Driving Change: Insights from the 2024 Lifesavers Conference

Anthony Lam, NTSB Transportation Safety Specialist, Office of Safety Recommendations and Communications

Attendees stepped into the world of road safety innovation and collaboration at last week’s Lifesavers Conference 2024 in Denver, Colorado. Each year, experts, advocates, and policymakers convene at Lifesavers to tackle pressing issues shaping the future of safer roadways. From combating impaired driving to ensuring equitable access to cutting-edge vehicle technology, NTSB staff presented and moderated a variety of workshops that offered invaluable insights and strategies for creating a safer tomorrow.

NTSB staff at 2024 Lifesavers Conference exhibit booth

NTSB Transportation Research Analyst Dr. Ryan Smith’s presentation, “The Oral Fluids Factor: Roadside & Evidential Testing to Reduce Drug-impaired Driving,” shed light on the rising interest in using oral fluid testing in roadside and evidential testing for drug impairment. With the landscape of cannabis legalization evolving and concerns about drugged driving escalating, the timing couldn’t be more crucial. Attendees gained insights into the nuances between preliminary and evidential testing, the mechanics of roadside testing, and the outcomes from states already implementing oral fluid testing. Discussions encompassed emerging challenges such as detecting novel drugs, ongoing research, and legal hurdles faced by states.

In 2022, we released a safety research report titled, Alcohol, Other Drug, and Multiple Drug Use Among Drivers, which found oral fluid is a valuable—but underused—biological specimen for detecting drug use by drivers. The report also recommended states modify their impaired-driving laws, if they have not already, to allow for oral fluid drug testing. Smith pointed this out in his presentation, adding, “It [oral fluid testing] can play a key role in supporting the enforcement of impaired-driving laws.”

Dr. Ryan Smith, Transportation Research Analyst, Office of Research and Engineering

Smith also organized and moderated the session, “Brave New World in Cannabis Detection,” which brought together leading-edge researchers in the field of cannabis detection. Cannabis impairment is a critical issue, and researchers discussed novel ways that cannabis use can be detected in drivers. In his opening remarks, Smith stated: “More than half of the US population now lives in a state where cannabis has been legalized. Recent NTSB research demonstrates the high prevalence of cannabis use among drivers, second in prevalence only to alcohol. Effective methods for detecting signs of cannabis impairment are critical for getting impaired drivers off our nation’s roadways.”

NTSB Office of Highway Safety Program Manager Ellen Lee gave a presentation on the dangers of speeding titled, “Not so Fast & Furious – Channeling Our Energy to Prevent Speed-related Fatalities,” which highlighted the urgent need to address speed-related fatalities through a comprehensive approach. Lee talked about the NTSB’s recent recommendations from our investigation of a crash in North Las Vegas, Nevada, where speeding and speeding recidivism were key.

Ellen Lee, Program Manager, Office of Highway Safety

Lee emphasized our findings that the driver in the crash was impaired and had received seven recent speeding offenses in the 5 years before the crash. “Despite repeated law enforcement actions, the driver’s record was inaccurate (showing only one speeding violation) and local courts treated this driver as a new offender for each violation,” Lee said.

Drawing from NTSB crash investigations and real-world examples, attendees learned about effective countermeasures and community engagement strategies. From leveraging data insights to advocating for vehicle safety technologies and infrastructure enhancements, the workshop underscored the importance of collaboration to curb excessive speed and protect lives on the road.

NTSB Safety Advocate Leah Walton moderated a thought-provoking discussion in her session, “A Safe System Approach to Address Impaired Driving” exploring where and how impaired driving fits into the five pillars of the Safe System Approach. Walton and her panel explored the multifaceted challenges posed by impaired driving, particularly concerning polysubstance impairment. Attendees gained a deeper understanding of the prevalence and risks associated with this behavior, along with potential policy interventions and enforcement strategies.

Leah Walton, Safety Advocate, Office of Safety Recommendations and Communications

In Walton’s opening remarks, she emphasized, “We cannot have a safe system while impaired driving is killing over 13,000 people a year. To achieve zero fatalities, we must expand our view of impaired-driving prevention through the Safe System lens.” With an emphasis on partnership-building at both the state and national levels, the workshop provided a roadmap for stakeholders to tackle impaired driving head-on and enhance road safety.

