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    <title>Transport Research International Documentation (TRID)</title>
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    <copyright>Copyright © 2026. National Academy of Sciences. All rights reserved.</copyright>
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    <managingEditor>tris-trb@nas.edu (Bill McLeod)</managingEditor>
    <webMaster>tris-trb@nas.edu (Bill McLeod)</webMaster>
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      <title>Transport Research International Documentation (TRID)</title>
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      <title>Drug presence in driving deaths in Maryland: Comparing trends and prevalence in medical examiner and FARS data</title>
      <link>https://trid.trb.org/View/1841049</link>
      <description><![CDATA[Accurate and reliable information on drug use by road users is essential to inform safety policy development but the reliability of national data has been questioned. There are two primary repositories of drug test information from fatal motor vehicle crashes in Maryland: (1) the Fatality Analysis Reporting System (FARS), which is a national crash database managed by the US Department of Transportation, and (2) the Maryland Medical Examiner (ME). In this study, the authors compared drug test information for people killed in crashes in Maryland between the FARS system and ME from 2006 – 2018. As ME records are the primary source for the FARS data from Maryland, these two data sets should be closely correlated. The authors used probabilistic linkage to match FARS and ME cases and compared matched cases by individual drug group. Matching was achieved on 83 % of cases (N = 4803 matched pairs). ME data consistently indicated higher overall incidence and trends in the presence of depressants, narcotics, and stimulants in crash deaths. Sensitivity analysis using both strict and relaxed matching criteria did not change this result. Road safety policy and prevention efforts for crashes involving drugs and alcohol require an accurate understanding of both long-term trends and year-to-year changes in drug prevalence. These findings demonstrate the potential value of using ME data as source of drug test information for crash deaths in the United States.]]></description>
      <pubDate>Mon, 05 Apr 2021 09:51:35 GMT</pubDate>
      <guid>https://trid.trb.org/View/1841049</guid>
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      <title>The prevalence of alcohol and other drugs in fatal road crashes in Victoria, Australia</title>
      <link>https://trid.trb.org/View/1777459</link>
      <description><![CDATA[Driving under the influence of drugs, including alcohol, is a globally recognized risk factor for road traffic crashes. While the prevalence of alcohol and other drugs in fatal road crashes has been examined in other countries, recent data investigating drug driving in fatal Australian crashes are limited. This study aimed to examine how the presence of alcohol and other drugs in fatal road trauma in Victoria has changed over time in different road users. A population-based review of road trauma deaths was performed over the period of 01 July 2006 to 30 June 2016 in Victoria, Australia, using data from the National Coronial Information System (NCIS) and the Victorian State Trauma Registry (VSTR). Drugs were grouped according to type and analyzed accordingly. Poisson regression models were used to determine change in incidence rates over the study period. There were 2287 road traffic fatalities with complete toxicology data (97% of all road traffic fatalities). Alcohol (blood alcohol concentration, BAC) was the most commonly detected drug (>0.001 g/100 mL: 21.1%; >0.05 g/100 mL: 18.4%), followed by opioids (17.3%), THC (13.1%), antidepressants (9.7%), benzodiazepines (8.8%), amphetamine-type stimulants (7.1%), ketamine (3.4%), antipsychotics (0.9%) and cocaine (0.2%). Trends demonstrated changing use over time with specific drugs. Alcohol positive road fatalities declined 9% per year in passenger car/4WD drivers (IRR = 0.91, 95% CI: 0.88−0.95). The incidence of strong opioids (oxycodone, fentanyl, morphine, and methadone) increased 6% per year (IRR = 1.06; 95% CI: 1.02–1.10). Methylamphetamine was detected in 6.6% of cases and showed a yearly increase of 7% (IRR = 1.07; 95% CI: 1.01–1.13). The incidence of THC remained unchanged over the period, observed in 13.1% of cases. Stronger opioids were more commonly detected among pedal cyclists (19.0%) and pedestrians (20.9%) while THC was more commonly detected among motorcyclists (19.8%) and other light vehicle drivers (17.6%). A decline in the prevalence of alcohol in fatalities suggests that law enforcement and public health strategies in Australia to address road fatalities and drink-driving may have had a positive effect. However, increases were observed in the incidence of other potentially impairing drugs including opioids and amphetamines, specifically methylamphetamine, indicating a concerning trend in road safety in Victoria that warrants further monitoring.]]></description>
