Crash-related factors associated with the severity of road traffic injuries in Iran

Although the impact of traffic crashes is very high in Iran, there are few works on the association of crash-related factors with injury severity. This study was conducted on 145 drivers injured on the Qazvin-Loshan road in order to assess this association. The New Injury Severity Score (NISS), based on the conditions of the injured drivers during their first visit to regional hospitals, was used as the main outcome measure. Multiple linear regression analysis was performed by considering logarithmic scale for NISS as response variable and adjusting for the confounding effects, including the transfer to hospital variables. The results showed that high-vehicle damage (i.e. damage with repair cost more than 25% of the pre-crash value of the driver's vehicle) and being trapped inside the motor vehicle raised the NISS by 5.25 (95% confidence interval (CI) 2.51-10.71) and 2.34 (95% CI 1.20-4.67), respectively.     

A hybrid clustering and classification approach for predicting crash injury severity on rural roads

As a threat for transportation system, traffic crashes have a wide range of social consequences for governments. Traffic crashes are increasing in developing countries and Iran as a developing country is not immune from this risk. There are several researches in the literature to predict traffic crash severity based on artificial neural networks (ANNs), support vector machines and decision trees. This paper attempts to investigate the crash injury severity of rural roads by using a hybrid clustering and classification approach to compare the performance of classification algorithms before and after applying the clustering. In this paper, a novel rule-based genetic algorithm (GA) is proposed to predict crash injury severity, which is evaluated by performance criteria in comparison with classification algorithms like ANN. The results obtained from analysis of 13,673 crashes (5600 property damage, 778 fatal crashes, 4690 slight injuries and 2605 severe injuries) on rural roads in Tehran Province of Iran during 2011–2013 revealed that the proposed GA method outperforms other classification algorithms based on classification metrics like precision (86%), recall (88%) and accuracy (87%). Moreover, the proposed GA method has the highest level of interpretation, is easy to understand and provides feedback to analysts.     

Road traffic crashes with fatal and non-fatal injuries in Arkhangelsk,Russia in 2005–2010

The study investigated trends in traffic crashes with fatal and non-fatal injuries in Arkhangelsk, Russia in 2005–2010. Data were obtained from the road police. Negative binomial regression with time regressor was used to investigate trends in monthly incidence rates (IRs) of crashes, fatalities, and non-fatal injuries. During the six-year period, the police registered 4955 crashes with fatal and non-fatal injuries, which resulted in 217 fatalities and 5964 non-fatal injury cases. The IR of crashes with fatal and non-fatal injuries per total population showed no evident change, while the IR per increasing total number of motor vehicles decreased on average by 0.6% per month. Pedestrian crashes constituted 51.8% of studied crashes, and pedestrians constituted 54.6% of fatalities and 44.5% of non-fatal injuries. The IRs of pedestrian crashes and non-fatal pedestrian injuries per total population decreased on average by 0.3% per month, and these were the major trends in the data.     

Identifying the factors contributing to the severity of truck-involved crashes

To address the dilemma between the need for truck transportation and the costs related to truck-involved crashes, the key is to identify the risk factors that significantly affect truck-involved crashes. The objective of this research is to estimate the effects of the characteristics of traffic, driver, geometry, and environment on severity of truck-involved crashes. Based on four crash severity categories (fatal/incapacitating, non-incapacitating, possible injury, and no injury/property damage only), a multinomial logit model is conducted to identify the risk factors. The investigation of risk ratios indicates that lower traffic volume with higher truck percentage is associated with more serious traffic crash with fatal/incapacitating injury while a non-standard geometric design is the main cause of non-incapacitating crashes. The influences of weather are significant for the possible-injury crashes while driver condition is the principal cause of no-injury/property-damage-only crashes. In addition, the statistical results demonstrate that the influence of the truck percentage is significant. One-unit change in the truck percentage will cause more than one times probability of being in an injury.     

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.     

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.     

