Understanding on-road practices of electric bike riders: An observational study in a developed city of China

Although millions of electric bikes (E-bikes) operate in China and many associated deaths and injuries have been reported, E-bikers’ on-road practices are poorly characterized and few direct observational studies have been performed. This study aims to describe riding behaviors among E-bikers and to investigate factors influencing these practices to inform injury prevention. In March 2012, a cross-sectional observational study was conducted at 14 randomly selected intersections in Suzhou during a 7-day period. A pro-forma observation checklist was used to collect data on road riding practice. Adjusted Odds Ratios (OR) and 95% Confidence Intervals (CI) to assess the likelihood of specific riding practices among E-bikers were evaluated using mixed-effects logistic regression. Among 18,150 E-bikers observed, 37.6% rode E-bikes with cycling pedals, 86.0% of E-bikes were registered, 26.6% did not comply with the road rules, and 41.1% wore at least one safety item. The overall prevalence of carrying passengers, riding in a motor vehicle lane, running red lights, riding in opposite directions (i.e., facing oncoming traffic), mobile phone use, and helmet use were 12.4% (95%CI: 11.9–12.9%), 1.9% (95%CI: 1.7–2.1%), 4.8% (95%CI: 4.5–5.1%), 3.4% (95%CI: 3.1–3.7%), 0.4% (95%CI: 0.3–0.5%), and 9.0% (95%CI: 8.5–9.4%), respectively. Male E-bikers was associated with increased helmet use and riding in motor vehicle lanes, whereas riding a registered E-bike was associated with reduced likelihood of carrying passengers. This study demonstrates common road rule violations and low helmet use among E-bikers and supports the urgent need to develop additional regulations and behavioral interventions to improve safety practice among E-bikers in China.     

Safety riding program and motorcycle-related injuries in Thailand

A retrospective cohort study was conducted in Thailand from 2007 to 2009 to evaluate the efficacy of a safety riding program in preventing motorcycle-related injuries. A training group of motorcyclists were certified by the Asia-Pacific Honda Safety Riding Program in either 30-h instruction (teaching skills, riding demonstration) or 15-h license (knowledge, skills, and hazard perception) courses. The control group consisted of untrained motorcyclists matched on an approximately 1:1 ratio with the training group by region and date of licensure. In total, there were 3250 subjects in the training group and 2963 in the control group. Demographic data and factors associated with motorcycle-related injuries were collected. Motorcycle-related injuries were identified using the Road Injuries Victims Protection for injuries claims and inpatient diagnosis-related group datasets from the National Health Security Office. The capture–recapture technique was used to estimate the prevalence of injuries. Multivariate analysis was used to identify factors related to motorcycle-related injuries. The prevalence of motorcycle-related injuries was estimated to be 586 out of 6213 riders (9.4%) with a 95% confidence interval (CI): 460–790. The license course and the instruction course were significantly associated with a 30% and 29% reduction of motorcycle-related injuries, respectively (relative risk 0.70, 95% CI: 0.53–0.92 and 0.71, 95% CI: 0.42–1.18, respectively). Other factors associated with the injuries were male gender and young age. Safety riding training was effective in reducing injuries. These training programs differ from those in other developed countries but display comparable effects. Hazard perception skills might be a key for success. This strategy should be expanded to a national scale.     

Prevalence rates of helmet use among motorcycle riders in a developed region in China

This study aimed to determine the prevalence rates of helmet use, and of correct helmet use (chinstrap firmly fastened) among motorcycle riders and their passengers in Zhongshan, Guangdong Province, China. A cross-sectional survey involving direct observation of motorcycle riders was conducted at 20 randomly selected intersections. A total of 13,410 motorcycles were observed during a 10-day period in February 2009. The overall prevalence of helmet use was 72.6% (95% CI: 71.8–73.3%) among drivers and 34.1% (95% CI: 32.7–35.5%) among pillion passengers. The prevalence of correct use was 43.2% (95% CI: 42.4–44.0%) and 20.9% (95% CI: 19.8–22.1%) for drivers and passengers respectively. The helmet wearing rate on city streets was almost 95%, however city riders were more likely than rural riders to wear non-motorcycle helmets while riding. In multivariate analyses, factors associated with increased helmet use included riding on city streets, male gender, being a driver, carrying less passengers and riding a registered motorcycle. The results indicated enforcement and education activities need to be strengthened with respect to both helmet use and helmet quality, especially in rural areas, in order to improve wearing rates.     

