Fatal motorcycle crashes: a growing public health problem in Cambodia

This study examines the risk characteristics of fatal motorcycle crashes in Cambodia over a 5-year period (2007–2011). Secondary data analyses were conducted using the Cambodia Road Crash and Victim Information System, the only comprehensive and integrated road crash surveillance system in the country. Researchers from the Centers for Disease Control and Prevention and Handicap International found that (1) males are dying in motorcycle crashes roughly seven times more frequently than females; (2) motorcyclist fatalities increased by about 30% from 2007 to 2011; (3) the motorcyclist death rates per 100,000 population increased from 7.4 to 8.7 deaths from 2007 to 2011; and (4) speed-related crashes and not wearing motorcycle helmet were commonly reported for motorcyclist fatalities at approximately 50% and over 80% through the study years, respectively. Additionally, this study highlights that Cambodia has the highest motorcycle death rate in South-East Asia, far surpassing Thailand, Malaysia, and Myanmar. By recognising the patterns of fatal motorcycle crashes in Cambodia, local road-safety champions and stakeholders can design targeted interventions and preventative measures to improve road safety among motorcyclists.     

Pillion riders' cloth related injuries and helmet wearing patterns: a study of Lahore,Pakistan

This study aims at investigating the burden and pattern of clothing related pillion riders' injuries and their helmet wearing pattern in Lahore, Pakistan. Data were collected for nine months (July 2013 to March 2014), reporting 13,248 motorcycle related injuries, out of which 8751 (66%) cases were related to the clothing related pillion riders' injuries. Out of these injuries 10.30% were severe injuries which can be prevented or reduced by proper safety measure, e.g. wearing helmet. It was also found that most of the fatalities were not wearing helmet. Injuries due to wearing of loose fitting clothes and absence of helmet are not uncommon in Pakistan and other underdeveloped parts of the world. Such accidents may be reduced by creating awareness and safety sense in the riders, where use of safe dress and helmet should be encouraged in order to avoid such fatal damages.     

Determinants of severe injury and mortality from road traffic accidents among motorcycle and car users in Southern Thailand

Abstract

This study aimed to identify factors associated with severe injury and mortality from road traffic accidents (RTA) among motorcycle and car users in southern Thailand. The data were obtained from the Office of Disease Prevention and Control, Thailand, for years 2008–2013. Chi-squared tests were used to assess associations between determinants and outcomes and these associations were then estimated after adjusting for possible confounding with other factors using logistic regression. Severe injury and mortality contributed 11.6% and 5% to RTA of motorcycle users, and 14.3% and 7.5% for car users. Among motorcycle users, male gender, older age, and not wearing a helmet increased severe injury and mortality rates, whereas drivers had more severe injuries than passengers. Older car users had higher severe injury and mortality rates, whereas not fastening seat belts had higher mortality. Safety device use should be made mandatory for both drivers and passengers. Male motorcycle users and the elderly should be focused on.     

An application of the theory of planned behaviour to understand compliance with daytime running headlights law among motorcycle riders

Abstract

Fatal motorcycle crashes are a persistent problem in Southeast Asia. In many respects, road safety experts have acknowledged conspicuity issue as one of the main causes of such accidents. To mitigate this deficiency, daytime running headlights (DRHs) law has been documented among the widely exercised countermeasures. The present study aimed to explore socio-psychological factors shaping intentions towards use of DRHs among Malaysian motorcyclists, because compliance level with this rule has remained constant since 1996 (80%). For this purpose, a model was constructed through the Theory of Planned Behaviour (TPB) to evaluate factors affecting motorcyclists’ intentions towards compliance with DRHs law. A series of statistical analyses were performed to explain the effect of these factors and to predict degree of compliance with this rule. The model applied on a sample of university students (N?=?398) demonstrated that the TPB components could significantly predict motorcycle riders’ behaviours and degree of compliance with DRHs law. Moreover, it would be of assistance to policy-makers to recognize groups of motorcyclists more likely to cause an increase in traffic accidents. In general, regular educational campaigns were recommended to raise awareness regarding consequences of not using DRHs and also to nurture factors influencing motorcyclists’ attitudes towards DRHs.     