      <pubDate>Thu, 25 Mar 2021 09:35:06 GMT</pubDate>
      <guid>https://trid.trb.org/View/1777459</guid>
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      <title>The incidence and characteristics of illicit drug related driver fatalities in Western Australia, 2000-2012</title>
      <link>https://trid.trb.org/View/1399500</link>
      <description><![CDATA[Evidence continues to accumulate of the impairing nature of illicit drugs on driving and the prevalence of use among crash and non-crash involved drivers. The prevalence of illicit substances among drivers varies with the type of substance and whether the driver was involved in a crash. For example, illicit substances of all types have been detected in up to 33% of fatally injured drivers with cannabis being the most frequently detected substance (Beasely, Beirness & Porath-Waller, 2011). Among non-crash involved drivers, between 4%-18% self-report having driven after using illicit drugs (AIHW, 2011), while up to 3.5% of drivers subject to a roadside oral fluids test in one Australian state have tested positive (Davey, Davies, French, Williams & Lang, 2005). Research has also identified that certain drivers have a higher risk of illicit drug-driving, including males (e.g., Blencowe, Pehrsson, Mykkanen, Gunar & Lillsunde, 2012), younger age persons (e.g., Clarke, Ward, Bartle & Truman, 2010) and those that engage in other on-road risk behaviours such as failing to wear a seat-belt (e.g., Beasley et al., 2011), drink-driving (Ashbridge, Poulin & Donato, 2005), and unlicensed driving (e.g., Boorman & Owens, 2009). Annual reporting of illicit drug driving in Western Australia (which commenced in 2008) is limited to fatally injured drivers and general descriptors such as the type of substance, age and gender of driver, road user status, and day of week. Unfortunately the reports fail to provide a detailed understanding of the trend and pattern of illicit drug involvement over time and associated driver and crash risk factors. This paper reports on the selected findings of a recent in-depth investigation of illicit drug-driving in Western Australia during the period 2000-2012. The findings of two of the study’s objectives to be considered in this presentation are: to document the incidence, trend and characteristics of illicit drug related motor vehicle driver and motorcycle rider fatalities; and the multivariate modelling of driver/rider and crash risk factors for an illicit drug driver/rider fatality.]]></description>
      <pubDate>Fri, 26 Feb 2016 09:30:05 GMT</pubDate>
      <guid>https://trid.trb.org/View/1399500</guid>
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    <item>
      <title>Traffic and drowning incidents with emphasis on the presence of alcohol and drugs</title>
      <link>https://trid.trb.org/View/1367651</link>
      <description><![CDATA[Worldwide, fatal traffic injuries and drowning deaths are important problems. The aim of this thesis was to investigate the cirumstances of fatal and non-fatal traffic injuries and drowning deaths in Sweden including analysis of the presence of alcohol and drugs, which are considered to be major risk factors for these events. Data where obtained from the database of the Swedish National Board of Forensic Medicine. In the first study, we investigated 420 passenger deaths from 372 crashes during 1993-1996. There were 594 drivers involved. In total, 21% of the drivers at fault were alcohol positive compared to 2% of drivers not at fault (p<0.001) (Paper I). During 2004-2007, crashes involving 56 fatally and 144 non-fatally injured drivers were investigated in a prospective study from Northern Sweden (Paper II). The drivers were alcohol positive in 38% and 21%, respectively. Psychoactive drugs were found in 7% and 13%, respectively. Benzodiazepines, opiates and antidepressants were the most frequent drugs found in drivers. Illict drugs were found 9% and 4% respectively, with tetrahydrocannabinol being the most frequent of these drugs (Paper II). We investigated 5,125 drowning deaths in Sweden during 1992-2009 (Paper III). The incidence decreased on average by about 2% each year (p<0.001). Unintentional drowning was most common (50%). Alcohol was found in 44% of unintentional, 24% of intentional, and 45% of