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March 01, 2001  |   Comments (0)   |   Post a comment

Scrutinizing the Safety Risks of Older Bus Drivers

Supervisors need to monitor aging drivers for diminishing visual and cognitive skills. Specialized training and more frequent assessment tests might also be in order.

by Jim Ellis


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After retirement, a gentleman we’ll call John took up school bus driving to supplement his income. Although he was in his middle 70s, John was in good health and loved his new career. He arrived at the bus garage well before anyone else and pre-tripped the fleet’s three spare buses every morning. Between runs he tidied up the driver’s room. He never missed a day of work, got along well with the kids and was basically just a “nice guy.” Understandably, John’s supervisor was thrilled to have found such an employee. But a few other drivers in the fleet had had a chance to ride with John, and all told a similar story — basically, John’s driving was scary. Although he didn’t drive fast, he was generally inattentive to other motorists, occasionally bumped the curb during turns and once drove right through a stop sign. One driver said John had gotten confused about what run he was doing. When these drivers eventually went to the transportation supervisor with their concerns, he said he knew there might be a problem with John’s driving and was trying to keep an eye on him, but didn’t know what else to do without it being perceived as insensitivity or even age discrimination.

An unexamined issue
John’s situation, and his supervisor’s uncertainty about how to handle it, are not rare. But for the most part, the question of aging drivers hasn’t been addressed as a safety issue in the school bus industry. This is probably for two reasons: first, it’s an emotional, painful, sensitive and complex topic. Second, with bus drivers in such short supply it feels almost disloyal to raise safety concerns about older drivers. In fact, many school districts and bus companies actively target retirees in their driver recruitment efforts. And like John, older drivers are often the most reliable and conscientious drivers in the fleet. But questions about how to handle aging drivers are increasingly unavoidable because school bus drivers are “graying” along with the overall motoring public (one in eight drivers in America is over 65 today; by 2025, it will increase to one in five). With mandatory retirement ages largely a thing of the past, many supervisors and trainers find themselves working with drivers in their mid-70s and beyond.

Anecdotes and worries
Surprisingly, there are no current studies analyzing school bus driver age as a factor in potential crash risk. But in recent years a number of frightening incidents have come to light involving aging school bus drivers. For instance, in Central Bridge, N.Y., last year a 79-year-old school bus driver on a field trip rolled through a stop sign into the path of a truck, seriously injuring several children. In the Pupil Transportation Safety Institute’s accident database, there is information on 23 national “dragging/snagging” incidents in which the driver’s age was known. (These include fatalities, injuries and close-calls.) The drivers’ ages were 76, 75, 67, 64, 64, 63, 63, 62, 61, 60, 59, 56, 55, 54, 54, 46, 42, 42, 40, 40, 33, 28, and 26. Other types of “by-own-bus” tragedies have occurred in recent years with 79-, 75-, 71- and 68-year-old drivers. Of course, with such tiny sample sizes absolutely nothing is “proven.” But most of us would be lying if we said anecdotes and fragmentary evidence like this, or what we’ve seen firsthand in our own operations with a particular older driver, didn’t worry us.

Variability and risk
Life is not fair, and aging impacts individuals in markedly different ways, both in the onset and severity of symptoms. Chronological age and functional age are not the same: some 65-year-olds have the energy and mentality of a 40-year-old, while others appear debilitated and senile at the same age. This extreme variability is why aging is such a painful topic — as we’ve already pointed out, many older people are safe drivers, yet in terms of relative risk, as a group, there is an increasing chance of a crash as we age. The pain is doubled for transportation supervisors, because our older drivers are often among the most experienced and valuable drivers in our fleet. Sometimes we’ve worked side-by-side with them for years; they’re family. Thinking of them as part of a potentially high-risk group of drivers just rubs the wrong way.

Looking at age factors
Research indicates that the higher relative crash risk for older drivers is due to several physiological and mental factors associated with aging.

