Implications for research

We aimed to study the anatomical distribution, severity, and outcome of hospitalised trauma pedestrian patients in Al Ain, United Arab Emirates (UAE), so as to improve preventive measures. All pedestrian trauma patients who were involved with a road traffic collision and admitted to Al Ain Hospital for more than 24 hours or who died in the hospital were included in the study. Data were prospectively collected during March 2003–October 2007. Three hundred and eighteen patients were studied, 279 (87.7%) were males. Median (range) age was 31 (1–75) years. UAE nationals were significantly younger than non-nationals (median (range) age of 14 (2–75) years compared with 33 (1–75) years, p = 0.001, Mann–Whitney U-test). The lower limb (57.2%) was the most common injured region followed by the head (46.9%). The median (range) Injury Severity Score of patients was 5 (1–45). The median (range) total hospital stay was 11.3 (1–130) days. Thirty patients died (overall mortality 9.4%). In conclusion, mortality of pedestrian injured patients in the UAE is high. Severe head injury was the main cause of death. Measures to improve pedestrian safety should be adopted so as to reduce morbidity and mortality. These include educating drivers and pedestrians on road safety and enforcement of traffic safety laws.     

Road traffic crash injuries and fatalities in the city of Kerman,Iran

The objective of this study was to investigate road traffic crash injuries and fatalities. Cases of 3902 road traffic injuries (1709 drivers, 891 passengers, 376 pedestrians and 926 motorcyclists) and 1564 road traffic fatalities (RTFs; 1222 males and 342 females) were collected from 2005 to 2008 using the database of the police forces and Department of Forensic Medicine in Kerman, respectively. Results showed that 66% of the injuries were related to car occupants (drivers and passengers) and men/women ratio was 5:1. The highest men/women ratio was (12.2:1) for drivers, while the lowest ratio (1.8:1) was for pedestrians. Most of the injuries had taken place at 16:01–20:00 h followed by 08:01–12:00 h. Highest numbers of injuries were found in male with the age groups of 18–24 years. The highest fatality rate of 79 per 100,000 population occurred in 2007–2008. Fatality ratio indicated higher male ratio, four times higher than females. The victims were 39% male between 30 and 55 years of age. Head injuries were present in 69% of the cases. In our series of forensic autopsy cases, head injuries were more frequent in motor vehicle occupants, pedestrians and motorcyclists. On average, two people died per day in RTFs in Kerman.     

Effects of ethyl alcohol on injuries severity according to injury severity scales in pedestrian fatal injury in traffic crashes

Abstract

Introduction: The dominant cause of injuries in traffic crashes. A significant portion of them affects victims under the influence of ethyl alcohol. The goal of the studies was to assess the correlation between the state of sobriety and the severity of injuries expressed by injury severity scales in fatal pedestrian victims of traffic crashes. Research Material and Method: The data were obtained from the Warsaw Medical University's Department of Forensic Medicine. The analysis covered the data for 2009–2013 and included 200 fatal pedestrian victims hit by passenger cars. The assessment of the effect of risk factors on injury severity expressed in terms of injury severity scales such as Life Threat Indicator (LTI), International Classification based Injury Severity Score (ICISS), Injury Severity Score (ISS) and New Injury Severity Score (NISS), was made using adequately selected methods of statistical analysis. Results: As alcohol concentration increases in women, the values of LTI, ICISS-10 and ICISS-15 decrease, which denotes more severe injuries. In the ISS and NISS, the effect of alcohol concentration on the severity of injuries turned out to be negligible. However, these injuries are significantly heavier in women than in men. According to all the scales used, the older the victims, the milder injuries cause their death. Conclusions: The studies show that ethyl alcohol concentration may harm injury severity, especially in the case of women. The assessment of the severity of injuries in traffic crash victims is significantly influenced by their age and gender. The more risk factors the scale takes into consideration, the more precise is the assessment.     

