Off-highway vehicle parks: Combining environment,knowledge, and enforcement for all-terrain vehicle injury prevention

The number of off-highway vehicle (OHV) parks continues to grow to meet the recreational needs of ATV enthusiasts and the increasing popularity of the vehicle. Little is known about how OHV park regulations and enforcement affect ATV safety among their users. This study was designed to determine whether there were differences in crash mechanisms and/or compliance with ATV safety laws and regulations when comparing off-road ATV crashes inside and outside state OHV parks. Relative to outside the parks, a smaller percentage of park victims were under the age of sixteen, a lower percentage were passengers, and a dramatically higher percentage were helmeted. Mean injury severity scores were not different inside and outside the parks, but 5% of outside victims had severe brain injuries, as compared to no park victims. Overall, park victims exhibited better compliance with ATV safety laws and regulations and suffered less severe brain injury outcomes. However, park crashes involved more jump-related injuries, suggesting that additional approaches are needed to improve park safety. These findings support the hypothesis that riding environments with safety regulations and effective enforcement can promote safe behaviors and may prevent injuries.     

Injury typology of fatal motorcycle collisions with roadside barriers in Australia and New Zealand

Motorcyclists contribute significantly to road trauma around the world through the high incidence of serious injuries and fatalities. The role of roadside safety barriers in such trauma is an area of growing concern amongst motorcyclists, road authorities and road safety researchers and advocates. This paper presents a case series analysis of motorcyclists that were fatally injured following a collision with a roadside barrier during the period 2001–2006 in Australia and New Zealand. Injury profiles and severities are detailed, and associations with crash characteristics are investigated. It is shown that the thorax region had the highest incidence of injury and the highest incidence of maximum injury in fatal motorcycle-barrier crashes, followed by the head region. This is in contrast to fatal motorcycle crashes in all single- and multi-vehicle crash modes, where head injury predominates. The injury profiles of motorcyclists that slid into barriers and those that collided with barriers in the upright posture were similar. However, those that slid in were more likely to receive thorax and pelvis injuries.     

Are all-terrain vehicle injuries becoming more severe?

BACKGROUND: There are several reasons to suspect that injuries from all-terrain vehicles (ATV) have become both more serious and frequent in recent years. These reasons include increasing engine power, younger age of operators and inconsistent enforcement of helmet laws. The purpose of this study was to determine if the increase in ATV injuries was out of proportion to the increase in ATV usage and whether ATV injuries have increased in severity. METHODS: A retrospective analysis of the Consumer Product Safety Commission (CPSC) ATV injury data and the Pennsylvania Trauma System Foundation (PTSF) database from 1989 to 2002 was performed. ATV use, sales, deaths, trauma center admissions, Injury Severity Score (ISS), hospital length of stay (LOS) and Glascow Coma Score (GCS) were reviewed. RESULTS: ATV sales increased to 316%. In the decade prior to 2003, reported deaths nationally increased from 183 to 357 (95%) nationally and from 5 to 10 (100%) in Pennsylvania (PA). Admissions to trauma centers in PA increased 240%, yet the percentage of deaths to trauma center admissions remained constant at 2.6% during this period (p>.50). ISS and LOS from 1989 to 2002 did not significantly change (all p>.05) and GCS improved significantly. CONCLUSION: Despite concerns regarding the increasing dangers associated with ATVs, it appears that the severity of injuries from ATV use has not increased.     

The relationship between blood alcohol concentration and crash responsibility for fatally injured drivers.

Data for 595 fatally injured drivers in Texas were analyzed using logistic regression to determine the probability of crash responsibility as a function of blood alcohol concentration (BAC). Three independent panelists rated crash responsibility on a three-point scale, based on information contained in traffic accident reports. High inter-rater reliability was noted. Panel members were in agreement 98% of the time, unanimously assigning full responsibility in 61% of the cases and no responsibility in 31% of the cases. In addition to BAC, time of day and day of week were considered as variables in the regression model. A highly significant (P less than .01) relationship was found between BAC and the probability of crash responsibility. Furthermore, results of the analysis support previous studies that noted a high rate of responsibility among fatally injured drivers, in general, even those with negative BAC test results. Such findings are of importance in evaluating driver impairment at various BACs and for determining other factors that interact with alcohol in driver fatality crashes.     