Declining visual processing speed and visual attention. Eye exams are a standard part of bus driver physicals, but researchers now believe it is the slowing down of the mind’s “visual processing” speed, more than a decline in static visual acuity or peripheral vision usually tested, that accounts for the increased crash risk in aging drivers. Rapid visual processing is critical to safe driving. Driving is a complex mental task. It can be broken into four steps: sensory perception of a hazard; accurate recognition of the hazard; determination of an appropriate driving strategy in response to the hazard; and timely execution of that strategy. In real-world driving situations, these four mental steps are occurring constantly and simultaneously. The mind’s capacity to quickly identify the most important detail in a fluid visual field of many briefly presented details, and the ability to pay undivided attention to it when necessary, is critical to safe driving. For school bus drivers, rapid visual processing is fundamental to effective hazard searching, comprehension and prioritization in a complex traffic environment. Researchers now believe a degeneration in the brain’s ability to attend to significant visual clues accounts for the most common “elderly crash scenarios,” including failing to recognize traffic signs, failure to yield, pulling in front of other vehicles during left turns and general problems at intersections. On a hopeful note, the ability to assess a person’s visual processing abilities appears to be a good predictor of crash risk. For instance, a study conducted at the University of Alabama found that drivers with a 40 percent or greater impairment in their useful field of view are more than twice as likely to crash a motor vehicle. Still more hopeful, rehabilitative training may be able to correct some visual processing impairments.

Cognitive impairments. Driving depends on more than the ability to process visual information. Other types of cognitive impairments, such as memory lapses or breakdowns in logical thought, can also increase crash risk. Researchers now see “mild cognitive impairment” as part of the normal aging process. Age-associated memory impairment (AAMI), for instance (difficulty recalling specific facts, names, etc. but not a breakdown in logical thinking itself) affects approximately two-thirds of the older population. Unfortunately, AAMI may or may not be a herald of more severe degenerative diseases of the mind. Dementia, a profound breakdown of lucid thought (for instance, not just forgetting where your car is parked at the mall, but forgetting you’re at the mall altogether), takes many forms and can occur at all ages, but is increasingly common as we age. For instance, some experts now believe as many as 1 in 10 people over 65 have some degree of Alzheimer’s — and half of those over 85. The onset of dementia is usually but not always insidious; an individual, and even those close to him or her, may or may not notice early signs of mental disorientation. Symptoms may present intermittently within an individual. Bouts of forgetfulness or the inability to maintain focus on a critical task raises serious safety issues for school bus drivers. An example is “a moment of truth” such as loading and unloading students when attention to details is a matter of life and death.

Decreasing flexibility. As many of us have learned, arthritis, joint or muscle pain and other types of orthopedic limitations are routine in older people. Because of the importance of actively moving in the bus seat to see around the many view obstructions such as posts, pillars and mirror backs on school buses (“rocking before you roll”), decreasing flexibility is more of a problem for school bus drivers than it is for the general motoring public. “Stiff neck driving” — ill or aging bus drivers who have a hard time turning their head to check for traffic, etc. — is an under-appreciated school bus driving problem and one that usually “slips through the cracks” in bus driver physicals and physical performance tests.

Effects of illness/medications. Another unpleasant aspect of aging is the increasing prevalence of serious illnesses, which can affect some people’s capacity for safe driving. Along with illness goes an increasing reliance on medications. Failing to take some medications (e.g., diabetes medications) can seriously impair drivers, and has been a factor in school bus crashes. But the side effects of medications, both prescription and over-the-counter — drowsiness, delayed reaction time, mood swings — can also have serious implications for driving and especially school bus driving. “Fine print” warnings on medications are widely ignored both by the general motoring public and regrettably the school bus industry as well; the potential side effects of mixing medications even more so. This issue cries out for more study.

Risk of sudden incapacity. Heart attacks, strokes, aneurysms, for example. It was worries over the possibility of sudden illness or death that led to the 1959 Federal Aviation Administration’s “Age 60 Rule,” which established a mandatory retirement age for commercial pilots. Although medical science has progressed in many ways since then, cardiovascular disease is still the most frequent cause of death for the general population, and its risk rises steeply with age.