undetermined drowning deaths. Psychoactive substances were detected in 40% and benzodiazepines were the most common substance. Illicit drugs were detected in 10%. Of all drowning deaths, a significantly higher proportion females commited suicide compared with males (55% vs. 21%, p<0.001). Suicidal drowning deaths (n=129) in Northern Sweden were studied further in detail (Paper IV). of these, 53% had been hospitalized due to a psychiatric diagnosis within five years prior to the suicide. Affective and psychotic disorders were the most common psychiatric diagnoses. Almost one third had performed a previous suicide attempt. One fourth had committed suicide after less than one week of discharge from hospital. Alcohol was found in 16% and psychoactive drugs in 62% of these cases, respectively. In conclusion, alcohol and psychoactive drugs are commonly detected among injured drivers and drowning victims, and probably play a role in these events. Most of the individuals that tested positive for alcohol and high blood concentrations, indicating alochol dependence or abuse. This association warrants futher attention when planning future prevention.]]></description>
      <pubDate>Tue, 01 Sep 2015 11:20:51 GMT</pubDate>
      <guid>https://trid.trb.org/View/1367651</guid>
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    <item>
      <title>The incidence of drugs in road accident fatalities in Great Britain</title>
      <link>https://trid.trb.org/View/1163783</link>
      <description><![CDATA[]]></description>
      <pubDate>Thu, 23 Aug 2012 14:24:49 GMT</pubDate>
      <guid>https://trid.trb.org/View/1163783</guid>
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    <item>
      <title>The incidence of drugs and alcohol in road accident fatalities</title>
      <link>https://trid.trb.org/View/1161389</link>
      <description><![CDATA[]]></description>
      <pubDate>Thu, 23 Aug 2012 09:39:12 GMT</pubDate>
      <guid>https://trid.trb.org/View/1161389</guid>
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    <item>
      <title>Road Safety Effects of Prescription Drugs in the Older Driver</title>
      <link>https://trid.trb.org/View/923638</link>
      <description><![CDATA[This chapter describes how it is well known that drugs other than alcohol play a significant role in road trauma. In Australia, the incidence of these drugs is similar to the prevalence of alcohol in fatal crashes. The drugs of highest prevalence are cannabis, amphetamine-type stimulants (ATS), opiates and the benzodiazepines. Similar prevalence of one or more of these drug classes ahs been observed in other jurisdictions. These drugs are capable of adversely affecting driving ability. In particular, the greatest evidence of an adverse effect on road safety exists for ATS, benzodiazepines and cannabis in its various forms. Although older drivers do not have a high or even significant incidence of drink driving or illicit drug use, they do take many prescribed medications that can have an effect on driving ability.]]></description>
      <pubDate>Tue, 20 Jul 2010 08:16:09 GMT</pubDate>
      <guid>https://trid.trb.org/View/923638</guid>
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    <item>
      <title>Killer crashes: a multiple case-study of fatal road-traffic collisions</title>
      <link>https://trid.trb.org/View/862786</link>
      <description><![CDATA[This paper reports on fatal road traffic accidents, based on detailed case-by-case studies of 1000 police files. Forty-four per cent of fatal accidents sampled involved a vehicle going out of control on a bend or curve. The mean age of drivers was significantly younger than the mean age of drivers in all other accidents in the sample. Approximately five times as many male drivers were at fault as female river in this fatality class. Excessive speed was a major factor in loss of control. 57% of these accidents occurred during the hours of darkness. Of all fatal accidents, 19% involved a driver over the drink drive limit and 4% involved drugs. The incidence of drink and drug related accidents was highest in drivers aged under 30 and lowest in those aged over 70. In 34% of fatal accidents, the fatally injured person was not wearing a safety belt. Fatalities involving drivers engaging in right of way violations formed 16% of the sample and had a greater mean age of driver than all other accidents in the sample. With drivers over 65 years of age 'looked but did not see'  or failure to observe correctly accidents explained over 70% of fatalities. The highest incidence of passenger fatalities involved males aged 16-20. Often the occupants of a vehicle had all consumed alcohol, or drugs, or had not worn safety belts. These accidents were commonest after 2200h and before 0200h. The reasons for the increased accident fatality rate among young and old drivers are discussed.   For the covering abstract see ITRD E138063.]]></description>
