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.     

An analysis of risk factors associated with road crash severities in Namibia

Abstract

Road crash is a leading cause of death and disabilities in Namibia and other developing countries. Based on recent trends, the World Health Organization indicated that progress to realize Sustainable Development Goal (SDG) target 3.6 – which calls for a 50% reduction in the number of road traffic deaths by 2020 – remains far from sufficient. To contribute to efforts in reducing road fatalities in Namibia, this study examined risk factors associated with the severity of crashes recorded in the country. Mixed logit modelling methodology was adopted to address the problem of unobserved heterogeneity in injury severity analysis. Model estimation results reveal that collision with pedestrians, head-on collisions, ran-off road collisions and crashes involving high occupancy passenger vehicles were more likely to result in fatalities and severe injuries. The findings and recommendations of this study are expected to enhance countermeasure implementation to reduce road crashes in Namibia.     

A review of national policies and programs to prevent unintentional injuries in the Americas

Injuries are a global public health problem, with injury mortality increasing in many regions. We describe a survey of injury policies and programs in 23 countries in the Americas. Most countries surveyed (87%) perceived unintentional injuries to be a significant public health problem. When asked about actual policy agendas, however, just one-fourth (26%) of the countries ranked unintentional injuries among policy makers’ top five concerns. Approximately half of the countries reported having a national injury prevention strategy, injury prevention coordinator, or consultative group. Virtually all countries with national strategies and consultative groups had established them in the 1990s, suggesting that concern about injuries is both recent and growing. Three-fourths (74%) reported that their country had a surveillance system to monitor injury-related mortality and, to a lesser extent, morbidity. The study’s results suggest that most policies and programs for the prevention and control of unintentional injuries have been developed in the past 10 years, and primarily address motor vehicle injuries. It is essential that current efforts be both broadened and strengthened so that the societal burden of unintentional injuries in the Americas can be reduced.     

Child motor vehicle occupant and pedestrian casualties before and after enactment of Child Restraint Seats Legislation in Japan

Problem. Prevention of injuries to child passengers is a significant public health priority, as motor vehicle-related injuries remain a leading cause of death for children in Japan. The purpose of compulsory child restraint seats legislation in April 2000 was to reduce the number of child passengers killed or injured in motor vehicle crashes.

Methods. The objectives of this preliminary evaluation are to measure the effectiveness, benefits and usage of safety seats for child passengers aged 1–5 years by analysing the child casualty data for the period of 1997–2002. Population and vehicle miles travelled based injury and fatality rates were used to compare before and after legislation trends in child casualties.

Results. Despite overall increases in the use of child restraint seats (as observed by different national surveys), overall casualty rates in motor vehicle occupants in the 1–5 year age group did not change (fatalities and serious injuries) or even increased (minor injuries).

Conclusions. Casualties among restrained children have not decreased since the law came to effect in the year 2000, perhaps because of incorrect usage of the seats. Given that exposure to crash environments is increasing, traffic safety advocates and public health community need to be aware of the importance of child restraints as a means of reducing the likelihood of injury. It is necessary to implement effective community-based child safety seat campaigns to disseminate the information on appropriate restraint use and to increase efforts to enforce the existing legislation.     

The employer costs of motor vehicle crashes

The latest published estimate of the cost of US motor vehicle crashes to employers is for 1989. This study estimates annual employer costs in 1998-2000. Incidence was estimated with occupational injury data and motor vehicle crash data for 1998-2000. Employer costs were estimated from Federal estimates of crash costs by source of payment using data on the percentage of varied payment streams (e.g. health insurance, sick leave) paid by employers. Motor vehicle crash injuries on and off the job cost employers almost $60 billion annually, including $16.3 billion in fringe benefit costs; $25.2 billion in property damage, workplace disruption and other non-fringe costs; and $18.4 billion in wage-risk premiums. Traffic safety programmes can reduce the fringe benefit bill without reducing the benefits offered to employees. Eliminating alcohol-impaired and unrestrained driving would save employers $15.2 billion annually.     

