Adolescent injuries in relation to economic status: An international perspective

The primary objective of the study was to examine the relationship between patterns in car-to-car crashes involving young drivers and car and driver characteristics and the research design was a national register-based prospective cohort study. Individual records in a cohort born 1970 – 1972 are linked to road-traffic-crash data (1988 – 2000). Subjects' first police-registered two-car crash leading to severe or fatal injury (n = 4875) are identified. Typical crash patterns are highlighted and associations between pattern and both car and individual socio-demographic characteristics are tested. Four crash patterns are highlighted. Male drivers and those with lower educational attainment are over-represented in all patterns. Pattern-based risk levels vary considerably according to car safety level and driver's age at time of injury and socio-economic status. Crash patterns might be considered in young adult driver education systems, bearing in mind the consistent higher risks of male drivers and of drivers with lower educational attainment.     

Morbidity and mortality from road traffic crashes in children in Metro West,City of Cape Town – 2014

The road traffic crash injury burden significantly impacts the lives of South African children. This study aimed to assess the fatal and non-fatal pattern of road traffic crash injury of children under 13 years old from Metro West, City of Cape Town, from 1 January until 31 December 2014. The data were stratified by age, sex and mechanism of road traffic crash. The overall mortality rate was 8.7 per 100 000 population and pedestrians contributed the most to this burden (72.5%). There were more male children involved in a road traffic crash (p?=?0.0001). The greatest proportion of fatal and non-fatal road traffic crash injuries was observed in children aged 5–9 years. Fractures contributed to the greatest rate of years lived with disability (3.0 years of life lived with disability per 100 000). Our study found that the burden of road traffic crashes primarily affects male pedestrians aged 5–9 years old.     

Under-reporting of road traffic crash data in Ghana

Having reliable estimates of the shortfalls in road traffic crash data is an important prerequisite for setting more realistic targets for crash/casualty reduction programmes and for a better appreciation of the socio-economic significance of road traffic crashes. This study was carried out to establish realistic estimates of the overall shortfall (under-reporting) in the official crash statistics in Ghana over an eight-year period (1997–2004). Surveys were conducted at hospitals and among drivers to generate relevant alternative data which were then matched against records in police crash data files and the official database. Overall shortfalls came from two sources, namely, ‘non-reporting’ and ‘under-recording’. The results show that the level of non-reporting varied significantly with the severity of the crash from about 57% for property damage crashes through 8% for serious injury crashes to 0% for fatal crashes. Crashes involving cyclists and motorcyclists were also substantially non-reported. Under-recording on the other hand declined significantly over the period from an average of 37% in 1997–1998 to 27% in 2003–2004. Thus, the official statistics of road traffic crashes in Ghana are subject to significant shortfalls that need to be accounted for. Correction factors have therefore been suggested for adjusting the official data.     

Fatal and serious road crashes involving young New Zealand drivers: a latent class clustering approach

The over-representation of young drivers in road crashes remains an important concern worldwide. Cluster analysis has been applied to young driver sub-groups, but its application by analysing crash occurrence is just emerging. We present a classification analysis that advances the field through a holistic overview of crash patterns useful for designing youth-targeted road safety programmes. We compiled a database of 8644 New Zealand crashes from 2002 to 2011 involving at least one 15–24-year-old driver and a fatal or serious injury for at least one road user. We considered crash location, infrastructure characteristics, environmental conditions, demographic characteristics, driving behaviour, and pre-crash manoeuvres. The analysis yielded 15 and 8 latent classes of, respectively, single-vehicle and multi-vehicle crashes, and average posterior probabilities measured the odds of correct classification that revealed how the identified clusters contain mostly crashes of a particular class and all the crashes of that class. The results raised three major safety concerns for young drivers that should be addressed: (1) reckless driving and traffic law violations; (2) inattention, error, and hazard perception problems; and (3) interaction with road geometry and lighting conditions, especially on high-speed open roads and state highways.     