      <pubDate>Mon, 16 Jun 2008 08:37:35 GMT</pubDate>
      <guid>https://trid.trb.org/View/862786</guid>
    </item>
    <item>
      <title>SAM Survey on “Drugs and Fatal Accidents”: Search of Substances Consumed and Comparison between Drivers Involved under the Influence of Alcohol or Cannabis</title>
      <link>https://trid.trb.org/View/850949</link>
      <description><![CDATA[A survey was conducted to produce reliable epidemiological data concerning the role played by alcohol and drugs in fatal road accidents in France. The aims are to describe the conduct of the survey, evaluate the overall quality of the findings, and analyze the substances consumed by the involved drivers. A comparison between drivers involved under the influence of alcohol only, cannabis only, or both substances is emphasized. By a June 1999 law, all drivers in France involved in an immediate fatality accident between October 2001 and 2003 had to undergo a urine test and, if that was not possible or the test proved positive, had a blood sample taken in order to test for drugs (cannabis, cocaine, heroin, amphetamines). The results were combined with the usual procedures of the police force, which include the results of tests for illegal alcohol levels. A unique and reliable set of accident data on the role of drugs was thus compiled for epidemiological purposes: 10,000 accident reports involving over 17,000 drivers were analyzed. The responsibility level of each driver involved in an accident was determined. Results were generated for a representative sample of about 11,000 drivers. Alcohol levels above the legal limit (0.5 g/L of blood) were found in 21% of all drivers involved in accidents (killed, injured, or unharmed). Cannabis headed the list of illicit drugs detected, with a prevalence of 6.8% (THC ≥ 1 ng/mL); it was present in the under-35s and especially the under-25s. About 40% of drivers under the influence of cannabis also had an illegal alcohol level. The other drugs, whether alone or in association with cannabis, are relatively rare. Accident characteristics of drivers detected positive for cannabis only are markedly different from drivers under the influence of alcohol. The overrepresentation of drivers responsible, from 1.7 over the whole population, rises to 2.3 for cannabis alone (THC ≥ 1 ng/mL), to 9.4 for alcohol alone (≥0.5 mg/L), and to 14.1 for the alcohol-cannabis combination. The high incidence (26%) of alcohol or drugs among the population of drivers involved in fatal accidents highlights the importance for road safety of the consumption of these substances. Alcohol remains the major risk at any age. Young drivers consuming alcohol and cannabis represent a priority target for prevention.]]></description>
      <pubDate>Wed, 23 Apr 2008 11:49:21 GMT</pubDate>
      <guid>https://trid.trb.org/View/850949</guid>
    </item>
    <item>
      <title>Segment Characteristics and Severity of Head-on Crashes on Two-Lane Rural Highways in Maine</title>
      <link>https://trid.trb.org/View/783195</link>
      <description><![CDATA[More than two out of three of all fatal crashes in Maine occur on rural, two-lane collector or arterial roads. Head-on crashes on these roads account for less than 5% of the crashes, but they are responsible for almost half of all fatalities. Data analyzed in this study was provided by Maine Department of Transportation and covers all head-on crashes for 2000–2002 during which period there were 3136 head-on crashes reported. Out of these, 127 were fatal crashes and 235 produced incapacitating but not fatal injuries. These two categories made up over 75% of the crash cost. A clear majority of head-on crashes on two-lane, rural roads in Maine were caused by drivers making errors or misjudging situations. Illegal/unsafe speed was a factor in 32% of the crashes while driver inattention/distraction was a primary factor in 28%. Fatigue was responsible for around one in 40 crashes and one in 12 fatal crashes. Alcohol or drugs was a factor in one in 12 crashes and one in nine fatal head-on crashes. Less than 8% of fatalities involved someone overtaking another vehicle, and only around 14% involved a driver intentionally crossing the centerline. Two in three fatal head-on crashes occurred on straight segments and 67% of these happened on dry pavement. There is a clear trend towards higher speed limits leading to a higher percentage of crashes becoming fatal or having incapacitating injuries. There