Built environment effects on cyclist injury severity in automobile-involved bicycle crashes

This analysis uses a generalized ordered logit model and a generalized additive model to estimate the effects of built environment factors on cyclist injury severity in automobile-involved bicycle crashes, as well as to accommodate possible spatial dependence among crash locations. The sample is drawn from the Seattle Department of Transportation bicycle collision profiles. This study classifies the cyclist injury types as property damage only, possible injury, evident injury, and severe injury or fatality. Our modeling outcomes show that: (1) injury severity is negatively associated with employment density; (2) severe injury or fatality is negatively associated with land use mixture; (3) lower likelihood of injuries is observed for bicyclists wearing reflective clothing; (4) improving street lighting can decrease the likelihood of cyclist injuries; (5) posted speed limit is positively associated with the probability of evident injury and severe injury or fatality; (6) older cyclists appear to be more vulnerable to severe injury or fatality; and (7) cyclists are more likely to be severely injured when large vehicles are involved in crashes. One implication drawn from this study is that cities should increase land use mixture and development density, optimally lower posted speed limits on streets with both bikes and motor vehicles, and improve street lighting to promote bicycle safety. In addition, cyclists should be encouraged to wear reflective clothing.     

Alcohol and drugs in fatally and non-fatally injured motor vehicle drivers in northern Sweden

Alcohol and drugs are important risk factors for traffic injuries, a major health problem worldwide. This prospective study investigated the epidemiology and the presence of alcohol and drugs in fatally and hospitalized non-fatally injured drivers of motor vehicles in northern Sweden. During a 2-year study period, blood from fatally and hospitalized non-fatally injured drivers was tested for alcohol and drugs. The study subjects were recruited from well-defined geographical areas with known demographics. Autopsy reports, medical journals, police reports, and toxicological analyses were evaluated. Of the fatally injured, 38% tested positive for alcohol and of the non-fatally 21% tested positive; 7% and 13%, respectively, tested positive for pharmaceuticals with a warning for impaired driving; 9% and 4%, respectively, tested positive for illicit drugs. The most frequently detected pharmaceuticals were benzodiazepines, opiates, and antidepressants. Tetrahydrocannabiol was the most frequently detected illicit substance. No fatally injured women had illegal blood alcohol concentration. The relative proportion of positively tested drivers has increased and was higher than in a similar study 14 years earlier. This finding indicates that alcohol and drugs merit more attention in future traffic safety work.     

Trams-a risk factor for pedestrians

In Gothenburg tram injuries were identified to be an important cause of traffic injuries and fatalities (48%) among pedestrians. During the summer middle-aged men, often under the influence of alcohol, were often severely injured and the injury rate was also high during the autumn. A majority (60%) of those fatally injured were under the influence of alcohol. Most injury events happened at or near a tram stop. The most serious injuries arose when the victim landed under a tram. In 1992, a runaway tram caused a major disaster, killing 10 pedestrians and injuring 30. The injury reducing measures the tram company has now started to introduce include safety railings at tram stops, side barriers on the tramcars to prevent people from falling under the tram and lower speeds near tram stops.     

Preventability of vehicle-related fatalities.

Several different methods have been used to evaluate the survivability of traffic injuries. Previously published methods were reviewed to develop a specific method for vehicle-related fatalities. All fatally injured victims (n = 474) of vehicle-related crashes in the four northern-most counties of Sweden during a 5-year period were studied. Almost half (48%) of the victims had non-survivable injuries. The remaining cases were classified into different injury groups according to the Injury Severity Score (ISS) including 56 (12%) with an ISS < 25, 150 (32%) with ISS 25-49 and 42 (9%) with ISS 50-74. The median distance from the scene to the nearest hospital was 49 km. In the cases with ISS < 50 the medical care was further analyzed. In close to half of these cases, the victim did not receive optimal care in time with transportation time being of major importance. The absence of first aid was judged to have contributed to the death in 4% of the cases.     

