Traffic Medicine-2: Behavioural Factors in Road Traffic Crashes

It's trite recounting the deplorable state of our roads in Nigeria. Every traveller has one sad story or the other to tell and we all bear, directly or indirectly, the scars of the death trap we call roads in various parts of the country. However, it is important to highlight behavioural factors and decision making processes that are significant factors in road traffic crashes, injuries and fatalities notwithstanding the state of our roads.
These factors include:

• Excess speed for the prevailing conditions of the road
• Driving under the influence of alcohol and other drugs that impair driving ability and judgement
• Fatigue or driving while drowsy/sleepy
• Poor attention and distraction
• Aggressive driving behaviour
• Noncompliance with safety measures e.g., use of seat-belts
• Age-related issues and inexperience
• Decision errors
• Belief in some "invincibility" by some magical powers
• Other related behavioural factors

One of the roles of Forensic Medicine in road safety is in the evaluation of some categories of drivers for fitness to drive especially in testing for alcohol and drug use, and any medical conditions that could impair driving. At least we can agree that it is in our collective interest to have drivers truly certified to be fit to drive. Some categories of drivers are of major concern e.g. drivers of heavy duty trucks, trailers, long luxuries buses which convey scores of people at the same time, police and ambulance drivers, and other special duty drivers. It is not only important to have a "snapshot" test for alcohol or drug use by these individuals, it is also equally or perhaps more important to test them for pattern of use over a certain period. Some forensic toxicological tests can tell us a history of drug use in any individual and this will be particularly important in a pre-employment assessment of potential drivers in the category indicated. This test is also conducted periodically to ensure that there is strict compliance with regulations regarding alcohol or drug use. These are some of the activities that bring about sanity to road use in any society, and it is essentially paying attention to small details.
Unfortunately, there is no forensic toxicology testing in Nigeria, the giant of Africa! Those in authority get away with this irresponsibility and perfidy because we have resigned to fate and accepted the carnage on our roads as the "will of God". It is so easy to see our gullibility and these "leaders" have continued to exploit it on virtually all issues of national importance while we continue to waste lives on Nigeria's roads where more people die than could be attributed to any single organic disease.

Driving through our roads, burnt or irreparably damaged vehicles involved in fatal crashes with attendant human and economic loss is a common sight. In the usual attitude of "pound-foolishness", we commit so much resources in acquiring these vehicles and in making them road worthy but we ignore the vital factor-the driver. Some commercial drivers often work back to back and are celebrated by employers as "hardworking" only for them to acquire enough "confidence" to dispatch self and other passengers and road users to untimely death usually on account of  fatigue and sleepiness on wheel. At our major motor parks in Nigeria, vendors freely sell local gins or spirits and other alcoholic beverages to drivers and some of these drinks are disguised as local medicinal concoctions. Amazingly passengers themselves,  in our usual docile attitude, ignore this time bomb and board these vehicles driven by drunk drivers! We all know that the local concoction is just some roots soaked in locally brewed gins with strong alcohol content. In our investigation of road traffic fatalities, unfortunately we fail to objectively document the role of alcohol and drugs basically because we are unable to do so. Countries have legal alcohol limits. What is the legal alcohol limit for driving in Nigeria? In addition, there is no forensic toxicology laboratory to assist in the forensic medical investigation of road traffic crashes. These are some of the issues that should engage those in authority and policy makers. Making the society a safe place is one of the primary tasks of leadership and it is a gross failure to neglect this duty in any way.