Bicycle helmet use four years after the introduction of helmet legislation in Alberta, Canada

Background

Bicycle helmets reduce fatal and non-fatal head and face injuries. This study evaluated the effect of mandatory bicycle helmet legislation targeted at those less than 18 years old on helmet use for all ages in Alberta.

Methods

Two comparable studies were conducted two years before and four years after the introduction of helmet legislation in Alberta in 2002. Bicyclists were observed in randomly selected sites in Calgary and Edmonton and eight smaller communities from June to October. Helmet wearing and rider characteristics were recorded by trained observers. Poisson regression adjusting for clustering by site was used to obtain helmet prevalence (HP) and prevalence ratio (PR) (2006 vs. 2000) estimates.

Results

There were 4002 bicyclists observed in 2000 and 5365 in 2006. Overall, HP changed from 75% to 92% among children, 30% to 63% among adolescents and 52% to 55% among adults. Controlling for city, location, companionship, neighborhood age proportion <18, socioeconomic status, and weather conditions, helmet use increased 29% among children (PR = 1.29; 95% CI: 1.20–1.39), over 2-fold among adolescents (PR 2.12; 95% CI: 1.75–2.56), and 14% among adults: (PR = 1.14; CI: 1.02–1.27).

Conclusions

Bicycle helmet legislation was associated with a greater increase in helmet use among the target age group (<18). Though HP increased over 2-fold among adolescents to an estimated 63% in 2006, this percentage was approximately 30% lower than among children <13.     

The association of age, sex and helmet use with the risk of death for occupants of two-wheeled motor vehicles involved in traffic crashes in Spain

Background

This study was designed to separate the association of age, sex and helmet use with the risk of death for occupants of two-wheeled motor vehicles (TWMV) involved in crashes into its two theoretical components: severity of the crash and occupant resilience.

Methods

We analyzed the retrospective cohort comprising all 48 016 pairs of drivers and passengers aged 14 years or more in TWMV involved in crashes with victims in Spain from 1993 to 2007 recorded in the Spanish traffic crash registry. The outcome (death or survival), age, sex and helmet use was known for both occupants. Adjusted relative risks (RR) for the association of age, sex and helmet with the risk of death were calculated with Poisson regression models.

Results

Each 1-year increase in age was related with a 3% increase in the risk of death related with lower resilience. The severity-dependent RR of death was 1.84 for male sex and 0.86 for non-helmet use, and the resilience-dependent RR was 0.72 and 2.53, respectively.

Conclusions

The direction and magnitude of the association between age, sex and helmet use and the risk of death of an occupant of a TWMV involved in a crash changed depending on which component of risk was considered: crash severity or occupant resilience. Specifically, female sex and non-helmet use seemed to be associated with crashes of lower severity, but together with increased age they were also related with lower resilience to the energy released in the crash, and therefore with a higher risk of death after adjustment for crash severity. This should be taken into account when assessing the association of individual factors with the risk of death after a crash.     

Observational study of compliance with Queensland bicycle helmet laws

Mandatory bicycle helmet laws have been found to increase helmet wearing rates in Australia and internationally. However, much of the research on factors influencing compliance with the Australian helmet laws is dated or focuses on commuters and city areas only. To address this gap, video recordings of bicycle riders were undertaken at 17 sites across Queensland, Australia, representing a mixture of on- and off-road locations, speed limits and regions. Helmet status was able to be determined for 98% of riders observed. The level of compliance with the laws was very high, with 98.3% of the more than 27,000 riders observed wearing helmets. Riders riding on roads were less compliant than those riding on bicycle paths, but no significant differences were observed between the school-holiday and school-term periods. Among the on-road riders, boys were less compliant than girls and overall children were less compliant than adults. Higher compliance levels were found for group riders, road bike riders, lycra-clad riders, during morning hours, and on 50 km/h or lower speed limit roads. While the overall level of compliance was very high, certain subgroups were identified as a possible focus for interventions to further improve the compliance level, for example children (particularly boys) riding mountain bikes away from groups during the afternoon hours on 60 km/h roads.     