Predictors of injury among younger and older adults in fatal motor vehicle crashes

With 2003 Fatality Analysis Reporting System data, we examined relationships among predictors of motor vehicle injury/fatality outcomes for younger (35–54 years) and older (65 years and older) drivers. Using the Precede-Proceed Model of Health Promotion as an organizing framework, we classified variables into person, vehicle and environment domains and conducted a multinomial logistic regression.Significant risk factors for older driver injuries were impact crashes at 1–3 o’clock (OR = 1.65; CI: 1.05–2.59), 7–9 o’clock angles (OR = 2.59; CI = 1.45–4.63), and driving with one passenger (OR = 2.25; CI: 1.58–3.20). Previous other motor vehicle convictions were significantly associated with reduced risk of injury (OR = 0.55; CI = 0.34–0.90). The 7–9 o’clock angle (OR = 3.06; CI: 1.83–5.12), and driving in daylight hours were risk factors for fatality among older drivers.Many risk factors (e.g., female gender, non-seatbelt use, rollover crashes, and vehicle body type), and protective factors (e.g., number of lanes and non-airbag deployment) were relevant for younger and older drivers. Findings showed relevant factors for drivers from both age groups, with some pointing to older adults, and set the stage for further research to develop injury and fatality prevention programs.     

Helmet use, patterns of injury, medical outcome, and costs among motorcycle drivers in Maryland.

A comprehensive study was conducted of all motorcycle traffic crashes occurring in Maryland during a one-year period. All available medical and cost data were linked with police crash reports. During the study period, 1,900 motorcycle drivers were involved in crashes. The data indicated that (i) helmet usage was 35% overall, 30% among fatally injured drivers, and only 16% among drivers with a history of drug/alcohol conviction, (ii) unhelmeted drivers seen at an emergency department were almost twice as likely to have sustained head injury (40%) as were helmeted drivers (21%) (the corresponding percentages for hospitalized drivers were 55% and 38%), and (iii) acute care cost for unhelmeted drivers was three times ($30,365) that of helmeted drivers.     

Incidence and characteristics of school bus crashes and injuries

Objective

Studies of school bus crashes have focused on the biomechanics of catastrophic collisions, with very few examining crash incidence.

Methods

Crashes in the state of Iowa were examined from January 2002 through December 2005. School bus crashes were identified through the Iowa Crash Data, a comprehensive database of all reported crashes in the State of Iowa. School bus mileage data were provided by the Iowa Department of Education. School bus crash, fatality, and injury rates were calculated and differences in crash and injury characteristics between school buses and other vehicles were examined.

Results

The school bus crash, fatality and non-fatal injury rates were 320.7, 0.4 and 13.6 per 100 million bus miles travelled, respectively. School bus crash fatality and injury rates were 3.5 and 5.4 times lower than overall all vehicle crash fatality and injury rates, respectively. Drivers of other vehicles were more likely to have caused the crash than the bus driver (P < 0.001).

Conclusions

School buses experience low crash rates, and the majority of crashes do not lead to injury. Buses are among the safest forms of road transportation, and efforts to educate drivers of other vehicles may help reduce crashes with buses.     

Analysis of large truck crash severity using heteroskedastic ordered probit models

Long-combination vehicles (LCVs) have significant potential to increase economic productivity for shippers and carriers by decreasing the number of truck trips, thus reducing costs. However, size and weight regulations, triggered by safety concerns and, in some cases, infrastructure investment concerns, have prevented large-scale adoption of such vehicles. Information on actual crash performance is needed. To this end, this work uses standard and heteroskedastic ordered probit models, along with the United States’ Large Truck Crash Causation Study, General Estimates System, and Vehicle Inventory and Use Survey data sets, to study the impact of vehicle, occupant, driver, and environmental characteristics on injury outcomes for those involved in crashes with heavy-duty trucks. Results suggest that the likelihood of fatalities and severe injury is estimated to rise with the number of trailers, but fall with the truck length and gross vehicle weight rating (GVWR). While findings suggest that fatality likelihood for two-trailer LCVs is higher than that of single-trailer non-LCVs and other trucks, controlling for exposure risk suggest that total crash costs of LCVs are lower (per vehicle-mile traveled) than those of other trucks.     