Seating position and patterns of severely injured body parts among child passengers in motor vehicle crashes: Japan as a distinct case

ABSTRACT

This study describes injury patterns and outcomes related to the seating position of child passengers involved in motor vehicle crashes in Japan. Using data obtained from a national trauma registry database, we compared the occurrence of injuries by body parts, length of hospital stay and in-hospital deaths between front-seating and rear-seating among children. We analysed 166 children aged 0–5 years and 205 children aged 6–12 years. No significant differences were observed between front- and rear-seating for injured body parts, length of hospital stay or in-hospital deaths in the 0–5-year-old victims. Among those aged 6–12 years, rear-seating was associated with a higher incidence of head and chest injuries but the length of stay or in-hospital deaths did not differ. These findings contrast those of previous studies, which found that rear-seating reduces injury risk, possibly attributed to low age-appropriate restraint use among school-aged children in Japan.     

Assessment of the road safety performance of four roundabouts in Kumasi,Ghana

Upgrade of the Ejisu-Kumasi section of the N6 saw the construction of roundabouts at selected intersections. Their use appears challenging particularly for vehicles with elevated Centre-of-Gravity. The objective of this study was to establish the relative risk of traffic accident deaths or hospitalized injuries at the roundabouts. Five-year crash data covering a 100 m stretch upstream and downstream of the roundabouts were analysed. A total of 119 crashes occurred with 18% casualty hospitalization and 12%fatalities. Compared with the Ejisu roundabout, fatal or hospitalized injuries were significantly higher at the Boadi (OR = 25.6, p = 0.0021) and Kwame Nkrumah University of Science and Technology Police Station Junctions (OR = 48.2, p < 0.001). Occupants of buses, heavy goods vehicles and riders of two wheelers were at elevated risk of deaths or serious injuries. Crash severity at the round abouts was aggravated by night-time, steep gradients and adverse cambers. It is recommended that, signalization and grade separation should be used in the current arrangement where appropriate.     

Parental perceptions of child placement within vehicles: a focus group study

Although rear-seating children in motor vehicles results in fewer injuries and fatalities in motor vehicle crashes, many children continue to be front-seated. This study seeks to identify parental barriers to rear-seating children in motor vehicles and strategies to increase child rear seat placement. Focus groups were conducted with parents of children 12 or younger to determine barriers to rear seating and strategies to increase child rear seat placement. Barriers to rear seat placement identified include the logistics of transporting multiple children with limited rear seat availability, the potential of children to harm themselves if rear-seated, and peer pressure. Parents felt there should be no option to sit elsewhere within the vehicle to help normalize rear-seating. Successful interventions to increase child rear seat placement should focus on parental barriers to rear-seat their children in vehicles, including normalizing rear seat placement, and determining approaches to make rear-seat placement with multiple children uncomplicated.     

National burden of road traffic injuries in Argentina

More than 1.2 million people die and as many as 50 million people are injured or disabled due to road traffic injuries (RTIs) every year worldwide. The lack of reliable data hinders efforts to describe the characteristics of the issue and prioritise prevention activities. The objective was to provide a snapshot of fatal and non-fatal RTI in Argentina. We used the methodology proposed by the Global Burden of Disease Injury Expert group. External causes of deaths with unknown codes were proportionately redistributed over the known categories. In 2007 in Argentina, we estimated 5915 RTI deaths, compared with 3983 RTI deaths reported previously by the Ministry of Health, accounting for 1931 additional cases. The highest number of deaths occurred in young men (15-29 years old), although the highest RTI death rates were in the age group of 55 years and older. Four-wheeled vehicle occupants were the most common road user type killed (59.1%); vulnerable road users represented one third (29.5%) of deaths and 64% of non-fatal RTI. The national and regional estimates of RTI in Argentina should help policy makers and public-health researchers to understand the importance of RTI prevention and design specific interventions to further reduce these preventable deaths and injuries.     

