Distracted Drivers, Safer Cars?
Tech Revolution Provides Some Safety Pluses But Many Minuses For Drivers
Article Outline
Even at 42 years old Jeff Kalina, MD, feels like he's part of the texting revolution. He uses text messages to keep in touch with his wife while working shifts in the emergency department (ED). But unlike most younger people, Dr. Kalina also sees first hand the perils of tapping out a message on a mobile phone while driving an automobile.
“We're seeing the effects every day,” said Dr. Kalina, co-director of the ED at The Methodist Hospital in Houston, TX. “There seem to be more car accidents than ever, and a lot of them now are due to texting. We still, on a Saturday night, see our fair share of guys who have had too much to drink or other substances, but we're now seeing more normal people who are otherwise sober who have had accidents. Many of them were texting.”
Even as study after study shows drivers dangerously diverting their eyes from the road, the technology available to them, both installed in vehicles and mobile devices, is only growing more interactive and more distracting. This spring AT&T plans to launch an in-car entertainment service with 22 satellite TV channels. In some of its vehicles Ford plans to include a fully functional dashboard computer, complete with keyboard, that will allow users to surf the Web. Mobile devices will become more distracting as well, with video messaging perhaps supplanting phone calls in the not-too-distant future.
Featured at the Consumer Electronic Show in Las Vegas in January, “infotainment systems,” as the tech and car industries call them, will become available this year. Built-in navigation features are likely to be standard equipment in a wide range of cars, and 10-inch dashboard screens will show high-definition videos, 3-D maps and Web pages. They prevent drivers from watching video and using some other functions while the car is in motion, but they can still pull up content as varied as restaurant reviews and the covers of music albums.
Mitigating Factors
All of this would seem to bode ill for the practice of emergency medicine in already crowded EDs. Does the increasing sophistication and interactivity of mobile technology, then, presage a rising rate of accidents due to distracted driving, sending surging numbers of crash victims into EDs?
Surprisingly the answer may be no. As mobile technology matures 3 factors may combine to offset the distractions of these ubiquitous devices. Foremost, there's a dazzling array of new crash avoidance technologies now coming to vehicles that have considerable potential to reduce crashes and injuries. Then, as lawmakers recognize the dangers posed by mobile phones, there's also some hope they may enact more stringent laws to curb their use. And finally, there's some support, even within the mobile phone industry, for technology that could voluntarily limit use of the devices in mobile vehicles.
Let's begin with the unassailable fact that using mobile technology in automobiles, especially the modes preferred today by the youngest drivers in their teens, is simply incredibly dangerous.
Last September, after continuously observing drivers for more than 6 million miles of driving using cameras and instrumentation in participants' vehicles, the Virginia Tech Transportation Institute released results of a study that found truck drivers dialing a telephone were 5.9 times more likely to have a crash, or near-crash event as a non-distracted driver, and a remarkable 23.2 times more likely to have such an event while text messaging. This text messaging statistic was far higher than for any other distracting activity including looking at a map (7 times more likely than non-distracted drivers to have a crash) and reading a book or newspaper (4 times more likely). In other words, the researchers found that text messaging was 6 times more dangerous to drivers than reading a book.
The transportation researchers also studied “eyes off road” time, measuring it to be an average of 4.6 seconds over a 6-second period while text messaging, or 77% of the time. At a speed of just 55 mph this is the equivalent of someone driving the length of a football field without looking at the roadway.
“Texting should be banned in moving vehicles for all drivers,” the Virginia Tech report states.
“This cell phone task has the potential to create a true crash epidemic if texting-type tasks continue to grow in popularity and the generation of frequent text message senders reach driving age in large number.”
If mobile technology poses the threat, perhaps technology of another sort can provide a solution to the problem.
“There's a class of technology we would call crash avoidance technologies that have tremendous potential for reducing crashes in injuries,” said Anne McCartt, Vice President of Research for the Insurance Institute for Highway Safety, a nonprofit research and communications organization funded by auto insurers. “I would say they have more than a good chance to offset some of the dangers posed by distracted driving.”
Foremost among the technologies is electronic stability control, which selectively applies brakes to one or more wheels when a vehicle is about to slide out of control. Consumer Reports has hailed the technology as “the most important safety advance since the safety belt.” Recent studies, including those by McCartt's organization, Insurance Institute for Highway Safety, have found that universal application of electronic stability control could save as many as 9,000 lives a year, and beginning in 2012 the federal government will mandate that all new cars come equipped with the technology. For 2010 models, according to Insurance Institute for Highway Safety, electronic stability control is standard on 85% of cars, 100% of SUVs, and 62% of pickups. Engineers are already at work on second-generation stability control technologies, which will include slight steering control.
Bells, Brakes and Blind Spots
Perhaps the safety development most critical to mobile technology is lane departure warnings, or small cameras that detect stripes between lanes and alert an inattentive (or sleepy) driver that he or she has wandered out of a lane. A chime or warning light then alerts the driver. This technology might not be quite ready for prime time, however, as if it does not work properly by providing too many false warnings, and therefore proves annoying to drivers, it could be turned off.
