Clothing-related motorcycle injuries in Pakistan: findings from a surveillance study

This study aims to assess the burden and patterns of clothing-related motorcycle injuries in Karachi, Pakistan. Data were extracted from an ongoing traffic injury surveillance system. In three years (2007–2009), out of 99155 road traffic injury cases there were 986 (0.9%) cases of clothing-related motorcycle injuries. Most cases were females (73.9%) and pillion riders (80.6%). The crashes involving clothing-related injuries were mostly single vehicle (98.5%), and largely resulted in injuries to the external body (60.3%), limbs (51.0%), head (41.5%) and face (35.9%). One-third of injuries were either moderate (26.7%) or severe (10.2%) while 10 (1.01%) deaths were reported. Female gender (11.4%), age ≥ 45 years (19.4%), pillion riding (11.3%) and crashes occurring at intersections (12.3%) were more likely to result in moderate or severe injury as compared to other users (P < 0.001). Injuries due to entanglement of loose fitting clothing in motorcycles are not uncommon in Karachi. Awareness campaigns for prevention of such injuries may involve promotion of appropriate dressing for motorcycle riding including close wrapping of clothes and encouraging installations of covers on the rear wheels and drive chains.     

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.     

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.     

Feasibility of routine collection of injured worker occupational information in hospital emergency departments

The aim of this study was to examine injury events and risk-factors among Swedish adult eventing athletes. A cross-sectional study design with retrospective recording of 1-year sports-specific exposure and injury data was used. The invited study population consisted of all members of the Swedish Equestrian Federation with eventing as their primary discipline (n = 513). The participation rate was 70.0%. The total 1-year injury prevalence was 26.6%; the specific 1-year prevalence of traumatic injury was 19.3% and of overuse injury 10.9%. The incidence of traumatic injury events was 0.54 injury events/1000 eventing hours (95% confidence interval (CI), 0.35–0.73 injury events/1000 eventing hours) for novices and 0.35 injury events/1000 eventing hours for qualified riders (95% CI, 0.21–0.49 injury events/1000 eventing hours). A total of 27.9% of the traumatic injury events led to severe injuries (causing more than 3 weeks absence from riding). Attitude to risk-taking was the only factor predicting an athlete becoming injured (p = 0.023), and qualification level was the only risk factor for additional injuries among injured riders (p = 0.003). Our results suggest that injury prevention programs in eventing should also give attention to overuse injuries and that care should be taken when eventing athletes are licensed into higher qualification groups.     

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.     

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.     

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.     

Injury rates and risk-factors associated with eventing: a total cohort study of injury events among adult Swedish eventing athletes

The aim of this study was to examine injury events and risk-factors among Swedish adult eventing athletes. A cross-sectional study design with retrospective recording of 1-year sports-specific exposure and injury data was used. The invited study population consisted of all members of the Swedish Equestrian Federation with eventing as their primary discipline (n = 513). The participation rate was 70.0%. The total 1-year injury prevalence was 26.6%; the specific 1-year prevalence of traumatic injury was 19.3% and of overuse injury 10.9%. The incidence of traumatic injury events was 0.54 injury events/1000 eventing hours (95% confidence interval (CI), 0.35-0.73 injury events/1000 eventing hours) for novices and 0.35 injury events/1000 eventing hours for qualified riders (95% CI, 0.21-0.49 injury events/1000 eventing hours). A total of 27.9% of the traumatic injury events led to severe injuries (causing more than 3 weeks absence from riding). Attitude to risk-taking was the only factor predicting an athlete becoming injured (p = 0.023), and qualification level was the only risk factor for additional injuries among injured riders (p = 0.003). Our results suggest that injury prevention programs in eventing should also give attention to overuse injuries and that care should be taken when eventing athletes are licensed into higher qualification groups.     

