Age-related differences in driving behaviors among non-professional drivers in Egypt

Ahmed Arafa; Lamiaa H Saleh; Shaimaa A Senosy

doi:10.1371/journal.pone.0238516

. 2020 Sep 3;15(9):e0238516. doi: 10.1371/journal.pone.0238516

Age-related differences in driving behaviors among non-professional drivers in Egypt

Ahmed Arafa ¹, Lamiaa H Saleh ¹, Shaimaa A Senosy ^1,^*

Editor: Sergio A Useche²

PMCID: PMC7470271 PMID: 32881906

Abstract

Purpose

This study aimed to investigate whether young and old non-professional drivers in South Egypt have aberrant driving behaviors compared with their middle-aged counterparts.

Materials and methods

In this cross-sectional study, a total of 1764 non-professional drivers aged ≥ 19 years, residing in Beni-Suef in South Egypt, and having ≥ one year of driving experience were randomly selected. All drivers were asked to fill out a self-administered questionnaire, including personal information, driving habits, and the Arabic version of the Driver Behavior Questionnaire which evaluates driving violations, errors, and lapses.

Results

This study included 560 young drivers (19–25 years), 850 middle-aged drivers (26–59 years), and 354 old drivers (≥ 60 years). Compared with middle-aged drivers, young drivers reported more non-use of the seatbelt, eating while driving, and driving while feeling drowsy. Old drivers, in contrast, showed more careful driving behaviors including fewer violations, errors, and lapses and less likelihood of driving while feeling sleepy.

Conclusion

This study supports the conception that young drivers pose less careful driving habits. Initiating educational programs targeting young drivers to improve their driving habits and create a traffic safety culture in Egypt is highly warranted.

Introduction

With over 1.35 million annual fatalities worldwide, road traffic injuries (RTIs) represent the 8^th leading cause of mortality for all ages. Recent trends indicated, however, that RTIs will be one of the top five causes of mortality by 2030 unless urgent actions are taken [1, 2]. In Egypt, RTIs contributed to 613 disability-adjusted life years lost per 100,000 population in 2016, making the country one of the most affected in Africa and the Middle East [3]. In this regard, the United Nations aspired in its Agenda for Sustainable Development Goals to halve global mortalities and morbidities from RTIs and enhance road safety for all through controlling the risk factors for RTIs [4].

Human, environmental, road, and vehicle factors actively interact in RTI involvement [5–7]. Human factors, in which aberrant driving behaviors are central, profoundly contribute to RTIs [7, 8]. Aberrant driving behaviors can be categorized into violations, errors, and lapses. While violations refer to intentional deviations from essential driving practices, errors refer to incorrect driving practices associated with inadequate information. Different mechanisms presumably lead to different aberrant behaviors: violations result from risk-taking and errors from low abilities; however, both behaviors significantly threaten road safety. Lapses encompass occasional inattentions and memory failures and unlike violations and errors are less likely to affect road safety [8, 9].

The issue of driving behaviors is multidimensional with various intersecting demographic, social, psychological, legal, economic, and cultural factors [10, 11]. The age of drivers is among the most influential factors affecting driving behaviors [9–16]. A cross-sectional study on 1600 drivers from the UK revealed a negative correlation between the age of drivers and their violations [9]. Alike, a study on 343 mini-bus drivers from Ethiopia showed that young age predicted risky driving behavior [7]. A study on 518 professional and non-professional drivers in Egypt reported a higher prevalence of errors and lapses but not violations among drivers < 30 years, yet the significant association between age and driving behaviors disappeared after adjustment for other sociodemographic features and driving distance [16].

The age of drivers can also cast the relationship between driving behaviors and RTIs as young and old drivers could have a high risk of RTI involvement for different reasons [6, 9, 10, 12–16]. The increased probability of RTIs among young drivers can be a result of risky driving behavior, a lack of driving skills and experience, and the propensity to drive in high-risk situations [10, 12, 13] while physical, sensorial, and cognitive age-related deteriorations that affect driving ability could explain the high risk among old drivers [14, 15].

Since the prevalence rates of RTIs and aberrant driving behaviors in Egypt exceed those in other Middle Eastern countries, Australia, and Western Europe [3, 16–20] and given the fact that driving behavior is closely related to RTIs [8, 10], studying the potential associations with aberrant driving behaviors is essential for a better prediction of RTIs in the country. Nevertheless, data is lacking about the relationship between the age of drivers and their driving behaviors. Detecting such a relationship can play a role in modifying the national driving regulations and refining road safety awareness programs to suit the age of drivers. We, therefore, conducted this cross-sectional study on a large sample of drivers in Beni-Suef city in Egypt to investigate whether young or old drivers would show more aberrant driving behaviors compared with middle-aged drivers.

Subjects and methods

Study design, population, and setting

This population-based, cross-sectional, analytical study was conducted on non-professional drivers residing in Beni-Suef city, the Capital of Beni-Suef governorate in South Egypt, during the period between October and December 2019. At the time of the 2017 census, more than 3.15 million people were residing in Beni-Suef governorate, and 30% of them were living in Beni-Suef city [21]. Although Beni-Suef governorate has one of the fewest numbers of private vehicles nationwide [21], it suffers a hefty burden of RTIs [16, 22]. The prevalence of RTI involvement among non-professional drivers in the governorate during the past two years reached a high of 15.6% [16]. Beni-Suef governorate came on top of RTIs/total injuries list in Egypt with 51.2%, almost 20% higher than Ismailia governorate which came second and 35% higher than Cairo governorate [22].

In the current study, non-professional drivers were defined as people who were driving their vehicle or one owned by relatives or friends without being part- or full-time professional drivers. For the non-professional driver to be eligible for participation, he/she had to be aged ≥19 years and had been driving for at least one year.

Sampling

The sample size was estimated using the Epi- Info version 7 StatCalc designed by the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). We more than doubled the least required sample size to enhance statistical power and avoid unpredicted low response rates. Eventually, we invited 2000 non-professional drivers to participate in this study.