Road traffic injury among child motorcyclists in Vientiane Capital,Laos: a cross-sectional study using a hospital-based injury surveillance database

This study investigated the distribution of motorcyclists, including drivers and passengers, who were involved in road traffic crashes and admitted to hospital in Vientiane Capital, Laos. The focus was on child motorcycle drivers and passengers under 15 years. A hospital-based injury surveillance database in Vientiane Capital was used. The surveillance was performed in two hospitals. From 1 September to 31 December 2009, 3968 patients were admitted to the participating hospitals with road traffic injuries. Patients under 15 years accounted for 10.8% (427/3968). The majority of patients under 15 years were motorcycle drivers or passengers (71.7%, 306/427). Child motorcyclists including drivers and passengers were less likely to wear a helmet than adults (adjusted odds ratio [OR], 0.3, 95% confidence interval [CI], 0.2–0.5, for children 10–14 years; adjusted OR: 0.1, 95% CI, 0.05–0.4, for children under 10 years). It is suggested that stricter regulation enforcement for child motorcycle drivers and passengers may be needed. In addition, barriers against wearing helmets for motorcycle drivers and passengers in Laos should also be examined in further studies.     

Measuring compliance with Viet Nam's mandatory motorcycle helmet legislation

The objective of this roadside observational study was to monitor helmet wearing among motorcycle riders and passengers in three provinces (Yen Bai, Da Nang and Binh Duong) in the Socialist Republic of Viet Nam, before and after a mandatory helmet law took effect on 15 December 2007. A total of 665,428 motorcycle riders and passengers were observed between November 2007 and February 2011 at 45 randomly selected sites covering the entire road network. Across all locations and time periods, correct helmet wearing averaged 40.1% before the law and 92.5% after; however, there were significant differences between time points and locations. The Viet Nam Government's decision to require all motorcycle riders and passengers to wear helmets has been thoroughly implemented nation wide and the results show that high wearing has been sustained. Further study is required on how high helmet wearing has and will translate into a reduction in motorcycle head injuries; however, Viet Nam's motorcycle helmet legislation should be seen as an important policy example for other low- and middle-income countries with a high utilization of motorcycles for personal transport.     

Impact of safe community program on motorcyclists' safety with focus on helmet usage in 14 cities of IR Iran

The aim of this study was to evaluate the effectiveness of safe community interventions on motorcyclists' safety. Two cross sectional observations were conducted in 14 cities (five safe community practicing and nine safe community non-practicing cities) independently on 2005 and 2007. Ten percent of registered motorcycles were observed and interviewed (n=1114 in each observation). 87.9% used motorcycle for commercial purposes. All motorcyclists were male and mostly aged 18–29 years old. Death rate significantly rose from 122 to 254 per 100000 motorcyclists in Fars province since the first observation (p < 0.0001). Helmet usage rate was constant (13%). Recorded crashes increased from 16.4% to 23.1% in safe community setting (p < 0.0001). 11% carried more than one pillion. Heat disturbances, embarrassment, hearing blockage, and negligence were the most mentioned excuses for not using helmet. Law enforcement, public education, accessibility to helmets on discount rate, new legislation and, finally, access to new designed helmet were the most suggestions made by motorcyclists to promote helmet usage. No significant effect was noticed between two settings except in injury registration system in safe community. Community involvement in the safety programs could ensure sustainability of initiatives and continuity of interventions in safe communities.     

Motorcycle helmet use in Mar del Plata,Argentina: prevalence and associated factors

Injuries resulting from motorcycle crashes constitute a growing problem in Argentina and other Latin American countries. The problem is aggravated because helmet use is not widespread. This observational study analysed the prevalence of helmet use and related factors in a city in Argentina. The sample consisted of 2542 observations of motorcyclists. The results show an incidence of helmet use of 69.8% for drives and 43.4% for passengers. Helmet use was greater among women. Environmental and temporal conditions were related with the rate of helmet use. The findings indicate a considerable increase in helmet use with respect to prior years, providing evidence in favour of government policies. However, the number of motorcycles in circulation has tripled in the past five years, and therefore, the public health impact of injuries due to motorcycle crashes persists.     