A cross-sectional observational study of helmet use among motorcyclists in Wa,Ghana

Motorcyclists’ injuries and fatalities are a major public health concern in many developing countries including Ghana. This study therefore aimed to investigate the prevalence of helmet use among motorcyclists in Wa, Ghana. The method used involved a cross-sectional roadside observation at 12 randomly selected sites within and outside the CBD of Wa. A total of 14,467 motorcyclists made up of 11,360 riders and 3107 pillion riders were observed during the study period. Most observed riders (86.5%) and pillion riders (61.7%) were males. The overall prevalence of helmet use among the observed motorcyclists was 36.9% (95% CI: 36.1–37.7). Helmet use for riders was 45.8% (95% CI: 44.8–46.7) whilst that for pillion riders was 3.7% (95 CI: 3.0–4.4). Based on logistic regression analysis, higher helmet wearing rates were found to be significantly associated with female gender, weekdays, morning periods and at locations within the CBD. Riders at locations outside the CBD were about 7 times less likely to wear a helmet than riders within the CBD (48.9% compared to 42.3%; χ²₍₁₎ = 49.526; p < 0.001). The study concluded that despite the existence of a national helmet legislation that mandates the use of helmets by both riders and pillion riders on all roads in Ghana, helmet use is generally low in Wa. This suggests that all stakeholders in road safety should jointly intensify education on helmet use and pursue rigorous enforcement on all road types especially at locations outside the CBD to improve helmet use in Wa.     

Are formally trained motorcyclists safer?

The present study was conducted to determine whether graduates of the Motorcycle Training Program (MTP) were less likely to have had an accident or committed a traffic violation while riding a motorcycle compared to informally trained (IT) motorcyclists. Since motorcyclists could not be randomly assigned to the training program, multivariate analyses were used to impose statistical control on the data. Samples of MTP graduates (N = 811) and IT motorcyclists (N = 1080) were interviewed about their riding experiences during the past four years including accidents and violations. Univariate analyses indicated that the MTP graduates were less likely than IT riders to have had accidents and violations during the criterion period. However, the graduates and IT riders differed in sex, age, time licensed, distance travelled, education and riding after drinking, all characteristics significantly related to accident and violation likelihood. Multivariate analyses, controlling for the differences in these characteristics, revealed that the MTP graduates and IT riders did not differ in accident likelihood but the MTP graduates were significantly less likely to have committed a traffic violation than the IT riders. Although the lower incidence of traffic violations among graduates could be attributed to the training program, it is possible that the graduates sought formal training because they were safety conscious and this attitude also influenced their riding behaviour.     

Determinants behind young motorcyclists’ risky riding behavior

Young motorcyclists have traditionally been considered a high-risk population. Given the critical influence of riders’ behaviors on traffic safety, identifying what riders think can help clarify the nature of accidents. Although psychological studies have explored the relationships among personality traits, attitudes and risky driving behavior, the primary difference this study makes from past studies is incorporating both positive and negative effects in a refined causal framework. This study adopts structural equation modeling to analyze data collected from 683 young motorcyclists aged between 18 and 28. The results conclude three primary personality traits of young motorcyclists, namely sensation seeking, amiability and impatience. While amiable riders represent a group of relatively mature and safe riders, the sensation-seeking riders are extremely self-confident, comfortable with unsafe riding and interested in the utility gained from it. Meanwhile, the sensation-seeking ones also are highly aware of traffic conditions, which may lower the chances of getting into an accident, but the accident could be extremely severe if it ever occurs. Impatient riders, having low riding confidence and traffic awareness deficiency, also seek utility from certain risky riding behaviors. However, their fear of an accident leads them to fail to observe surrounding traffic conditions. The result indicates various mental compromise mechanisms for young motorcyclists in conducting riding behaviors. Thus, corresponding countermeasures, including licensure system and ITS roadway development, should consider the heterogeneous characteristics of young riders.     

