Injury incidence rates of cyclists compared to pedestrians,car occupants and powered two-wheeler riders,using a medical registry and mobility data,Rhône County,France

Purpose

In France, the bicycle's modal share is stabilizing after a decline; in some of France's major cities, it has even increased since the 1990s. It is hence relevant to improve the knowledge of the injury risk associated with cycling, compared with other means of transport such as car, walking and powered two-wheeler (PTW) riding.

Methods

The injury incidence rates were estimated by the ratio between accident data and mobility (exposure) data. Two accident data sources were used: police data and hospital-based data (outpatients and inpatients) from the Rhône road trauma Registry. This provides four injury categories: all-injury, hospitalization, serious-injury and fatal-injury. Exposure data were estimated from a regional household travel survey (RTS), using three measures of mobility: number of trips, distance traveled and time spent traveling. The survey was carried out from November 2005 to April 2006, on weekdays, outside school and public holidays; this seasonality was corrected using the 2007–2008 national household travel survey (NTS) that covered an entire year. Only information involving accidents and trips in, and residents of, the Rhône County (1.6 million inhabitants, including the city Lyon) were included in our study. Trends of injury rates were also evaluated in Greater Lyon, using previous travel surveys.

Results

The PTW riders had the highest all-injury, hospitalization, serious-injury and fatal-injury rates, followed by cyclists, and lastly by pedestrians and car occupants. The rates between men and women seemed similar among pedestrians and among car occupants. For car occupants, pedestrians and cyclists, the age group 18–25 years had higher all-injury rate compared with the age group 25–65 years. On the contrary, the age group ≥65 years seemed to have higher hospitalization and serious-injury rates, compared with the age group 25–65 years. For cyclists, the injury rates seemed higher in non-dense areas than in dense areas. Between 1996–1997 and 2005–2006 and with regards to time spent traveling, the all-injury, serious-injury and fatal-injury rates seemed to have decreased for car occupants and cyclists.

Conclusion

The higher risk for PTW riders is confirmed and quantified; it is very high. Decrease in injury rates seems more marked for cyclists; this may indicate the “safety in numbers” effect. Countermeasures for improving road safety could be implemented, especially for vulnerable road user types. However, they will not be sufficient to fill in the gap between the much higher risk for PTW riders and that of car occupants. Exposure-based injury rates can be a tool for monitoring and evaluating the effectiveness of policies and programs, and for comparisons between countries.     

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.     

Powered two-wheeler drivers’ crash risk associated with the use of bus lanes

Context

Authorizing powered two-wheeler drivers to drive in lanes reserved to buses is a measure that is sometimes mentioned to improve mobility conditions for these users. But what effect would this measure have on the safety of these users and on the safety of the other users with whom they share the traffic space?

Objective

The objective of this study is to contribute elements to help answer this question. More precisely, the objective is to estimate the risk of having an accident per kilometer driven by powered two-wheeler drivers who drive in bus lanes and to compare this risk with that of powered two-wheeler drivers who drive in general traffic lanes.

Method

Using the bodily injury accidents recorded by the police over two years on 13 roads in the city of Marseille and a campaign of periodical observations of powered two-wheeler traffic, we estimated the risk per kilometer driven by powered two-wheeler drivers who drive in bus lanes and compared it with that of drivers who do not drive in them.

Results

The results show that the risk for powered two-wheeler drivers who drive in bus lanes of being involved in a bodily injury accident is significantly higher than the risk run by drivers who drive in general traffic lanes. For the 13 roads studied, it is on average 3.25 times higher (95% CI: 2.03; 5.21).

Conclusion

In the current situation, powered two-wheeler drivers who drive in bus lanes are less safe than those who drive in general traffic lanes. The analysis of police reports suggests that part of this increased risk comes from collisions between automobile drivers turning right and powered two-wheelers driving in the bus lane who continue straight ahead.     