The cost of childhood injury in France

Injuries are a major public health problem worldwide. In the USA, injuries cause 146, 400 deaths annually, with 31 million non-fatal injury visits to emergency departments (EDs). EDs thus represent an important source of injury data. The primary objective of the current study was to describe the epidemiology of injury-related ED visits and assess injury-related utilization of health care resources in an inner-city hospital in Indiana, using data stored in a computerized medical record system. It involved a retrospective review of the records for injury visits to EDs and injury admissions over a 3-year period. The variables extracted and analysed included patients' demographics, external cause of injury, diagnosis, length of stay, ED and hospital charges. A total of 60,470 injury-related ED visits were made, the majority of patients were male (61.6%), uninsured (63.1%), treated in ED and discharged (98.4%). The leading causes of injury were falls (18.8%), motor vehicle crashes (18.4%), assaults (17.6%), being struck (11.2%) and overexertion (10.6). Firearms caused most injury deaths (32.4%; n = 314); motor vehicle crashes were the leading cause of hospitalization (26.6%; n = 642) and also the most expensive to treat as inpatients (mean charge $19,190). The mean charge per patient treated and discharged was $150 compared to $11,116 for patients admitted. These findings demonstrate the value of computerized medical records in capturing and storing E-coded injury data. The system generates data that can be used for epidemiological surveillance and injury prevention at the local level, and for assessment of impact of specific injuries on health care resources.     

Severity of alcohol-related motor vehicle crashes in British Columbia: case - control study

The objective of the present study was to compare the injury severity and vehicle damage severity rates of alcohol-related crashes with rates of non-alcohol-related crashes in British Columbia (BC). Injury severity rates and vehicle damage severity rates were taken from 2002 Insurance Corporation of British Columbia traffic collision data. The data were computed in order to compare the differences in injury severity and vehicle damage severity rates of alcohol-related vs. non-alcohol-related motor vehicle crashes. Case - control methods were used in this study to analyse the risk of alcohol-related crashes compared to non-alcohol-related crashes in BC. Odds ratios (OR) and 95% CI were calculated to estimate relative risks. In the case - control analysis, the risk of fatal collision was increased for those drinking and driving compared with those driving sober (OR 4.70; 95% CI 3.15 - 7.01). Risk of injury collision was increased for those drinking and driving compared with those driving sober (OR 1.32; 95% CI 1.19 - 1.37). Importantly, the risk of vehicle damage severity was increased for those drinking and driving compared with those driving sober (write-off vehicle OR 4.24; 95% CI 3.70 - 4.86, severely damaged vehicles OR 1.98; 95% CI 1.77 - 2.21). The study reinforces existing literature to suggest that current evidence is sufficient to show an increased risk of injury and fatality to drivers and occupants in alcohol-related crashes. This paper not only emphasizes this well-known relationship, but also such consequences as increased vehicle damage severity. The connection between drinking and severity of motor vehicle crashes is popularly believed and has now received substantial scientific support. There is strong justification for injury prevention experts and policy-makers to step up motor vehicle crash injury prevention advocacy by implementing evidence-based policies to reduce rates of alcohol-impaired driving in the province of BC. Most unintentional injuries in BC are related to motor vehicle crashes. Significant improvements can be made in these statistics by: increasing the use of occupant protection (safety belt and child restraint seats); reducing alcohol-related injuries through multiple strategies including corrections in the physical environment, extensive enforcement of drinking and driving laws and health promotion/education.     

