Driver behavioral and psychological traits as risk factors for traffic accidents: a systematic review and...

Driver behaviors and psychological traits are important and modifiable risk factors for traffic accidents. Previous studies have reported inconsistent results, often with small sample sizes. We conducted a systematic review and meta-analysis to quantitatively synthesize evidence on the association between driver behaviors, psychological traits, and traffic accident risk. PubMed and CNKI databases were searched. Eligible cross-sectional and case-control studies reporting odds ratios (ORs) or sufficient data to calculate them were included. Study quality was assessed using the 11-item Agency for Healthcare Research and Quality checklist. Pooled ORs were calculated using a random-effects model. I² and τ² statistics assessed heterogeneity, and leave-one-out sensitivity analyses were performed. Eighteen studies were included, covering nine behavioral factors (alcohol drinking, fatigue, lack of speed limit awareness, running a red light, sleep disorder, sleep duration less than 8 h, unawareness of entering the non-motorized lane, phone use, and not wearing a seatbelt/helmet) and five psychological traits (anger, anxiety, and three Eysenck personality dimensions). Pooled ORs ranged from 1.16 to 3.65. Study quality was generally moderate to high (scores 5-10), with no studies rated as high risk of bias. Heterogeneity was moderate to high for most factors but decreased after excluding certain studies, and effect directions remained consistent. Multiple driver behaviors and psychological traits significantly increase traffic accident risk, highlighting the importance of incorporating behavioral and psychological risk factor assessment into traffic safety policies and designing targeted prevention strategies.