School regulations governing bicycle helmet use and head injuries among Japanese junior high school students

We examined the effectiveness of school regulations concerning bicycle helmet use in reducing head injuries among student bicycle commuters to junior high schools in the Japanese prefecture of Saitama. This was done by comparing the rates of head injuries and the ratios of head injuries to non-head injuries between junior high schools with and without school regulations concerning helmet use. Bicycle injury data were derived from school insurance records. Information relating to numbers of bicycle commuters and demographics was collected for each school. We identified that the head injury rate was significantly higher in schools that had no regulations governing the use of bicycle helmets (rate ratio 2.97, 95% confidence interval (CI) 1.03-8.56; odds ratio 2.46, 95% CI 0.80-7.60). The observed trend was more prominent in male students than in female students. The actual rate of bicycle injuries did not significantly differ between the schools with and without regulations concerning helmet use. This suggests that students at schools with regulations were no more cautious in riding their bicycles than their counterparts in schools with no regulations, and that there was no significant difference in the traffic environments surrounding each school. Thus implicating that the observed difference in the head injury rate was most accounted for by the presence of school regulations governing helmet use.     

Pediatric anthropometrics are inconsistent with current guidelines for assessing rider fit on all-terrain vehicles

Background/purpose

This study sought to establish objective anthropometric measures of fit or misfit for young riders on adult and youth-sized all-terrain vehicles and use these metrics to test the unproved historical reasoning that age alone is a sufficient measure of rider-ATV fit.

Methods

Male children (6-11 years, n = 8; and 12-15 years, n = 11) were selected by convenience sampling. Rider-ATV fit was quantified by five measures adapted from published recommendations: (1) standing-seat clearance, (2) hand size, (3) foot vs. foot-brake position, (4) elbow angle, and (5) handlebar-to-knee distance.

Results

Youths aged 12-15 years fit the adult-sized ATV better than the ATV Safety Institute recommended age-appropriate youth model (63% of subjects fit all 5 measures on adult-sized ATV vs. 20% on youth-sized ATV). Youths aged 6-11 years fit poorly on ATVs of both sizes (0% fit all 5 parameters on the adult-sized ATV vs 12% on the youth-sized ATV).

Conclusions

The ATV Safety Institute recommends rider-ATV fit according to age and engine displacement, but no objective data linking age or anthropometrics with ATV engine or frame size has been previously published. Age alone is a poor predictor of rider-ATV fit; the five metrics used offer an improvement compared to current recommendations.     

Development of the BACKIE questionnaire: A measure of children's behaviors, attitudes, cognitions, knowledge, and injury experiences

Objective

The objective of this study was to develop a standardized questionnaire (BACKIE) that would assess the Behaviors (B), Attitudes (A), Cognitions (C), Knowledge (K), and Injury Experiences (IE) that elementary-school children possess pertaining to seven types of injuries, including: falls; motor vehicle collisions; burns; drowning; choking/suffocation; poisoning; and bicycle/pedestrian injuries.

Methods

Over 500 children in grades two through seven completed the questionnaire, with a sub-sample repeating it two months later to assess test-retest reliability of the measure.

Results

Psychometric assessment of the instrument revealed acceptable internal and test-retest reliabilities and results of a Confirmatory Factor Analysis provided support for the hypothesized factor structure.

Conclusion

Having a psychometrically sound measure that allows one to assess attitudes, cognitions, and knowledge is an essential first step to exploring the relative influence of these factors on children's risk and safety practices.     

