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1. Department of Biostatistics and Medical Informatics, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul 34098, Turkey
2 Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester M13 9PL, UK
3. Department of Psychology, İstanbul Medipol University, Kavacik, 34810 Beykoz, İstanbul, Turkey
4. Safety Research Unit, Department of Psychology, Middle East Technical University, Ankara 06800, Turkey
5. Department of Civil Engineering , Faculty of Engineering, University of Jordan, Amman 11942, Jordan
6. Department of Transportation Engineering, University of Illinois at Urbana-Champaign, IL 61820-6983, USA


No study has been conducted to determine the relationship between RTC (road traffic crashes) and depression, anxiety and stress scale (DASS-21), tiredness, fatigues and sleeping. The aim of the present study was to examine the effect of aggressive driver behaviour, fatigue and sleeping on RTC comparison between commercial taxi and minibus/van/pick-up cars drivers. A cross-sectional study included a representative sample of 2,300 drivers of which 1,786 drivers (77.6%) agreed to participate. The Manchester DBQ (Driver Behaviour Questionnaire) was used to measure the aberrant driving behaviours leading to accidents. The study is based on the measurement using the depression anxiety stress scales (DASS-21). Participants completed a DASS-21 questionnaire with items related to socio-demographic information, BMI (body mass index), driving experience, fatigue , sleeping, adherence to traffic laws (including speed limits and wearing seat belt), and drivers’ driving records. Univariate and multivariate statistical analyses were performed. In a representative sampling, the age distribution of the participants ranged from 25 to 65 years with the mean age 38.3±10.2 and the mean annual mileage (km) per month was 14,587±1,741 (p < 0.001). There was a significant difference found between both group minibus/van/pick-up and commercial taxi drivers regarding of their age group (p < 0.001), education (p = 0.003), history of accident (p = 0.003), seat belt use (p = 0.022) time of accident (p = 0.005); crossing red light (p < 0.001), excessive speed limits (p = 0.002), BMI group (p = 0.022), physical activity (p = 0.003), annual mileage in km (p < 0.001), number of working days (p = 0.010) and hours (p = 0.030); number of sleeping hours (p = 0.025), CD music listening (p = 0.010), mobile phone use (p = 0.001), soft drinking (p = 0.002) and cigarette smoking habit (p < 0.001). When the history of RTC was assessed, minibus/van/pick-ups were more likely to be involved in accidents compared to commercial taxi drivers and there was a highly statistically significant difference between both groups. Furthermore, minibus/van/pick-up drivers have more sleeping disorders and fatigue severity compared to commercial taxi drivers. This study revealed that minibus/van/pick-up drivers exhibited more depression, anxiety and stress symptoms compared to commercial taxi drivers. DASS-21 variables were found to contribute significantly to the explanation of the RTC involvement rate. Chronic fatigue and acute sleepiness, and overtime or heavy work-load on car drivers significantly increases the risk of a car crash which a car occupant can be injured or killed. Reductions in RTC may be achieved if fewer people drive when they have fatigue or are sleepy or have been deprived of sleep or drive during rush hours.


Aggressive behavior, sleeping fatigue, violation, driving accident.

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