Training and monitoring
As with many other safety issues, supervisors and driver trainers have two basic tools for addressing concerns about aging school bus drivers: training and monitoring. Training can raise drivers’ self-awareness of how aging can impact their ability to be a safe school bus driver. Given the fact that school bus drivers are getting older, it makes sense for aging to become a regular training topic. There are many ways it can be worked into a training curriculum:

Compensation. Trainers can discuss strategies for compensating for age-related limitations: e.g., more thorough visual scanning approaching intersections or other hazards, more methodical use of pedestrian mirrors, slower pace while loading and unloading children. In recent years a number of trainers, like Laidlaw’s Dona Beauchea in New York state, have developed excellent training programs focusing on how aging can affect a school bus driver. Driver brainstorming on this topic often leads to many additional tips.

Self-regulation. Honest and non-judgmental discussion of the potential effects of aging on driving a school bus may facilitate “self-regulation.” School bus drivers really are a unique group — uniquely caring, uniquely serious about their responsibilities. The great majority want to do the right thing when it comes to safety and kids. Self-regulation can mean turning down field trips because, as visual attributes such as dark adaptation and glare recovery degrade, driving a school bus at night has become less than enjoyable. Or, self-regulation can mean deciding “it’s time to hang up the keys.” Self-surrender of their driver’s license is often bitterly resisted by elderly people — understandably enough, since driving can be their treasured last link with the world and a last shred of independence. For an elderly person in a rural community, not being able to drive can be a death sentence. Taking an elderly parent’s car keys away is one of the worst things anyone will ever have to do. But for an experienced school bus driver, proud of their own and the industry’s safety record and steeped in an awareness of the potentially grave consequences of any letdown in their driving abilities, deciding to step down “when it’s time” may be more acceptable, if still painful.

Guest experts. Physicians specializing in aging issues, pharmacologists, rehabilitation specialists, ophthalmologists, gerontologists, et al, can participate in driver training programs to discuss the effects of aging and methods for compensating for its limitations.

Have fun. Done right, a program about aging and traffic safety can actually be fun — that hard-to-find “something different” that drivers supervisors are always looking for. It works best when all drivers in the fleet are included — “the whole family” — not just the older drivers. For instance, drivers can be grouped by either age or years of service, with the small groups then directed to discuss and problem-solve some safety issue (e.g., student behavior scenarios, special driving situations, etc.), eventually reporting their suggestions back to the whole class. Participatory training programs like this can break down stereotypes and produce some surprising conclusions — for instance, when asked how their attitude toward children has changed over the years, older drivers may turn out not to all be the classic “grumpy old timers” they’re assumed to be. In one training program, the older drivers’ small group reported that one way they’d changed over the years was by becoming more tolerant of children’s energy and noise. At this point a driver in a younger group yelled out, “Sure they’re more tolerant of noisy kids — they can’t hear them any more!” and everyone, older drivers included, had a good laugh. Because aging is such a universal phenomenon, laughter can help drivers learn to adapt and change.

Veteran driver attitude. Veteran driver attitude is another complex issue that overlaps with physiological aging in many ways: the question of how years of service, not just years on earth, can impact our ability to drive safely. Veteran drivers are very diverse and shouldn’t be stereotyped. Many vets are open-minded, non-defensive, and eager to learn. But experience shows that a dangerously complacent mindset can take root in seasoned bus drivers, and some exhibit an indifference or even disdain towards new safety procedures, feeling they don’t need to change with the times. Experienced drivers may be more vulnerable to the “it can’t happen to me” syndrome; occasionally, overconfident older drivers become the worst “rushers” and risk-takers in the fleet. Both older and younger drivers appreciate frank discussions of how increasing years of service and a good safety record can become a “two-edged sword.”

Monitoring is key
Unfortunately, not all older school bus drivers are open to self-awareness and self-regulation. Careful monitoring of drivers is probably the most important responsibility of a supervisor, and it applies to the effects of aging upon driving just as it does to any other safety concern.

Road tests and road observations
. State mandates for behind-the-wheel road tests and road observations or defensive driving reviews vary widely, but all state laws should be seen as minimum requirements anyway. They can always be exceeded so long as the i’s are dotted and t’s crossed. Careful road observations are the best way to pick up visual, cognitive or orthopedic impairments in a driver. “Commentary driving” — where the driver being tested verbally identifies significant hazards and traffic control signs and devices as he or she drives — can help an evaluator determine whether the driver is really aware of what they need to be. Veterans (and those that evaluate them on the road) must understand they have “nothing in the bank” when it’s their turn for a road test — years of service do not entitle anyone to a relaxation of safety standards. Holding all drivers to the same high standard is the mark of a safety professional.