Evaluation and replication of impact damage to bicycle helmets

A group of 72 impacted bicycle helmets were collected, primarily from manufacturers with a crash replacement policy that encourages the return of damaged helmets. Each damaged helmet was thoroughly inspected and measured to determine the construction details and collision damage. Laboratory replication tests were then performed on selected samples using exemplar helmets to determine impact velocity and peak headform aceleration. The predominant impact location was the front left quarter and the replication studies indicate that the majority of impacts took place on flat surfáces from drop heights of 1 meter or less. Overall, it is evident that a large number of bicycle helmet users who have benefited from the use of a bicycle helmet, and future bicycle helmet standards must incorporate the protective requirements of this unique group.     

The impact response of traditional and BMX-style bicycle helmets at different impact severities

Bicycle helmets reduce the frequency and severity of severe to fatal head and brain injuries in bicycle crashes. Our goal here was to measure the impact attenuation performance of common bicycle helmets over a range of impact speeds. We performed 127 drop tests using 13 different bicycle helmet models (6 traditional style helmets and 7 BMX-style helmets) at impact speeds ranging from 1 to 10 m/s onto a flat anvil. Helmets were struck on their left front and/or right front areas, a common impact location that was at or just below the test line of most bicycle helmet standards. All but one of the 10 certified helmet models remained below the 300 g level at an impact speed of 6 m/s, whereas none of the 3 uncertified helmets met this criterion. We found that the helmets with expanded polystyrene liners performed similarly and universally well. The single certified helmet with a polyurethane liner performed below the level expected by the Consumer Product Safety Commission (CPSC) standard at our impact location and the helmet structure failed during one of two supplemental tests of this helmet above the test line. Overall, we found that increased liner thickness generally reduced peak headform acceleration, particularly at higher impact speeds.     

The use of narrative text for injury surveillance research: A systematic review

Objective

To summarise the extent to which narrative text fields in administrative health data are used to gather information about the event resulting in presentation to a health care provider for treatment of an injury, and to highlight best practise approaches to conducting narrative text interrogation for injury surveillance purposes.

Design

Systematic review.

Data sources

Electronic databases searched included CINAHL, Google Scholar, Medline, Proquest, PubMed and PubMed Central. Snowballing strategies were employed by searching the bibliographies of retrieved references to identify relevant associated articles.

Selection criteria

Papers were selected if the study used a health-related database and if the study objectives were to a) use text field to identify injury cases or use text fields to extract additional information on injury circumstances not available from coded data or b) use text fields to assess accuracy of coded data fields for injury-related cases or c) describe methods/approaches for extracting injury information from text fields.

Methods

The papers identified through the search were independently screened by two authors for inclusion, resulting in 41 papers selected for review. Due to heterogeneity between studies meta-analysis was not performed.

Results

The majority of papers reviewed focused on describing injury epidemiology trends using coded data and text fields to supplement coded data (28 papers), with these studies demonstrating the value of text data for providing more specific information beyond what had been coded to enable case selection or provide circumstantial information. Caveats were expressed in terms of the consistency and completeness of recording of text information resulting in underestimates when using these data. Four coding validation papers were reviewed with these studies showing the utility of text data for validating and checking the accuracy of coded data. Seven studies (9 papers) described methods for interrogating injury text fields for systematic extraction of information, with a combination of manual and semi-automated methods used to refine and develop algorithms for extraction and classification of coded data from text. Quality assurance approaches to assessing the robustness of the methods for extracting text data was only discussed in 8 of the epidemiology papers, and 1 of the coding validation papers. All of the text interrogation methodology papers described systematic approaches to ensuring the quality of the approach.

Conclusions

Manual review and coding approaches, text search methods, and statistical tools have been utilised to extract data from narrative text and translate it into useable, detailed injury event information. These techniques can and have been applied to administrative datasets to identify specific injury types and add value to previously coded injury datasets. Only a few studies thoroughly described the methods which were used for text mining and less than half of the studies which were reviewed used/described quality assurance methods for ensuring the robustness of the approach. New techniques utilising semi-automated computerised approaches and Bayesian/clustering statistical methods offer the potential to further develop and standardise the analysis of narrative text for injury surveillance.     

