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  • 1.
    Anund, Anna
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Swedish Natl Rd & Transport Res Inst VTI, Linkoping, Sweden.
    Forward, Sonja
    Swedish Natl Rd & Transport Res Inst VTI, Linkoping, Sweden.
    Dahlman, Anna Sjors
    Swedish Natl Rd & Transport Res Inst VTI, Linkoping, Sweden; Chalmers Univ Technol, Sweden.
    Seat belt usage in buses-An observation study of usage and travellers perspectives2023Ingår i: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 190, artikel-id 107138Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aims to evaluate seat belt usage in buses and to understand travellers incentives of seat belt usage. Methods used are observational studies (10 cities, with 328 bus observations), focus group discussion (7 groups with a total of 32 participants) and a web survey (n = 1737 respondents). The results show that the seat belt use among bus passengers can be improved especially in regional and commercial bus traffic. It is more common to buckle up on long trips than on short trips. However, even though observations show high usage during long trips, travellers report that they remove the seat belt after a while if they want to sleep or for comfort reasons. For the bus drivers it is not possible to control passengers usage. Dirty seat belts and technical malfunction might deter some passengers from using them and therefore systematic cleaning and control of seats and belts are recommended. On short trips one reason for not using the belt is related to worries about getting stuck and not being ready to get off in time. In general, it is most important to increase the usage on high-speed roads (>60 km/ h), in lower speed it might be more important to provide a seat for each passenger. Based on the results a list of recommendations is presented.

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  • 2.
    Bakker, Bram
    et al.
    Cygnify BV, Netherlands.
    Zablocki, Bartosz
    Cygnify BV, Netherlands; Bolcom, Netherlands.
    Baker, Angela
    Shell Int, Netherlands.
    Riethmeister, Vanessa
    Shell Int, Netherlands.
    Marx, Bernd
    Shell Int, Netherlands.
    Iyer, Girish
    Shell Trading & Supply, England.
    Anund, Anna
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Swedish Natl Rd & Transport Res Inst VTI, S-58195 Linkoping, Sweden; Stockholm Univ, Sweden.
    Ahlström, Christer
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten. Swedish Natl Rd & Transport Res Inst VTI, S-58195 Linkoping, Sweden.
    A Multi-Stage, Multi-Feature Machine Learning Approach to Detect Driver Sleepiness in Naturalistic Road Driving Conditions2022Ingår i: IEEE transactions on intelligent transportation systems (Print), ISSN 1524-9050, E-ISSN 1558-0016, Vol. 23, nr 5, s. 4791-4800Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Driver fatigue is a contributing factor in about 20% of all fatal road crashes worldwide. Countermeasures are urgently needed and one of the most promising and currently available approaches for that are in-vehicle systems for driver fatigue detection. The main objective of this paper is to present a video-based driver sleepiness detection system set up as a two-stage model with (1) a generic deep feature extraction module combined with (2) a personalised sleepiness detection module. The approach was designed and evaluated using data from 13 drivers, collected during naturalistic driving conditions on a motorway in Sweden. Each driver performed one 90-minute driving session during daytime (low sleepiness condition) and one session during night-time (high sleepiness condition). The sleepiness detection model outputs a continuous output representing the Karolinska Sleepiness Scale (KSS) scale from 1-9 or a binary decision as alert (defined as KSS 1-6) or sleepy (defined as KSS 7-9). Continuous output modelling resulted in a mean absolute error (MAE) of 0.54 KSS units. Binary classification of alert or sleepy showed an accuracy of 92% (sensitivity = 91.7%, specificity = 92.3%, F1 score = 90.4%). Without personalisation, the corresponding accuracy was 72%, while a standard fatigue detection PERCLOS-based baseline method reached an accuracy of 68% on the same dataset. The developed real-time sleepiness detection model can be used in the management of sleepiness/fatigue by detecting precursors of severe fatigue, and ultimately reduce sleepiness-related road crashes by alerting drivers before high levels of fatigue are reached.

  • 3.
    Mirnig, Alexander G.
    et al.
    Univ Salzburg, Austria; AIT Austrian Inst Technol GmbH, Austria.
    Gärtner, Magdalena
    Univ Salzburg, Austria.
    Fröhlich, Peter
    AIT Austrian Inst Technol GmbH, Austria.
    Wallner, Vivien
    Univ Salzburg, Austria.
    Dahlman, Anna Sjörs
    Swedish Natl Rd & Transport Res Inst, Linkoping, Sweden; Chalmers Univ Technol, Sweden.
    Anund, Anna
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Swedish Natl Rd & Transport Res Inst, Linkoping, Sweden; Stockholm Univ, Sweden.
    Pokorny, Petr
    TOI Inst Transport Econ, Norway.
    Hagenzieker, Marjan
    TOI Inst Transport Econ, Norway.
    Bjornskau, Torkel
    TOI Inst Transport Econ, Norway.
    Aasvik, Ole
    TOI Inst Transport Econ, Norway.
    Demir, Cansu
    Univ Salzburg, Austria.
    Sypniewski, Jakub
    Univ Salzburg, Austria.
    External communication of automated shuttles: Results, experiences, and lessons learned from three European long-term research projects2022Ingår i: Frontiers in Robotics and AI, E-ISSN 2296-9144, Vol. 9, artikel-id 949135Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Automated shuttles are already seeing deployment in many places across the world and have the potential to transform public mobility to be safer and more accessible. During the current transition phase from fully manual vehicles toward higher degrees of automation and resulting mixed traffic, there is a heightened need for additional communication or external indicators to comprehend automated vehicle actions for other road users. In this work, we present and discuss the results from seven studies (three preparatory and four main studies) conducted in three European countries aimed at investigating and providing a variety of such external communication solutions to facilitate the exchange of information between automated shuttles and other motorized and non-motorized road users.