Contextual deprivation, daily travel and road traffic injuries among the young in the Rhône Département (France)

This study investigated the effect of the socioeconomic level of the municipality of residence on personal injury road traffic accident risk among young persons of 10–24 years of age in the Rhône Département. This effect was assessed by comparing incidences of injuries (n = 2792 casualties) on the basis of three denominators: the resident population of young people, the number of users of each mode and the distances covered by each mode. The results are presented for each type of road users (pedestrians, car passengers, car drivers, motorised two-wheeler riders, cyclists, public transport users).Young persons from deprived municipalities use motorised-two wheelers, bicycles and the car (as passengers and drivers) less frequently, they walk more and take public transports more often than those from other municipalities.When considering injury risk, motorised two wheeler injuries among adolescent males, for example, are significantly less frequent in deprived municipalities. But the motorised two-wheeler riders as well as car passengers from deprived municipalities are characterized by an excess injury risk, whether the selected denominator is the number of users or the kilometres travelled by this mode.For the first time in France, this study has enabled a comparison of the effects of a contextual socioeconomic indicator (the type of municipality of residence, deprived, or not) on daily travel practices and injury incidences among the population, among the users of each mode and per km of travel.     

Will the light truck bumper height-matching standard reduce deaths in cars?

Background

In a collision between a car and a sport utility vehicle (SUV) or pickup truck, car occupants are more likely to be killed than if they crashed with another car. Some of the excess risk may be due to the propensity of SUVs and pickups with high bumpers to override the lower bumpers in cars. To reduce this incompatibility, particularly in head-on collisions, in 2003 automobile manufacturers voluntarily established a bumper height-matching standard for pickups and SUVs.

Objective

To assess whether height-matching bumpers in pickups and SUVs were associated with the risk of death in either car occupants or pickup and SUV occupants.

Methods

Case–control study of collisions between one car and one SUV or pickup in the US during 2000–2008, in which the SUV or pickup was model year 2000–2006. Cases were all decedents in fatal crashes; one control was selected from each crash in a national probability sample of crashes.

Findings

Occupants of cars that crashed with SUVs or pickups with height-matching bumpers may be at slightly reduced risk of death compared to those that crashed with other SUVs or pickups (adjusted odds ratio: 0.83 (95% confidence interval 0.61–1.13)). There was no evidence of a reduction in risk in head-on crashes (1.09 (0.66–1.79)). In crashes in which the SUV or pickup struck the car on the side, height-matched bumpers were associated with a reduced risk of death (0.68 (0.48–0.97)). Occupants of SUVs and pickups with height-matching bumpers may also be at slightly reduced risk of death (0.91 (0.64–1.28)).

Conclusions

Height-matching bumpers were associated with a reduced risk of death among car occupants in crashes in which SUVs or pickups struck cars in the side, but there was little evidence of an effect in head-on crashes. The new bumper height-matching standard may not achieve its primary goal of reducing deaths in head-on crashes, but may modestly reduce overall deaths in crashes between cars and SUVs or pickups because of unanticipated benefits to car occupants in side crashes, and a possible beneficial effect to SUV and pickup occupants.     

Motorized two-point safety belt effectiveness in preventing fatalities

The effectiveness of two-point motorized restraint systems in preventing fatalities to outboard front-seat car occupants is estimated using published fatality data for one model car equipped with a motorized two-point-belt system, together with a number of assumptions. Effectiveness estimates are obtained for the motorized belt system as used in the field, which reflects the mix of occupants who do and do not fasten the manual lap belt, and for effectiveness when the lap belt is not used. This latter estimate is, therefore, an estimate of the effectiveness of shoulder belts in preventing fatalities. In the data for the one car model, 18% of the fatally injured occupants were ejected. By assuming that three-point belt systems prevent ejection, these data are used to compute the difference in effectiveness between two-point and three-point systems. The result applies to the two-point belt system used in conjunction with whatever manual belt-use rates occurred in traffic. From published observations of lap-belt-use rates for this same vehicle, the effectiveness of the shoulder belt only is estimated. It is found that effectiveness of the two-point restraint system in conjunction with the lap-belt use that occurred in traffic is (32 +/- 5)%. The effectiveness of the shoulder belt only is estimated as (29 +/- 8)%.     