Trends in head injuries associated with mandatory bicycle helmet legislation targeting children and adolescents

Background

Bicycling related head injuries (HIs) can be severe. Helmet use reduces head injury risk; however, there are few controlled studies of the effect of helmet legislation. We conducted this study to investigate changes in HIs after bicycle helmet legislation targeting those <18 in Alberta, Canada in 2002.

Methods

Bicyclist and pedestrian (control) HI rates and HIs as a proportion of all injuries were compared for the three years (1999–2001) before and four years (2003–2006) after bicycle helmet legislation in three age groups (children: <13, adolescents: 13–17, and adults: 18+).

Results

There were 41,270 ED visits and 2782 hospitalizations for bicyclists and 9836 ED visits and 2029 hospitalizations for pedestrians (excluding the legislation year 2002). The rate of ED HIs declined for child bicyclists and child pedestrians, while the rate of non-HIs declined in adult bicyclists and child pedestrians. The rate of hospitalized HIs declined in child bicyclists and all ages of pedestrians while non-HI rates declined for child and adult pedestrians. Non-HI rates for adolescent and adult bicyclists increased. After adjusting for sex and location, the proportion of ED bicycle HIs declined by 9% (APR = 0.91; 95% CI: 0.86, 0.95) in children, was unchanged among adolescents and increased in adults (APR = 1.08; 95% CI: 1.01, 1.15). The proportion of bicycle HI related hospitalizations decreased by 30% (APR = 0.70; 95% CI: 0.55, 0.90) in children, 36% (APR = 0.64; 95% CI: 0.49, 0.84) in adolescents and 24% (APR = 0.76; 95% CI: 0.63, 0.91) in adults. There were no observed changes in the proportion of pedestrian HIs resulting in ED visits or hospitalizations.

Interpretation

Our data indicate significant declines in the proportion of child bicyclist ED HIs and child, adolescent and adult bicyclist HI hospitalizations. This is in contrast to no significant trends in the proportion of ED or hospitalized HIs among pedestrians and the unexpected increases in the proportion of ED HIs for adult bicyclists. Comparing bicyclist and pedestrian trends in the proportion of child and adolescent HIs suggests a bicycle helmet legislation effect.     

Accident rates amongst regular bicycle riders in Tasmania,Australia

Purpose

To characterise the demographics, cycling habits and accident rates of adult cyclists in Tasmania.

Methods

Volunteers ≥18 years of age who had cycled at least once/week over the previous month provided information on demographics; cycling experience; bicycles owned; hours/km/trips cycled per week; cycling purpose; protective equipment used; and major (required third-party medical treatment or resulted ≥1 day off work) or minor (interfered with individuals’ regular daily activities and/or caused financial costs) accidents while cycling.

Results

Over 8-months, 136 cyclists (70.6% male) completed the telephone survey. Mean (standard deviation) age was 45.4 (12.1) years with 17.1 (11.4) years of cycling experience. In the week prior to interview, cyclists averaged 6.6 trips/week (totalling 105.7 km or 5.0 h). The most common reason for cycling was commuting/transport (34% of trips), followed by training/health/fitness (28%). The incidence of major and minor cycling accidents was 1.6 (95% CI 1.1–2.0) and 3.7 (2.3–5.0) per 100,000 km, respectively. Male sex was associated with a significantly lower minor accident risk (incidence rate ratio = 0.34, p = 0.01). Mountain biking was associated with a significantly higher risk of minor accident compared with road or racing, touring, and city or commuting biking (p < 0.05).

Conclusions

Physical activity of regular cyclists’ exceeds the level recommended for maintenance of health and wellbeing; cyclists also contributed substantially to the local economy. Accident rates are higher in this sample than previously reported in Tasmania and internationally. Mountain biking was associated with higher risks of both major and minor accidents compared to road/racing bike riding.     