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  • 4.
    Ahlström, Christer
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten. Swedish Natl Rd & Transport Res Inst VTI, S-58195 Linkoping, Sweden.
    van Leeuwen, Wessel
    Stockholm Univ, Sweden.
    Krupenia, Stas
    Scania CV AB, Sweden.
    Jansson, Herman
    Smart Eye AB, Sweden.
    Finer, Svitlana
    Smart Eye AB, Sweden.
    Anund, Anna
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Swedish Natl Rd & Transport Res Inst VTI, S-58195 Linkoping, Sweden; Stockholm Univ, Sweden.
    Kecklund, Goran
    Stockholm Univ, Sweden.
    Real-Time Adaptation of Driving Time and Rest Periods in Automated Long-Haul Trucking: Development of a System Based on Biomathematical Modelling, Fatigue and Relaxation Monitoring2022Ingår i: IEEE transactions on intelligent transportation systems (Print), ISSN 1524-9050, E-ISSN 1558-0016, Vol. 23, nr 5, s. 4758-4766Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Hours of service regulations govern the working hours of commercial motor vehicle drivers, but these regulations may become more flexible as highly automated vehicles have the potential to afford periods of in-cab rest or even sleep while the vehicle is moving. A prerequisite is robust continuous monitoring of when the driver is resting (to account for reduced time on task) or sleeping (to account for the reduced physiological drive to sleep). The overall aims of this paper are to raise a discussion of whether it is possible to obtain successful rest during automated driving, and to present initial work on a hypothetical data driven algorithm aimed to estimate if it is possible to gain driving time after resting under fully automated driving. The presented algorithm consists of four central components, a heart rate-based relaxation detection algorithm, a camera-based sleep detection algorithm, a fatigue modelling component taking time awake, time of day and time on task into account, and a component that estimates gained driving time. Real-time assessment of driver fitness is complicated, especially when it comes to the recuperative value of in-cab sleep and rest, as it depends on sleep quality, time of day, homeostatic sleep pressure and on the activities that are carried out while resting. The monotony that characterizes for long-haul truck driving is clearly interrupted for a while, but the long-term consequences of extended driving times, including user acceptance of the key stakeholders, requires further research.

  • 5.
    Dahlman, Anna Sjörs
    et al.
    Swedish Natl Rd & Transport Res Inst VTI, Linkoping, Sweden; Department of Electrical Engineering and SAFER Vehicle, Chalmers University of Technology, Gothenburg, Sweden; Traffic Safety Centre Chalmers University of Technology, Gothenburg, Sweden.
    Anund, Anna
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Swedish Natl Rd & Transport Res Inst VTI, Linkoping, Sweden; Stockholm University, Stockholm Stress Centre, Stockholm, Sweden.
    Seroprevalence of SARS-CoV-2 antibodies among public transport workers in Sweden2022Ingår i: Journal of Transport and Health, ISSN 2214-1405, E-ISSN 2214-1405, Vol. 27, artikel-id 101508Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Public transportation is an essential societal function in crisis situations like the coronavirus disease 2019 (COVID-19) pandemic. Bus drivers and other public transport workers are essential workers that need to keep working despite the risk of contagion. The SARS-CoV-2 virus may pose an occupational health risk to public transport workers and especially to bus drivers as they interact with passengers in a confined area. By analyzing antibodies towards SARS-CoV-2 proteins in blood samples it is possible to measure if an individual has been infected by COVID-19. Here, we report the prevalence of antibodies among bus drivers and other public transport employees in Stockholm, Sweden and relate it to socio-demographic factors.Methods: Seroprevalence of IgG antibodies towards SARS-CoV-2 proteins was investigated in a sample of 262 non-vaccinated public transport workers (182 men and 40 women) recruited between April 26 and May 7, 2021. Most of the participants were bus drivers (n = 222). The relationship between socio-demographic factors and seroprevalence was investigated with logistic regression.Results: The seroprevalence was 50% in the total sample of public transport workers. Among bus drivers, 51% were seropositive compared to 44% seropositive among the other public transport workers. The difference was not significant. The seroprevalence was higher than the national seroprevalence in Sweden during the same period (18.3% in non-vaccinated people aged 20-64 years). The logistic regression model using Wald forward selection showed that men had a higher risk of being seropositive (OR 2.7, 95% CI 1.3 - 5.8) and there was a higher risk with increasing number of people in the household (OR 1.3, 95% CI 1.1 - 1.6).Conclusions: These findings could imply an occupational risk for COVID-19 infection among public transport workers. Infection control measures are warranted during virus epidemics to assure bus drives safety and reduce transmission in public transport.