Vulnerability of motorcycle riders and co-riders to injuries in multi-occupant crashes

In developing countries, most motorcycles are ridden with more than one occupant. The objective of this study was to establish the relative vulnerability of riders and co-riders to injury and determine the injury risk factors in multi-occupant motorcycle crashes. Between January and December 2010, we collected crash and injury data from victims of multi-occupant motorcycle. It is a hospital-based study. The probability of sustaining injuries was similar for co-riders and riders, but co-riders were more likely to sustain severe injuries. Occupants of >2-occupant motorcycles were also more likely to be involved in risky behaviours like not wearing helmet and speeding than those on 2-occupant motorcycles. Occupants of motorcycles on which there were more than two occupants were at an increased risk of sustaining injuries compared with occupants of motorcycles with only two occupants (OR: 2.1, 95% CI: 1.1–4.3). Motorcycle co-riders were more vulnerable to severe injuries than riders. The significance of the study finding to prevention was discussed.     

Factors associated with child passenger motorcycle helmet use in Cambodia

This study examines factors associated with child passenger helmet use in five Cambodian provinces. We performed an analysis of periodic roadside observations of helmet use over a four-year period. A total of 62,039 child passengers 12 years of age and younger met inclusion criteria and were included in the analysis. Overall, 1369 (2.1%) of child passengers were observed to be wearing a helmet. Most significantly, children were six times more likely to wear a helmet if the driver was wearing a helmet (OR 6.2; 95% CI 5.1–7.5). In addition, the odds of helmet use were noted to be significantly different depending on province, day of the week, time of day and number of passengers on the motorcycle. This study highlights the extremely low rate of child passenger helmet use in Cambodia, and provides priorities for interventions and enforcement to ensure all children are protected from head injury.     

Preventing motor vehicle crash injuries and deaths: science vs. folklore lessons from history

Abstract

Not long after the beginnings of motorization in the early 1900s, deaths and injuries from motor vehicle crashes became a problem in a number of high-income-countries (HIC)s, especially the United States. With the biggest problem the US led early efforts to address this issue, and for six decades these efforts were based on folklore (ie a body of widely held but false or unsubstantiated beliefs). They were not evaluated, but clearly were unsuccessful as crash deaths and injuries continued to rise. It was not until the 1970s that a broader range of countermeasures began to be adopted and was scientifically evaluated, and as a result, crash deaths and injuries declined. This history has important lessons today for many low-and-middle-income countries that have growing numbers of motor vehicle crash deaths and injuries, many of which are pedestrians and motorcyclists. This is because there continue to be advocates for many of the failed approaches (especially educational) that dominated the early efforts in HICs.     

Gender and age distribution of motorcycle crashes in Spain

This study analysed motorcycle crashes in Spain. Ninety-nine thousand three hundred and four motorcycle crash reports filed in the years 2006–2011 were extracted from the Directorate General of Traffic database of crashes with victims. These data were analysed in terms of gender, age groups, trip purpose, type of crash, speed violation, day of the week, harm caused, use of helmet and psychophysical conditions of the driver to study the characteristics of motorcycle crashes in Spain and to assess the differences between male and female motorcycle drivers in these crashes. Significant differences were found in all the variables considered in the study, which implies gender differences in the profile of the injured motorcycle driver. The severity of motorcycle crashes suffered by male drivers is higher than that of women. These results corroborate the need to develop measures differentiated by gender, based on their profile.     

Trends in helmet use by motorcycle riders in the decades following the repeal of mandatory helmet laws

Several US states repealed universal motorcycle helmet laws in the 1990s and 2000s. The purpose of this study was to examine national trends in helmet use among adult trauma patients with motorcycle-related injuries. We hypothesized that motorcycle helmet use declined over time. We retrospectively analyzed the National Trauma Data Bank's National Sample Program for 2003–2010. We also obtained data on US motorcycle fatalities reported in the Fatality Analysis Reporting System and population data from the U.S. Census Bureau to calculate motorcycle-related fatality rates over time. A total of 255,914 patients met inclusion criteria, of whom 148,524 (58%) were helmeted. During the study period, helmet use increased from 56% in 2003 to 60% in 2010 (p < 0.001). However, motorcycle-related fatality rates also increased in states with and without universal helmet laws. Nationally, rates of helmet use have increased. However, fatalities due to motorcycle crashes have also increased during the same period.     

Driver education: how effective?