Stephanie Shaw, NTSB Management Analysis Officer, moderated the session, “Safety for All: How Vehicle Technology Addresses Underserved Populations.” Exploring design considerations, benefits, and challenges, attendees learned ways to extend these advancements to underserved populations. Shaw emphasized the importance of building a system that guarantees safe transportation for all who use it, regardless of socioeconomic status or mode of travel, whether it be personal vehicle, bike, walking, rolling, hailing a rideshare or an autonomous shuttle service, or taking public transportation. This sentiment encapsulated the overarching theme of inclusivity and accessibility discussed throughout the workshop.

Stephanie Shaw, Management Analysis Officer, Office of Railroad, Pipeline, and Hazardous Materials Investigations

The Lifesavers Conference serves as a catalyst for meaningful dialogue and collaboration in advancing road safety initiatives. By harnessing innovation, data-driven approaches, and community engagement, attendees are empowered to drive tangible change and create safer roads for everyone. We hope to continue these important dialogues at next year’s Lifesavers Conference in Long Beach, California!

Traffic Safety Through a Public Health Lens

By Sophia Peerzada, Safety Advocate

On March 28th, I moderated a webinar titled “Traffic Safety Through a Public Health Lens.” This joint effort between the NTSB and the American Public Health Association (APHA) ahead of National Public Health Week highlighted traffic safety as a public health issue.

This topic is very important to me as a transportation safety advocate with a degree in public health. When I was studying for my Master of Public Health degree at the University of South Florida, I was the only student in my program (that I knew of) who was interested in traffic safety. I was motivated by the Tampa Bay region’s regrettably high rates of traffic-related fatalities, and the perceptible imbalance of safety interventions along socioeconomic lines. I also knew the statistics nationwide: each year, 43,000 people die on US roadways. I thought, of course this is a public health issue—people are getting hurt and dying on our roads each day!  

Since joining the NTSB in November 2023, I have had the pleasure of meeting folks who bring a public health mindset to transportation safety. In fact, the NTSB itself plays a significant role in public health by identifying transportation safety issues and issuing recommendations to make travel safer for the public.

Prior to the webinar, I connected with former NTSB Vice Chair T. Bella Dinh-Zarr, who notably referred to traffic fatalities as an “epidemic on wheels.” Of course, I was thrilled when Dr. Dinh-Zarr and public health colleagues Dr. Kathleen Carlson, Dr. David Ederer, and Dr. Mighty Fine agreed to be panelists on this first-of-its-kind webinar.

Each panelist brought an invaluable perspective to the conversation.

Dr. Carlson, a professor of epidemiology at the Oregon Health and Science University-Portland State University School of Public Health and core investigator at the Portland VA, opened the event with a review of injury epidemiology. She explained that “public health takes a scientific approach to a public health problem” as it seeks to identify the problem’s cause and develop strategies for preventing it from happening again.

Dr. Ederer, an epidemiologist at the CDC’s Physical Activity and Health Branch, followed with a presentation on the Safe Systems Pyramid and how public health principles can be applied to engineering. His presentation underscored the need to apply traffic safety interventions systematically to improve population health.

Dr. Dinh-Zarr, Senior Advisor at FIA Foundation and the Traffic Injury Research Foundation, built upon Dr. Carlson’s and Dr. Ederer’s presentations by providing concrete examples of how the public health lens has been applied to traffic safety efforts. She highlighted the NTSB’s investigation process as an example of taking a public health approach to preventing the recurrence of traffic-related injuries and fatalities.

Finally, Dr. Fine, associate executive director of the APHA’s Division of Public Health Policy & Practice, rounded out the panel by emphasizing the need to apply a health equity perspective to all traffic safety efforts. He urged traffic safety practitioners to ensure that interventions are inclusive, accessible, and culturally relevant.

Overall, it was a wonderful and much-needed discussion that I am certain each attendee walked away from having learned something new. Dr. Ederer said it best in his presentation: “Public health is a way of describing and solving problems.” Given that, I think all of us in the traffic safety space are public health practitioners.

You can view the full webinar recording here: https://youtu.be/DMNxSFNANeI?si=FDR2BhF6vZXdJDut..