Contribution of exposure,risk of crash and fatality to explain age- and sex-related differences in traffic-related cyclist mortality rates

This study was designed to quantify the percent contribution of exposure, risk of collision and fatality rate to the association of age and sex with the mortality rates among cyclists in Spain, and to track the changes in these contributions with time. Data were analyzed for 50,042 cyclists involved in road crashes in Spain from 1993 to 2011, and also for a subset of 13,119 non-infractor cyclists involved in collisions with a vehicle whose driver committed an infraction (used as a proxy sample of all cyclists on the road). We used decomposition and quasi-induced exposure methods to obtain the percent contributions of these three components to the mortality rate ratios for each age and sex group compared to males aged 25–34 years. Death rates increased with age, and the main component of this increase was fatality (around 70%). Among younger cyclists, however, the main component of increased death rates was risk of a collision. Males had higher death rates than females in every age group: this rate increased from 6.4 in the 5–14 year old group to 18.8 in the 65–79 year old group. Exposure, the main component of this increase, ranged between 70% and 90% in all age categories, although the fatality component also contributed to this increase. The contributions of exposure, risk of crash and fatality to cyclist death rates were strongly associated with age and sex. Young male cyclists were a high-risk group because all three components tended to increase their mortality rate.     

Crash fatality risk and unibody versus body-on-frame structure in SUVs

Background

In crashes between cars and SUVs, car occupants are more likely to be killed than if they crashed with another car. An increasing proportion of SUVs are built with unibody, rather than truck-like body-on-frame construction. Unibody SUVs are generally lighter, less stiff, and less likely to roll over than body-on-frame SUVs, but whether unibody structure affects risk of death in crashes is unknown.

Objective

To determine whether unibody SUVs differ from body-on-frame SUVs in the danger they pose to occupants of other vehicles and in the self-protection they offer to their own occupants.

Methods

Case–control study of crashes between one compact SUV and one other passenger vehicle in the US during 1995–2008, in which the SUV was model year 1996–2006. Cases were all decedents in fatal crashes, one control was selected from each non-fatal crash.

Findings

Occupants of passenger vehicles that crashed with compact unibody SUVs were at 18% lower risk of death compared to those that crashed with compact body-on-frame SUVs (adjusted odds ratio 0.82 (95% confidence interval 0.73–0.94)). Occupants of compact unibody SUVs were also at lower risk of death compared to occupants of body-on-frame SUVs (0.86 (0.72–1.02)).

Conclusions

In two-vehicle collisions involving compact SUVs, unibody structure was associated with lower risk of death both in occupants of other vehicles in the crash, and in SUVs’ own occupants.     

A few seconds to have an accident,a long time to recover: Consequences for road accident victims from the ESPARR cohort 2 years after the accident

Objective

The aim of the present study was to describe the consequences of a road accident in adults, taking account of the type of road user, and to determine predictive factors for consequences at 2 years.

Design

Prospective follow-up study.

Methods

The cohort was composed of 1168 victims of road traffic accidents, aged ≥16 years. Two years after the accident, 912 victims completed a self-administered questionnaire. Weighted logistic regression models were implemented to compare casualties still reporting impact related to the accident versus those reporting no residual impact. Five outcomes were analysed: unrecovered health status, impact on occupation or studies, on familial or affective life, on leisure or sport activities and but also the financial difficulties related to the accident.

Results

46.1% of respondents were motorised four-wheel users, 29.6% motorised two-wheel (including quad) users, 13.3% pedestrians (including inline skate and push scooter users) and 11.1% cyclists. 53.3% reported unrecovered health status, 32.0% persisting impact on occupation or studies, 25.2% on familial or affective life, 46.9% on leisure or sport activities and 20.2% still had accident-related financial difficulties. Type of user, adjusted on age and gender, was linked to unrecovered health status and to impact on leisure or sport activities. When global severity (as measured by NISS) was integrated in the previous model, type of user was also associated with impact on occupation or studies. Type of user was further associated with impact on occupation or studies and on leisure or sport activities when global severity and the sociodemographic data obtained at inclusion were taken into account. It was not, however, related to any of the outcomes studied here, when the models focused on the injured body region. Finally, type of road user did not seem, on the various predictive models, to be related to financial difficulties due to the accident or to impact on familial or affective life.