To include a representative sample of non-professional drivers from Beni-Suef city, we divided the city areas according to their socioeconomic standards into three categories: high, middle, and low. Then, one area was randomly selected, by card withdrawal, from each socioeconomic standard, and non-professional drivers residing in the selected areas were invited to participate in this study. A team of data collectors, led by one of the authors, visited the selected areas. Out of each area, 500 households or more were chosen using a random start, and data collectors moved from door to door asking those who were eligible to take part in the study. Those who gave their permission and signed their informed consent were handed a questionnaire to fill out on their own before handing the questionnaire back to data collectors after one hour. No rewards were offered for participation.

Data collection tool

Study participants were asked to fill out a self-administered questionnaire composed of two parts. The first part involved questions about age (years), sex (men or women), educational level (elementary or high), driving hours per day, the year model of vehicle, and some driving habits including eating and using the cellphone while driving, using the seatbelt, and driving while feeling sleepy or drowsy. Answer options for the driving habits were requested on a scale of “never, seldom, sometimes, and always.” The second part of the questionnaire included the Arabic version of the Driver Behavior Questionnaire (DBQ), which involved 26 items on a six-point scale from zero to five (never, hardly ever, occasionally, quite often, frequently, and nearly all the time). The items were divided as follows: ten items for violations such as “disregarding the speed limits on a motorway,” “being involved in races,” and “sounding horn to annoy others”, eight items for errors such as “applying sudden brakes,” “missing signs,” and “failing to recognize the pedestrians”, and eight items for lapses such as “getting into wrong lanes,” “forgetting site of a car park,” and “misreading signs.” High scores of DBQ indicated aberrant driving behavior [9, 23]. The factor analysis and reliability of the Arabic version of DBQ were first examined by Berner and colleagues who surveyed drivers from Arab Gulf countries [17]. The DBQ was also used to assess driving behaviors in Egypt, Australia, Sweden, the United Kingdom, Finland, and the Netherlands [16, 18–20]. However, since traffic culture varies between countries and given the absence of culture-specific items, it is hard to assume that drivers’ perception of DBQ was the same across countries [17].

Ethical consideration

The research proposal was approved by the Research Ethics Committee of the Faculty of Medicine Beni-Suef University, and the study was conducted in full accordance with the guidelines for the Declaration of Helsinki. Participants had to sign their informed consent forms before filling out their questionnaires.

Statistical analyses

The Statistical Package for Social Science (SPSS) Version 22.0 (IBM SPSS Statistics for Windows, IBM Corporation, Armonk, New York) was used for data analysis. Age of drivers was categorized as follows: young drivers (19–25 years), middle-aged drivers (26–59 years), and old drivers (≥ 60 years). Drivers were considered to have aberrant driving habits (eating or using the cellphone while driving, non-use of the seatbelt, and driving while feeling sleepy or drowsy) if they selected “sometimes or always” as answers for these habits. The chi-squared test was used to compare the sociodemographic characteristics of non-professional drivers among different age groups. Linear regression was used to detect the relationship between the age of drivers and their driving behaviors (violations, errors, and lapses). Logistic regression was used to detect the relationship between the age of drivers and their driving habits (eating, using the cellphone, and using the seatbelt while driving and driving while feeling sleepy or driving while feeling drowsy). Since our primary hypothesis suggested different forms of aberrant driving behaviors and habits among young and old drivers, we calculated betas (Bs) for aberrant behaviors and odds ratios (ORs) for aberrant driving habits with their corresponding 95% confidence intervals (CIs) among young drivers (19–25 years) and old drivers (≥ 60 years) in comparison with middle-aged drivers (26–59 years). Unadjusted and multivariable-adjusted linear and logistic regression models were conducted. The multivariable models included sex, education, vehicle model, and driving hours per day.

Results

A total of 1764 non-professional drivers participated in this study with a response rate of 88.2%. Of them, 560 were young drivers (19–25 years), 850 were middle-aged drivers (26–60 years), and 354 were old drivers (≥ 60 years). The group of old drivers included significantly more men, less educated people, and earlier vehicle models compared with the groups of middle-aged and young drivers (p<0.001) (Table 1).

Table 1. Sociodemographic characteristics of non-professional drivers distributed by age category.

Characteristics		19–25 years (n = 560)	26–59 years (n = 850)	≥ 60 years (n = 354)	P-value
Age (Mean±Sd)		21.43±2.01	38.79±8.87	64.38±3.79	---
Sex	Men	410 (73.2)	633 (74.5)	321 (90.7)	<0.001
Sex	Women	150 (26.8)	217 (25.5)	33 (9.3)	<0.001
Education	Elementary	194 (34.6)	323 (38.0)	220 (62.1)	<0.001
Education	High	366 (65.4)	527 (62.0)	134 (37.9)	<0.001
Vehicle model	Before 2000	64 (11.4)	103 (12.1)	75 (21.2)	<0.001
Vehicle model	Recent	496 (88.6)	747 (87.9)	279 (78.8)	<0.001
Driving hours/day	≥4	279 (49.8)	472 (55.5)	193 (54.5)	0.100
Driving hours/day	<4	281 (50.2)	378 (44.5)	161 (45.5)	0.100

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After adjustment for sex, education, vehicle model, and driving hours per day, old drivers, compared with middle-aged drivers, reported fewer violations (B -1.70, 95% CI: -2.28, -1.12), errors (B -0.65, 95% CI: -1.05, -0.24), and lapses (B -0.81, 95% CI: -1.24, -0.37) (Table 2).

Table 2. Betas and 95% confidence intervals for non-professional drivers’ aberrant driving behaviors according to their age category.

