ESRA Consulting Corporation TM

New, Improved, Comprehensive, and Automated Driver's License Test and Vision Screening System

Final Report 559(1)

Prepared by:

ESRA Consulting Corporation™

1650 South Dixie Highway, Third Floor

Boca Raton, Florida 33432 USA

MAY 2005

Prepared for:

Arizona Department of Transportation

206 South 17th Avenue Phoenix, Arizona 85007

in cooperation with

U.S. Department of Transportation Federal Highway Administration

The contents of the report reflect the views of the authors who are responsible for the facts and the accuracy of the data presented herein. The authors assume no liability for the use or misuse of any information, opinions, or conclusions contained in this report. The contents do not necessarily reflect the official views or policies of the Arizona Department of Transportation or the Federal Highway Administration. This report does not constitute a standard, specification, or regulation. Trade or manufacturers’ names which may appear herein are cited only because they are considered essential to the objectives of the report. The

U.S. Government and The State of Arizona do not endorse products or manufacturers.

ESRA CONSULTING CORPORATION DISCLAIMER

Neither ESRA Consulting Corporation (ESRA), its affiliates, its associates, nor any agency thereof, nor any of their employees, makes any warranty, express or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness of any information, apparatus, product or process disclosed, or represents that its use would not infringe privately owned rights. References herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise, does not necessarily constitute or imply its endorsement, recommendation, or favoring by ESRA or any agency thereof. The views and opinions of authors expressed herein do not necessarily state or reflect those of ESRA or any agency thereof. This report is for informational purposes only. Readers are encouraged to confirm the information contained herein with other sources. The information is not intended to replace medical advice offered by physicians. Reliance on any information in this report is solely at your own risk. ESRA Consulting Corporation is not responsible or liable for any direct, indirect, consequential, special, exemplary, or other damages arising from any use of any product, information, idea, or instruction contained in this report and all publications and presentations and/ or implementations therefrom.

Notice is hereby provided that a patent application has been filed on one or more of the systems and methods described herein.

Notice is hereby provided that ESRA may be involved in development and/ or marketing of products in the systems and/ or methods described herein.

In the event that consideration is given to any component in the system described herein in which ESRA may have a marketing arrangement or other involvement, at the time of such consideration, full disclosure will made.

Technical Report Documentation Page

1. Report No. FHWA-AZ-04-559(1)		2. Government Accession No.		3. Recipient’s Catalog No.
4. Title and Subtitle SPR 559 - New, Improved, Comprehensive, and Automated Driver’s License Test and Vision Screening System				5. Report Date May 2005
				6. Performing Organization Code
7. Authors Sandy H. Straus				8. Performing Organization Report No.
9. Performing Organization Name and Address ESRA Consulting Corporation 1650 South Dixie Highway, 3rd Floor Boca Raton, Florida 33432 (561) 361-0004 http://www.esracorp.com				10. Work Unit No.
				11. Contract or Grant No. SPR-PL-1-(61) 559
12. Sponsoring Agency Name and Address ARIZONA DEPARTMENT OF TRANSPORTATION 206 S. 17TH AVENUE PHOENIX, ARIZONA 85007 Project Manager: John Semmens				13.Type of Report and Period Covered
				14. Sponsoring Agency Code
15. Supplementary Notes Prepared in cooperation with the U.S. Department of Transportation, Federal Highway Administration
16. Abstract This one-of-a-kind comprehensive study highlights the importance of automated testing techniques and the significance of vision screening measures other than standard visual acuity testing for assessing all drivers and, in particular, at-risk drivers and older drivers. Non-automated tests tend to be subjective, time-consuming, costly, and heavily reliant on the experience of the examiner. Due to the high collision, injury, and fatality rates of all drivers in the State of Arizona, and the disproportionate number of at-fault older drivers and collision risks in the States of Arizona and Florida, new and automated screening methodologies and vision standards are now needed to promote road safety, predict visual impairment, and evaluate possible restriction or confiscation of driver’s licenses. This study demonstrates that environmental factors and manner of collisions increase in collision involvement for drivers between ages 50 to 59 years in both Arizona and Florida. Drivers age 80 to 89 years in both states are most likely at-fault in collisions compared to all other age cohorts. These results are consistent among drivers cited for collision involvement due to visual defects. Our findings, which span an 11- year period from 1991 to 2001, not only apply to Arizona and Florida, two states with some of the largest proportions of older individuals in the United States, but, as our global survey of motor vehicle bureau directors or their representatives of the United States, Commonwealth of Puerto Rico, United Kingdom, Canada, New Zealand, and Australia illustrate, any state, country, province, territory, commonwealth, or nation with an increasing number of older drivers. A pilot study, to follow, ultimately allows for the implementation of effective strategies for screening of visual impairment and eye disease in all Arizona drivers. Snellen acuity, the most widely used vision testing measure, accounts for less than 0.1 percent of the visual field and fails to quantify contrast sensitivity and color vision (Fink and Sadun, 2004), two of several visual parameters needed for safe driving. It is recommended that at-risk and older drivers in Arizona are tested for vision through a newly designed system of measures provided by two automated tests (to test vision condition and function) and one driving simulator (to assess eye status). Hence we integrate it into a larger system and provide additional recommendations as these relate to motor vehicle operation skills and cognition. These automated systems and methodologies may ultimately serve as a prototype of transportation license testing improvements for all other states, countries, and agencies (e.g., aviation, rail, maritime, commercial vehicles, etc.) to follow. Such techniques may also reduce the incidence of fraudulent schemes and issuances of driver’s licenses, commercial driver’s licenses, and hazardous materials transportation licenses.
17. Key Words older driver, at-risk driver, driver’s license test, UFOV, RAIR, Relative Accident Involvement Ratio, probabilistic risk assessment, visual acuity, driving simulator, vision test, dementia, Alzheimer’s Disease, Parkinson’s Disease, Macular Degeneration, Arizona, Florida, ESRA Dynamic Vision Assessment for Transportation, license renewal, automated testing, vision screening system, ESRA DVAT, ESRA VAPT, ESRA Vision Assessment Procedure for Transportation, simulator sickness, flashback effect, aftereffect, cybersickness, ESRA DAT, driver license test procedure, transportation license test			18. Distribution Statement Document is available to the U.S. public through the National Technical Information Service, Springfield, Virginia, 22161			23. Registrant’s Seal
19. Security Classification Unclassified	20. Security Classification Unclassified		21. No. of Pages 438		22. Price