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  • 6.
    Anund, Anna
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Swedish Natl Rd & Transport Res Inst, Linkoping, Sweden; Stockholm Univ, Sweden.
    Ihlstrom, Jonas
    Swedish Natl Rd & Transport Res Inst, Linkoping, Sweden.
    Threats and violence towards urban bus drivers in Sweden: Drivers experiences and general recommendations to prevent violence and threats2022Ingår i: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 72, nr 4, s. 1279-1287Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Approximately 30% of Swedish urban bus drivers report having been exposed to threats or violence. As 50% of drivers have voiced concerns about the occurrences, threats and violence also represent contributing factors to driver stress and fatigue. OBJECTIVE: The aim of this study was to explore bus drivers experience of threats and violence; how threats and violence manifests and how the problem is handled by drivers. Gaining understanding of the circumstances is important to reduce the number of threats and violent incidents to provide healthy and attractive working conditions for drivers. METHODS: This study is based on in-depth interviews with 12 urban bus drivers in the City of Malmo in Sweden. RESULTS: Urban bus drivers experience threats daily from passengers, although physical violence occurs less often. The most common situations resulting in threats involve asking passengers to show valid tickets, denying child carriages onboard and running late to a bus stop. The drivers have not received clear guidelines as to strategic handling of the invalid ticket situation. CONCLUSIONS: Recommendations include a clear policy and consensus with regard to handling invalid tickets, providing drivers with guidelines for appropriate procedures for passengers refusing to pay, improving reporting routines and establishing a strategy for the Public Transportation provider and operator to follow with regard to reports, in-vehicle surveillance cameras including informing passengers that they are being video recorded as well as harmonizing the location of alarm buttons on buses.

  • 7.
    Ahlström, Christer
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten. Swedish Natl Rd & Transport Res Inst VTI, Olaus Magnus Vag 35, SE-58330 Linkoping, Sweden.
    Zemblys, Raimondas
    SmartEye AB, Sweden.
    Jansson, Herman
    SmartEye AB, Sweden.
    Forsberg, Christian
    Autol Dev AB, Sweden.
    Karlsson, Johan
    Autol Dev AB, Sweden.
    Anund, Anna
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Swedish Natl Rd & Transport Res Inst VTI, Olaus Magnus Vag 35, SE-58330 Linkoping, Sweden; Stockholm Univ, Sweden.
    Effects of partially automated driving on the development of driver sleepiness2021Ingår i: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 153, artikel-id 106058Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The objective of this study was to compare the development of sleepiness during manual driving versus level 2 partially automated driving, when driving on a motorway in Sweden. The hypothesis was that partially auto-mated driving will lead to higher levels of fatigue due to underload. Eighty-nine drivers were included in the study using a 2 ? 2 design with the conditions manual versus partially automated driving and daytime (full sleep) versus night-time (sleep deprived). The results showed that night-time driving led to markedly increased levels of sleepiness in terms of subjective sleepiness ratings, blink durations, PERCLOS, pupil diameter and heart rate. Partially automated driving led to slightly higher subjective sleepiness ratings, longer blink durations, decreased pupil diameter, slower heart rate, and higher EEG alpha and theta activity. However, elevated levels of sleepiness mainly arose from the night-time drives when the sleep pressure was high. During daytime, when the drivers were alert, partially automated driving had little or no detrimental effects on driver fatigue. Whether the negative effects of increased sleepiness during partially automated driving can be compensated by the positive effects of lateral and longitudinal driving support needs to be investigated in further studies.