Driving behaviors	19–25 years (n = 560)	26–59 years (Ref) (n = 850)	≥ 60 years (n = 354)
Violations
Mean (standard deviation)	15.8 (9.8)	15.4 (9.2)	12.1 (9.2)
Unadjusted	0.39 (-0.62, 1.39)	1	-1.65 (-2.22, -1.08)
Adjusted	0.64 (-0.35, 1.62)	1	-1.70 (-2.28, -1.12)
Errors
Mean (standard deviation)	12.8 (6.7)	13.2 (6.5)	11.6 (6.1)
Unadjusted	-0.41 (-1.11, 0.29)	1	-0.79 (-1.18, -0.39)
Adjusted	-0.31 (-1.00, 0.38)	1	-0.65 (-1.05, -0.24)
Lapses
Mean (standard deviation)	11.8 (7.2)	12.8 (6.7)	10.8 (7.0)
Unadjusted	-0.94 (-1.68, -0.20)	1	-0.99 (-1.41, -0.57)
Adjusted	-0.88 (-1.61, -0.15)	1	-0.81 (-1.24, -0.37)

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Adjusted for sex, education, vehicle model, and driving hours per day.

Linear regression was used.

Regarding aberrant driving habits, young drivers were more likely to report non-use of the seatbelt (OR 1.56, 95% CI: 1.25, 1.95), eating while driving (OR 1.47, 95% CI: 1.15, 1.88), and driving while feeling drowsy (OR 1.75, 95% CI: 1.22, 2.52) compared with middle-aged drivers. In contrast, old drivers, compared with middle-aged ones, reported less driving while feeling sleepy (OR 0.49, 95% CI: 0.28, 0.84) and tended to show less use of the cellphone while driving (OR 0.77, 95% CI: 0.58, 1.02) and eating while driving (OR 0.74, 95% CI: 0.53, 1.03) (Table 3).

Table 3. Odds ratios and 95% confidence intervals for non-professional drivers’ aberrant driving habits according to their age category.

Driving behaviors	19–25 years (n = 560)	26–59 years (Ref) (n = 850)	≥ 60 years (n = 354)
Not using the seatbelt (Sometimes or always)
n (%)	338 (60.4)	424 (49.9)	187 (52.8)
Unadjusted	1.53 (1.23, 1.90)	1	1.13 (0.88, 1.44)
Adjusted	1.56 (1.25, 1.95)	1	0.90 (0.69, 1.17)
Using the cellphone while driving (Sometimes or always)
n (%)	205 (36.6)	279 (32.8)	94 (26.6)
Unadjusted	1.18 (0.95, 1.48)	1	0.74 (0.56, 0.98)
Adjusted	1.20 (0.96, 1.51)	1	0.77 (0.58, 1.02)
Eating while driving (Sometimes or always)
n (%)	164 (29.3)	193 (22.7)	60 (16.9)
Unadjusted	1.41 (1.11, 1.80)	1	0.70 (0.50, 0.96)
Adjusted	1.47 (1.15, 1.88)	1	0.74 (0.53, 1.03)
Driving while feeling sleepy (Sometimes or always)
n (%)	64 (11.4)	86 (10.1)	17 (4.8)
Unadjusted	1.15 (0.81, 1.62)	1	0.45 (0.26, 0.77)
Adjusted	1.18 (0.84, 1.67)	1	0.49 (0.28, 0.84)
Driving while feeling drowsy (Sometimes or always)
n (%)	68 (12.1)	65 (7.6)	24 (6.8)
Unadjusted	1.67 (1.17, 2.39)	1	0.88 (0.54, 1.43)
Adjusted	1.75 (1.22, 2.52)	1	0.96 (0.59, 1.59)

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Adjusted for sex, education, vehicle model, and driving hours per day.

Logistic regression was used.

Discussion

The current study illustrated the association of age with driving behaviors and habits among non-professional drivers in South Egypt. Young drivers (19–25 years) exhibited more aberrant driving habits including non-use of the seatbelt, eating while driving, and driving while feeling drowsy compared with middle-aged drivers (26–59 years). In contrast, old drivers (≥ 60 years) showed more careful driving behaviors and habits than middle-aged drivers involving fewer violations, errors, and lapses and less likelihood of driving while feeling sleepy.

Our study came in line with several reports that showed aberrant driving behaviors and habits among young drivers. In one study, 504 young drivers (16–20 years) and 409 middle-aged drivers (25–45 years) in the United States were surveyed for their driving behaviors. The results showed that young drivers, compared with middle-aged drivers, did not just demonstrate more risky driving behaviors but lower risk perception of their driving behaviors as well [24]. Also, more than half of 484 Australian drivers (17–25 years) reported using the cellphone while driving. The young drivers were even unable to acknowledge the increased risk of RTIs associated with dialing, texting, and browsing while driving [25].

Young drivers are in the phase of seeking identity and building relationships with peers. While still evolving their identity and relationships, they tend to test their limits and abilities behind the wheel [26]. Therefore, young drivers demonstrate a high propensity for taking crash risks to fulfill their motives for experience-seeking, excitement, social influence, and prestige-seeking [12, 13]. Besides, young drivers who undertake or are exposed to risky driving behaviors have a low perception of driving risks [10].

Old drivers in this study reported more careful driving behaviors and habits. In agreement with our results, a study conducted on 1793 drivers (≥ 65 years) from the United States showed that 90.8% of drivers reported no violations during the past two years and the vast majority of old drivers strongly disapproved of the unsafe driving habits involving non-use of the seatbelt, use of the cellphone while driving, and driving while feeling drowsy. Adhering to safe driving habits was even more evident among drivers ≥ 75 years [27]. Another study analyzed 679 sleep-related vehicle crashes from police databases in England and showed that old drivers were less likely to be engaged in this kind of injury [28].

Unlike young drivers, old drivers are aware of their cognitive and physical limitations; therefore, they tend to exhibit self-monitoring behaviors that lead to a better risk estimation while driving. Also, the ability of safe driving is a process that takes a long time, and old drivers are experienced enough to avoid situations that might necessitate risky driving decisions [29–31]. Further, old drivers are not only concerned about their driving, but the driving of others as well. This concern was shown to be associated with careful driving habits, such as using the seatbelt [14].