Pedestrians: the daily underestimated victims on the road

Traffic-related pedestrian injuries (TRPI) are vulnerable to road users. In this study, we aimed to evaluate the demographic pattern of injury and outcome of TRPI. Patients with TRPI admitted between November 2007 and March 2010 to the only level 1 trauma centre in Qatar were included. A retrospective analysis was based on medical records and Emergency Medical Services run sheets. The spreadsheet included demographic data and pre-hospital transport, service admissions and injuries by system and mortality. Of 4077 patients who were admitted, 420 (10.3%) had TRPI. The mode of transportation included ambulances (91%), private vehicles (6%) and helicopters (3%). The direct dispositions were trauma intensive care units (38%), surgical wards (42%) and operating rooms (17%). Patients were classified according to Injury Severity Score (1–8 in 28%, 9–15 in 25%, 16–24 in 20% and 25–75 in 17% cases). Multisystem injuries were most characteristic. Of 804 injures, injury of extremities was predominant followed by head, thorax and abdomen. The overall mortality was 8%. Pedestrian injuries are a significant cause of serious trauma in Qatar. Motor vehicle/pedestrian interface contributes to this ongoing public health problem. Reducing pedestrian trauma requires recognition of the problem and implementing programmes to mitigate these largely preventable injuries.     

两相位交叉口左转车辆抢行的元胞自动机模型

为了解决道路两相位交叉口所存在的左转车辆抢行问题,避免造成严重交通冲突,首先分析了左转车辆抢行行为、路径抢行、以及与直行车辆到达冲突点的时间差相关的概率抢行,在考虑过街行人对抢行行为干扰的情况下,构建了车辆、行人耦合的双路径左转-直行冲突元胞自动机模型,通过计算机仿真分析研究了左转车辆抢行行为对交叉口通行能力的影响。结果表明,无过街行人时,左转车辆抢行使交叉口通行能力下降约5%;有过街行人干扰时,交叉口的通行能力则进一步降低10%～25%。研究结果可为提高道路交叉口服务水平、提高道路通行率和安全性决策提供参考。     

Environmental risk factors contributing to traffic accidents in children: a case-control study

The aim of this study is to identify environmental risk factors related to road accidents in children of Tehran. This case-control study was performed in 2013. The cases were injured pedestrians aged 5–15 who were admitted to major hospitals supervised by Tehran University of Medical Sciences. The sample size for the cases was 273 and for the control group was 546. For the completeness of the clusters, 7 extra persons in case (total = 280) and 14 persons (total = 560) in control group were included. The interference of confounding variables assessed through forward conditional logistic regression. Result shows occurrence of traffic accidents was significantly associate with the width of the alleys or (<5 m: OR = 8.4, 95% CI: 3.3–21.5; 5–8 m: OR = 4.7, 95% CI: 1.8–12.2), distance from home to school((<100 m: OR = 1.7, 95% CI: 1.0–2.8), existence of parking lot (OR = 1.5, 95% CI: 1.0–2.3), traffic congestion (OR = 4.1, 95% CI: 2.6–6.4), traffic speed (OR = 2.1, 95% CI: 1.3–3.2) and existence of pedestrian bridges(OR = 4.2, 95% CI: 2.6–6.8). In the light of the important role of environmental factors in the occurrence of child traffic accidents, alleviating structural risk factors in addition to education and enforcement need more systematic efforts and planning by policymakers and urban planners to attain pedestrian safety goals.     

Spatial environmental risk factors for pedestrian injury collisions in Ciudad Juárez,Mexico (2008–2009): implications for urban planning

The aim of this study is to examine the spatial distribution of pedestrian injury collisions and analyse the environmental (social and physical) risk factors in Ciudad Juarez, Mexico. More specifically, this study investigates the influence of land use, density, traffic and socio-economic characteristics. This cross sectional study is based on pedestrian injury collision data that were collected by the Municipal Transit Police during 2008–2009. This research presents an analysis of vehicle–pedestrian collisions and their spatial risk determinants using mixed methods that included (1) spatial/geographical information systems (GIS) analysis of pedestrian collision data and (2) ordinary least squares (OLS) regression analysis to explain the density of pedestrian collisions data. In our model, we found a higher probability for pedestrian collisions in census tracts with population and employment density, large concentration of commercial/retail land uses and older people (65 and more). Interventions to alleviate this situation including transportation planning such as decentralisation of municipal transport system, investment in road infrastructure – density of traffic lights, pedestrian crossing, road design, improves lane demarcation. Besides, land use planning interventions should be implemented in commercial/retail areas, in particular separating pedestrian and vehicular spaces.