Prioritizing Safety This Holiday Travel Season

By Stephanie Shaw, Acting Chief, NTSB Safety Advocacy Division

This week, families and friends will gather to celebrate the Thanksgiving holiday. According to estimates from AAA, nearly 55 million people will travel away from home this year, with about 49 million of them taking to the roads.

As we mark the beginning of the holiday travel season, we want to ensure that everyone arrives safely at their destinations. Unfortunately, travel on our roads can be the riskiest mode of travel during the holiday season.

NTSB investigations continue to highlight actions needed by regulators, legislators, and industry to ensure the safest transportation system for the traveling public. Our Most Wanted List (MWL) identifies specific transportation safety improvements needed across all modes. It includes five road safety improvements that address pervasive problems like speeding, alcohol and other drug impairment, and distraction. The MWL also calls for collision-avoidance and connected vehicle technologies and implementation of a Safe System Approach to better protect all road users.

At the NTSB, we believe that safety is a shared responsibility, so for the traveling public, we’ve highlighted some ways you can keep yourself and others safe, regardless of the travel mode you choose.

By Car

Impairment by alcohol and other drugs, unsafe speeds, fatigue, and distraction continue to play major roles in crashes. Here’s what you can do:

• Designate a sober driver, or call a taxi, or ridesharing service if your holiday celebrations involve alcohol or other impairing drugs.
• Follow safe speeds. In bad weather, safe speeds are often below the designated speed limit. Speeding increases the chance of being involved in a crash and intensifies the severity of crash injuries.
• Make sure you’re well rested! A fatigued driver is just as dangerous as one impaired by alcohol or other drugs.
• Avoid distractions. Don’t take or make calls or text while driving, even using a hands-free device. Set your navigation system before you start driving. If you’re traveling with others, ask them to navigate.
• Make sure to use the correct safety restraint for child passengers, and be sure it’s installed correctly.
• Ensure you and all your passengers are buckled up! In a crash, seat belts (and proper child restraints) are your best protection against death and serious injuries.

By Bus

The NTSB has made recommendations to improve motorcoach operations and vehicle crashworthiness, but travelers should know what to do in an emergency.

• Pay attention to safety briefings and know where the nearest emergency exit is. If it’s a window or roof hatch, make sure you know how to use it.
• Ask your driver to give you a safety briefing if you’re unsure of where the exits are or how to use them.
• Use your seat belt when they’re available!

By Plane or Boat

These tips can help you and your loved ones in an emergency on planes or vessels.

• Pay close attention to the safety briefing! Airline and marine accidents have become very rare, but you and your family can be safer by being prepared.
• Know where to find the nearest emergency exit and flotation device whether you’re on an airplane or a boat.
• Confirm that you and your traveling companions—even children under age 2—have your own seats and are buckled up when flying.
• Don’t forget your child’s car seat. The label will usually tell you if your child car seat is certified for airplane use; the owner’s manual always has this information.
• Call the airline and ask what the rules are for using a child’s car seat on your flight, if you don’t already know.
• Follow crewmember instructions and remain calm in an emergency.

By Train

The NTSB has made recommendations to improve passenger rail operations and vehicle crashworthiness, but travelers should also follow these safety tips.

• Stow carry-ons in the locations provided (overhead and racks). Don’t block aisles.
• Review your trains safety information which may be provided as a safety card in your seat pocket or displayed in your railcar.
• Follow crewmember instructions and remain calm in an emergency.

No matter how you travel, make a commitment to put safety first.

We wish everyone a safe and happy Thanksgiving.

Honor Traffic Victims with Action

By Chair Jennifer Homendy

50 million deaths. Hundreds of millions of injuries.

That’s the worldwide cost of traffic violence, in human terms. It’s difficult to comprehend fully, which is why the World Day of Remembrance for Road Traffic Victims is so meaningful.

This annual observance provides a time to reflect on the real people behind the statistics: mothers, fathers, sons, daughters, grandparents, aunts, uncles, cousins, colleagues, best friends, and neighbors.

It’s a time to support those who’ve lost a loved one to the public health crisis on our roads.

And it’s a time to act, starting with NTSB recommendations.

Lessons from Tragedy

Since last year’s World Day of Remembrance, the NTSB has made 26 new recommendations to improve road safety. All remain open.