Temporal distribution of motorcyclist injuries and risk of fatalities in relation to age, helmet use, and riding while intoxicated in Khon Kaen, Thailand

This study investigated the temporal distribution of risky behaviors among injured motorcyclists, that is, riding unhelmeted or while intoxicated, and showed how they are associated with risk of fatal injuries. Data of motorcyclists injured in Khon Kaen municipality in northeastern Thailand and transferred to Khon Kaen Regional Hospital were obtained from the trauma registry system of the hospital. Case fatalities were compared by time of day, age group, helmet use, and alcohol intoxication. Unhelmeted riding peaked late in the evening and riding while intoxicated peaked around midnight. Both were associated with increased fatality risk after stratification by time of day; the odds ratios were 3.49 (95% confidence interval (CI) = 1.48-9.36) and 3.01 (CI = 1.71-5.19), respectively. Nighttime injuries were not significantly associated with increased fatality risk after stratification by helmet use or alcohol intoxication. Unhelmeted driving was prevalent and associated with higher fatality risk among younger drivers, whereas intoxicated driving was less prevalent among teens but associated with increased risk among those aged 20-39 years. This study shows that riding unhelmeted or while intoxicated can explain the increased fatality risk at night, suggesting that safety education or enforcements should be targeted at specific age groups and appropriate times.     

More screen operation than calling: The results of observing cyclists' behaviour while using mobile phones

Operating a mobile telephone while riding a bicycle is fairly common practice in the Netherlands, yet it is unknown if this use is stable or increasing. As such, whether the prevalence of mobile phone use while cycling has changed over the past five years was studied via on-road observation. In addition the impact of mobile phone use on lateral position, i.e. distance from the front wheel to the curb, was also examined to see if it compared to the results seen in previous experimental studies.     

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.     

Validation of the Chinese-language brief sensation seeking scale: Implications for risky riding behaviors of parental motorcyclists and their child passengers

Motorcycles are the leading cause of road traffic deaths in the Western Pacific and Southeast Asia, where Mandarin Chinese is the most commonly used language. Sensation seeking (SS) is reported to correlate with many risky motor vehicle behaviors, and therefore a culture-adapted Chinese instrument is needed to assess this personality trait in Chinese-speaking motorcycling populations. The standard front and blinded-backward process was carried out to formulate the Chinese-language Brief Sensation Seeking Scale (C-BSSS). 193 parental motorcyclists who rode with their young children were interviewed concerning their SS levels, demographics, riding behaviors, and the driving/riding experiences. A random sample of 30 subjects was re-interviewed 1–2 weeks later to examine the test-retest reliability. Psychometric analyses revealed satisfactory item characteristics, internal consistency, intraobserver reliability, and interobserver reliability. Additionally, parental motorcyclists who had the following characteristics were more likely to be the high sensation seekers (SSers), including male, younger age, presenting risky motor vehicle behaviors of themselves (e.g., higher riding speeds, operating after drinking, using a mobile phone while operating, and receiving a traffic ticket), and carrying child passengers who demonstrated dangerous motorcycling behaviors (e.g., a younger age, non-helmeted, and overloaded). We conclude that the C-BSSS is a useful and reliable measure of SS for ethnic Chinese populations. This instrument may be helpful to develop the future prevention strategy of motorcycle injuries in Chinese parental motorcyclists and their young child passengers.     