Hospitalisation costs and duration of elderly motorcyclists’ non-fatality crashes in Taiwan

This paper investigates the relationship between medical treatment costs and the length of hospital stays resulting from motorcycle crashes involving the elderly. The World Health Organization defines ‘elderly’ as people more than 65 years old. The sample for this study consisted of data for the year 2007 collected by the Bureau of National Health Insurance, Taiwan. We develop models for predicting medical costs and the length of hospital stays based on diagnosis, hospital and user types. The seemingly unrelated regression equation (SURE) model was applied first to investigate the relationship between medical costs and the length of hospital stays. The SURE model shows that the type of injury (e.g. head injury) is statistically significant and has positive effects on medical costs for motorcycle crashes involving the elderly in Taiwan. Due to the statistical insignificance of the dependency between medical costs and length of hospital stays, two separate simple linear regression models were subsequently estimated. For motorcycle crashes, patients over 80 years old had the highest medical costs. The findings reinforce the need for transportation authorities to focus on preventing certain types of injuries that are particularly serious and costly for the elderly in Taiwan.     

Trends in fatal motorcycle injuries in the Americas, 1998–2010

Injuries, disabilities and deaths among motorcyclists have been rising worldwide but what is happening in the American Continent is not completely known. Deaths from motorcycle crashes of the Pan American Health Organization database (PAHO/WHO, 1998–2010) were included in an ecologic multi-national study to quantify the temporal trends and to estimate the association between motorcycle riders’ deaths and selected socio-economic indicators. Mortality rates increased in all sub-regions. The highest increase was reported in the countries of the Andean sub-region (Ecuador, 78.3%) and Mesoamerica (Costa Rica, 60.0%). Poorer countries fared worse in terms of motorcycle mortality relative to richer countries, as did more unequal ones. Recent economic changes, rapid increment of motorisation rates, affordability of motorcycles over public transportation, lack of adequate public transportation policies and other insufficient measures aimed at improving safety can explain these trends.     

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.     

Self-reported load carriage injuries of military soldiers

The aim of this study was to investigate whether occupational load carriage constitutes a significant source of injury to military soldiers. An online survey was sent to soldiers serving in specific Australian Army Corps known to experience the greatest occupational exposure to load carriage. Of the 338 respondents, 34% sustained at least one load carriage injury. Fifty-two per cent of those injured during initial training reported sustaining an additional load carriage injury. The majority of injuries (61%) were to the lower limbs with bones and joints the most frequently injured body structures (39%). Endurance marching (continuous marching as part of a physical training session) was the activity accounting for most (38%) injuries. Occupational load carriage is associated with military soldier injuries and, once injured, soldiers are at a high risk of future load carriage injury. The bodily sites and nature of self-reported injuries in this study are akin to those of formally reported injuries and those of other militaries.     

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.     

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.     

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 accidents involving bicycles: configurations and injuries

This study analyzed the most common types of accident involving bicycles and compared the frequency of injuries. The data source was the database of German In-Depth Accident Study (GIDAS). Cases consist of bicycles and their riders involved in accidents between 2000 and 2010. In most collisions, the bicycle impacted with a car. The percentage of injured bicyclists was higher in collisions with a heavy vehicle and decreased when the bicycle impacted with lighter vehicles. A high percentage of injured bicyclists in single accidents was observed; the most severe injury was more frequently to head and extremities. Accidents involving a car and a bicycle with the right of way in a bicycle path represented about 20% of involved and injured bicyclists. The ten most frequent configurations represented about 60% of involved and injured bicyclists. These results contribute to understand the dangerous scenarios for bicyclists and to suggest preventive actions.     

Injuries from Motorcycle- and Moped crashes in Sweden from 1987 to 1999

The objective of this paper is to study injuries from motorcycle and moped crashes in Sweden from 1987 to 1999. Databases at the National Board for Health and Welfare and codes from both ICD9 and ICD10 systems were used, including patterns of age, gender, E-code and type of injury. Length of hospital stay, type of injuries and trends over time was evaluated. To get a more detailed picture of the age distribution, type of vehicle used and number of killed, data from the Swedish National Road Administration were also used. In Sweden, 27,122 individuals received in-patient care due to motorcycle and moped injuries between 1987 and 1999. The motorcycle and moped injury rate was reduced in the second half of the studied period and so were the total days of treatment per year. Males had eight times the incidence of injuries compared to females. Riders under the age of 26 and in particular those at an age of 15 had the highest incidence rate. Head injuries were the most frequent diagnosis, followed by fractures to the lower limbs. Concussion was the most frequent head injury. Focal and diffuse brain injuries combined showed the same frequency as concussion. It is concluded that more preventative strategies must be presented before the injury rate can be reduced.     

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.