There are myriad other technologies in various stages of development and deployment in new vehicles that promise to lower crash statistics: brake assist, which during panic braking maximizes the braking power available; blind spot warning lights, which are already on some Volvo and Audi models; active head restraints, which move the restraints behind a person's head forward during a collision to help absorb energy and prevent whiplash injuries; proximity warning systems (on some Volvo models there already are alert systems that warn drivers they're about to rear-end another vehicle) and voice recognition systems to control climate, audio and navigation systems that could cut down on driver distractions.
“I think the bottom line message for emergency doctors is a hopeful one,” McCartt said. “I think it's an exciting era for vehicle technology.”
Yet there's still going to be a need for safe, attentive drivers in the foreseeable future. Futurist Peter Bishop, an associate professor at the University of Houston, said while safety technologies will make a great leap forward, fully autonomous vehicles will likely remain in the realm of science fiction for at least the next few decades.
Alongside new technologies that will make automobiles safer, it's hoped by some transportation experts that lawmakers will step forward to legislate against driver distractions. For example, the National Safety Council, a nonprofit, nongovernmental public service organization dedicated to protecting life and promoting health, has called for a total ban on cell phone use while driving.
Although no state has gone as far as the total ban sought by the safely council, there are an increasing number of laws limiting use of cell phones while driving. According to the Governors Highway Safety Association, which represents US state and territorial highway safety offices, as of December, 2009, 6 states (California, Connecticut, New Jersey, New York, Oregon and Washington) and the District of Columbia now have laws prohibiting all drivers from talking on handheld cell phones while driving. And 19 states and the District of Columbia now ban text messaging for all drivers.
“State legislatures have responded to the growing concern over cell phone use and texting while driving by passing a variety of new laws, including banning handheld cell phone use or texting by all drivers or restricting cell phone use or texting for a specific demographic, such as teens or school bus drivers,” the governors association says. “Recently, states have been passing texting bans for all drivers at a frenetic pace.”
The big question with legislating cell phone use is whether such laws are actually effective. McCartt says New York enacted the first ban on handheld cell phones in 2001, and driver use of such phones subsequently fell by 50%. However, when measured a year later, the decline largely dissipated.
McCartt believes this is evidence that, absent a stringent and sustained enforcement campaign like the Click It or Ticket program for seatbelt use, most drivers are unlikely to change their behavior in communities that enact laws. There's the additional trouble of hands-free cell phones, which some studies, including the one by Virginia Tech, found to have little safety benefit over a handheld phone. Enforcing bans of hands-free cell phones would prove difficult for law officers.
Laws against text messaging have faced little opposition, even from the wireless industry.
“There is no way that typing on a keyboard and safely operating a motor vehicle are compatible,” said John Walls, Vice President of Public Affairs for CTIA – The Wireless Association. “If people want to outlaw that, and make it an illegal activity, we support that.”
Additionally, Walls said the wireless industry is “neutral” on outright bans of cellular use while driving and hands-free legislation. But, he added, legislation should not be viewed as the end-all and be-all when it comes to dealing with distracted driving.
Specifically, Walls believes technology could be embedded in wireless networks that would allow users to control cell phone behavior. For example, a parent could control a child's phone behavior by preventing the mobile device from being used while it is in motion. Or automobiles could include dampening systems for mobile devices when they are in motion.
A Welcome Solution
It's a solution some emergency physicians might welcome.
“The mobile technology is going so fast that we may need drastic solutions,” said Dr. Kalina, the Houston-based emergency physician. “At some point Big Brother may just have to step in and deactivate these devices when they're in motion.”
Such a solution could be fraught with issues, of course, from privacy to on-the-go users aboard trains, subways, buses or passengers in automobiles.
What seems clear is that, for now at least, safety technologies seem to be holding their own against mobile technologies, though that doesn't necessarily justify erasing gains in one area by allowing the dangerous distractions in the other.
According to the most recent data available from the US Centers for Disease Control and Prevention, from 2001 to 2003, the annual rate of Americans aged 18 and older who were admitted to US EDs because of motor vehicle traffic incidents was 148.4 per 10,000 persons. From the period of 2004 to 2006, the rate fell to 139.7 per 10,000. This is consistent with a continued decline in the number of fatalities per 100,000 miles traveled, which has seen a decades long slide as cars have become safer, with stronger materials, seat belts, air bags and other technologies.
Yet it remains too early to say what effect mobile technologies will have on traffic accidents and fatalities. As noted above, text messaging and other activities such as Web surfing that require dedicated attention on mobile screens have dramatically raised the level of distractions available to drivers.
The CDC data from the years 2004 to 2006 fails to capture this recent rise in activities requiring eyes to be off the road. For text messaging the surge has come in just the last few years. In 2000, there were a few tens of millions of text messages sent in the US, according to CTIA. By 2005 about 57 billion text messages were sent by US wireless users. That seems like a large number–until one considers CTIA's estimate for the number of text messages sent in 2009, 1.36 trillion. And then there's mobile Web surfing, which only really began to take off in mid-2007, with the release of the iPhone, along with a slew of other smart phones that provide users their very own visually rich portal to the Internet.
Section editor: Truman J. Milling, Jr, MD
Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The author has stated no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.
PII: S0196-0644(10)00115-0
doi:10.1016/j.annemergmed.2010.02.003