Red flags and patterns. Supervisors and safety personnel should be alert to “red flags” indicating cognitive, visual or other aging-prevalent impairments in their drivers. On a road test, for example, not noticing traffic signs or other hazards, stopping for green lights or in the middle of an intersection for no reason, merging into another lane without looking, making awkward turns, pulling into traffic with inadequate clearance, etc., could indicate a significant visual processing or mental problem. Repeated mental lapses during the driver’s daily routine — for instance, failing to put the gas cap back on, failing to turn switches off at the end of the day, forgetting to pick up a child on the route — not just once but several times, may be a sign not just of carelessness but of a more serious cognitive problem. Getting lost in a familiar area is a telltale sign of a mental decline. “Minor” accidents, “mystery dings,” hitting curbs, etc. are a warning that something new might be going on with a previously safe driver. A decline of skills necessary for safe driving may occur subtly or suddenly. Credible citizen or coworker complaints should always be thoroughly and objectively investigated. As with any safety problem being looked at, age-related patterns may emerge only over time, so careful logging of complaints, road observations, incidents and accidents is important. Monitoring drivers for the sometimes subtle problems associated with aging-related degeneration of driving skills is a responsibility comparable to reasonable suspicion drug and alcohol responsibilities for supervisors.

Treat all drivers the same. Singling out a driver for greater monitoring is always dangerous and can open the door to a charge of harassment or discrimination; when greater scrutiny is called for, supervisors must be able to demonstrate that all drivers in the fleet are subject to the same tests and observations and that any extra observations of a particular driver were generated solely by compelling, unambiguous and well-documented safety concerns.

Counseling and support. Unlike so many other industries, supervisors and trainers in the school bus industry have been privileged to work with the kind of employees who more often than not have been open to new ideas, to change and growth — so long as we could show them how it would benefit children. The industry’s proud safety record would not exist without our veteran drivers. We owe our aging drivers, not just for the years they’ve put in, but more importantly for walking step-by-step with safety personnel as one new safety procedure after another has been implemented over the years. In fact, many of those innovative procedures first came from a driver, years ago — a driver who today might be experiencing some of the physiological or cognitive problems mentioned above. Taking aging seriously as a potential safety problem does not mean throwing older drivers on the trash heap. When aging-related problems emerge, drivers need counseling, not judgment. The real question for supervisors is whether drivers trust them enough to come forward on their own to talk about their own worries about aging. If a driver has a close call — almost pulling their bus out in front of a car, for instance — do they come to their supervisor to talk about what happened, or do they try to cover it up? Safety theorist James Reason has talked about the importance of creating a “learning and reporting cultures” in transportation organizations, where employees feel they can talk about problems without fear of recrimination. Supervisors should know resources in their community to refer aging drivers for expert evaluation and advice. Drivers struggling with whether or not to retire deserve counseling and support. Supervisors should be prepared to discuss non-driving employment alternatives — for instance, becoming a bus attendant or classroom safety trainer. In some situations it may be possible, and worth it to everyone involved, to accommodate an aging employee by offering a non-driving position at a driver’s salary. Even individuals who aren’t interested in alternative jobs per se may still find it easier to retire if they know they can remain involved in the transportation department in some way, for instance by remaining active on the safety committee, the roadeo organizing committee, etc.

The pilot comparison
Training, monitoring and counseling are the tools supervisors have at hand when working with aging drivers now, but there are larger questions involved as well. For instance, is it reasonable and prudent to require additional physical screenings and other assessment tests for older drivers? More controversially: practically speaking, aside from concerns about political correctness, should there be a there a maximum age after which no one should be driving a school bus? One way to look at such big questions is by comparing commercial airline pilots to school bus drivers. As mentioned above, the FAA established a mandatory retirement age for commercial pilots 40 years ago. This requirement was revisited in the mid-90s, and after much debate and deliberation was retained and is still in effect today. Obvious, although not simple, questions arise: Whose job is more demanding — a pilot’s or a school bus driver’s? Who has the greatest responsibility? Whose tasks are less forgiving of a mistake? In fact, unlike school bus drivers, pilots work in a highly controlled transportation environment. All the other “road users” sharing the air space around them are also professionals — unlike school bus drivers who share the road with people of every conceivable skill level and mindset. And passenger distractions are seldom a problem for pilots. There’s that nice little wall between the cabin and the passengers. But passenger distractions for school bus drivers... does the magnitude of that problem even need to be discussed? And who could say which is the “worse” accident — a plane crash or a school bus tragedy? Who would even deign to answer such a question?