Seat belt misuse among children transported in belt-positioning booster seats

Objective

Observe and report seat belt use among children transported in belt-positioning booster seats.

Design

We conducted a cross-sectional, observational survey of children transported in motor vehicles between 2006 and 2007. While drivers completed a survey reporting the child's age, weight and gender, and the driver's age, gender, race, income, education, and relationship to the child; a child passenger safety technician recorded vehicle seating location, restraint type, and use of the car safety seat harness or seat belt as appropriate for the child.

Setting

Twenty-five fast food restaurants and discount department stores throughout Indiana.

Participants

A convenience sample of drivers transporting children younger than 16 years.

Main exposure

Seat belt use among children transported in belt-positioning booster seats.

Outcome measure

Seat belt misuse.

Results

Overall, 1446 drivers participated, 2287 children were observed with 564 children in belt-positioning booster seats. At least one seat belt misuse was observed for 64.8% of the children transported. Common misuses were the shoulder belt being placed over the booster seat armrest (35.8%); shoulder belt not at mid-shoulder position (28.5%), seat belt was too loose (24.5%), and the shoulder belt was either behind the child's back (9.1%) or under their arm (10.0%).

Conclusion

There is a high frequency of seat belt misuses among children transported in booster seats. Advice to parents on appropriate car seat selection, and encouragement to parents to supervise seat belt use may decrease misuse.     

BikeSafe: Evaluating a bicycle safety program for middle school aged children

Purpose

The purpose of this study is to measure the effectiveness of a bicycle safety education curriculum for middle school age children in order to reduce the number of injuries and fatalities of bicyclists hit by cars in Miami-Dade County.

Methods

The University of Miami BikeSafe^® program includes a four day off-bike middle school curriculum that follows a train-the-trainer model, where a small number of staff trains a larger group of grades 6th–8th physical education teachers from various schools to teach the bike safety curriculum to their students. Subjects in this study included 193 students from 18 classes (3 per school) at 6 selected middle schools. Measures included a knowledge assessment of the curriculum that was administered to students pre- and post-curriculum implementation. Data were collected and analyzed with school and class period examined as predictors of post-score.

Results

A significant difference (p < .001) was found between pre- and post-test conditions across all subjects. In addition, there was no significant difference between testing from class periods (p > .05), suggesting that a standard intervention was applied.

Conclusion

The BikeSafe educational curriculum was found to improve the bike safety knowledge of middle school aged children. Future efforts will focus on sustaining and expanding this program throughout Miami-Dade County and other high risk communities.     

Risk factors for injury accidents among moped and motorcycle riders

Objective

To study and quantify the effect of factors related to the riders of powered two-wheelers on the risk of injury accident involvement.

Methodology

Based on national data held by the police from 1996 to 2005, we conducted a case–control study with responsibility for the accident as the event of interest. We estimated the odds ratios for accident responsibility. Making the hypothesis that the non-responsible riders in the study are representative of all the riders on the road, we thus identified risk factors for being responsible for injury accidents. The studied factors are age, gender, helmet wearing, alcohol consumption, validity of the subject's driving licence and for how long it has been held, the trip purpose and the presence of a passenger on the vehicle. Moped and motorcycle riders are analyzed separately, adjusting for the main characteristics of the accident.

Results

For both moped and motorcycle riders, being male, not wearing a helmet, exceeding the legal limit for alcohol and travelling for leisure purposes increased the risk of accident involvement. The youngest and oldest users had a greater risk of accident involvement. The largest risk factor was alcohol, and we identified a dose–effect relationship between alcohol consumption and accident risk, with an estimated odds ratio of over 10 for motorcycle and moped riders with a BAC of 2 g/l or over. Among motorcycle users, riders without a licence had twice the risk of being involved in an accident than those holding a valid licence. However, the number of years the rider had held a licence reduced the risk of accident involvement. One difference between moped and motorcycle riders involved the presence of a passenger on the vehicle: while carrying a passenger increased the risk of being responsible for the accident among moped riders, it protected against this risk among motorcycle riders.