The contribution of passengers versus mobile phone use to motor vehicle crashes resulting in hospital attendance by the driver

There is evidence that mobile phone use while driving (including hands-free) is associated with motor vehicle crashes. However, whether the effects of mobile phone use differ from that of passengers in the vehicle remains unclear. The aim of this research was to estimate the risk of crash associated with passenger carriage and compare that with mobile phone use. A case-control study (‘passenger study’) was performed in Perth, Western Australia in 2003 and 2004. Cases were 274 drivers who attended hospital following a motor vehicle crash and controls were 1096 drivers (1:4 matching) recruited at service stations matched to the location and time and day of week of the crash. The results were compared with those of a case-crossover study (‘mobile phone study’) undertaken concurrently (n = 456); 152 cases were common to both studies. Passenger carriage increased the likelihood of a crash (adjusted odds ratio (adj. OR), 95% confidence interval (95% CI), 1.6, 1.1–2.2). Drivers carrying two or more passengers were twice as likely to crash as unaccompanied drivers (adj. OR 2.2, 95% CI 1.3–3.8). By comparison, driver's use of a mobile phone within 5 min before a crash was associated with a fourfold increased likelihood of crashing (OR 4.1, 95% CI 2.2–7.7). Passenger carriage and increasing numbers of passengers are associated with an increased likelihood of crash, though not to the same extent as mobile phone use. Further research is needed to investigate the factors underlying the increased risks.     

Does an on-road motorcycle coaching program reduce crashes in novice riders? A randomised control trial

ObjectivesMotorcycle riding is increasing globally and confers a high risk of crash-related injury and death. There is community demand for investment in rider training programs but no high-quality evidence about its effectiveness in preventing crashes. This randomised trial of an on-road rider coaching program aimed to determine its effectiveness in reducing crashes in novice motorcycle riders.MethodsBetween May 2010 and October 2012, 2399 newly-licensed provisional riders were recruited in Victoria, Australia and completed a telephone interview before randomisation to intervention or control groups. Riders in the intervention group were offered an on-road motorcycle rider coaching program which involved pre-program activities, 4 h riding and facilitated discussion in small groups with a riding coach. Outcome measures were collected for all participants via telephone interviews at 3 and 12 months after program delivery (or equivalent for controls), and via linkage to police-recorded crash and offence data. The primary outcome was a composite measure of police-recorded and self-reported crashes; secondary outcomes included traffic offences, near crashes, riding exposure, and riding behaviours and motivations.ResultsFollow-up was 89% at 3 months and 88% at 12 months; 60% of the intervention group completed the program. Intention-to-treat analyses conducted in 2014 indicated no effect on crash risk at 3 months (adjusted OR 0.90, 95% CI: 0.65–1.27) or 12 months (adjusted OR 1.00, 95% CI: 0.78–1.29). Riders in the intervention group reported increased riding exposure, speeding behaviours and rider confidence.ConclusionsThere was no evidence that this on-road motorcycle rider coaching program reduced the risk of crash, and we found an increase in crash-related risk factors.     

A hazard-based duration model for analyzing crossing behavior of cyclists and electric bike riders at signalized intersections

This paper presents a hazard-based duration approach to investigate riders’ waiting times, violation hazards, associated risk factors, and their differences between cyclists and electric bike riders at signalized intersections. A total of 2322 two-wheeled riders approaching the intersections during red light periods were observed in Beijing, China. The data were classified into censored and uncensored data to distinguish between safe crossing and red-light running behavior. The results indicated that the red-light crossing behavior of most riders was dependent on waiting time. They were inclined to terminate waiting behavior and run against the traffic light with the increase of waiting duration. Over half of the observed riders cannot endure 49 s or longer. 25% of the riders can endure 97 s or longer. Rider type, gender, waiting position, conformity tendency and crossing traffic volume were identified to have significant effects on riders’ waiting times and violation hazards. Electric bike riders were found to be more sensitive to the external risk factors such as other riders’ crossing behavior and crossing traffic volume than cyclists. Moreover, unobserved heterogeneity was examined in the proposed models. The finding of this paper can explain when and why cyclists and electric bike riders run against the red light at intersections. The results of this paper are useful for traffic design and management agencies to implement strategies to enhance the safety of riders.     