Conclusions

Overall, victims were affected by their accident even 2 years after it occurred. The severity of lesions induced by the accident was the main predictive factor. However, considering lesion as intermediary factors between the accident and the recovery status at 2 year post-accident, impact on health status was lower for cyclists than M4W users or M2W users.     

Risk and threat factors in prior representations of driving situations among powered two-wheeler riders and car drivers

Our research objective is to contribute to gaining a better understanding of the difficulties inherent to managing interactions between power two-wheeler riders and car drivers. 132 power two-wheeler riders and 94 car drivers have been asked what they perceive as being riskiest in driving situations for the representatives of their generic reference group. From all the answers produced, only those which provide information on risk factors related to the other and the occurrence of interferences due to the dynamic situation have been retained and analysed. The results provide a partial explanation of the difficulties related to the two types of users’ taking each other into account. On the one hand, the frequency with which the other is mentioned as a source of risk is linked to the concept of conspicuity. This interpretation is related to the relative frequency of the interactions and the difference of real and perceived vulnerability between the users. On the other hand, the specific risk factors attributed to the other illustrates a mutual misunderstanding or ignorance of the driving situation's determinants. These include various practices among users which can be related to the physical and dynamic characteristics of their vehicle and their level of familiarity with other users. The potential road safety consequences of prior representations of risk factors among users are presented and suggestions for improving road user safety are proposed.     

Seat-belt legislation and risk homeostasis: Further analysis of the British data

It has been suggested that seat-belt legislation may result in drivers' feeling overprotected and their consequent riskier driving may lead to more injuries to other road users (the risk homeostasis or compensation theory). We have examined data in Britain before and after legislation made seat-belt use compulsory for front-seat occupants of specified vehicles. The relative numbers of injuries to cyclists and pedestrians in collisions with vehicles requiring and not requiring seat-belt use were compared, using a loglinear analysis taking into account possible confounding variables. It was not possible directly to incorporate vehicle distance travelled for the two categories of vehicle. However, a simple adjustment for differential vehicle use accounted for most of an apparent effect. The revised odds ratio (for mandated seat-belt use vehicles versus nonmandated, post- versus prelegislation) was 1.04 for cyclists and 1.06 for pedestrians, showing minimal, if any, evidence for the theory.     

Relative risk of injury and death in ambulances and other emergency vehicles

This study addresses of the impacts of emergency vehicle (ambulances, police cars and fire trucks) occupant seating position, restraint use and vehicle response status on injuries and fatalities. Multi-way frequency and ordinal logistic regression analyses were performed on two large national databases, the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System (FARS) and the General Estimates System (GES). One model estimated the relative risk ratios for different levels of injury severity to occupants traveling in ambulances. Restrained ambulance occupants involved in a crash were significantly less likely to be killed or seriously injured than unrestrained occupants. Ambulance rear occupants were significantly more likely to be killed than front-seat occupants. Ambulance occupants traveling non-emergency were more likely than occupants traveling emergency to be killed or severely injured. Unrestrained ambulance occupants, occupants riding in the patient compartment and especially unrestrained occupants riding in the patient compartment were at substantially increased risk of injury and death when involved in a crash. A second model incorporated police cars and fire trucks. In the combined ambulance–fire truck–police car model, the likelihood of an occupant fatality for those involved in a crash was higher for routine responses. Relative to police cars and fire trucks, ambulances experienced the highest percentage of fatal crashes where occupants are killed and the highest percentage of crashes where occupants are injured. Lack of restraint use and/or responding with ‘lights and siren’ characterized the vast majority of fatalities among fire truck occupants. A third model incorporated non-special use van and passenger car occupants, which otherwise replicated the second model. Our findings suggest that ambulance crewmembers riding in the back and firefighters in any seating position, should be restrained whenever feasible. Family members accompanying ambulance patients should ride in the front-seat of the ambulance.     

Inexperience and risky decisions of young adolescents,as pedestrians and cyclists,in interactions with lorries,and the effects of competency versus awareness education

Background

Road injuries are a prime cause of death in early adolescence. Often road safety education (RSE) is used to target risky road behaviour in this age group. These RSE programmes are frequently based on the assumption that deliberate risk taking rather than lack of competency underlies risk behaviour. This study tested the competency of 10–13 year olds, by examining their decisions – as pedestrians and cyclists – in dealing with blind spot areas around lorries. Also, the effects of an awareness programme and a competency programme on these decisions were evaluated.