The effect of seat belts on minor and severe injuries measured on the abbreviated injury scale

Following the implementation of seat belt wearing legislation in Victoria in December 1970, the Royal Australasian College of Surgeons established a survey to collect detailed injury and crash data from car accidents in that State. An analysis of the effect of seat belt wearing on severe injuries sustained by car occupants during the first two years of the survey was reported by Cameron and Nelson[1977]. Minor injuries were ignored in that analysis. Further work extended the file to cover 8537 occupants injured during the first three years of the survey and the injuries (including minor injuries) were coded on the Abbreviated Injury Scale. This paper examines the effect of seat belt wearing on both minor and severe injuries. Some comparisons of injury severity distributions in the Victorian data and in data collected by North American MDAI teams are also made. The paper concludes that the wearing of static three-point lap/sash belts by front outboard seat occupants of cars and car derivatives is associated with: (a) Reduced likelihood of severe-to-fatal injury to the head-face, thorax, lower torso and lower extremities when injured and not ejected in crashes in built-up areas and, for some body regions, in open road crashes, (b) Increased likelihood of minor injury to the thorax and lower torso when injured and not ejected in crashes in all locations and of minor injury to the neck (i.e. whiplash) when injured and not ejected in crashes in built-up areas. There are suggestions that the increased likelihoods of the minor injuries are not artefacts of the injury criterion for inclusion, nor of the reduced likelihood of severe injury to the trunk when seat belts are worn, but are due to the wearing of the seat belt.     

Deaths of teenagers as passengers in motor vehicles

Teenagers far exceed all other ages in fatalities per capita both as drivers and as passengers in motor vehicles. Most studies of vehicle crashes involving teenagers focus on teenage drivers, despite the fact that the numbers of teenage deaths as passengers and as drivers are about equal. In 1978, 63% of all fatally injured teenage passengers sustained their injuries in vehicles driven by teenage drivers: 72% of the passengers fatally injured in vehicles driven by teenage drivers were teenagers. Half of the teenage passenger deaths occurred in nighttime crashes. Possible ways to reduce the crash deaths of teenagers are discussed. These include restricting the driving of teenagers; prohibiting teenage drivers from transporting teenage passengers; greater implementation of crash packaging technologies; cleaning up highway and roadside hazards, and laws requiring seat belt use by teenagers.     

Characteristics of alcohol-related fatal general aviation crashes

BACKGROUND: The effects of alcohol on piloting performance have been studied extensively. Information describing alcohol-related aviation crashes, however, is scant. METHODS: We developed a data system for fatally injured pilots in Maryland, New Mexico, and North Carolina by linking autopsy data from the state medical examiner offices and crash investigation reports from the National Transportation Safety Board. Alcohol-related crashes are defined as those in which the pilot had a blood alcohol concentration of 20 mg/dL or greater. Differences between alcohol- and non-alcohol-related crashes were assessed with regard to pilot characteristics, crash circumstances, and human factors. RESULTS: The National Transportation Safety Board recorded 313 general aviation crashes fatal to the pilot in the three states between 1985 and 2000. Of these crashes, 255 (81%) were matched successfully with medical examiner records. Alcohol testing results were available for 233 of the fatally injured pilots. Of those tested for alcohol, 25 (11%) had blood alcohol concentrations > or =20 mg/dL (mean=75 +/- 64 mg/dL). The majority of alcohol-related crashes (52%) occurred at night (7p.m. to 6a.m.), compared with 28% of other crashes (P < 0.01). Alcohol-related crashes were significantly more likely than other crashes to have involved continued flight under visual flight rules (VFR) into instrument meteorological conditions (IMC) (32% versus 12%, P < 0.01), and flawed decisions (64% versus 41%, P = 0.03). CONCLUSIONS: Distinctive epidemiological patterns are exhibited in alcohol-related fatal general aviation crashes. Alcohol appears to play a particularly important role in crashes involving flight under VFR into IMC.     

The burden of injuries in the Philippines: implications for national research policy

Injuries cause 10% of the mortality and 15% of disability worldwide. However, there is a paucity of data on injuries in the developing world where two-thirds of all injury deaths occur. This is the first published report characterizing the overall problem of injuries in the Philippines, a developing country in southeast Asia. This report defines the burden of injuries in the Philippines and identifies priority areas for the national health research agenda. A systematic review of 35 years of published and unpublished data on injuries in the Philippines (1960–1995) was conducted. Injury fatality rates increased by 196% from 14.3 per 100,000 in 1960 to 42.3 per 100,000 in 1995, and one in 11 deaths in the Philippines are due to injuries. Intentional injuries account for 48% of all injury deaths and motor vehicle crashes for 15%. For 15–44 year old males, injuries account for 42% of all deaths, 67% of which are intentional. The proportion of all deaths attributable to intentional injuries has increased by 925% and that of motor vehicle crashes by 600% from 1960 to 1995. Improvements in injury surveillance and documentation of non-fatal injury outcomes are needed. Research into risk factors and potential interventions for the prevention of intentional injuries should be a priority in the Philippines.     