Besides, it was suggested that the claim that old drivers are excessively involved in RTIs is affected by low mileage bias. Since old drivers typically drive less distance, they have a higher chance of RTI involvement per unit of distance compared with younger drivers who drive long distances. Thus, controlling for driving distance could attenuate the age-related differences in RTI involvement across age categories [32–34]. However, daily driving hours that reflect distance driven did not differ significantly across age categories in our study.

It should be noted that this study had some limitations. First, we included only non-professional drivers who carried different sociodemographic characteristics and driving behaviors compared with professional drivers [16]; therefore, the results of the current study cannot be generalized to all drivers. Second, this study covered one city in South Egypt. It could be speculated that drivers in different cities may not share the same driving behaviors. Third, driving behaviors were documented by self-reporting, making them vulnerable to recall bias and socially desirable response bias. However, a previous study showed that self-reporting of driving could be trusted, and the impact of socially desirable response in DBQ was minimal [35]. Fourth, the cross-sectional design of the study did not allow it to imply a causal relationship. Fifth, we did not collect data on RTI involvement to investigate the relationship between driving behaviors and RTIs. Asking people about RTI involvement would have discouraged many drivers who were involved in RTIs to participate in the study due to the fear of legal consequences leading to non-response bias.

In conclusion, this study indicated that young non-professional drivers in South Egypt exhibit aberrant driving habits. Hence, generating educational programs to improve driving behavior and create a traffic safety culture in Egypt is highly desirable. These programs should be tailored to suit young drivers.

Supporting information

S1 File. New driving.

(SAV)

Click here for additional data file.^{(110KB, sav)}

Data Availability

All relevant data are within the manuscript and its Supporting Information files.

Funding Statement

The author(s) received no specific funding for this work.

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PLoS One. doi: 10.1371/journal.pone.0238516.r001

Decision Letter 0

Sergio A Useche

6 May 2020

PONE-D-20-06735

Age-related differences in driving behaviors among non-professional drivers in Egypt

PLOS ONE

Dear ASS.PROF senosy,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Your paper has been reviewed by two acknowledged experts in the field covered by the manuscript. Overall, they highlight a certain potential in it, but many clarifications, amendments and improvements are needed to consider it for publication in PLOS ONE. Please refer to all the comments appended below for your guidance. Further, the English writing is considerably poor, and my recommendation is to submit the paper to a professional editorial proof-reading.

Also, the introduction of the paper lacks enough background and support for psychosocial risk factors that have been demonstrated to influence/affect profesional driver's risky road behaviors (i.e., stress, fatigue, etc.), and more context on it (even though you did not measure all these variables, but they still count) and discussion in the glance of your results is needed. For this stage, please consider to access original research papers published in high-impact journals, showing empirical data and (if possible) predictive models on the explanation of risky road behavior among Professional Drivers, even if not all the studies have been performed in Egypt.

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PLOS ONE

Additional Editor Comments:

Major language revisions are needed.

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2. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified (1) whether consent was informed and (2) what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: No

Reviewer #2: Yes

**********

2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: No

Reviewer #2: No

**********

4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: No

Reviewer #2: Yes

**********

5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: This manuscript presents a study of driver behavior by age group among non-professional drivers in an Egyptian city. I have several concerns with the manuscript.

1) The manuscript does not provide a strong rationale for conducting the study. It is already well-documented that young drivers are risk-takers, inexperienced, and sensation seekers and it is already well-documented that older drivers make mistakes while driving due to declining abilities and are not risk takers. Given that this paper focuses on a single city in Egypt, the manuscript should present arguments why it is important to investigate driver behavior in Beni-Suef.

2) The introduction does not show a thorough understanding of the constructs underlying the driving behavior questionnaire (DBQ). Yes, the questionnaire divides aberrant driving behaviors into violations, errors, and lapses, it does so because these behaviors presumably result from different mechanisms: Violations result from risk-taking and errors from declining abilities. Many studies do not even include the lapses construct because it is not clear what underlies this type of behavior. Given the focus on driver age in this study, the authors should generate hypotheses based on these mechanisms.

3) The DBQ driver behavior questionnaire has been used extensively around the world to study driver behavior by age group. This research should be reviewed briefly in the introduction not in the results section of the paper.

4) The description of the methods is missing critical details. How were specific drivers selected to be in the study? Were they compensated for participation? How was the questionnaire administered (e.g., paper and pencil; Internet)? How was the purported randomization achieved? Given the focus on driver age, why were the three age groups balanced for equal cell sizes? Why weren’t the groups also balanced by gender, since it is know that driver self-report is often influenced by gender?

5) The designation of “old driver” as being age 60 or older is counter to the contemporary research and thinking in the older driver literature. Work over the past decade defines an older driver as either 65 years or 70 years and older. Indeed, the most recent work has defined older driver as 75 years or older. The fact that the mean age of the older driver group in this study was less than 65 years of age indicates that this group would not be considered older drivers to other researchers in the field of aging and transportation. This also probably is the reason why no significant differences were found between middle and old drivers on overall errors, lapses, or violations.

6) The authors should justify why comparisons for young and old drivers were made for middle age drovers, but not between each other. One would expect the greatest differences when comparing young versus old.

7) The second paragraph of the discussion implies that aberrant and risky driving behaviors are distinct. I would argue that risky driving behavior is one type of aberrant driving behavior and would, in particular, fall under the violations category of the DBQ. The authors should clarify.

8) The discussion includes some statements that are not supported by the literature and/or do not include proper citations. For example, the fourth paragraph of the discussion states that old drivers are aware of their cognitive and physical limitations and they therefore tend to exhibit self-monitoring behavior. This statement of fact does not have a citation and it is not supported by the research on older driver self-regulation.

Reviewer #2: This study investigates differences in driving behaviour for younger and older drivers (compared to middle-aged drivers) in a large sample of Egyptian drivers. Young drivers report significantly more risk-taking and violations. Differences between middle and older drivers were less common with older drivers showing more cautious driving than middle aged.