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  • 8.
    Forsman, Asa
    et al.
    Swedish Natl Rd & Transport Res Inst VTI, SE-58195 Linkoping, Sweden.
    Anund, Anna
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Swedish Natl Rd & Transport Res Inst VTI, SE-58195 Linkoping, Sweden; Stockholm Univ, Sweden.
    Skyving, Marie
    Karolinska Inst, Sweden; Swedish Transport Agency, Sweden.
    Filtness, Ashleigh J.
    Loughborough Univ, England.
    Injury crashes and the relationship with disease causing excessive daytime sleepiness2021Ingår i: Traffic Injury Prevention, ISSN 1538-9588, E-ISSN 1538-957X, Vol. 22, nr 4, s. 272-277Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective The objective of this study was to understand the relationship between some of the most common diseases that are known to contribute to excessive daytime sleepiness (EDS) and traffic injury crashes. Specific focus was on the relationship between disease and crash type (single-vehicle or multiple-vehicle crash) and between disease and injury severity. Methods This registry-based study considered all passenger car drivers involved in a crash in Sweden between 2011 and 2016 who were 40 years or older at the time of the crash (n = 54,090). For each crash-involved driver, selected medical diagnoses registered from 1997 until the day before the crash were extracted from the National Patient Register. The drivers were assigned to 1 of 4 groups, depending on prior diseases: sleep apnea (SA; group 1, n = 2,165), sleep disorders (group 2, n = 724), Parkinsons or epilepsy (group 3, n = 645) and a reference group (group 4, n = 50,556). Logistic regression analysis compared single-vehicle crashes with multiple-vehicle crashes and moderately/severely injured drivers with slightly/uninjured drivers. Results Drivers with EDS-related diseases (groups 1-3) had higher probability of a single-vehicle crash than a multiple-vehicle crash compared to the reference group. The most sizeable effect was found for Parkinsons/epilepsy with an odds ratio (OR) of 2.5 (confidence interval [CI], 2.1-3.0). For multiple-vehicle crashes, the probability of a moderate/severe injury was higher for drivers with other sleep disorders (OR = 1.5; CI, 1.0-2.2) and Parkinsons/epilepsy (OR = 1.6; CI, 1.1-2.3) compared to the reference group. Conclusions This study has made first steps toward understanding the relationship between some of the most common diseases that are known to contribute to EDS and crashes. Having Parkinsons/epilepsy, in particular, elevated the probability of a single-vehicle crash compared to a multiple-vehicle crash. A single-vehicle crash was seen as indicative of causing a crash; thus, having Parkinsons/epilepsy could be interpreted as a risk factor for crash involvement. Having Parkinsons/epilepsy, as well as other sleep disorders, was also related to more severe outcomes in multiple-vehicle crashes, given that a crash occurred. This was not identified in single-vehicle crashes.

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  • 9.
    Vadeby, Anna
    et al.
    VTI, Swedish Natl Rd and Transport Res Inst, Linkoping, Sweden.
    Anund, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. VTI, Swedish Natl Rd and Transport Res Inst, Linkoping, Sweden.
    Choi, Saerona
    KOTSA, South Korea.
    Road Safety on Five Continents - Conference in Jeju, South Korea 20182019Ingår i: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 132, artikel-id 105206Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 10.
    Ahlstrom, Christer
    et al.
    Swedish Natl Rd and Transport Res Inst VTI, Linkoping, Sweden.
    Lovgren, Maria Gink
    Volvo Bus Corp, Denmark.
    Nilsson, Mats
    Volvo Bus Corp, Denmark.
    Willstrand, Tania Dukic
    Swedish Natl Rd and Transport Res Inst VTI, Linkoping, Sweden.
    Anund, Anna
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken. Swedish Natl Rd and Transport Res Inst VTI, Linkoping, Sweden.
    The effect of an active steering system on city bus drivers muscle activity2019Ingår i: International Journal of Occupational Safety and Ergonomics, ISSN 1080-3548, E-ISSN 2376-9130, Vol. 25, nr 3, s. 377-385Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    City bus drivers spend hours driving under time pressure, in congested traffic and in a monotonous sitting position. This leads to unhealthy working conditions, especially in terms of physical and psychological stress. The aim of this study is to investigate whether an active steering system can alleviate the musculoskeletal stress involved in manoeuvring a bus. Twenty bus drivers drove a city bus equipped with the Volvo dynamic steering (VDS) support system in real traffic. Steering effort was evaluated with electromyography and with a questionnaire. Compared to baseline, VDS significantly reduced the required muscle activity by on average 15-25% while turning, and up to 68% in the part of the manoeuvre requiring maximum effort. The bus drivers believed that VDS will help reduce neck and shoulder problems, and they expressed a desire to have VDS installed in their own bus.

  • 11.
    Hughes, Brett P.
    et al.
    Curtin University, Australia.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Curtin University, Australia.
    Anund, Anna
    VTI, Sweden.
    Black, Melissa H
    Curtin University, Australia.
    The relevance of U.S. Strategic Highway Safety Plans in a future context2019Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 14, nr 10, artikel-id e0223646Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    While road safety in the United States (U.S.) has been continually improving since the 1970s, there are indications that these improvements are becoming increasingly difficult to sustain. Strategic Highway Safety Plans (SHSPs) are prepared by States to guide road safety management, however assessing the appropriateness of these plans remains a significant challenge, especially for the future in which they are to be applied. This study developed a new methodology to assess SHSPs from the perspectives of comprehensive system-based safety management and relevant future issues that can be applied before SHSPs are implemented, thereby avoiding long periods after implementation before assessing the appropriateness of the plans. A rating scale was developed and applied to assess 48 U.S. SHSPs against two key criteria: 1. a comprehensive framework for road safety, and 2. the anticipated changing, difficult and unpredictable nature of future transport and its context. The analysis concluded that current SHSPs have good national oversight with several strengths but were weak in some areas of content and did not address future challenges. Improvements are suggested to strengthen the plans thoroughness by being consistent with systems theory and practice, as well as ways that these SHSPs can be more resilient to future circumstances. Implementing the recommendations in this paper provides the opportunity to adopt a system-based safety management practice that has been successful in other hazardous industries. Doing so is expected to most efficiently and effectively continue the recent improvements to road safety, which is likely to be increasingly difficult otherwise.