Conclusion

This analysis of responsibility has identified the major factors contributing to excess risk of injury accidents, some of which could be targeted by prevention programmes.     

Driver seat belt use indicates decreased risk for child passengers in a motor vehicle crash

Study objective

We examined the association between driver restraint use and child emergency department (ED) evaluation following a motor vehicle crash (MVC).

Methods

This cohort study included child passengers aged 0-12 years riding with an adult driver aged 21 years or older involved in a MVC in Utah from 1999 to 2004. The 6 years of Utah MVC records were probabilistically linked to statewide Utah ED records. We estimated the relative risk of ED evaluation following a MVC for children riding with restrained versus unrestrained drivers. Generalized estimating equations were used to calculate relative risks adjusted for child, driver, and crash characteristics.

Results

Six percent (6%) of children riding with restrained adult drivers were evaluated in the ED compared to twenty-two percent (22%) of children riding with unrestrained adult drivers following a MVC (relative risk 0.29, 95% confidence interval 0.26-0.32). After adjusting for child, vehicle, and crash characteristics, the relative risk of child ED evaluation associated with driver restraint remained significant (relative risk 0.82, 95% confidence interval 0.72-0.94). Driver restraint use was associated with child restraint use, less alcohol/drug involvement, and lower relative risk of severe collision types (head-on, rollover).

Conclusions

Driver seat belt use is associated with decreased risk of ED evaluation for child passengers in the event of a MVC.     

Geographic and sociodemographic variation in self-reported seat belt use in the United States

Background

With new data available, we sought to update existing literature on the prevalence of self-reported seat belt use by state, region, and rural/urban status and to estimate the strength of the association between seat belt use and rural/urban status adjusted for type of seat belt law and several other factors.

Methods

We examined data on self-reported use of seat belts from 50 states, the District of Columbia, and three territories using the 2008 Behavioral Risk Factor Surveillance System, a state-based random-digit-dialed telephone survey (n = 406,552). Reported seat belt use was assessed by state, U.S. Census regions, and U.S. Department of Agriculture (USDA) rural/urban continuum codes.

Results

Overall, 85% of adults in the United States reported they always used seat belts. Regionally, the West had the highest prevalence of persons who reported that they always wear seat belts (89.6%) and the Midwest had the lowest (80.4%). States with primary seat belt laws had the highest prevalence of reported seat belt use, compared with states with secondary or no laws. After adjusting for various sociodemographic characteristics, body mass index, and type of seat belt law, persons in the most densely populated metropolitan areas were significantly more likely to report always wearing seat belts than those in most sparsely populated rural areas (adjusted odds ratio = 2.9).

Conclusion

Our findings reinforce the evidence that primary enforcement seat belt laws are effective for increasing seat belt use, and suggest that upgrading to primary enforcement laws will be an important strategy for reducing crash-related fatalities in rural areas.     

The frequency and predictors of helmet use among Iranian motorcyclists: A quantitative and qualitative study

Objective

This study examines the rate of helmet use and identifies barriers and facilitators of wearing helmets among Iranian motorcyclists. A mixed-method approach was used, including a structured seasonal survey with specific observations of a random sample of 6010 riders and qualitative methods that included 29 in-depth interviews and seven focus groups (n = 31).

Results

Only 10% of motorcyclists wear a standard helmet while riding. However, another 23% of motorcyclists used non-standard or partial helmets that covered only part of the head and do not prevent head trauma injuries effectively. We observed only 2 of 264 child passengers and 22 of 1951 adult passengers wearing helmets. Almost no one used protective pants or clothing made to be more visible in traffic. Themes emerged from qualitative interviews and were grouped into three main categories: (1) helmet characteristics; (2) social and cultural factors; and (3) personal and psychological factors.