Method

Table-top models were used, representing seven scenarios that differed in complexity: one basic scenario to test the identification of blind spot areas, and 6 traffic scenarios to test behaviour in traffic situations of low or high task complexity. Using a quasi-experimental design (pre-test and post-test reference group design without randomization), the programme effects were assessed by requiring participants (n = 62) to show, for each table-top traffic scenario, how they would act if they were in that traffic situation.

Results

On the basic scenario, at pre-test 42% of the youngsters identified all blind spots correctly, but only 27% showed safe behaviour in simple scenarios and 5% in complex scenarios. The competency programme yielded improved performance on the basic scenario but not on the traffic scenarios, whereas the awareness programme did not result in any improvements. The correlation between improvements on the basic scenarios and the traffic scenarios was not significant.

Conclusions

Young adolescents have not yet mastered the necessary skills for safe performance in simple and complex traffic situations, thus underlining the need for effective prevention programmes. RSE may improve the understanding of blind spot areas but this does not ‘automatically’ transfer to performance in traffic situations. Implications for the design of RSE are discussed.     

Burden of road traffic injuries: Disability-adjusted life years in relation to hospitalization and the maximum abbreviated injury scale

Background

The consequences of non-fatal road traffic injuries (RTI) are increasingly adopted by policy makers as an indicator of traffic safety. However, it is not agreed upon which level of severity should be used as cut-off point for assessing road safety performance. Internationally, within road safety, injury severity is assessed by means of the maximum abbreviated injury scale (MAIS). The choice for a severity cut-off point highly influences the measured disease burden of RTI. This paper assesses the burden of RTI in terms of disability adjusted life years (DALYs) by hospitalization status and MAIS cut-off point in the Netherlands.

Methods

Hospital discharge register (HDR) and emergency department (ED) data for RTI in the Netherlands were selected for the years 2007–2009, as well as mortality data. The incidence, years lived with disability (YLD), years of life lost (YLL) owing to premature death, and DALYs were calculated. YLD for admitted patients was subdivided by MAIS severity levels.

Results

RTI resulted in 48,500 YLD and 27,900 YLL respectively, amounting to 76,400 DALYs per year in the Netherlands. The largest proportion of DALYs is related to fatalities (37%), followed by admitted MAIS 2 injuries (25%), ED treated injuries (16%) and admitted MAIS 3+ injuries (18%). Admitted MAIS 1 injuries only account for a small fraction of DALYs (4%). In the Netherlands, the diseases burden of RTI is highest among cyclists with 39% of total DALYs. One half of all bicycle related DALYs are attributable to admitted MAIS 2+ injuries, but ED treated injuries also account for a large proportion of DALYs in this group (28%). Car occupants are responsible for 26% of all DALYs, primarily caused by fatalities (66%), followed by admitted MAIS 2+ injuries (25%). ED treated injuries only account for 5% of DALYs in this group.

Conclusions

When using admitted MAIS 3+ or admitted MAIS 2+ as severity cut-off point, 54% and 80% of all DALYs are captured respectively. Assessing the influence of different severity cut-off points by MAIS on the proportion and number of DALYs captured gives valuable information for guiding choices on the definition of serious RTI.     

Injury profiles of road traffic deaths

The objective is to describe injuries of road traffic deaths in Barcelona and identify injury profiles by road user type, through a cross-sectional study including road traffic deaths for the period 1997-2004. The data source was the Institut de Medicina Legal de Catalunya. Diagnoses were coded using the International Classification of Diseases, 9th revision, Clinical Modification, and classified using the Barell Matrix. Of the 719 deaths studied, 45% were pedestrians, 32% two wheel motor vehicle users, and 23% car occupants. The injury profile of the road traffic deaths in Barcelona is internal injuries and fractures to the torso and to the head/neck. This profile is repeated in all the road user groups, although pedestrians present higher frequencies of fractures and contusions to extremities and contusions to the head/neck, and fewer internal torso injuries than car occupants or two wheel motor vehicle users.     