The comparison groups of <25 and >59 are interesting. I was not sure that “middle-aged” was an appropriate term for the whole 25-59 age group, particularly for 26-39. However, I don’t have an immediate suggestion for a better label for this group.

Overall, I found this an interesting study, but believe that a deeper analysis, as outlined below, might substantially increase the impact of the work.

Abstract

Ors are shown for group comparisons, but odds ratios cannot be interpreted unless the scales of the variables involved is clear. Please clarify the scales. It looks like age is categorised whereas the DBQ scales are simply the item means or totals? This needs to be clarified. Standardising the DBQ scales might provide a more interpretable metric.

The OR for errors and lapses is written as if the difference between younger and middle-aged is significant but the CI on the OR includes 1. It needs to be clearer that this difference is ns, or perhaps left out of the abstract. This issue is also relevant in the discussion.

Introduction

P1 Older drivers are argued to be at risk of injuries due to cognitive decline. This is plausible, but there is work that provides an alternative explanation simply based on lower mileage. I recommend considering this paper in the consideration of this issue:

Langford, J., Methorst, R., & Hakamies-Blomqvist, L. (2006). Older drivers do not have a high crash risk—A replication of low mileage bias. Accident Analysis & Prevention, 38(3), 574-578. doi:https://doi.org/10.1016/j.aap.2005.12.002

Methods

Please say a little more about how the Arabic version of the DBQ was obtained and which of the many versions of the DBQ the questionnaire was based on. It looks like the commonly made distinction between aggressive and non-aggressive violations was not made here. On what basis was this decision made?

Analyses: Additional control for annual mileage would be helpful if that was recorded.

Results

As currently presented, the results are interesting, and with note of the point about metrics made regarding the abstract, can be interpreted.

I would find a more detailed analysis of the DBQ data more interesting.

I don’t think it can be assumed that the factor structure of the DBQ is stable across cultures. Therefore, the paper would benefit from discussion of this issue in the introduction and from analysis in the present paper. This might be an Exploratory or Confirmatory analysis, depending on whether the literature review provides a strong expectation for the factor structure to be observed in this context.

Was crash involvement measured? A key question about applying measures of driving risk developed in HICs to LMICs is whether they maintain their validity in their central purpose; to identify propensity for crash involvement. Therefore analyses testing the relationship with crash involvement would be helpful and the sample size seems big enough to provide a meaningful test of this relationship. Finding a significant relationship with crash involvement would support the application of the DBQ in Egypt, but if it is not found then that would still be an interesting result for the research community. Coverage of this issue in the introduction would also be helpful. This needs to be raised as a limitation if crash involvement was not measured.

Discussion

Ensure the discussion focusses only on significant comparisons.

The idea of self-monitoring in older drivers is interesting and plausible. However, I was unclear how this was supported by the data collected.

**********

6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

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Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email us at figures@plos.org. Please note that Supporting Information files do not need this step.

PLoS One. 2020 Sep 3;15(9):e0238516. doi: 10.1371/journal.pone.0238516.r002

Author response to Decision Letter 0

11 May 2020

Dear Editor in Chief,

Thank you for the valuable comments.

Herein, we included our response to the comments made by the editor and reviewers.

Editor

1. Further, the English writing is considerably poor, and my recommendation is to submit the paper to a professional editorial proof-reading.

Response: The manuscript was reviewed by a professional editorial proof-reading as suggested.

2. Also, the introduction of the paper lacks enough background and support for psychosocial risk factors that have been demonstrated to influence/affect profesional driver's risky road behaviors (i.e., stress, fatigue, etc.), and more context on it (even though you did not measure all these variables, but they still count) and discussion in the glance of your results is needed. For this stage, please consider to access original research papers published in high-impact journals, showing empirical data and (if possible) predictive models on the explanation of risky road behavior among Professional Drivers, even if not all the studies have been performed in Egypt.

Response: The introduction was modified as suggested (Page 5,6). We added brief descriptions for studies assessing the relationship between the age of drivers and their driving behaviors and crash involvement. We also added a brief description of the factors affecting driving behaviors (Page 5 lines 19-25 & Page 6 lines 26-36).

Journal Requirements

When submitting your revision, we need you to address these additional requirements.

1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming.

Response: Modified throughout the manuscript as requested.

Response: The ethical considerations section was modified as requested (Page 9 lines 103-107).

Response: We added more details about the questionnaire (Page 8 lines 82-98 & Page 9 lines 99-102). We also made all data available.

Reviewers' comments

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #1: No

Reviewer #2: Yes

Response: We conducted rigorous modifications to make the manuscript technically clear.

2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

Response: Thank you.

3. Have the authors made all data underlying the findings in their manuscript fully available?

Reviewer #1: No

Reviewer #2: No

Response: We made all data available.

4. Is the manuscript presented in an intelligible fashion and written in standard English?

Reviewer #1: No

Reviewer #2: Yes

Response: The manuscript was reviewed by a professional editorial proof-reading.

Review Comments to the Author

Reviewer #1: This manuscript presents a study of driver behavior by age group among non-professional drivers in an Egyptian city. I have several concerns with the manuscript.

Response: We added an argument about the importance of investigating the behaviors of drivers in Egypt (Page 6 lines 37-46). We made a further argument about why studying the associations with driving behaviors was required in Beni-Suef governorate (Page 7 lines 54-61).

Response: We agree with you, therefore, we added further descriptions of driving behaviors and their possible associations with age. We also added brief examples of previous studies in this regard. As suggested, we generated a hypothesis postulating that young drivers could have more violations and errors while old drivers could have more lapses (Page 5 lines 19-25 & Page 6 lines 26-36).

Response: We added a brief review of earlier research investigating the relationship between the age of drivers and their driving behaviors to the introduction section (Page 5 lines 19-25 & Page 6 lines 26-36).

Response: We added more details to the methods section about the selection and data collection process (Page 8 lines 76-81).