Motor vehicle drivers’ injuries in train–motor vehicle crashes

The objectives of this research were to: (1) identify a more suitable model for modeling injury severity of motor vehicle drivers involved in train–motor vehicle crashes at highway–rail grade crossings from among three commonly used injury severity models and (2) to investigate factors associated with injury severity levels of motor vehicle drivers involved in train–motor vehicle crashes at such crossings. The 2009–2013 highway–rail grade crossing crash data and the national highway–rail crossing inventory data were combined to produce the analysis dataset. Four-year (2009–2012) data were used for model estimation while 2013 data were used for model validation. The three injury severity levels—fatal, injury and no injury—were based on the reported intensity of motor-vehicle drivers’ injuries at highway–rail grade crossings.     

Analysis of factors associated with injury severity in crashes involving young New Zealand drivers

Young people are a risk to themselves and other road users, as motor vehicle crashes are the leading cause of their death. A thorough understanding of the most important factors associated with injury severity in crashes involving young drivers is important for designing well-targeted restrictive measures within youth-oriented road safety programs. The current study estimates discrete choice models of injury severity of crashes involving young drivers conditional on these crashes having occurred. The analysis examined a comprehensive set of single-vehicle and two-vehicle crashes involving at least one 15–24 year-old driver in New Zealand between 2002 and 2011 that resulted in minor, serious or fatal injuries. A mixed logit model accounting for heterogeneity and heteroscedasticity in the propensity to injury severity outcomes and for correlation between serious and fatal injuries proved a better fit than a binary and a generalized ordered logit. Results show that the young drivers’ behavior, the presence of passengers and the involvement of vulnerable road users were the most relevant factors associated with higher injury severity in both single-vehicle and two-vehicle crashes. Seatbelt non-use, inexperience and alcohol use were the deadliest behavioral factors in single-vehicle crashes, while fatigue, reckless driving and seatbelt non-use were the deadliest factors in two-vehicle crashes. The presence of passengers in the young drivers’ vehicle, and in particular a combination of males and females, dramatically increased the probability of serious and fatal injuries. The involvement of vulnerable road users, in particular on rural highways and open roads, considerably amplified the probability of higher crash injury severity.     

Prevalence of alcohol and drugs among motorcycle riders killed in road crashes in Norway during 2001–2010

The aim of the study was to examine the prevalence of alcohol and drugs in blood samples from motorcycle riders who died in road crashes in Norway from 2001 to 2010. An additional aim was to compare the prevalence of alcohol and drugs in blood samples from fatally injured motorcycle riders and car drivers who died during the same time period.     

Mixed logit model-based driver injury severity investigations in single- and multi-vehicle crashes on rural two-lane highways

Crashes occurring on rural two-lane highways are more likely to result in severe driver incapacitating injuries and fatalities. In this study, mixed logit models are developed to analyze driver injury severities in single-vehicle (SV) and multi-vehicle (MV) crashes on rural two-lane highways in New Mexico from 2010 to 2011. A series of significant contributing factors in terms of driver behavior, weather conditions, environmental characteristics, roadway geometric features and traffic compositions, are identified and their impacts on injury severities are quantified for these two types of crashes, respectively. Elasticity analyses and transferability tests were conducted to better understand the models’ specification and generality. The research findings indicate that there are significant differences in causal attributes determining driver injury severities between SV and MV crashes. For example, more severe driver injuries and fatalities can be observed in MV crashes when motorcycles or trucks are involved. Dark lighting conditions and dusty weather conditions are found to significantly increase MV crash injury severities. However, SV crashes demonstrate different characteristics influencing driver injury severities. For example, the probability of having severe injury outcomes is higher when vans are identified in SV crashes. Drivers’ overtaking actions will significantly increase SV crash injury severities. Although some common attributes, such as alcohol impaired driving, are significant in both SV and MV crash severity models, their effects on different injury outcomes vary substantially. This study provides a better understanding of similarities and differences in significant contributing factors and their impacts on driver injury severities between SV and MV crashes on rural two-lane highways. It is also helpful to develop cost-effective solutions or appropriate injury prevention strategies for rural SV and MV crashes.