Exploring the factors influencing pedestrian-vehicle crash severity in Dhaka,Bangladesh

Abstract

Although the rate of road crashes and their severity is relatively higher in developing countries, there is still a lack of research on pedestrian-vehicle crash severity in these contexts, particularly in Bangladesh. Therefore, this study aimed to identify the contributing environmental, road, and vehicular factors that influenced pedestrian—single-vehicle crash severity in Dhaka, a megacity and the capital of Bangladesh. A binary logistic regression model was developed in this study by analyzing a data set of pedestrian—single-vehicle crashes involving casualties in Dhaka from 2010 to 2015. The model identified seven significant factors influencing pedestrian-vehicle crash severity. Significant factors increasing the likelihood of fatal crashes included crashes during adverse weather, dawn/dusk period, night period (where street light was absent), off-peak period, crashes where road divider was unavailable, road geometry was straight and flat, and crashes those were occurred by heavier vehicles. Besides, crashes at three-legged intersections were less likely to be fatal. Both similarities and differences were found among the significant factors influencing pedestrian-vehicle crash severity in Dhaka from the findings of the developed countries. The findings of this study would help transport engineers and planners to design safer roadways for both pedestrians and vehicles.     

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.     

Pattern of road traffic injuries in Ghana: Implications for control

Road traffic injuries and fatalities are increasing in Ghana. Police-collected crash and injury data for the period 1994-1998 were aggregated and analyzed using the MAAP5 accident analysis package developed by the Transport Research Laboratory, U.K. Published results of recent transport-related epidemiological and other surveys provided an additional data source. According to the 1994-1998 police data, road traffic crashes were a leading cause of death and injuries in Ghana. The other leading causes of death and injuries are occupational injuries which involve nonmechanized farming and tribal conflicts. The majority of road traffic fatalities (61.2%) and injuries (52.3%) occurred on roads in rural areas. About 58% more people died on roads in the rural areas than in urban areas, and generally more severe crashes occurred on rural roads compared with urban areas. Pedestrians accounted for 46.2% of all road traffic fatalities. The majority of these (66.8%) occurred in urban areas. The second leading population of road users affected was riders in passenger-ferrying buses, minibuses and trucks. The majority of these (42.8%) were killed on roads that pass through rural areas. Pedestrian casualties were overrepresented (nearly 90%) in five regions located in the southern half of the country. Efforts to tackle pedestrian safety should focus on the five regions of the country where most pedestrian fatalities occur in urban areas. Policies are also needed to protect passengers in commercially operated passenger-ferrying buses, minibuses and trucks because these vehicles carry a higher risk of being involved in fatal crashes.     

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.     

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.     

The association of light trucks and vans with paediatric pedestrian deaths

The hypothesis that relative to cars, light trucks and vans (including sports utility vehicles) are more likely to result in fatal paediatric pedestrian injury was investigated. It was further hypothesized that this increased risk is a result of head injuries. The study sample consisted of 18 117 police records of motor vehicles involved in crashes in which one or more pedestrians aged 5 to 19 years old was injured or killed. Frequencies and case fatality ratios for each vehicle body type were calculated. A logistic regression analysis was conducted, with light truck or van vs. car as the exposure variable and fatal/non-fatal pedestrian injury as the outcome variable. After controlling for driver age, driver gender, vehicle weight, road surface condition and presence of head injury, 5 to 19 year-olds struck by light trucks or vans were more than twice as likely to die than those struck by cars (odds ratio (OR) 2.3; 95% CI 1.4, 3.9). For the 5 to 9 year-old age group, light trucks and vans were four times as likely to be associated with fatal injury (OR 4.2; 95% CI 1.9, 9.5). There was an association between head injury and light trucks and vans (OR 1.2; 95% CI 1.1, 1.3). It was concluded that vehicle body type characteristics play an important role in paediatric pedestrian injury severity and may offer engineering-based opportunities for injury control.     