is also a clear trend – if one keeps speeds constant and AADT within a certain range – that wider shoulders give higher crash severities. Also, for higher-speed roads, more travel lanes (than two) increase crash severity. In summary, there seems to be two major reasons why people get across the centerline and have head-on collisions: (a) people are going too fast for the roadway conditions; or (b) people are inattentive and get across the centerline more or less without noticing it. The latter category of crashes could probably be reduced if centerline rumble-strips were installed. More or less all head-on collisions could be eliminated if median barriers were installed. In-vehicle technology could also be used to significantly reduce the incidence of lane departures. Furthermore, today's speed limits should be better enforced since a high percentage of serious crashes involve illegal speeding. This should be combined with lowered speed limits for targeted high-crash segments.]]></description>
      <pubDate>Thu, 29 Jun 2006 07:38:44 GMT</pubDate>
      <guid>https://trid.trb.org/View/783195</guid>
    </item>
    <item>
      <title>A COMPARISON OF THE INCIDENCE OF DRUGS IN DRINK DRIVERS AND FATAL ROAD CASUALTIES</title>
      <link>https://trid.trb.org/View/699773</link>
      <description><![CDATA[Results from a study of the incidence of alcohol and drugs in road accident fatalities carried out between 1996 and 2000 show a large increase in the incidence of illicit drugs (from 3% to 14%) since the last comparable study in Great Britain in the mid-1980s. For practical and ethical reasons, there are extreme difficulties in obtaining an un-biased control sample of the incidence of drugs in a population of non-accident involved road users. Whilst a fatal road accident population represents a well defined population for study it was considered desirable to study the incidence of drugs in alternative populations of road users, particularly those who were primarily non-accident involved. One such population is the sample of drivers and riders who are required to give an evidential sample, under the 1988 Road Traffic Act, after suspicion of drink-driving above the legal limit. A subset of 2000 such cases where blood was given was selected anonymously from England and Wales and subsequently analysed for comparison with the fatally injured sample. The results show that the incidence of drugs in a broadly representative sample of drink-drivers (26.7%) was similar to that in a population of fatally injured road users carried out over the same period (24.1%). When the fatally injured population who had also consumed alcohol was taken into account, there was shown to be no significant difference in drug usage between the two populations. The distribution of those who had consumed drugs and those who had not was not significantly different in the two populations. Drug usage was therefore found not to be associated with accident involvement and strongly suggests that drugs were not a major causative factor within the fatal road casualty population. (Abstarct only) (A) For the covering abstract of the conference, see ITRD Abstract No. E201067.]]></description>
      <pubDate>Thu, 22 Apr 2004 00:00:00 GMT</pubDate>
      <guid>https://trid.trb.org/View/699773</guid>
    </item>
    <item>
      <title>DRUG IMPAIRMENT RESEARCH AT THE ROADSIDE AND IN THE LABORATORY</title>
      <link>https://trid.trb.org/View/644894</link>
      <description><![CDATA[Recent studies of the incidence of illicit drugs have increased to 18% of road accident fatalities in the UK in recent research and while the drugs did not necessarily cause the accidents the increase is cause for concern. Cannabis comprised two-thirds of total drug use. An increase in multiple drug use had also occurred. Drug users were no more likely to be over the drink drive limit than non drug users. In 1999 only 2000 samples were submitted by police for suspected drug driving compared with 800,000 roadside breath tests, implying that drug-impaired drivers go undetected by police. Trials of two drug screening devices, Drugwipe (using perspiration) and Cozart (using saliva), were conducted. The devices were found acceptable. Drug recognition training for police was also undertaken. Of those drivers who failed a field impairment test, 92% proved positive for drugs. Other methods of assessing drug impairment are being developed and these are discussed. It is suggested that adopting a zero tolerance option to drug driving would simplify testing and law enforcement. A study of the effects of cannabis on driving was conducted using the TRL driving simulator. Cannabis use reduced driving speeds by about 5mph, caused more cautious behaviour but did not compensate for the loss of capability in some psychomotor skills including tracking ability. Increased dose worsened performance. General medical examination and standardised impairment testing of the subjects by police surgeons were effective in determining impairment.]]></description>