Conclusion

Overall, the motorcyclists in our study believed that wearing a safety helmet protects them against serious injuries or death during a crash; however, only a small percentage of the motorcyclists used safety helmets. National intervention programs addressing motorcycle safety should aim to overcome barriers to and promote facilitators of helmet use, including providing inexpensive standard helmets, banning manufacturing/using unsafe partial or dummy helmets, as well as enforcing helmet use on a consistent basis.     

Effects of graduated driver licensing on licensure and traffic injury rates in Upstate New York

Objective

In 2003, New York State implemented an enhanced graduated driving licensing (GDL) program that requires extended supervised driving and a passenger restriction. This study examines its safety benefit in 55 Upstate New York counties.

Methods

We analyzed fatal/incapacitating traffic injury data among 16-, 17- and 21-24-year olds for the years 2001 and 2005 using the negative binomial model. To adjust for trends in the traffic injury rate, the relative rate ratio (rRR) of 16- and 17-year olds relative to 21-24-year olds was estimated.

Results

GDL implementation was associated with a 31% reduction in the driver injury rate (rRR 0.69, 95% confidence interval (CI) 0.49-0.96), but not with any statistically significant change in the passenger injury rate (rRR 1.19, 95% CI 0.77-1.84), or pedestrian and bicyclist injury rate (rRR 1.53, 95% CI 0.89-2.62) among 16-year olds. Sixteen-year olds experienced a 21% decline in licensure rates between 2001 and 2005. GDL implementation had no appreciable impact on driver injury and licensure rates for 17- and 21-24-year olds.

Conclusions

GDL implementation is associated with a significant reduction in licensure and driver injury rate among 16-year olds. GDL implementation does not have a statistically significant impact on passenger, pedestrian, and bicyclist injury rates for 16-year olds.     

Overweight children: Are they at increased risk for severe injury in motor vehicle collisions?

Background

Obesity is an epidemic in the United States. The relationship between traumatic injury and obesity in children is not well-studied. We hypothesized that overweight children suffer more severe injuries, different distributions of injuries and improper use of restraints in motor vehicle collisions.

Methods

We conducted a secondary analysis of the CIREN database of motor vehicle collisions of subjects 2-17 years old. Overweight was defined as a BMI percentile for age >85%. Significant injury was an Injury Severity Score (ISS) >15 or an Abbreviated Injury Scale (AIS) score greater than one. Further analysis looked at injuries classified as head, trunk, or extremities and appropriateness of restraints. Odds ratios compared the overweight to lean groups.

Results

335 subjects met inclusion criteria with 35.5% of cases being overweight. For significant injury, overweight cases had an odds ratio of 1.2 [95% CI: 0.8-1.9]. Analysis by AIS for overall significant injury and to specific body regions also did not show any significant associations. Overweight versus lean subjects had an odds ratio of 1.3 [95% CI: 0.8-2.1] for improper use of restraints.

Conclusions

We found no significant relationship between pediatric injury severity, distribution of injuries, or restraint use and being overweight. Limitations of this study were the small sample size in this database and the large number of unrestrained subjects.     

Which young people accept a lift from a drunk or drugged driver?

Introduction

Riding with a drunk and/or a drugged driver (RDD) is a risk behaviour that has received very little attention in spite of its potential dangers. Young people involved in the recreational nightlife context are especially at risk.

Method

1363 regular users of recreational nightlife from nine European countries (mean age: 21.75; 51.5% women) filled out a self-administered and anonymous questionnaire (in 2006).

Results

37.2% had practised RDD during the previous month. RDD is related to drunkenness and use of drugs, personality factors such as impulsivity, preferring to use a private car to get to nightlife venues, living in a southern European country and being unemployed. No significant influence was found for age, gender, educational level or socioeconomic status.

Discussion

It is important to raise awareness about the high prevalence of RDD. This lack of awareness can be related to its social acceptance among young people. The use of private cars for going to nightlife venues should be discouraged.