecutable
Officer as role model
Liability
Loss of vehicle time
Loss of life
Review MDT policies
•
Is there a voice-control option?
47
HOW COULD LEGISLATION BE
STRENGTHENED?
1. Adopt mobile device law similar to
Oregon (does not require “phone to
ear”; device button-pushing of any sort
not allowed)
2. Adopt “Inattentive driving” citation
when distracted behavior but source
not ascertainable
3. Strengthen laws (points, on the record)
48
CONCLUSIONS
1. Distraction is a growing
hazard
2. Strengthening enforcement
of distracted driving laws is
most effective strategy
3. Distraction risky for the
public and for law
enforcement
UW MEDICINE │ INJURY CONTROL
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