Seat-belt use still low in Kuwait: self-reported driving behaviours among adult drivers

Kuwait mandated seat-belt use by drivers in 1976 and by front seat passengers in 1994. The study objectives were to identify and estimate current factors associated with seat-belt use and levels of potentially unsafe driving behaviours in Kuwait. In 2010, 741 adults were surveyed regarding driving habits and history. Only 41.6% of drivers reported always using a seat belt. Front seat passenger belt use was more common (30.5%) than rear seat belt use (6.5%). Distracted driving behaviours were common, including mobile phone use (‘always’ or ‘almost always’: 51.1%) and texting/SMS (32.4%). Logistic regression indicated that drivers who were young (18–19 years), male, Kuwaiti nationals or non-Kuwaiti Arabs, drove over the speed limit, had traffic violation tickets or >1 car crashes in the last year, were less likely to use seat belts. Targeted initiatives to increase public awareness and to enforce car-safety legislation, including use of seat belts, are necessary to decrease the health burden of car crashes in Kuwait.     

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.     

Vehicle head restraint positioning knowledge and behaviours in a sample of Irish drivers

A correctly positioned vehicle head restraint (HR) can reduce whiplash injury risk in collisions, however, HRs are often sub-optimally positioned. The primary aim of this study was to investigate vehicle HR position and driver knowledge of correct HR positioning in an Irish population. Secondary aims were to investigate the associations with driver age, gender and vehicle age. Data collection involved HR measurement and a driver questionnaire (n = 110). Just 27% of drivers had optimal HR positioning, while 30% had poor or marginal positioning. Newer vehicles (<5 years old) had better positioned HR in the horizontal plane (p = 0.036), than older vehicles. Younger drivers (<30 years) were more likely to have poorer positioning of HR (p = 0.002), than the 30 years or over group. Females were more likely to have better vertical positioning of their HR (p = 0.003) than males. Driver knowledge of correct position was variable, and not associated with actual HR position, with 65% knowing the correct vertical positioning standard but only 27% identifying the correct horizontal position. Many drivers have inadequately positioned HR, which needs to be addressed by improved vehicle design and public education.     

Underreporting,crash severity and fault assignment of minor crashes in China – a study based on self-reported surveys

Unreported minor crashes have importance as a surrogate for more serious crashes that require infrastructure, education, and enforcement strategies; and they still inflict damages. To study factors that influence underreporting, cause, and severity of minor crashes; a survey was performed in Kunming and Beijing to collect self-reported personal characteristics and crash history data of the three major urban road users in China: automobile drivers, bicycle riders and electric bike (e-bike) riders. Underreporting rates of automobile to automobile, automobile to non-motorized vehicle, and non-motorized vehicle to non-motorized vehicle crashes are 56%, 77% and 94%, respectively. Minor crashes with higher reported injury severity levels are more likely to be reported. E-bike riders without a driver's license are more likely to cause crashes. Licensing and education could be an effective way to reduce their crashes. The party that is not at fault in a crash is more likely to sustain high level of injury.     

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.     

A contemporary analysis of road traffic crashes,fatalities and injuries in Trinidad and Tobago

Road safety, in particular pedestrian safety, is a problem in Trinidad and Tobago. Data were derived from the database of the Traffic and Highway Patrol Unit of the Trinidad and Tobago Police Service. Road traffic crashes in Trinidad and Tobago are largely an urban problem. Four urban areas accounted for nearly three-quarters of reported road traffic crashes, fatalities and injuries. Pedestrians, passengers and drivers accounted for 93% of fatalities and 95% of injuries due to road traffic crashes in 2000. Pedestrians alone accounted for 42% of fatalities and 34% of injuries in 2000. Trends over time show that there has been a decline in fatality rates from 17 deaths per 100,000 population in 1960 to 10 deaths per 100,000 population in 2000, despite rapid motorization. Motorization increased four-fold from 63 registered vehicles per 1000 population in 1960 to 250 vehicles per 1000 population in 2000. In conclusion, effort should be intensified to ensure safety for all road users and, in particular, pedestrians, passengers and drivers. Improved data collection and operational research would improve monitoring and evaluation of policy interventions.     