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  • 12.
    Anund, Anna
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Swedish National Road and Transport Research Institute, Linköping, Sweden.
    Fors, Carina
    Swedish National Road and Transport Research Institute, Linköping, Sweden.
    Ihlstrom, Jonas
    Swedish National Road and Transport Research Institute, Linköping, Sweden.
    Kecklund, Goran
    Stress Research Institute, Stockholm University, Stockholm, Sweden; Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
    An on-road study of sleepiness in split shifts among city bus drivers2018Ingår i: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 114, s. 71-76Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Bus drivers often work irregular hours or split shifts and their work involves high levels of stress. These factors can lead to severe sleepiness and dangerous driving. This study examined how split shift working affects sleepiness and performance during afternoon driving. An experiment was conducted on a real road with a specially equipped regular bus driven by professional bus drivers. The study had a within-subject design and involved 18 professional bus drivers (9 males and 9 females) who drove on two afternoons; one on a day in which they had driven early in the morning (split shift situation) and one on a day when they had been off duty until the test (afternoon shift situation). The hypothesis tested was that split shifts contribute to sleepiness during afternoon, which can increase the safety risks. The overall results supported this hypothesis. In total, five of the 18 drivers reached levels of severe sleepiness (Karolinska Sleepiness Scale 8) with an average increase in KSS of 1.94 when driving in the afternoon after working a morning shift compared with being off duty in the morning. This increase corresponded to differences observed between shift workers starting and ending a night shift. The Psychomotor Vigilance Task showed significantly increased response time with split shift working (afternoon: 0.337 s; split shift 0.347 s), as did the EEG-based Karolinska Drowsiness Score mean/max. Blink duration also increased, although the difference was not significant. One driver fell asleep during the drive. In addition, 12 of the 18 bus drivers reported that in their daily work they have to fight to stay awake while driving at least 2-4 times per month. While there were strong individual differences, the study clearly showed that shift working bus drivers struggle to stay awake and thus countermeasures are needed in order to guarantee safe driving with split shift schedules.

  • 13.
    Anund, Anna
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Swedish National Rd and Transport Research Institute VTI, Linkoping, Sweden..
    Ahlström, Christer
    Swedish National Rd and Transport Research Institute, Linkoping, Sweden.
    Fors, Carina
    Swedish National Rd and Transport Research Institute, Linkoping, Sweden.
    Åkerstedt, Torbjorn
    Karolinska Institute, Sweden; Stockholm University, Sweden.
    Are professional drivers less sleepy than non-professional drivers?2018Ingår i: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 44, nr 1, s. 88-95Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective It is generally believed that professional drivers can manage quite severe fatigue before routine driving performance is affected. In addition, there are results indicating that professional drivers can adapt to prolonged night shifts and may be able to learn to drive without decreased performance under high levels of sleepiness. However, very little research has been conducted to compare professionals and non-professionals when controlling for time driven and time of day. Method The aim of this study was to use a driving simulator to investigate whether professional drivers are more resistant to sleep deprivation than non-professional drivers. Differences in the development of sleepiness (self-reported, physiological and behavioral) during driving was investigated in 11 young professional and 15 non-professional drivers. Results Professional drivers self-reported significantly lower sleepiness while driving a simulator than nonprofessional drivers. In contradiction, they showed longer blink durations and more line crossings, both of which are indicators of sleepiness. They also drove faster. The reason for the discrepancy in the relation between the different sleepiness indicators for the two groups could be due to more experience to sleepiness among the professional drivers or possibly to the faster speed, which might unconsciously have been used by the professionals to try to counteract sleepiness. Conclusion Professional drivers self-reported significantly lower sleepiness while driving a simulator than non-professional drivers. However, they showed longer blink durations and more line crossings, both of which are indicators of sleepiness, and they drove faster.

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  • 14.
    Ahlström, Christer
    et al.
    VTI, Swedish Natl Rd and Transport Res Inst, Linkoping, Sweden.
    Anund, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. VTI, Swedish Natl Rd and Transport Res Inst, Linkoping, Sweden.
    Fors, Carina
    VTI, Swedish Natl Rd and Transport Res Inst, Linkoping, Sweden.
    Åkerstedt, Torbjorn
    Stockholm Univ, Sweden; Karolinska Inst, Sweden.
    Effects of the road environment on the development of driver sleepiness in young male drivers2018Ingår i: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 112, s. 127-134Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Latent driver sleepiness may in some cases be masked by for example social interaction, stress and physical activity. This short-term modulation of sleepiness may also result from environmental factors, such as when driving in stimulating environments. The aim of this study is to compare two road environments and investigate how they affect driver sleepiness. Thirty young male drivers participated in a driving simulator experiment where they drove two scenarios: a rural environment with winding roads and low traffic density, and a suburban road with higher traffic density and a more built-up roadside environment. The driving task was essentially the same in both scenarios, i.e. to stay on the road, without much interaction with other road users. A 2 x 2 design, with the conditions rural versus suburban, and daytime (full sleep) versus night-time (sleep deprived), was used. The results show that there were only minor effects of the road environment on subjective and physiological indicators of sleepiness. In contrast, there was an increase in subjective sleepiness, longer blink durations and increased EEG alpha content, both due to time on task and to night-time driving. The two road environments differed both in terms of the demand on driver action and of visual load, and the results indicate that action demand is the more important of the two factors. The notion that driver fatigue should be countered in a more stimulating visual environment such as in the city is thus more likely due to increased task demand rather than to a richer visual scenery. This should be investigated in further studies.