The ESRA DAT ™ System is developed by:

ESRA Consulting Corporation

ESRA DAT ™ Sales Division

1650 South Dixie Highway, Third Floor

Boca Raton, Florida 33432

USA

Telephone: (561) 361-0004

Arizona Fax: (520) 844-8555

e-mail: dat@esracorp.com

web: http://www.esracorp.com

I dedicate this report to the memory of Max, my grandfather, a pedestrian statistic. May this report serve as a testament to his legacy. He is sorely missed.

This one is for you, Papa.

Review of Literature.

Introduction.

The Older Populations of Arizona and Florida.

Older Drivers In The News.

Vision Impairment

Affected Eye Structures.

Visual Acuity.

Contrast Sensitivity.

Color Vision.

Some Diseases Of The Eyes.

Refractive Error.

Infectious Disorders of the Eye.

Nutritional And Metabolic Factors.

Alzheimer’s Disease, Dementia, and Driving.

Some Driver’s License Vision Testing Policies: An Overview.

Vision Testing: Self Versus Other.

Field Of Vision Testing.

Older Versus Younger Drivers.

SURVEY OF DRIVER’S LICENSE BUREAU DIRECTORS OR THEIR REPRESENTATIVES.

Analysis of Collision Data

Introduction.

Methodology.

The Framework.

Comparison of Relative Accident Involvement Ratio (RAIR) of Collisions of Arizona and Florida Drivers, Years 1991 TO 2001.

Bathtub Curves.

Descriptive Statistics and Calculated Risks of Violations/Behavior-Related Collisions in the State of Arizona, Years 1991 to 2001.

COMPARISON OF AVERAGE INDIVIDUAL RISKS OF COLLISIONS, INJURIES, AND FATALITIES OF ARIZONA AND FLORIDA DRIVERS, YEARS 1991 to 2001.

REVIEWS OF VISION TESTS AND DRIVING SIMULATORS.

Introduction.

The History and Future of Vision Tests.

Vision Screening Tests.

Vision Screening Methods in Other Settings.

Recommended Vision Screening Equipment.

Driving Simulators: Yesterday and Today.

From the Past to the Present

Research, Training, and Screening Usage.

Simulator Sickness and Aftereffects.

What is simulator sickness?.

Aftereffects.

Flashback Effects.

Cyberadaptation Syndrome and Simulator Adaptation Syndrome.

Factors of Simulator Sickness.

Simulator Sickness Studies.

The Simulator Sickness Questionnaire.

Field of View and Flicker.

Gender.

Incidence of simulator sickness.

Impacts of Cybersickness.

Studies of At-Risk Drivers.

Simulator Sickness Mitigation Strategies.

Future Simulator Sickness Studies.

Safety Recommendations.

Recent and Current Driving Simulator Research

Recommended Driving Simulators

CONCLUSION..

RECOMMENDATIONS.

Vision Screening System..

Cognition Test

Knowledge Test

Driving Test

Driver’s License Renewal

Additional Recommendations.

Implementation.

Benefits of ESRA DVAT ™.

REFERENCES.

APPENDIX A: Horizontal section of the human eyeball and some common conditions that may affect it.

APPENDIX B: RESULTS OF GLOBAL SURVEY OF DRIVER’S LICENSE DIRECTORS OR THEIR REPRESENTATIVES, YEAR 2004.

APPENDIX C: COLLISIONS IN ARIZONA, YEARS 1991 to 2001.

APPENDIX D: DESCRIPTIVE STATISTICS OF COLLISIONS, FATALITIES, AND INJURIES OF ARIZONA AND FLORIDA DRIVERS, YEARS 1991 to 2001.

