In China, where someone is killed in traffic every five minutes, one entrepreneurial doctor has an unusual approach for making roads safer: Treat bad driving like a disease you can diagnose before the driver even gets near a car.
Dr. Jin Huiqing has spent nearly three decades trying to figure out why some motorists seem more accident prone than others. He has translated his research into a lucrative business selling his road safety program to Chinese municipalities. At least one city using his methods reports a decline in traffic deaths.
He has studied the records of thousands of Chinese bus, van and cab drivers, put dozens through neurological tests, examined hundreds of blood samples. Since last year, he's even been trying to find gene markers for bad drivers.
"Cars can be fitted with the highest levels of equipment: safety belts, air bags, and so on. Roads can be more regulated. But people, how can you help them become better?" Jin said in an interview in the central city of Hefei, where he is based. "People still need to be controlled, they must face restrictions."
Jin tries to target the root cause of crashes by identifying the physical or psychological traits of poor drivers, such as risk-taking or poor response time under stress, and keeping them off the streets or ensuring they get adequate training.
The cost of traffic casualties is so high that accident-prone people should at least be barred from driving commercially, he said.
Similar studies in the West have sparked debate among researchers, with many dismissing the findings as too uncertain to be of any use. And extreme use of a genetic approach could limit someone's right to drive based on DNA - clearly unfeasible in many countries.
But China is grasping for solutions to its risky roads. Traffic accidents are the leading cause of death for Chinese aged 15 to 44, the World Health Organization says, growing apace with an 11-fold jump in the number of motor vehicles between 1990 and 2008.
Despite improved road safety laws, stricter driver training and lower speed limits, crashes remain common, particularly involving overloaded trucks or buses careening along highways at high speeds in wet conditions.
"In China, in general, I think each day there will be over 300 people killed on the roads, which equals to one Boeing 747 aircraft crash each day. So that is pretty serious," said Ann Yuan, the China country director of the Global Road Safety Partnership, a grouping of business, civil society and government organizations.
Jin's company, Anhui Sanlian Group, developed a three-pronged approach to road safety that involves a battery of tests to screen drivers, training with simulators and surveillance cameras to closely monitor roads for problems.
The eastern city of Jinan adopted the system, and police in the provincial capital say traffic deaths have fallen by a third in the past five years.
Bus and taxi drivers in Jinan are put through fully automated physical and psychological tests developed by Jin's company. The tests determine a driver's ability to estimate speed, react to complex stimuli, vision at night, as well as their attitudes toward safety and perception of danger.
Those whose test results indicate they're predisposed to causing crashes are informed of their "shortcomings" and advised on corrective actions, company Vice President Yu Wansheng said. For example, someone who fails the night vision test would be advised not to drive when it is dark. The driver's potential employer also gets the recommendations.
The company also sells products to around 400 other jurisdictions, and at least one other provincial capital is also interested in adopting the full, three-pronged approach, company officials say.
From a small research institute he set up in 1990, Jin now runs a road safety empire that includes a company with 2,000 employees that earns more than $4 million a year, plus a private college with nearly 10,000 students. "It's a sunrise industry," he said.
On a recent drive with Jin through Hefei, China's road safety challenges were on display: Cars cruised down the wrong side of the street, others mounted sidewalks to make illegal turns. Motorcyclists without helmets whizzed by or stopped short and pushed their bikes backward for a missed turn.
Even Jin needed a reminder to wear the seat belt in his shiny, black Hummer. He ignored the vehicle's insistent beeping. He is not alone: Drivers in China rarely wear seat belts even in larger, more policed cities such as Beijing.
"We are determined to see if we can make a contribution toward accident prevention measures and in the process provide some experience for the world," Jin said, taking one hand off the wheel as he punctuated his words by stabbing his index finger in the air.
Among his earlier findings: 6 to 8 percent of Chinese motorists are accident prone, which he defines as having caused three or more crashes in five consecutive years. When compared to safe drivers, accident prone ones score worse on tests of their night vision, depth perception and ability to estimate speed. Personality tests show they tend to be more extroverted and enjoy taking risks.
By testing the DNA samples of about 350 Chinese bus drivers from Hangzhou, he's found that three genes show potential links to accident prone driving. The findings have been submitted to medical journals for review, he said.
Jin's approach has its critics. Researchers in the West have debated "accident proneness" for decades - and largely dismissed it due to inconsistent research results and its lack of practical use, says Guohua Li, a Columbia University epidemiologist specializing in injury prevention, who is familiar with Jin's work.
"The real question is whether that kind of research, that kind of theory, will lead to any meaningful reduction of accidents or improvements of safety, and the answer was proven: no," Li said, adding that researchers in the U.S. now focus on improving the safety environment, which includes roads.
Li said it would be unethical to shape policies on granting license or providing insurance based on a person's genetic information.
"You can't do a thing to change your genotype. If people use your genes or your genotype or genomic data against you, to deny you health insurance, or to deny you access to or the privilege of driving, that's an unjust social policy," Li said.
Others think Chinese researchers like Jin can lead the way in fields of study deemed politically incorrect in the U.S.
"The population is not as sensitive to some of the issues we're sensitized to in the United States," said Bruce Alberts, editor-in-chief of Science magazine, which recently profiled Jin's work. Alberts later accepted Jin's offer to be an honorary president of his private college.
"China can do things there and in other places that are interesting and in which they can become a world leader quite easily."