Policy suggestions
Pilots clearly have an awesome responsibility, and the technical demands for flying a large plane are daunting. But it’s not exaggerating to say school bus drivers have a comparable set of responsibilities and demands. Three policy suggestions are in order:

More frequent tests. More frequent physicals, physical performance tests and other types of additional screening for older school bus drivers are entirely reasonable and prudent given what is known about aging’s potential impact on driving. In fact, some jurisdictions do it now. One way to approach more frequent testing requirements is as an additional free employee benefit for older drivers, possibly helping to discover a serious health problem at an early stage.

Studies. There is an urgent need for studies of the relationship between school bus driver age and crash risk. Additionally, field surveys of supervisors, managers, trainers and drivers about aging-related problems they’ve encountered on the job would be illuminating.

New assessment tests. As bus drivers continue to age, the industry may find itself facing a choice: either begin to utilize more sophisticated visual-cognitive school bus driver assessment tests for identifying particularly at-risk individuals, or try to go back in time to a mandatory retirement age. As with any new safety procedure, there are many uncertainties, as well as significant costs, attached to the first option. The second option is not a pleasant one — it’s inherently unfair to many individuals, costly to the industry in terms of further reducing the driver pool and possibly illegal. Of course, there’s a third choice too: doing nothing. But the problem won’t go away — we’re probably one accident away from a public outcry. Sometimes it takes a terrible event to force change. But the children we transport deserve more than that.


Crash risk and age

For the motoring public as a whole, there’s no question that aging can have a drastic impact on safety. To say this is not age discrimination — just reality. And while sensitivity about how this depressing fact affects individual bus drivers, or the school bus industry as a whole, is important, the main thing we need to be sensitive about is how it affects children’s safety. For the general motoring public, although crash rate per licensed driver does not show an age effect, crash rate per mile traveled definitely does. (Older people tend to drive much fewer miles, on the average, than the rest of the population.) Research shows that when the number of miles is taken into account, older drivers have more automobile crashes than any other adult age group. Although different studies arrive at slightly different conclusions, the general consensus is that the public’s crash risk begins to rise about age 55, accelerates after 65, and by the mid-70s approaches that of teenage drivers. According to the Transportation Research Board, the involvement rate in all crashes of drivers over 75 is about twice that of middle-aged drivers. According to U.S. Department of Transportation, fatal crashes increase steadily after the age of 75, while the California Department of Motor Vehicles indicates that drivers over 80 are more than twice as likely to be at fault in a fatal collision than the average driver. (Of course, this doesn’t mean every older driver is unsafe. These are averages — most older drivers are safe drivers. There are great drivers and lousy drivers at every age.) Having a crash risk comparable to teenagers is unsettling enough. But it gets worse. Two additional factors must be kept in mind. First, compared to other drivers, older drivers tend to drive on safer roads and at safer times. Why? Because older people are smart and learn to “self-regulate” and compensate for aging’s limitations by avoiding the most difficult driving situations (e.g., busy highways, night driving, unfamiliar areas, etc.) whenever possible. Second, few older drivers engage in high-risk driving behaviors such as driving under the influence, speeding, conscious indifference to traffic controls or laws, etc. — i.e., the follies of youth. Older people’s driving errors tend to be sins of omission — for instance, failure to yield the right of way — not deliberate risk-taking. These additional factors mean comparisons between older and younger people’s crash rates are not really comparing apples to apples. Therefore, the extent to which driving skills degenerate as we age is undoubtedly even worse than what is reflected in existing crash statistics.

Jim Ellis is curriculum development specialist at the Pupil Transportation Safety Institute (PTSI) in Syracuse, N.Y. For more information about PTSI, call (800) 836-2210 or visit the Website at www.ptsi.org.


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