Pedestrian traffic injuries in Mexico: A country update

Road traffic injuries in general and pedestrian injuries in particular are a major public health problem in Mexico, especially in large urban areas. Analysis of mortality and road crashes at the national level was done using routine data recorded on death certificates. Fatality rates for different age groups were estimated by region for the year 2000. These data were supplemented by a cross-sectional study of pedestrian injuries in Mexico City based on death certificates information for pedestrians who lived and died in Mexico City between 1994 and 1997. Participant observation of physical spaces where crashes occurred was carried out. The spaces were filmed and in-depth interviews of survivors conducted. Road traffic crashes were responsible for approximately 17,500 deaths in Mexico during 2000. The mean age of the victims was 37 years. Mexico lost an average of 30 years of productive life for each individual who died in a traffic crash – 525,000 years in 2000. An estimated 9500 (54.3%) of all fatalities were pedestrians, and for every pedestrian death there were 13 others who sustained nonfatal injuries requiring medical care. The overall crude mortality rate for pedestrian injuries in Mexico City was 7.14 per 100,000 (CI 6.85-7.42). A concentration of deaths was observed in 10 neighborhoods at specific types of street environments. The underlying factors included dangerous crossings and the absence or inadequacy of pedestrian bridges, as well as negative perceptions of road safety by pedestrians. In conclusion, this study demonstrates the importance of elucidating the underlying contextual determinants of pedestrian injuries.     

Product involvement in do-it-yourself maintenance injury

Abstract

PROBLEM Numerous activities to promote bicycle safety have been implemented in Norway. The overall effect of these activities has not been evaluated.

method Information about cases of bicycle-related injuries occurring in 1990-1993 was obtained from prospective registration of all injuries treated by hospitals and emergency clinics in four urban centers in NORWAY. Incidence was calculated per number of cyclists, based on data obtained from the 1992 National Bicycle Survey. Temporal changes in injury severity and in age-specific incidence (per bicycle riders) of all injuries, upper-head injuries, other injuries, injuries due to bicycle-motor vehicle collision, and injuries leading to inpatient treatment were analyzed by logistic regression analysis.

RESULTS 3,893 injuries occurred in the study population in 1990-1993. The average annual incidence was 33.1 per 10,000 population aged 4 years and higher, or 47.9 per 10,000 bicyclists. No significant secular trends were found for any of the analyzed parameters.

CONCLUSIONS Bicycle safety promotion measures implemented during 1990-1993 did not significantly reduce the risk of bicycle-related injury in Norway. Effective bicycle safety programs should be implemented, based on the positive experiences from other countries. Injury surveillance systems appear to be a useful tool for evaluating injury prevention programs.     

The influence of licence status on Kansas child fatalities due to motor vehicle crashes

The influence of driver licensure on child motor vehicle crash (MVC) deaths in Kansas was investigated. Fatalities from 1994-2000 due to MVCs were extracted from the Kansas State Child Death Review Board and the Fatality Analysis Reporting Systems databases. It was found that 14% (52 of 363) of child fatalities from MVCs in Kansas occurred in vehicles where the driver was not licensed. Driver licence status was associated with use of safety restraints, the victim's age and race, weekend driving and rural county location. All child deaths involving unlicensed drivers were preventable. New legislation on vehicle sanctions may be required to assist law enforcement. Safety restraint laws should be enforced and promoted to the public. Transportation options are necessary for unlicensed drivers, particularly if they have young children and live in a rural community. Thus, a multi-system approach involving law enforcement, accident prevention strategies and transportation options will save the lives of children.     

Road safety impacts of the motorcycle in Brazil

Brazil has had high indices of traffic injuries and deaths since the 1950s, mostly related to the increasing and irresponsible use of the automobile. Upon approval of the Brazilian Transit Code (CTB) in 1997, traffic injuries and deaths began to diminish, despite an increase in vehicle fleet size, a phenomenon that had never occurred previously. Concurrently, starting in 1991 and with a great intensity after 1996, there has been a sizeable increase in motorcycle production and use, facilitated and encouraged by public officials. Between 1995 and 2000 annual sales figures for motorcycles doubled and reached 2 million units in 2008. Traffic deaths associated with motorcycles increased exponentially, rising from 725 in 2006 to 10,143 in 2010, eliminating the advances gained by the CTB in reducing auto-related injuries. This article analyses the process and its impacts on road safety. The first part summarises the main public policy decisions related to the theme. Part two analyses changes in traffic safety after the introduction of this new technology. Part three looks at the possible political, economic and social motives that lie behind this process. The final part suggests solutions to the great prejudice caused to society and the nation.     