Where did these recommendations come from? They are the result of rigorous NTSB investigations into devastating crashes, outlined below. Each one is a lesson from tragedy, which is why we don’t rest until a recommendation is implemented.

At the NTSB, we believe the most meaningful thing we can do for victims of traffic violence is to advocate for our safety recommendations.

In other words: we choose to honor the victims with action.

Here are just some of the victims we’re remembering today — along with the recommended safety improvements to best honor their memory. 

Today we remember two people who were killed and seven who were injured in a Belton, SC, crash between an SUV and a bus carrying disabled passengers. The actions we demand on their behalf include the following:

• Ban nonemergency use of portable electronic devices, like cellphones, for all drivers.  
• Recruit cellphone manufacturers in the fight against distracted driving; they should automatically disable distracting functions when a vehicle is in motion.
• Provide annual safety training for people employed to transport wheelchair users.  
• Develop a side-impact protection standard for new, medium-size buses, regardless of weight — and require compliance.

We should honor the victims of the Pennsylvania Turnpike crash that injured 50 people and killed five others — including a nine-year-old child — by taking the following actions:

• Develop performance standards for advanced speed-limiting technology, connected-vehicle technology, and collision-avoidance systems — and require their use on new vehicles, as appropriate.
• Require newly manufactured heavy vehicles to have onboard video event recorders.
• Deploy connected-vehicle technology nationwide.
• Take a comprehensive approach to eliminate speeding. Among other measures, this means thinking long and hard about the 85th percentile approach and using speed safety cameras, which includes working to remove restrictions against them. 

Here’s what we must do to honor the three people who were killed and the 18 who were injured when a bus overturned in Pala Mesa, California:

• Require all new buses to meet a roof strength standard.
• Sponsor research into safe tire tread depths for commercial vehicles.
• Require seat belt use.

The best way to remember the victims of the Decatur, Tennessee, school bus crash that injured 14 people and killed two people, including a 7-year-old child, is to take the following steps:

• Make lap-shoulder belts mandatory in new school buses.
• Require lane-departure prevention systems on heavy vehicles.

And what about the nine people who died in a head-on crash in Avenal, California, on New Year’s Day — seven of whom were children? We must implement the following NTSB recommendations in their memory:

• Require alcohol-detection systems in all new vehicles to prevent alcohol-impaired driving.
• Encourage vehicle manufacturers to combat alcohol-impaired driving by accelerating progress on advanced impaired driving prevention technology and finding new ways to use existing technology, like driver monitoring systems.
• Incentivize vehicle manufacturers and consumers to adopt intelligent speed adaptation (ISA) systems. One way to achieve this is to include ISA in the New Car Assessment Program. Notably, ISA became mandatory in July 2022 for all new models of vehicles introduced in the European Union.
• Develop a common standard of practice for drug toxicology testing by state officials.

Remember. Support. Act.

Even as we advocate for our safety recommendations, more crashes are occurring daily — which means more investigations. The work continues.

And yet, we cannot let the magnitude of the road safety crisis deter us.

We must keep fighting for zero, which is only possible through a Safe System Approach. 

We must fight for road users around the world who deserve to be safe.

We must fight for those whose lives are forever changed by traffic violence.

We must fight for those who are no longer here to fight for themselves.

For all these people and more, the NTSB will keep fighting. And so will I.

Help Us Reach Zero: Adopt All-offender Ignition Interlock Laws

By Leah Walton, NTSB Safety Advocate

In the Spring of this year, I attended the Association of Ignition Interlock Program Administrators (AIIPA) Annual Conference, a gathering of about 130 people all committed to eliminating impaired driving. Attendees included state ignition interlock program administrators, ignition interlock manufacturers, researchers, law enforcement, toxicologists, and representatives from the treatment and criminal justice communities.

It was no surprise that a hot topic of the conference was the early estimates of traffic fatalities for 2021 released the same week by the National Highway Traffic Safety Administration (NHTSA). The numbers showed a trend in the wrong direction, with an estimated 42,915 people killed in motor vehicle crashes, a 10.5 percent increase from 2020. This number is the highest number of fatalities since 2005. Specifically, fatalities in police-reported, alcohol-involvement crashes were up 5 percent compared to 2020.