Regarding the possibility of balancing the group by sex, this study was cross-sectional, and the cut-offs of age groups were decided before data collection, thus, drivers were not equally distributed across age groups: 560 young, 850 middle-aged, and 354 old. Besides, because women represent a small portion of non-professional drivers in Egypt and putting in mind that seeing a woman driving in South Egypt 30 years ago was uncommon, it was predicted to have a small number of women in the old age group (≥ 60 years) of drivers. However, to minimize the effect of sex, we adjusted the differences for sex and other variables, and it could be shown in (Table 2) that the adjusted model did not differ significantly from the unadjusted one.

Response: While most studies from the USA, Europe, and Japan use 65 years as a cut-off for old age, the Egyptian studies use 60 years as a cut-off. This cut-off is widely used nationwide for many reasons; 1- It is the age of pension in Egypt, 2- It is the age used by the Egyptian Census to refer to old people, 3- It is the age used by the Government to offer social welfare programs for old people, and 4- The overall average of life expectancy in Egypt is 71.5 years compared with 84.5 years in Japan, 83.5 years in Italy, Spain, Switzerland, and Australia, and 79 years in the USA.

• Aly HY, Hamed AF, Mohammed NA. Depression among the elderly population in Sohag governorate. Saudi Med J. 2018;39(2):185‐190.

• Ahmed D, El Shair IH, Taher E, Zyada F. Prevalence and predictors of depression and anxiety among the elderly population living in geriatric homes in Cairo, Egypt. J Egypt Public Health Assoc. 2014 Dec;89(3):127-35.

• Central Agency for Public Mobilization and Statistics (CAPMAS). Egypt statistics. Final results of 2017 Census; http://www.capmas.gov.eg

Response: Since our primary hypothesis was to detect aberrant driving behaviors in young and old drivers and to test whether young drivers had more violations and errors and old drivers had more lapses, we had to use the middle-aged people as a reference group because in our situation both young and old groups were study groups.

Response: We agree with you and we modified this section as suggested (Page 11 line 151).

Response: We clarified the citation and we added 2 more citations suggesting self-monitoring behavior among old drivers (Page 12 lines 176-182). However, we agree with you that some sections need proper citations and therefore we updated and added some references.

• Anstey K, Wood J, Lord S, Walker J. Cognitive, sensory and physical factors enabling driving safety in older adults. Clin Psychol Rev, 2005; 25:45-65.

• Conlon E, Rahaley N, Davis J. The influence of age-related health difficulties and attitudes toward driving on driving self-regulation in the baby boomer and older adult generations. Accid Anal Prev, 2017; 102:12-22.

• Molnar L, Eby D, Charlton J, Langford J, Koppel S, Marshall S, et al. Driving avoidance by older adults: is it always self-regulation? Accid Anal Prev, 2013; 57:96-104.

1). The comparison groups of <25 and >59 are interesting. I was not sure that “middle-aged” was an appropriate term for the whole 25-59 age group, particularly for 26-39. However, I don’t have an immediate suggestion for a better label for this group.

Response: Defining people <60 years as middle-aged was used before in research.

• Tsugane S, Sasaki S, Tsubono Y. Under- and overweight impact on mortality among middle-aged Japanese men and women: a 10-y follow-up of JPHC study cohort I. Int J Obes Relat Metab Disord. 2002 Apr;26(4):529-37.

• Yoshida M, Inoue M, Iwasaki M, Tsugane S; JPHC Study Group. Association of body mass index with risk of age-related cataracts in a middle-aged Japanese population: the JPHC Study. Environ Health Prev Med. 2010 Nov;15(6):367-73.

Overall, I found this an interesting study, but believe that a deeper analysis, as outlined below, might substantially increase the impact of the work.

Abstract

2). Ors are shown for group comparisons, but odds ratios cannot be interpreted unless the scales of the variables involved is clear. Please clarify the scales. It looks like age is categorised whereas the DBQ scales are simply the item means or totals? This needs to be clarified. Standardising the DBQ scales might provide a more interpretable metric.

Response: Thank you for this comment. We clarified the cut-offs for violations, errors, and lapses in the abstract section as suggested (Page 2).

3). The OR for errors and lapses is written as if the difference between younger and middle-aged is significant but the CI on the OR includes 1. It needs to be clearer that this difference is ns, or perhaps left out of the abstract. This issue is also relevant in the discussion.

Response: We rephrased the abstract to differentiate between the absolute statistically significant associations and the tendency of some factors to be associated with aberrant driving behaviors (Page 2).

Introduction

4). P1 Older drivers are argued to be at risk of injuries due to cognitive decline. This is plausible, but there is work that provides an alternative explanation simply based on lower mileage. I recommend considering this paper in the consideration of this issue:

Response: Thank you. This study was very helpful. We added this explanation to the discussion part to justify our findings (Page 12 lines 183-189).

Methods

5). Please say a little more about how the Arabic version of the DBQ was obtained and which of the many versions of the DBQ the questionnaire was based on. It looks like the commonly made distinction between aggressive and non-aggressive violations was not made here. On what basis was this decision made?

Response: More descriptions were added to the Arabic version of DBQ (Page 8 lines 82-98 & Page 9 lines 99-102). We made this decision based on the low scores of reliability and factorial analyses shown in a previous study using the Arabic version of DBQ and dividing the behaviors into four aspects.

• Bener A, Ozkan T, Lajunen T. The driver behaviour questionnaire in Arab Gulf Countries: Qatar and United Arab Emirates. Accid Anal Prev, 2008; 40:1411-1417.

6). Analyses: Additional control for annual mileage would be helpful if that was recorded.

Response: Since we limited our study population to nonprofessional drivers and given the fact that the streets in Egypt, including Beni-Suef, are very crowded, we thought that using driving hours may be more realistic in the current situation that mileage. Thus, we adjusted our results for driving hours.

Results

7). As currently presented, the results are interesting, and with note of the point about metrics made regarding the abstract, can be interpreted.

Response: Thank you. The abstract was modified as suggested in the first comment.