  • 15.
    Mårdh, Selina
    et al.
    Swedish National Rd and Transport Research Institute, Linkoping, Sweden.
    Mårdh, Pamela
    Region Östergötland, Närsjukvården i östra Östergötland, Akutkliniken i Norrköping.
    Anund, Anna
    Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Swedish National Rd and Transport Research Institute, Linkoping, Sweden.
    Driving restrictions post-stroke: Physicians compliance with regulations2017Ingår i: Traffic Injury Prevention, ISSN 1538-9588, E-ISSN 1538-957X, Vol. 18, nr 5, s. 477-480Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Suffering a stroke might lead to permanent cognitive and/or physical impairment. It has been shown that these impairments could have an impact on an individuals fitness to drive. In Sweden, as in many other countries, there are regulations on driving cessation post-stroke. Information on driving cessation should be given to all patients and noted in the journal. The present study sought to determine physicians compliance to driving regulations post-stroke as well as follow-up and gender aspects.Method: A retrospective study of medical records on stroke patients was carried out. The study covered all of the medical records on stroke incidents (n = 342) during a year at a typical medium to large-sized hospital in Sweden.Results: A journal entry on driving cessation post-stroke was missing in 81% of the medical records. Only 2% of the patients were scheduled for a follow-up meeting specifically concerning fitness to drive. Significantly more men than women had an entry on driving in the journal.Conclusions: We conclude that the Swedish regulations on driving cessation post-stroke were not followed at the participating hospital. It is crucial that all stroke patients receive information on driving cessation because their condition might affect fitness to drive. Analysis of follow-up records showed that there was no consistent method for assessment of a patients fitness to drive. There was also a gender difference in the material, which warrants further investigation.

  • 16.
    Vadeby, Anna
    et al.
    VTI, Swedish National Rd and Transport Research Institute, SE-58195 Linkoping, Sweden.
    Anund, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. VTI, Swedish National Rd and Transport Research Institute, SE-58195 Linkoping, Sweden.
    Effectiveness and acceptability of milled rumble strips on rural two-lane roads in Sweden2017Ingår i: European Transport Research Review, ISSN 1867-0717, E-ISSN 1866-8887, Vol. 9, nr 2, artikel-id 29Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose The study sought to estimate the effects of centreline milled rumble strips on rural two-lane roads in Sweden in a wide perspective. Traffic safety effects (i.e., fewer crashes and injuries), driver experience, and driver opinions of centreline milled rumble strip usage on rural roads are investigated. Methods To evaluate the traffic safety effects, an Empirical Bayes study comparing the outcome before and-after the introduction of rumble strips was conducted. This study is based on data from 2003-2012 from the Swedish national traffic accident database, STRADA. To capture driver experience and opinions about milled centreline rumble strips, focus groups and road-side interviews were performed. Results The results indicate a significant decrease in all types of severe injury crashes, a 20% (+/- 13%) reduction in the number of fatalities and seriously injured people (all crash types) and a 27% (+/- 18%) reduction in the number of fatalities and severely injured people in single-vehicle crashes. Participants in focus groups and road-side interviews generally favoured centreline rumble strips on rural roads, and up to 90% of the interviewed motorcyclists and commuters stated that the rumble strips would help improve traffic safety. Conclusions Rumble strips in the centre of two-lane rural roads are a countermeasure to help drivers who are unintentionally about to leave the lane, for example, due to sleepiness or inattention. Based on the results of this study, installing centreline milled rumble strips on two-lane rural roads 8-10 meters wide is a measure to consider to increase safety.

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  • 17.
    Phillips, Ross Owen
    et al.
    Inst Transport Econ TOI, Norway.
    Kecklund, Goran
    Stockholm Univ, Sweden.
    Anund, Anne
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Swedish Natl Rd & Transport Res Inst, Linköping, Sweden.
    Sallinen, Mikael
    Finnish Inst Occupat Hlth, Finland.
    Fatigue in transport: a review of exposure, risks, checks and controls2017Ingår i: Transport reviews, ISSN 0144-1647, E-ISSN 1464-5327, Vol. 37, nr 6, s. 742-766Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Human fatigue continues to threaten safe transport. There are claims that employers of operators should do more to mitigate the risks, and several regulators are promoting fatigue-risk management in the context of safety management systems (SMS). The current paper reviews fatigue-related risk and exposure factors and control measures for operators of land-and sea-based transport forms. Our review identifies 13 types of measures for the monitoring or control of fatigue risks: optimal staffing; optimal schedule design; optimisation of breaks/naps; monitoring of actual hours worked; optimisation of work content; monitoring and feedback of actual sleep; health screening and treatment; promotion of recovery from work; fitness-for-duty testing; monitoring of fatigue symptoms while operating; control of fatigue while operating; performance monitoring and assistance; and fatigue-proofing. We also identify two systemic measures needed to anchor risk mitigation in SMS: organisational learning and training/other. By structuring monitoring and control measures along Dawson and McCullochs [Managing fatigue: Its about sleep. Sleep Medicine Reviews, 9(5), 365-380] fatigue-risk trajectory, a framework is obtained that acts as a guide for fatigue-risk management by transport employers. To inform transport managers further, evaluations are needed of the effectiveness of individual control measures as well as whole fatigue-risk management interventions.