Abstract

In the early 20th century, the numbers of motor vehicles in use grew rapidly in the USA, Canada, and many European countries. By the 1930s, the number of automobile crashes and the resulting deaths and injuries was a significant problem and various safety organizations tried to address it with education and publicity programs aimed at changing driver behaviour. It is not clear when the high crash risks of young drivers were first identified, but in the early 1930s driver education courses began to be offered in US high schools (feasible because US licensing ages were 16 or younger) and soon such courses were being touted (with no evidence) as ‘the most obvious way’ to reduce traffic crashes. Over the years many claims were made for the effectiveness of high school driver education, however, it was not until the late 1960s that competent research studies (including randomized control trials) were undertaken. The consistent findings from these studies have been that high school driver education does not reduce crashes. Furthermore, the trained students get their licenses sooner, and because teenagers have very high crash risks, the net result of high school driver education is increased numbers of crashes.     

Cost analysis of road traffic crashes in China

Abstract

Fatalities and injuries resulting from road traffic crashes is always a serious problem. The overall economic losses caused by road traffic crashes are beyond imagination. Including the economic cost of property damage, productivity loss, medical cost, travel delay time cost, legal cost and insurance cost, the total economic cost of traffic crashes in China in 2017 is calculated as 490.1 billion yuan (72.6 billion USD 2017), which is equivalent to 0.60% of the GDP. The cost of productivity loss accounts for the highest proportion of total economic cost, which is 72%. The second is the travel delay cost, accounting for 12% insurance cost, property damage cost and medical cost are followed. The more serious the injury, the higher the unit economic cost. The unit cost of a crash that caused only property damage is 11,274 yuan. The unit cost of a minor injured crash is 20,223 yuan. The highest unit economic cost is the unit cost of a fatal crash, which is 3,181,394 yuan. This study provides important insights into the cost-benefit analysis of China's road safety policies.     

Built environment analysis for road traffic hotspot locations in Moshi,Tanzania

Road traffic injuries (RTIs) cause significant morbidity and mortality in low- and middle-income countries. Investigation of high risk areas for RTIs is needed to guide improvements. This study provides built environmental analysis of road traffic crash hotspots within Moshi, Tanzania. Spatial analysis of police data identified 36 hotspots. Qualitative comparative analysis revealed 40% of crash sites were on local roads without night lighting and increased motorcycle density. Paved narrow roads represented 26% of hotspots and 13% were unpaved roads with uneven roadsides. Roadside unevenness was more predominate in low risk [n = 19, (90.5%)] than high risk sites [n = 7 (46.7%)]. Both low [n = 6 (28.6%)] and high risk [n = 1 (6.7%)] sites had minimal signage. All sites had informal pedestrian pathways. Little variability between risk sites suggests hazardous conditions are widespread. Findings suggest improvement in municipal infrastructure, signage and enforcement is needed to reduce RTI burden.     

Matched analysis of parent’s and children’s attitudes and practices towards motor vehicle and bicycle safety: an important information gap

The purpose of this study was to compare parents’ and children’s attitudes and habits towards use of bicycle helmets and car seat belts. We hypothesized that parental perception of their children’s safety practices did not reflect actual behavior and further, that parental practices, rather than their beliefs about a particular safety practice, have a greater affect on their child’s risk-taking behavior. The study population consisted of children in grades four and five and their parents/guardians. Participation in the cross-sectional study was voluntary and confidential anonymous questionnaires were used. In separate and independent surveys, children and parents were questioned in parallel about their knowledge, habits and attitudes toward bicycle helmet use and car safety practices. In the study, 731 students participated with 329 matched child-parent pairs. Ninety-five percent of the children own bicycles and 88% have helmets. Seventy percent of parents report their child always wears a helmet, while only 51% of children report always wearing one (p &lt; 0.05). One-fifth of the children never wear a helmet, whereas parents think only 4% of their children never use one (p &lt; 0.05). Parents report their children wear seat belts 92% of the time while 30% of children report not wearing one. Thirty-eight percent of children ride bicycles with their parents and wear their helmets more often than those who do not ride with their parents (p &lt; 0.05). Parents who always wear a seat belt are more likely to have children who sit in the back seat and wear a seat belt (p &lt; 0.05). Parents’ perceptions of their children’s safety practices may not be accurate and their actions do affect their children’s. Injury prevention programs that target both parents and children may have a greater impact on reducing risk-taking behaviors than working with each group in isolation.