      <pubDate>Thu, 08 May 2003 00:00:00 GMT</pubDate>
      <guid>https://trid.trb.org/View/644894</guid>
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    <item>
      <title>THE CONFERENCE "ROAD SAFETY IN EUROPE", HELD IN BERGISCH GLADBACH, GERMANY, SEPTEMBER 21-23, 1998. THEME: DRUGS, ALCOHOL AND MEDICATION AS THREATS TO ROAD SAFETY</title>
      <link>https://trid.trb.org/View/710949</link>
      <description><![CDATA[At the conference "Road Safety Europe" held in Bergisch Gladbach, Germany, September 21-23, 1998, one of the themes was "Drugs, alcohol and medication as threats to road safety". Five of the papers presented within this framework were: Driving under the influence of drugs and medicaton aspects from Germany's point of view (Joo,S.); The incidence of drugs in road accidents fatalities in Great Britain (Tunbridge,R. and Rowe,D.); How to make useable research results on medicines and driver fitness to physicians? (Berghaus,G. and Friedel,B.); The use of ambivalence in a campaign against driving home from a discotheque under the influence of alcohol (Emsbach,M); Pilot study on alcohol prevention among young drivers (PAFF) - A new method of psychological intervention towards higher road safety (DeVol,D., Poppelreuter,S., Mueller,C. and Salk J.). For the covering abstract of the conference see ITRD E206917.]]></description>
      <pubDate>Fri, 03 May 2002 00:00:00 GMT</pubDate>
      <guid>https://trid.trb.org/View/710949</guid>
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    <item>
      <title>DRUGS AND DRIVING - ROADSIDE DETECTION</title>
      <link>https://trid.trb.org/View/707532</link>
      <description><![CDATA[A study conducted by TRL for the DETR on the incidence of alcohol and drugs in road accident fatalities showed a six-fold increase in illicit drug consumption by fatally injured drivers between 1987 and 1997. Reliable information on the extent of drug driving is difficult to obtain. This possibility of using drug-screening devices at the roadside has been investigated. Progress towards developing a reliable, robust and non-invasive device for roadside drug detection has been slow. Several police forces, notably Strathclyde, have undertaken initiatives to train police in drug recognition at the roadside. Drug Recognition Training (DRT) and Field Impairment Testing (FIT) have been evaluated. This paper was presented at the British Association of Science, 3 September 2001, Glasgow, UK.]]></description>
      <pubDate>Fri, 03 May 2002 00:00:00 GMT</pubDate>
      <guid>https://trid.trb.org/View/707532</guid>
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    <item>
      <title>THE DEVELOPMENT OF ROADSIDE IMPAIRMENT TESTING FOR DRIVERS</title>
      <link>https://trid.trb.org/View/674803</link>
      <description><![CDATA[The DETR began a three year study, in October 1996, to look at the current incidence of drugs in road fatalities.  Preliminary results show that illicit drug taking (mainly cannabis) has increased by a factor of five since an earlier study in the mid 1980s.  Over the same period, the incidence of medicinal drugs has remained more or less the same.  Some drugs remain in the system of users for a long period after use and the presence of drugs does not in itself show that they were a contributory factor in an accident, or that a driver is necessarily impaired.  Nevertheless, these figures are cause for significant concern.  In order to prosecute a driver for driving under the influence of drugs, police officers require relatively simple tests to demonstrate that a driver is impaired and the likelihood that this is due to drugs.  In 1997 two police officers from Scotland visited the United States to study their Drug Recognition Expert (DRE) Programme.  Parts of this have been developed for possible use by UK police forces.  Six police forces have trained officers in the use of DRE and Field Impairment Testing (FIT) and these techniques have been evaluated in a trail which involved testing 300 drivers.  The assessment also tested a similar control sample of non-drivers.  This paper will report on the preliminary results of these trials.  (A) For the covering abstract see ITRD E107650.]]></description>
      <pubDate>Wed, 07 Feb 2001 00:00:00 GMT</pubDate>
      <guid>https://trid.trb.org/View/674803</guid>
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