Identifying the factors behind fatal and non-fatal road crashes: a case study of Lahore,Pakistan

ABSTRACT

The study identifies the factors behind fatal and non-fatal road crashes in Lahore, Pakistan, by investigating 461 reported cases to Traffic Police Lahore that occurred during January–November 2014. Road crashes are categorized into fatal and non-fatal crashes and, because of the binary nature of the dependent variable, logistic regression is used to identify the factors behind these crashes. As a follow-up, discriminant analysis is employed to classify the factors related to fatal and non-fatal crashes. The logistic regression results reveal that females are at higher risk of fatalities than male drivers. Among vehicle types, rickshaws and cars are more involved in fatal accidents because both are growing at large on roads. Long trucks and trailers are also involved in fatal accidents, mainly because of their huge size and drivers’ risky driving behaviours. It is also noted that risk of fatalities is higher in case where two vehicles bumped each other. Speeding and overloading are the common behaviours resulting in fatal crashes. Better urban transport systems and strict compliance with traffic rules and regulations may improve road safety in Pakistan.     

Analysis of the mechanism of injury in non-fatal vehicle-to-pedestrian and vehicle-to-bicyclist frontal crashes in Sweden

The aim of this paper is to analyse and compare injuries and injury sources in pedestrian and bicyclist non-fatal real-life frontal passengercar crashes, considering in what way pedestrian injury mitigation systems also might be adequate for bicyclists. Data from 203 non-fatal vehicle-to-pedestrian and vehicle-to-bicyclist crashes from 1997 through 2006 in a city in northern Sweden were analysed by use of the hospitals injury data base in addition to interviews with the injured. In vehicle-to-pedestrian crashes (n = 103) head and neck injuries were in general due to hitting the windscreen frame, while in vehicle-to-bicycle crashes (n = 100) head and neck injuries were typically sustained by ground impact. Abdominal, pelvic and thoracic injuries in pedestrians and thoracic injuries in bicyclists were in general caused by impacting the bonnet. In vehicle-to-pedestrian crashes, energy reducing airbags at critical impact points with low yielding ability on the car, as the bonnet and the windscreen frame, might reduce injuries. As vehicle-to-bicyclist crashes occurred mostly in good lighting conditions and visibility and the ground impact causing almost four times as many injuries as an impact to the different regions of the car, crash avoidance systems as well as separating bicyclists from motor traffic, may contribute to mitigate these injuries.     

Road traffic injuries in Colombia

Road traffic injuries are a leading public health problem in Colombia. Pedestrians are the most vulnerable road users, especially in the main urban centers of Bogotá, Medellin and Cali. Data analyzed in this report include official statistics from the National Police and the National Institute of Legal Medicine and Forensic Sciences for 1996-2000, and results of a study conducted at the National University of Colombia in 2000. Methods from the Highway Capacity Manual were used for determining physical and technical variables, and a Geographical Information System tool was used for the location and spatial analysis of the road traffic crashes. Pedestrians accounted for close to 32% of injuries and 40% of the deaths from road traffic crashes. The problem of road traffic crashes existed predominately in urban areas. In the main urban centers, pedestrians constituted nearly 68% of road traffic crash victims. The high level of risky road use behaviors demonstrated by pedestrians and drivers, and inadequate infrastructure for safe mobility of pedestrians in some sections of the road network were the main contributing factors. Major improvements were achieved in Bogotá following enhancements to the municipal transport system and other policies introduced since 1995. In conclusion, policies and programs for improving road safety, in particular pedestrian safety, and strengthening urban planning are top priority.     

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.     

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.