Presented by: Dr. Richard Harkness, CEO ADEPT Driver Paul Farrell Safety First

1. Driving Miss Daisy: Safety Is No Accident! Prepared Exclusively For The Loss Control Section of CPCU Society September 11, 2007 Honolulu, Hawaii Presented by: Dr. Richard Harkness, CEO ADEPT Driver Paul Farrell Safety First

4. Outline Traffic Safety Overview Age Related Crash Risks Defining the Issue Analyzing the Factors Employment, Public Policy Issues Potential Solutions Summary

5. During this presentation… Somewhere in the USA, 10 people will die because of motor vehicle crashes (National Center for Statistics and Analysis, NHTSA) Worldwide, 274 drivers or pedestrians will perish on or next to a roadway, and another 11,415 will be injured (World Health Organization)

6. Global Perspective While crash rates have generally declined in the USA, they are climbing in other parts of the world. “World report on road traffic injury prevention” Highlights several provocative opinions: traffic safety is under funded based on the magnitude of the problem in developing countries Road deaths will eclipse many other health issues (TB, War, etc.) by CY 2020

7. Mortality Rates by Territory

8. Global Crash Costs

9. Traffic Safety Despite best efforts of governments, insurers and private firms, motor vehicle crashes remain: the leading cause of work place fatalities, the most costly lost-time workers compensation injury, and one of the leading causes of off-the-job, unintentional injury WHY?

10. Traffic Safety With limited exceptions, driving is the most complex task people handle in the course of their day.

11. Traffic Safety Despite the complexity of driving, people choose to increase their own risk, often beyond a “break point”

12. Traffic Safety Other factors affect a person’s ability to survive a crash event: Failure to wear seat belts Availability and speedy response time of rescue personnel

13. Traffic Safety “Personal Use” vs. “Business Use”

14. Traffic Safety - Personal Personal Use = getting to the grocery store, or commuting to a work location. For older drivers, driving is “lifeline” to daily needs, social activity and gainful employment.

15. Traffic Safety - Personal Most safety outreach efforts aimed at personal use are sponsored by public safety agencies, or vendors: • NHTSA • IIHS • Police Departments • Driving Schools • National Safety Council • AAA / AAFTS

16. Traffic Safety - Personal Personal use drivers participate in safety programs for many reasons.

17. Traffic Safety - Personal Most safety practices for personal use driving focus on “common sense details”

18. Traffic Safety – Business Use Business use = job requires the employee to drive. For older commercial drivers, driving provides a source of income.

19. Traffic Safety - Commercial Commercial safety training done by the employer, often required by regulation, voluntary standards and by case law. Participation is mandatory, and the time spent is often eligible for compensation.

20. Traffic Safety - Commercial Typically, a more formal approach to handling driver safety concerns. Hiring / Selection Annual Performance Review Skills Evaluation Medical Monitoring Periodic, Specialized Training

21. Traffic Safety Experience Vehicle Design Driver Impairments Deadlines Weather Equipment Maintenance Distractions Emotional Upset / Illness Varied factors contribute to crashes: Tool for analysis and understanding?

22. Haddon Matrix

23. Traffic Safety Analysis All traffic safety issues can be reviewed under the Haddon Matrix: Youthful drivers Impaired driving Large truck vs. small car crashes Safety ratings EMT training and hospital response to crashes

24. Traffic Safety Analysis First Dr. Harkness will help us define the scope of the age related drivers, then… We will apply the Haddon Matrix to the issue of elderly drivers to identify the factors and suggest potential solutions to deal with aging drivers.

25. An Innovative Approach to Reducing Auto Collisions Car Crashes Treated as a Behavioral Disorder

26. BackgroundAuto Crashes Resulting in Death 1st Mission: Teens Deaths Per 100,000 Licensed Drivers Driver Age Groups SOURCE: National Safety Council Injury Facts, 2004 edition p. 104

27. BackgroundTeen Crash Statistics In 2003, 50% of 16-18 year-old drivers were in a police-reported collision Teens have the highest car crash rate of any age group Teens are 400% more likely to die in a car crash than 25-34 year-old drivers SOURCE: National Safety Council Injury Facts, 2004 edition p. 104

28. BackgroundTeen Crash Trends Police Reported Crash Rate Per 100 Drivers Each Year Year 16 17 18 2000 58 45 36 2003 63 49 43 2005 32 26 24 Age On average over 50% of teens crash during the first year of driving SOURCE: National Safety Council Injury Facts, 2001 edition, p. 100 and Injury Facts, 2004 edition p. 104 and Injury Facts 2007 edition p. 104

29. BackgroundWhat Does the Data Tell Us? Teen car crashes are decreasing. Still the leading cause of death for teens The chance of one crash in the first three years of driving is 62%* The chance of two crashes in the first three years of driving is 18%* Per mile driven, teens are 300% more likely to die in car crash. SOURCE: National Safety Council Injury Facts, 2007 edition, p. 104