8). I would find a more detailed analysis of the DBQ data more interesting. I don’t think it can be assumed that the factor structure of the DBQ is stable across cultures. Therefore, the paper would benefit from discussion of this issue in the introduction and from analysis in the present paper. This might be an Exploratory or Confirmatory analysis, depending on whether the literature review provides a strong expectation for the factor structure to be observed in this context.

Response: We further discussed the possible cultural differences across DBQ versions (Page 8 lines 82-98 & Page 9 lines 99-102).

9). Was crash involvement measured? A key question about applying measures of driving risk developed in HICs to LMICs is whether they maintain their validity in their central purpose; to identify propensity for crash involvement. Therefore analyses testing the relationship with crash involvement would be helpful and the sample size seems big enough to provide a meaningful test of this relationship. Finding a significant relationship with crash involvement would support the application of the DBQ in Egypt, but if it is not found then that would still be an interesting result for the research community. Coverage of this issue in the introduction would also be helpful. This needs to be raised as a limitation if crash involvement was not measured.

Response: We did not assess crash involvement for 2 reasons: 1- This would greatly undermine the response rate leading to a high possibility of non-response bias because most traffic crashes that do not include injuries or include minor injuries are not reported to the police, so participants would be afraid of getting in legal troubles. A recent study from Egypt on crash involvement showed a response rate of only 52% and non-respondents expressed their concerns regarding data security. 2- Since many traffic crashes are not reported, we would not have any method of verification. However, we added this point as a limitation (Page 13 lines 199-202).

• Arafa A, El-Setouhy M, Hirshon J. Driving behavior and road traffic crashes among professional and nonprofessional drivers in South Egypt. Int J Inj Contr Safety Promot, 2019; 26:372-378.

Discussion

10). Ensure the discussion focusses only on significant comparisons. The idea of self-monitoring in older drivers is interesting and plausible. However, I was unclear how this was supported by the data collected.

Response: We limited the discussion to statistically significant associations as suggested (Page 10 lines 145-147 & Page 11 lines 148-150). Unfortunately, we did not assess self-monitoring, but previous studies suggested this explanation to justify the relatively safe driving of old people. Therefore, we cited these studies to explain our findings (Page 12 lines 176-182).

• Anstey K, Wood J, Lord S, Walker J. Cognitive, sensory and physical factors enabling driving safety in older adults. Clin Psychol Rev, 2005; 25:45-65.

• Molnar L, Eby D, Charlton J, Langford J, Koppel S, Marshall S, et al. Driving avoidance by older adults: is it always self-regulation? Accid Anal Prev, 2013; 57:96-104.

Attachment

Submitted filename: Driving Response (PLOS).docx

Click here for additional data file.^{(26.3KB, docx)}

PLoS One. doi: 10.1371/journal.pone.0238516.r003

Decision Letter 1

Sergio A Useche

6 Jul 2020

PONE-D-20-06735R1

Age-related differences in driving behaviors among non-professional drivers in Egypt

PLOS ONE

Dear Dr. senosy,

The Reviewer # 2 has provided additional comments that I found valuable and may contribute to improve the paper. Please address them carefully during your revisions of the paper. Also, and apart from the comments appended by the reviewer, I would like the authors could improve the literature review, in which much is discussed on some behavioral contributors of non-professional drivers, but the task-related issues of professional drivers, i.e., providing context on why it was important to differentiate them are (comparatively) uncompensated.

Please submit your revised manuscript by Aug 20 2020 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols

We look forward to receiving your revised manuscript.

Kind regards,

Sergio A. Useche, Ph.D.

Academic Editor

PLOS ONE

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #2: Partly

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

Reviewer #2: Yes

**********

6. Review Comments to the Author

Reviewer #2: Many thanks to the authors for their thoughtful responses to my comments. I remain of the opinion that the study provides results that will interesting to the research community. I have re-read the ms and provide further comments below.

Abstract

I am not convinced the sampling is random - were these volunteers? If so, volunteering is not random, so this needs to be clarified.

Results- I still find the ORs difficult to interpret. I recommend removing the Ors from the abstract an just describing the significant associations in the data. I do not believe any interpretation should be given for non-significant associations, anywhere in the ms.

Introduction

Now provides a solid introduction to the work in my reading.

Method

I don’t see the authors have dichotomised the DBQ scales to identify aberrant driving. The DBQ provides continuous measures of driving constructs and dichotomising them reduces the power of analysis without any benefit so far as I can see. I recommend analyses are re-run using the continuousDBQ scores as the outcome variables. This may mean that some of the tendencies identified in the data but falling below significance will become significant.

Discussion

No interpretation or consideration should be given to ns results.

P12Line 176. The point about self-monitoring older drivers needs to be grounded in literature.

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: Yes: Richard Rowe

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PLoS One. 2020 Sep 3;15(9):e0238516. doi: 10.1371/journal.pone.0238516.r004

Author response to Decision Letter 1

8 Jul 2020

Dear editor-in-chief,

Thank you for the favorable response.

Herein, our response to comments of reviewer 2

1. Abstract

1.1. I am not convinced the sampling is random - were these volunteers? If so, volunteering is not random, so this needs to be clarified.

Response: Thank you for this comment. The sample was randomly selected. The selection process was described in detail (lines 72-81). Since data were self-reported and given the fact that we offered no incentives for participation, it could be speculated that different forms of bias could be present, and we already cited these limitations (lines 191-194).

1.2. Results- I still find the ORs difficult to interpret. I recommend removing the Ors from the abstract an just describing the significant associations in the data. I do not believe any interpretation should be given for non-significant associations, anywhere in the ms.

Response: We modified the results in the abstract section as suggested (page 3).

2. Introduction

2.1. Now provides a solid introduction to the work in my reading.

Response: Thank you.

3. Method

3.1. I don’t see the authors have dichotomised the DBQ scales to identify aberrant driving. The DBQ provides continuous measures of driving constructs and dichotomising them reduces the power of analysis without any benefit so far as I can see. I recommend analyses are re-run using the continuous DBQ scores as the outcome variables. This may mean that some of the tendencies identified in the data but falling below significance will become significant.

