{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T21:12:11Z","timestamp":1790716331389,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2006,5,16]],"date-time":"2006-05-16T00:00:00Z","timestamp":1147737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2006,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>The present study of sleepiness and accident risk in a HI\u2010FI car simulator aimed to provide subject\u2010level relative risks (RR) with 95% confidence intervals (CI) for different levels of subjective sleepiness measured with the Karolinska Sleepiness Scale (KSS), 1\u2003=\u2003very alert, 9\u2003=\u2003very sleepy, fighting sleep, an effort to staying awake. Five male and five female shift workers, mean age 37\u2003years, participated with a 2\u2010h drive (08:00\u201310:00\u2003hours) in a dynamic high\u2010fidelity moving base driving simulator, after a night of work and after a night of sleep. Subjective sleepiness was measured with KSS every 5\u2003min and events of incidents (two wheels outside the right lane), accidents (two wheels off the road or four wheels in opposite lane) and crashes (four wheels off the road) were recorded. The probability of an accident was modelled with a Generalized Linear Mixed Model approach to estimate subject\u2010specific effects, rather than group average effects, to avoid the ecological fallacy. The results showed that sleepiness was strongly related to accident risk. An average subject was estimated at 28.2 times (95% CI RR\u2003=\u200310.7\u201374.1) increased risk at KSS\u2003=\u20038 and at 185 times (95% CI RR\u2003=\u200342\u2013316) at KSS\u2003=\u20039 compared with KSS\u2003=\u20035. There were large individual differences in event propensity that complicates the prediction of absolute accident risk for individual subjects.<\/jats:p>","DOI":"10.1111\/j.1365-2869.2006.00517.x","type":"journal-article","created":{"date-parts":[[2006,5,16]],"date-time":"2006-05-16T11:58:32Z","timestamp":1147780712000},"page":"142-148","source":"Crossref","is-referenced-by-count":93,"title":["Subjective sleepiness and accident risk avoiding the ecological fallacy"],"prefix":"10.1111","volume":"15","author":[{"given":"MICHAEL","family":"INGRE","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"TORBJ\u00d6RN","family":"\u00c5KERSTEDT","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BJ\u00d6RN","family":"PETERS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ANNA","family":"ANUND","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00d6RAN","family":"KECKLUND","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ANDREW","family":"PICKLES","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,5,16]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/00207459008994241"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/24.4.401"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.2004.00437.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7346.1125"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.1995.tb00220.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2869.2000.00195.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/17.3.236"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.82.7.1011"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-4575(01)00098-7"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8986.1973.tb00801.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.310.6979.565"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8986.1996.tb00428.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1081\/CBI-200036895"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19980228)17:4<447::AID-SIM752>3.0.CO;2-G"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199709113371106"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(89)90013-9"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/096228029200100303"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(02)00438-5"},{"key":"e_1_2_6_20_1","first-page":"1626","volume-title":"The Encyclopedia of Biostatistics","author":"Pickles A.","year":"1998"},{"key":"e_1_2_6_21_1","volume-title":"GLLAMM Manual","author":"Rabe\u2010Hesketh S","year":"2001"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X0200200101"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004140050131"},{"key":"e_1_2_6_24_1","first-page":"790","article-title":"Subjective surrogates of performance during night work","volume":"26","author":"Rogers N. 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