30. BackgroundOur Challenge Annual Automobile Crashes by Age 16 ADEPT’s Challenge: Give new-to-the-road drivers the skills that usually take years of on-the-road experience to master 17 18 10 15 20 25 30 35 40 45 50 55 60 65 Crashes Per 100 Licensed Drivers 19 20 25 35 45 55 65 75 16 25 35 45 55 65 75 Driver Age Driver Age SOURCE: National Safety Council Injury Facts, 2004 edition p. 104

31. Background Automobile Crashes Resulting in Injury or Death 2nd Mission: Seniors Crashes Per Million Miles Driven Driver Age Groups

32. BackgroundSenior Crash Statistics • Seniors have the highest death rate per mile driven of any age group • 89% of Seniors with 40% or greater visual cognition reduction will crash a car in the next three years. • 4% of Senior Drivers, 1.2 million will be killed or injured each year.

33. BackgroundSenior Crash Trends Police Reported Crash Rate Per 100 Drivers Each Year Year 75+ 2002 9 2003 5 2004 5 2005 4 Age Fatal Crash Rate Per 100 million vehicle miles 75+ 2002 11.5 2003 11.5 2004 11.5 2005 11.5 Age SOURCE: National Safety Council Injury Facts, 2003 edition, p. 104 and Injury Facts, 2004 edition p. 104,and Injury facts 2005 edition p.104 and Injury Facts 2007 edition p. 104

34. BackgroundWhat Does the Data Tell Us? On a per person basis, seniors have low crash rates On a per mile driven basis seniors have high crash rates Per mile driven, drivers over 75 are 383% more likely to die in a car crash. SOURCE: National Safety Council Injury Facts, 2007 edition, p. 104

35. Background • Senior Driver Population will Grow Significantly • > Currently 30 million Senior Drivers • > Estimated 70 million Senior Drivers by 2030

36. Factors Analysis We’ll focus mainly on the human factors as we largely cannot change the environment or vehicle designs.

37. Human Factors: Pre-Crash Impaired or Diminished Visual Acuity: Changes in eye shape Cataracts Lens degradation Diseases affecting vision such as Macular Degeneration, HIV, Diabetes

38. Human Factors: Pre-Crash Mental impairment: Dementia, Alzheimer's Mental impairment by proper or improper use of medication for other conditions Emotional duress

39. Human Factors: Pre-Crash Training and Awareness: Scanning around vehicle for right of way, merging, passing Situational awareness Practice traffic/road rules Spot and react to pedestrians

40. Human Factors: Post-Crash Crash Injuries and Treatment: Increased susceptibility to crash injuries (chest contusions and various fractures) Medical complications that may inhibit recovery “Fragility”

41. Vehicle Factors: Pre-Crash Size and weight of car Crash testing & safety ratings Are there supplemental safety systems in place (side/curtain airbags, traction control, etc.)?

42. Environmental Factors Older drivers (age 70+) had more crashes at intersections than younger drivers This type of crash accounted for about half of fatal crashes among drivers aged 85+ Has there been enough attention to making roadway designs easy to understand and see?

43. Haddon Analysis - Conclusions The human factors, specifically a person’s medical/biological condition, have the most direct impact on crash causation. The most promising programs to address these concerns focus on licensing, monitoring, & training.

44. Health Monitoring - Obstacles Highly personal and can be emotional. Requires professional diagnosis/testing of driver. This raises additional questions of: When to start testing (what age)? Frequency of evaluations? Cost (how much and who pays)? Voluntary or compulsory?

45. Health Monitoring - Solutions Mandatory reporting of “unfit to drive” by physicians is in place in Canada USA is different: Fifty States = fifty guidelines for physicians AMA provides a guide (online) http://www.ama-assn.org/ama/pub/category/10791.html

46. Performance Monitoring These systems range from “How’s My Driving?” call in programs to Satellite based Global Positioning Systems (GPS) The systems have been widely documented as effective in most commercial use settings. Crash rate reductions of 20-30% are common Many commercial insurers have loss control programs to provide, or encourage policyholders to adopt such systems.

47. Performance Monitoring The success of these programs comes from several critical factors: The data generated is funneled through a central contact person and evaluated based on a specific benchmark of performance. Affected drivers “must” participate in corrective coaching, counseling, training or if needed discipline.

48. Performance Monitoring Personal use of these systems is not as well documented. Limitations include: Who serves as “coach”? What is the basis of setting a realistic benchmark with the study group so small? These systems may have some bearing if they come complete with recommendations, training resources, etc.

49. Self Monitoring & Education Driver Competency Assessment Protocols www.agenet.com – checklist for older drivers www.seniordrivers.org – various resources AAA -- Roadwise Review The Adept Driving Program

50. Re-Engineering Teen Crash Reduction Training Development process What it teaches When it teaches How it teaches Crash reduction training differs from traditional pre-licensing drivers education in several critical ways