Response: While we appreciate your opinion, we have some concerns regarding treating DBQs scales as continuous scales rather than dichotomizing them for the following reasons:

1. This study aims, in the first place, to draw policies for traffic measures in South Egypt, therefore, the emerging results will be presented to officials and academics who might carry limited or no expertise in statistical analyses. We believe that presenting the results in the form of categorical variables will be easier to understand and can deliver our message directly. It is more convenient to claim that the younger age may be associated with a 46% increase in the risk of driving violations compared with the middle-aged than claiming that transition from middle age category to young age category may lead to an increase by 0.39 units on the violation scale of driving behaviors.

2. In response to your comment, we already re-ran the analysis, however, the results did not materially change.

3. In case of conducting linear regression to compute beta coefficients and their 95% CIs for violations, errors, and lapses, we will face another problem that other driving habits (using seatbelts, cellphones, eating, driving while feeling drowsy, and driving while feeling sleepy) are not continuous variables and conducting logistic regression in their case is a must. So, in such a case, the upper half of the table will be conducted by linear regression and presented by unit change and the lower half of the table will be conducted by logistic regression and presented by odds. Also, the descriptive data in the upper half will be presented by mean and Sd or median and IQR while the lower half will be presented by frequencies and percentages. We think that this inconsistency may leave the reader confused.

4. Discussion

4.1. No interpretation or consideration should be given to ns results.

Response: We modified this point as suggested.

4.2. P12Line 176. The point about self-monitoring older drivers needs to be grounded in literature.

Response: This part is cited in references 29, 30, and 3

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PLoS One. doi: 10.1371/journal.pone.0238516.r005

Decision Letter 2

Sergio A Useche

11 Aug 2020

PONE-D-20-06735R2

Age-related differences in driving behaviors among non-professional drivers in Egypt

PLOS ONE

Dear Dr. senosy,

Your revised manuscript has been reviewed again, raising new comments that need your attention, and I append below for your guidance. Please try to address them as rigorously as possible, in order to make a prompt editorial decision once you will resubmit the paper.

As a personal recommendation, please try to support the technical assumptions of the analyses performed (BQ paradigm) with more pertinent literature on it.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #2: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #2: Yes

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Reviewer #2: No

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6. Review Comments to the Author

Reviewer #2: Many thanks for your responses. Most are very helpful, but I do believe the ms will be much more valuable if the DBQ is treated as a continuous measure.

I can see the advantages of dichotomising the DBQ scales for ease of communication to non-academic audiences. However, it is an oversimplification that may mislead. There is no evidence that the cutpoints you have identified are in anyway meaningful in terms of risk of crash, but if you present the results in this way, any audience, particularly an uninformed one, is likely to think that they do mean something.

The audience you are writing for at PLOS ONE are academics who are familiar with interpreting continuous statistics in general. The audience with expertise in driving behaviour will expect that the DBQ will be treated as a continuous measure as it has always been in the very many studies that I have authored and read using this instrument.

The problem of some analyses addressing dichotomous variables and some addressing continuous is a common one in writing research papers, so I have no doubt you will be able to find an unambiguous way to present your tables.

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PLoS One. 2020 Sep 3;15(9):e0238516. doi: 10.1371/journal.pone.0238516.r006

Author response to Decision Letter 2

12 Aug 2020

Reviewer #2: Many thanks for your responses. Most are very helpful, but I do believe the ms will be much more valuable if the DBQ is treated as a continuous measure.

Response:

Thank you for your informative comment. We treated DBQ scales as continuous data as suggested and made some changes accordingly.

1- We divided table 2 to tables 2 and 3: table 2 for violence, errors, and lapses with associations conducted using linear regression and table 3 for driving habits such as eating, using the cell phone, and using the seatbelt during driving with associations conducted using logistic regression.

2- Some changes were made accordingly in the methods (lines 106-123), results (lines 130-140), and discussion sections (142-148).

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PLoS One. doi: 10.1371/journal.pone.0238516.r007

Decision Letter 3

Sergio A Useche

19 Aug 2020

Age-related differences in driving behaviors among non-professional drivers in Egypt

PONE-D-20-06735R3

Dear Dr. senosy,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #2: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

Reviewer #2: Yes

**********

6. Review Comments to the Author

Reviewer #2: Many thanks for responding carefully to my comments. My only final suggestions are:

Intro line 1 fatalities not mortalities

Line 118 betas not beats

**********

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Reviewer #2: Yes: Richard Rowe

PLoS One. doi: 10.1371/journal.pone.0238516.r008

Acceptance letter

Sergio A Useche

21 Aug 2020

PONE-D-20-06735R3

Age-related differences in driving behaviors among non-professional drivers in Egypt

Dear Dr. Senosy:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

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Data Availability Statement

All relevant data are within the manuscript and its Supporting Information files.

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Age-related differences in driving behaviors among non-professional drivers in Egypt

Ahmed Arafa

Lamiaa H Saleh

Shaimaa A Senosy

Roles

Abstract

Purpose

Materials and methods

Results

Conclusion

Introduction

Subjects and methods

Study design, population, and setting

Sampling

Data collection tool

Ethical consideration

Statistical analyses

Results

Table 1. Sociodemographic characteristics of non-professional drivers distributed by age category.

Table 2. Betas and 95% confidence intervals for non-professional drivers’ aberrant driving behaviors according to their age category.

Table 3. Odds ratios and 95% confidence intervals for non-professional drivers’ aberrant driving habits according to their age category.

Discussion

Supporting information

Data Availability

Funding Statement

References

Decision Letter 0

Sergio A Useche

Roles

Author response to Decision Letter 0

Decision Letter 1

Sergio A Useche

Roles

Author response to Decision Letter 1

Decision Letter 2

Sergio A Useche

Roles

Author response to Decision Letter 2

Decision Letter 3

Sergio A Useche

Roles

Acceptance letter

Sergio A Useche

Roles

Associated Data

Supplementary Materials

Data Availability Statement

ACTIONS

PERMALINK

RESOURCES

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