The impact of driver age on lost life years for other road users in France: A population based study of crash-involved road users

BACKGROUND: One of the concerns in road safety is the threat older drivers may pose to other road users. Using the rate of lost life years, the present study provides a public health approach to quantify this potential threat. METHODS: A total of 1570686 motorised vehicle drivers or motorcycle riders and 652246 non-drivers, i.e. vehicle passengers, pedestrians and cyclists involved in injury crashes in France between 1996 and 2004, were included in a population based cross-sectional study. Fatality rates and rate of lost life years for each crash-involved driver age class were calculated for the drivers themselves and for other road users. RESULTS: The study has shown a significant reduction in the rate of lost life years for crash-involved other road users (whether passengers, pedestrians, cyclists or opposing drivers) as driver age increases. Other road users lost half as many years of life when involved in crashes with drivers aged over 85 than with drivers under 65 (1.26 and 2.32 per 100 expected remaining life years, respectively). CONCLUSION: Our findings suggest that among road users involved in injury crashes, older drivers are less dangerous for the other road users. By attributing other road users' lost life years to each driver age, this study represents a new contribution to the debate about ageing and road safety.     

Investigation of the Failure Mechanism by Bending of a Rack Steering Gear

The wheel-drive system of a car has a major influence on the safety of car’s occupants. By turning the steering wheel, centrifugal forces are developed and these forces cause a bending moment on the rack steering gear. To avoid plastic deformation of the rack steering gear, sufficient strength and spring/stiffness properties are necessary for the material. In the case under investigation, the vehicle was traveling with 60 km/h on a slippery road. While negotiating a turn along the road, the driver was not able to bring the car back on the road. The car stopped without any crash, and the technical inspection which followed showed that the rack steering gear was deformed plastically at the right arm. The occupants were in great danger during this incident. Metallurgical failure analysis was conducted, revealing that plastic deformation by bending occurred because the mechanical properties of the steel were not adequate because of insufficient deoxidation practices and a defective hard coating. The lack of deoxidation and defects in the hard coating should not be allowed occur, and to avoid such failures, the quality control measures for acceptance of such parts should be modified. The new practices should include better control over the non-metallic inclusions, and measurement of the hard coating’s thickness over the whole length of the bar.     

Evaluating the effect of vehicle modification in reducing injuries from landmine blasts. An analysis of 2212 incidents and its application for humanitarian purposes

Introduction

Anti-vehicle (AV) mines have been laid indiscriminately in conflict areas for the past 100 years. With an indeterminate life-span they continue to pose a significant threat to the civilian population, as well as restrict the movement of people, aid and goods to vulnerable populations. The aim of this study was to analyse unique casualty data from 2212 mine incidents to determine if simple vehicle modifications can reduce fatality and injury rates from mine explosions.

Method

We analysed casualty data from the Rhodesian War (1972–1980), to assess the effects of basic vehicle modifications (V-shaped hull, increased ground clearance, widened axles, heavy vehicles and blast deflectors) on injury rates. A multinomial regression statistical model was developed for vehicle modifications and number of alterations to explore these effects.

Results

Incident data was available on 2212 vehicle mine incidents involving 16,456 people. The overall fatality rate was 3.3% (544/16,456) and the overall injury rate was 22.7% (3741/16,456). Explosions against mine-protected vehicles resulted in a fatality rate of 1.2% (150/12,919); occupants in unprotected vehicles sustained a fatality rate of 11.4% (395/3537). The injury rate in mine protected vehicles was 22.2% (2868/12,919) compared to 24.7% in unprotected vehicles (873/3537).Utilising a multinomial logistical-regression model, we show that each design feature significantly reduced fatality rate (from 45% in unprotected vehicles to 0.8% in protected vehicles); each of these designs had a cumulative effect in fatality reduction. In isolation, blast deflectors, whilst reducing fatality rates, increased injury rates.

Conclusions

Our data clearly demonstrates that simple vehicle modifications can have a significant effect on reducing fatality and injury rates from AV mine explosions. Given that the modifications described were produced using commercially available vehicles with basic engineering requirements, we believe that similar processes could be employed in post-conflict environments in a cost-effective manner.