APPENDIX E: OVERVIEW OF ARIZONA AND FLORIDA DRIVER’S LICENSEES, YEARS 1991 to 2001

APPENDIX F: COMPARATIVE RATES OF COLLISIONS, FATALITIES, AND INJURIES OF ARIZONA AND FLORIDA DRIVERS, YEARS 1991 to 2001.

APPENDIX G: COMPARISON OF RELATIVE ACCIDENT INVOLVEMENT RATIO (RAIR) OF COLLISIONS OF ARIZONA AND FLORIDA DRIVERS, YEARS 1991 to 2001.

APPENDIX H: RELATIVE ACCIDENT INVOLVEMENT RATIO OF ARIZONA DRIVERS WITH CORRECTIVE LENSES, INVOLVED COLLISIONS,

YEARS 1991 to 2001.

APPENDIX I: RELATIVE ACCIDENT INVOLVEMENT RATIO OF FLORIDA DRIVERS ASSOCIATED WITH INJURIES, YEARS 1991 to 2001.

APPENDIX J: RELATIVE ACCIDENT INVOLVEMENT RATIO OF FLORIDA DRIVERS ASSOCIATED WITH FATALITIES YEARS 1991 to 2001.

APPENDIX K: RELATIVE ACCIDENT INVOLVEMENT RATIO OF FLORIDA DRIVERS ASSOCIATED WITH COLLISIONS, YEARS 1991 to 2001.

APPENDIX L: DESCRIPTIVE STATISTICS OF WEATHER-RELATED COLLISIONS IN THE STATE OF ARIZONA, YEARS 1991 to 2001.

APPENDIX M: DESCRIPTIVE STATISTICS OF LIGHT-RELATED COLLISIONS IN THE STATE OF ARIZONA, YEARS 1991 to 2001.

APPENDIX N: DESCRIPTIVE STATISTICS OF MANNER OF COLLISIONS IN THE STATE OF ARIZONA, Years 1991 to 2001.

APPENDIX O: DESCRIPTIVE STATISTICS OF RESTRICTIONS-RELATED COLLISIONS IN THE STATE OF ARIZONA, YEARS 1991 TO 2001.

APPENDIX P: DESCRIPTIVE STATISTICS AND CALCULATED RISKS OF VIOLATIONS / BEHAVIOR-RELATED COLLISIONS IN THE STATE OF ARIZONA, YEARS 1991 to 2001.

APPENDIX Q: COMPARISON OF AVERAGE INDIVIDUAL RISKS OF COLLISIONS, INJURIES, AND FATALITIES OF ARIZONA AND FLORIDA DRIVERS, YEARS 1991 to 2001.

APPENDIX R: ARIZONA COLLISION RATES BY RESTRICTIONS, VIOLATIONS, AND BEHAVIORS, YEARS 1991 to 2001.

APPENDIX S: VISION SCREENING DEVICES.

APPENDIX T: DRIVING SIMULATORS.

APPENDIX U: COMPLETED GLOBAL SURVEYS.

United States of America and Commonwealth of Puerto Rico.

APPENDIX V: COPY OF THE SURVEY FORMS.

ACKNOWLEDGEMENTS.

TABLES


Table 1	The Haddon Matrix
Table 2	Thresholds of Annual Fatality Risk Levels According to Otway and Erdmann
Table 3	Model and Special Features of Vision Testing Equipment
Table 4	Model and Special Features of Driving Simulators

FIGURES


Figure 1	Horizontal section of the human eyeball and some common conditions that may affect it.
Figure 2	The Bathtub Curve
Figure 3	Comparison of Left Turn Manner of Collisions Among Drivers in Arizona and Florida for years 1991 to 2001
Figure 4	Comparison of Dawn or Dusk Related Collisions Among Drivers in Arizona and Florida for years 1991 to 2001
Figure 5	Comparison of Collisions Among Drivers with Visual Defects in Arizona and Florida for years 1991 to 2001
Figure 6	ESRA Vision Assessment Procedure for Transportation™ (ESRA VAPT™)
Figure 7	ESRA Dynamic Vision Testing for Transportation™ (ESRA DVAT™)
Figure 8	Figure 8. ESRA Dynamic Assessment for Transportation (ESRA DAT ™)

GLOSSARY OF ACRONYMS

3DAGT 3-Dimensional Amsler Grid Test

AAA American Automobile Association

AAMVA American Association of Motor Vehicle Administrators

AD Alzheimer’s Disease

ADL Activities of Daily Living

ADOT The Arizona Department of Transportation

AION Anterior Ischemic Optic Neuropathy

AMD Age-Related Macular Degeneration

AUS Australia

AZ Arizona

CA Canada

CMV Cytomegalovirus Retinitis

CPR Commonwealth of Puerto Rico

DAT ESRA Dynamic Assessment for Transportation™ (ESRA DAT ™)

DETR Department of the Environment, Transport and the Regions (UK)

DfT United Kingdom Department of Transport

DMV Department of Motor Vehicles

DVAT

New, Improved, Comprehensive, and Automated Driver's License Test and Vision Screening System

Final Report 559(1)

Prepared by:

MAY 2005

Prepared for:

ESRA CONSULTING CORPORATION DISCLAIMER

The ESRA DAT ™ System is developed by:

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