A breath ignition interlock device (IID), estimates a driver’s blood alcohol concentration (BAC). It is installed in a vehicle and the driver must provide a breath sample that does not exceed a certain BAC threshold (for instance, .00 BAC or .02 BAC) before the vehicle will start or continue to operate. Installing these devices can be a penalty for drivers convicted of driving while intoxicated (DWI) or driving under the influence (DUI). They allow impaired-driving offenders to continue to operate their vehicles on an ignition interlock restricted license, rather than having their license suspended altogether.

Ignition interlocks have been a piece of the NTSB’s comprehensive solution to eliminate impaired driving since 2000, when we recommended that all 50 states and DC establish a comprehensive program designed to reduce the incidence of alcohol-related crashes and fatalities caused by hard-core drinking drivers, including elements such as those suggested in the NTSB’s Model Program, such as requiring ignition interlocks for high-BAC first offenders and repeat offenders. The issue is still urgent enough that “Prevent Alcohol- and Other Drug-Impaired Driving” is on our 2021–2022 Most Wanted List of Transportation Safety Improvements.

In our 2012 Wrong Way Driving report, we found that installing alcohol ignition interlocks on the vehicles of all DWI offenders (first-time and subsequent-time offenders) would reduce crashes caused by alcohol-impaired drivers. Thus, we issued a safety recommendation to 33 states, Puerto Rico, and DC to enact laws to require the use of alcohol IIDs for all individuals convicted of DWI offenses (at the time of publishing the report, 17 states already had a law requiring mandatory IID installation for DWI first offenders).

In May 2012, the NTSB held a forum, Reaching Zero: Actions to Eliminate Substance-Impaired Driving, to identify the most effective, scientifically based actions needed to reach zero crashes associated with substance-impaired driving. In the resulting final report, adopted in May 2013, we discussed all-offender ignition interlock laws as part of a comprehensive strategy to prevent alcohol-impaired driving. Currently, 34 states have all-offender ignition interlock laws.

It’s difficult to quantify how many drivers currently have, an IID in their vehicle. However, in 2022, Mothers Against Drunk driving (MADD) reported that in 14 years (2006–2020), ignition interlocks had stopped 3.78 million drivers with a BAC of 0.08[1] g/dL or higher from starting their vehicles. Requiring ignition interlocks for all offenders is a swift and certain penalty for alcohol-impaired driving. IIDs can be installed on arrested DUI offenders’ vehicles immediately, to ensure they are not driving alcohol-impaired while they await trial. These devices are effective, both at preventing alcohol-impaired driving as well as reducing DUI recidivism. A 2016 California DMV study of the state’s ignition interlock pilot program showed ignition interlocks were associated with a 73 percent lower odds of recidivism compared to license suspension alone for first-time offenders during the first 182 days after conviction.

For more than a decade, the number of alcohol-impaired driving fatalities had become stagnant, with 10,000 people killed every year. Now, those numbers are rising again, with 11,654 impaired driving fatalities in 2020. And, like the fatality numbers, the conversation around impaired driving has stagnated, too. Many people are hopeful that new advanced driver assistance systems, collision-avoidance systems, in-vehicle alcohol detection technologies and automated vehicle technologies will end impaired driving once and for all. We are hopeful, too. But as we know, it takes at least 20 years for new technology to fully penetrate a fleet of vehicles. We cannot—and should not—accept the fully preventable loss of 10,000 lives each year while we wait. We must implement the countermeasures that we have available now that we know work, like IIDs.

While at the AIIPA conference, I had the opportunity to address the attendees. I shared that I started my highway safety career with MADD in 2001, and at that time, I could not imagine that in 20 years I would still be here advocating for countermeasures to eliminate impaired driving. I thought that by 2022, surely people would learn to make smart choices and designate a sober driver. Unfortunately, we have made very little progress. That can change if all states adopt all-offender ignition interlock laws. We could finally make meaningful progress toward eliminating this dangerous behavior that ends in so many completely preventable tragedies.  

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[1] NTSB recommends that all 50 states, Puerto Rico, and the District of Columbia lower their legal BAC limit to .05 percent g/dL or lower. In 2018, Utah became the first state with a BAC limit of .05 percent.