  • 18.
    Ahlström, Christer
    et al.
    Swedish National Rd and Transport Research Institute VTI, S-58195 Linkoping, Sweden.
    Jansson, Sabina
    Linköpings universitet, Institutionen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    Anund, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken. Swedish National Rd and Transport Research Institute VTI, S-58195 Linkoping, Sweden.
    Local changes in the wake electroencephalogram precedes lane departures2017Ingår i: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 26, nr 6, s. 816-819Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The objective of this exploratory study is to investigate if lane departures are associated with local sleep, measured via source-localized electroencephalography (EEG) theta power in the 5-9 Hz frequency range. Thirty participants drove in an advanced driving simulator, resulting in 135 lane departures at high levels of self-reported sleepiness. These lane departures were compared to matching non-departures at the same sleepiness level within the same individual. There was no correspondence between lane departures and global theta activity. However, at the local level an increased risk for lane departures was associated with increased theta content in brain regions related to motor function.

  • 19.
    Ihlstrom, Jonas
    et al.
    Swedish National Rd and Transport Research Institute, Linkoping, Sweden.
    Kecklund, Goran
    Stockholm University, Sweden.
    Anund, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken. Swedish National Rd and Transport Research Institute, Linkoping, Sweden.
    Split-shift work in relation to stress, health and psychosocial work factors among bus drivers2017Ingår i: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 56, nr 4, s. 531-538Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Shift work has been associated with poor health, sleep and fatigue problems and low satisfaction with working hours. However, one type of shift working, namely split shifts, have received little attention. OBJECTIVE: This study examined stress, health and psychosocial aspects of split-shift schedules among bus drivers in urban transport. METHODS: A questionnaire was distributed to drivers working more than 70% of full time which 235 drivers in total answered. RESULTS: In general, drivers working split-shift schedules (n = 146) did not differ from drivers not working such shifts (n = 83) as regards any of the outcome variables that were studied. However, when individual perceptions towards split-shift schedules were taken into account, a different picture appeared. Bus drivers who reported problems working split shifts (36%) reported poorer health, higher perceived stress, working hours interfering with social life, lower sleep quality, more persistent fatigue and lower general work satisfaction than those who did not view split shifts as a problem. Moreover, drivers who reported problems with split shifts also perceived lower possibilities to influence working hours, indicating lower work time control. CONCLUSIONS: This study indicates that split shifts were not associated with increased stress, poorer health and adverse psychosocial work factors for the entire study sample. However, the results showed that individual differences were important and approximately one third of the drivers reported problems with split shifts, which in turn was associated with stress, poor health and negative psychosocial work conditions. More research is needed to understand the individual and organizational determinants of tolerance to split shifts.

  • 20.
    Anund, Anna
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Swedish National Rd and Transport Research Institute VTI, SE-58195 Linkoping, Sweden.
    Fors, Carina
    Swedish National Rd and Transport Research Institute VTI, SE-58195 Linkoping, Sweden.
    Ahlström, Christer
    Swedish National Rd and Transport Research Institute VTI, SE-58195 Linkoping, Sweden.
    The severity of driver fatigue in terms of line crossing: a pilot study comparing day- and night time driving in simulator2017Ingår i: European Transport Research Review, ISSN 1867-0717, E-ISSN 1866-8887, Vol. 9, nr 2, artikel-id 31Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction The overall aim of this study is to compare daytime driving with night-time driving looking at line crossings during self-reported sleepiness and long blinks. The hypothesis is that high levels of self-reported sleepiness (KSS 9) and long blink duration (amp;gt;0.15 s) will be less associated with critical events during the day-time compared to night-time. Method The study is based on data from a driving simulator experiment with 16 participants driving 150 km on a typical Swedish motorway scenario twice: once during daytime and once during night time. In total data from 6 segments of 4 km each equally distributed along the drive was averaged and included in the analysis. A Mixed Model Anova was used to test the effects on KSS, Blink Duration and Line Crossings with factors for Session (Day/Night) and Road segment (1-6), and participant as random. In addition, a logistic regression was used to identify when there is a risk for line crossings. Finally, the proportion of line crossings in relation to high KSS values and long blink durations was tested with Fishers exact test. Results The results show no differences in the percentage of Line Crossings to the left during high levels of Karolinska Sleepiness Scale during daytime (33%) compare to night-time (40%). However, there was a significant difference between day and night time line crossings while the driver had long duration blinks (4% during daytime and 35% during night-time). Despite these results the most promising predictor of line crossings in each segment of 4 km/h was KSS with an Odds Ratio of 5.4 with a reference value at Karolinska Sleepiness Scale level 5. Conclusion In conclusion, the results do not support the hypothesis that high levels of KSS will result in more frequent line crossings at night time compared to day time. However, the result supports the hypothesis that long blink durations are associated with more line crossings when they appear during night time than during daytime.