Global collaboration on road traffic injury prevention

Worldwide, nearly 1.2 million people are killed in road traffic crashes every year and 20 million to 50 million more are injured or disabled. These injuries account for 2.1% of global mortality and 2.6% of all disability-adjusted life years (DALYs) lost. Low- and middle-income countries account for about 85% of the deaths and 90% of the DALYs lost annually. Without appropriate action, by 2020, road traffic injuries are predicted to be the third leading contributor to the global burden of disease. The economic cost of road traffic crashes is enormous. Globally it is estimated that US$518 billion is spent on road traffic crashes with low- and middle-income countries accounting for US$65 billion--more than these countries receive in development assistance. But these costs are just the tip of the iceberg. For everyone killed, injured or disabled by a road traffic crash there are countless others deeply affected. Many families are driven into poverty by the expenses of prolonged medical care, loss of a family breadwinner or the added burden of caring for the disabled. There is an urgent need for global collaboration on road traffic injury prevention. Since 2000, WHO has stepped up its response to the road safety crisis by firstly developing a 5-year strategy for road traffic injury prevention and following this by dedicating World Health Day 2004 to road safety and launching the WHO/World Bank World Report on Road Traffic Injury Prevention at the global World Health Day event in Paris, France. This short article highlights the main messages from the World Report and the six recommendations for action on road safety at a national and international level. It goes on to briefly discuss other international achievements since World Health Day and calls for countries to take up the challenge of implementing the recommendations of the World Report.     

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.     

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.     

Older adult pedestrian injuries in the United States: causes and contributing circumstances

As the US population ages, more older adults will face transportation and mobility challenges. This study examines the characteristics and contributing circumstances of nonfatal older adult pedestrian injuries. Data were obtained from the National Electronic Injury Surveillance System-All Injury Programme (NEISS-AIP) for the years 2001 through 2006. Cases included persons aged 65 years and older who were nonfatally injured on a public roadway. The results indicated that on average, an estimated 52,482 older adults were treated in emergency departments each year for nonfatal pedestrian injuries. Falling and being hit by a motor vehicle were the leading mechanisms of injury, resulting in 77.5% and 15.0% of older adult pedestrian injuries, respectively. More than 9000 older pedestrian fall-related injuries each year involved a kerb. It is concluded that the growth in the older adult population could add to the overall burden of these nonfatal pedestrian injuries. Making transportation and mobility improvements, including environmental modifications, is important for preventing these injuries.     

Factors contributing to motorcycle fatal crashes on National Highways in India

This study analyses fatal crash patterns, and identifies the risk factors contributing to motorcycle versus non-motorcycle fatal crashes using binomial logistic regression on two-, four- and six-lane National Highways (NHs) in India utilizing police fatal crash data. The distribution of victims’ mode by striking vehicles shows that percentage share of striking vehicles (truck) against the victims’ vehicles (motorcycle) is 44%, 52% and 37% on two-lane NH-8, four-lane NH-24 and six-lane NH-1, respectively. Nine explanatory variables pertaining to fatal crash, victim, roadway and environment are considered for the model (using combined data of cited three NHs). The results of the logistic regression model (motorcycle versus non-motorcycle fatal crashes) show that for variable ‘collision type’, likelihood of occurrence of ‘rear-end’, ‘sideswipe’ and ‘head-on’ fatal crashes are 42-times, 35-times and 25-times more than ‘hit pedestrian’ respectively. Similarly, for variable ‘number of vehicle’, likelihood is thrice as ‘single-vehicle’ than ‘two or more vehicles’; and, for variable ‘number of lane’, probability is more on ‘two-lane’ NH-8 than ‘four-lane’ NH-24. Based on the study results, it is recommended to upgrade two-lane (undivided carriageway) to four-lane (divided carriageway) NHs to reduce ‘head-on’ collision.     

Short Reports

As the US population ages, more older adults will face transportation and mobility challenges. This study examines the characteristics and contributing circumstances of nonfatal older adult pedestrian injuries. Data were obtained from the National Electronic Injury Surveillance System-All Injury Programme (NEISS-AIP) for the years 2001 through 2006. Cases included persons aged 65 years and older who were nonfatally injured on a public roadway. The results indicated that on average, an estimated 52,482 older adults were treated in emergency departments each year for nonfatal pedestrian injuries. Falling and being hit by a motor vehicle were the leading mechanisms of injury, resulting in 77.5% and 15.0% of older adult pedestrian injuries, respectively. More than 9000 older pedestrian fall-related injuries each year involved a kerb. It is concluded that the growth in the older adult population could add to the overall burden of these nonfatal pedestrian injuries. Making transportation and mobility improvements, including environmental modifications, is important for preventing these injuries.