Progress in pedestrian safety research

Abstract

This paper looks at the pedestrian safety issue and the research that has followed to understand and solve the problem of pedestrian safety in the last 120?years - since the time of the first reported pedestrian fatality in 1899. Researches have studied the epidemiology of pedestrian crashes, pedestrian behaviour, pedestrian movements and pedestrian flows. The suggested strategies to reduce pedestrian crashes have ranged from controlling vehicular speeds to controlling pedestrian behaviour. This study presents a summary of the progress we have made in understanding pedestrian crash patterns. Pedestrian behaviour observed in different regions of the world tend to have similarity in pedestrian behaviour: gap acceptance, preferences of route choice and location for crossing roads. High income countries(HIC) have reported reduction in pedestrian fatalities as compared to low and middle income countries(LMICs), however pedestrian trips have also reduced in these countries leading to concerns about the effectiveness of ‘known’ strategies. Speed control through active measures have been found to have themaximal benefit and education and training programs for altering pedestrian behaviour on the road the least benefits. Low and middle income countries face pedestrian exposure on high speed roads. New research efforts are required to address pedestrian safety in both HIC and LMICs.     

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.     

Investigation of pedestrian crashes using multiple correspondence analysis in India

Abstract

Pedestrian safety is of growing concern with an increasing number of traffic accidents, especially in developing economies like India. In 2017, there were 20,457 pedestrian fatalities in India. Pedestrian crashes have also become a key concern in the state of Tamilnadu, India, due to the high percentage of deaths. If the available datasets are large and complex, identifying key factors is a challenging task. In this study, Multiple Correspondence Analysis (MCA), an exploratory data analysis technique was used to explore the roadway, traffic, crash, and pedestrian-related variables influencing pedestrian crashes. This study used the data from Government of Tamilnadu Road Accident Traffic Management System (RADMS) database, to analyse accident data of nine years (2009–2017) related to pedestrian crashes. The results of the study show that crashes occurring on the express highways on a multilane road are often associated with hit-and-run behaviour among drivers. Factors such as lighting conditions, location, pedestrian behaviour, crossings, and physical separation are also significantly contributing to pedestrian crashes. The key advantage of MCA is that it identifies a possible association between various contributing factors. The findings from this study will be useful for state transport authorities to improve countermeasures for mitigating pedestrian crashes and fatalities.     

Investigation of contributing factors to extremely severe traffic crashes using survival theory

This study aimed to investigate the contributing factors to serious casualty crashes in China. Crashes with deaths greater than 10 people are defined as serious casualty crashes in China. The serious casualty crash data were collected from 2009 to 2014. The random forest analysis was first conducted to select the candidate variables that affect the risks of serious casualty crashes. The Bayesian random parameters accelerated failure time (AFT) model was then developed to link the probability of the serious casualty crash with road geometric conditions, pavement conditions, environmental characteristics, collision characteristics, vehicle conditions, and driver characteristics. The AFT model estimation results indicate that overload driving, country road, northwest china region, turnover crash, private car, snowy or icy road surface and sight distance conditions have significant fixed effects on the likelihood of serious casualty crashes. In addition to these fixed-parameter variables, freeway, clear weather conditions, coach drivers, and upgrade horizontal curve affect the likelihood of serious casualty crashes with varying magnitude across observations. One of the important findings is that the serious casualty crash likelihood does not always decrease with an increase in the driving experience (number of years driven). Before the inflection point of 7 years, the serious casualty crash likelihood increases as the driving experience grows. The results of this study can help to develop effective countermeasures and policy initiatives for the prevention of serious casualty crashes.