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  • 21.
    Hughes, B. P.
    et al.
    Curtin University, Australia.
    Anund, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Swedish Rd and Transport Research Institute, S-58195 Linkoping, Sweden.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Curtin University, Australia; La Trobe University, Australia.
    A comprehensive conceptual framework for road safety strategies2016Ingår i: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 90, s. 13-28Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Road safety strategies (generally called Strategic Highway Safety Plans in the USA) provide essential guidance for actions to improve road safety, but often lack a conceptual framework that is comprehensive, systems theory based, and underpinned by evidence from research and practice. This paper aims to incorporate all components, policy tools by which they are changed, and the general interactions between them. A framework of nine mutually interacting components that contribute to crashes and ten generic policy tools which can be applied to reduce the outcomes of these crashes was developed and used to assess 58 road safety strategies from 22 countries across 15 years. The work identifies the policy tools that are most and least widely applied to components, highlighting the potential for improvements to any individual road safety strategy, and the potential strengths and weaknesses of road safety strategies in general. The framework also provides guidance for the development of new road safety strategies, identifying potential consequences of policy tool based measures with regard to exposure and risk, useful for both mobility and safety objectives. (C) 2016 Elsevier Ltd. All rights reserved.

  • 22.
    Watling, Christopher N.
    et al.
    Queensland University of Technology, Australia; Stockholm University, Sweden.
    Akerstedt, Torbjorn
    Stockholm University, Sweden; Karolinska Institute, Sweden.
    Kecklund, Goran
    Stockholm University, Sweden; Radboud University of Nijmegen, Netherlands.
    Anund, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken. Swedish National Rd and Transport Research Institute, Linkoping, Sweden.
    Do repeated rumble strip hits improve driver alertness?2016Ingår i: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 25, nr 2, s. 241-247Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Driving while sleepy is associated with increased crash risk. Rumble strips are designed to alert a sleepy or inattentive driver when they deviate outside their driving lane. The current study sought to examine the effects of repeated rumble strip hits on levels of physiological and subjective sleepiness as well as simulated driving performance. In total, 36 regular shift workers drove a high-fidelity moving base simulator on a simulated road with rumble strips installed at the shoulder and centre line after a working a full night shift. The results show that, on average, the first rumble strip occurred after 20min of driving, with subsequent hits occurring 10min later, with the last three occurring approximately every 5min thereafter. Specifically, it was found that the first rumble strip hit reduced physiological sleepiness; however, subsequent hits did not increase alertness. Moreover, the results also demonstrate that increased subjective sleepiness levels, via the Karolinska Sleepiness Scale, were associated with a greater probability of hitting a rumble strip. The present results suggest that sleepiness is very resilient to even strongly arousing stimuli, with physiological and subjective sleepiness increasing over the duration of the drive, despite the interference caused by rumble strips.

  • 23.
    Anund, Anna
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken. Swedish National Rd and Transport Research Institute, Linkoping, Sweden.
    Ihlstrom, Jonas
    Swedish National Rd and Transport Research Institute, Linkoping, Sweden.
    Fors, Carina
    Swedish National Rd and Transport Research Institute, Linkoping, Sweden.
    Kecklund, Göran
    Stockholm University, Sweden.
    Filtness, Ashleigh
    Queensland University of Technology, Australia.
    Factors associated with self-reported driver sleepiness and incidents in city bus drivers2016Ingår i: Industrial Health, ISSN 0019-8366, E-ISSN 1880-8026, Vol. 54, nr 4, s. 337-346Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Driver fatigue has received increased attention during recent years and is now considered to be a major contributor to approximately 15-30% of all crashes. However, little is known about fatigue in city bus drivers. It is hypothesized that city bus drivers suffer from sleepiness, which is due to a combination of working conditions, lack of health and reduced sleep quantity and quality. The overall aim with the current study is to investigate if severe driver sleepiness, as indicated by subjective reports of having to fight sleep while driving, is a problem for city based bus drivers in Sweden and if so, to identify the determinants related to working conditions, health and sleep which contribute towards this. The results indicate that driver sleepiness is a problem for city bus drivers, with 19% having to fight to stay awake while driving the bus 2-3 times each week or more and nearly half experiencing this at least 2-4 times per month. In conclusion, severe sleepiness, as indicated by having to fight sleep during driving, was common among the city bus drivers. Severe sleepiness correlated with fatigue related safety risks, such as near crashes.

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