Mobile phone use while driving: A hybrid modeling approach

The analysis of the effects that mobile phone use produces while driving is a topic of great interest for the scientific community. There is consensus that using a mobile phone while driving increases the risk of exposure to traffic accidents. The purpose of this research is to evaluate the drivers’ behavior when they decide whether or not to use a mobile phone while driving. For that, a hybrid modeling approach that integrates a choice model with the latent variable “risk perception” was used. It was found that workers and individuals with the highest education level are more prone to use a mobile phone while driving than others. Also, “risk perception” is higher among individuals who have been previously fined and people who have been in an accident or almost been in an accident. It was also found that the tendency to use mobile phones while driving increases when the traffic speed reduces, but it decreases when the fine increases. Even though the urgency of the phone call is the most important explanatory variable in the choice model, the cost of the fine is an important attribute in order to control mobile phone use while driving.     

Novice riders and the predictors of riding without motorcycle protective clothing

Background

While helmet usage is often mandated, few motorcycle and scooter riders make full use of protection for the rest of the body. Little is known about the factors associated with riders’ usage or non-usage of protective clothing.

Methods

Novice riders were surveyed prior to their provisional licence test in NSW, Australia. Questions related to usage and beliefs about protective clothing, riding experience and exposure, risk taking and demographic details. Multivariable Poisson regression models were used to identify factors associated with two measures of usage, comparing those who sometimes vs rarely/never rode unprotected and who usually wore non-motorcycle pants vs motorcycle pants.

Results

Ninety-four percent of eligible riders participated and usable data was obtained from 66% (n = 776). Factors significantly associated with riding unprotected were: youth (17–25 years) (RR = 2.00, 95% CI: 1.50–2.65), not seeking protective clothing information (RR = 1.29, 95% CI = 1.07–1.56), non-usage in hot weather (RR = 3.01, 95% CI: 2.38–3.82), awareness of social pressure to wear more protection (RR = 1.48, 95% CI: 1.12–1.95), scepticism about protective benefits (RR = 2.00, 95% CI: 1.22–3.28) and riding a scooter vs any type of motorcycle. A similar cluster of factors including youth (RR = 1.17, 95% CI: 1.04–1.32), social pressure (RR = 1.32, 95% CI: 1.16–1.50), hot weather (RR = 1.30, 95% CI: 1.19–1.41) and scooter vs motorcycles were also associated with wearing non-motorcycle pants. There was no evidence of an association between use of protective clothing and other indicators of risk taking behaviour.

Conclusions

Factors strongly associated with non-use of protective clothing include not having sought information about protective clothing and not believing in its injury reduction value. Interventions to increase use may therefore need to focus on development of credible information sources about crash risk and the benefits of protective clothing. Further work is required to develop motorcycle protective clothing suitable for hot climates.     

Risk factors for fatal road traffic accidents in Udine, Italy.

In the Province of Udine, Northeast Italy, mortality from road accidents is 37% higher than in the country as a whole. To identify the major risk factors for fatal crashes in this area, we analyzed the Police reports of 10,320 road traffic accidents that occurred from 1991 to 1996. Logistic regression was used to evaluate the association of characteristics of drivers and accidents with accident severity. The risk of involvement in fatal rather than non-fatal accidents was lower among females than among males (odds ratio (OR) = 0.65; 95% confidence interval (95% CI), 0.53-0.80). Compared with subjects < 30 years of age, subjects aged > or = 65 had a significantly increased risk of fatal injury as pedestrians (OR = 10.87; 95% CI, 4.45-26.54), car drivers (OR = 1.85; 95% CI, 1.08-3.18), moped riders (OR = 3.53; 95% CI, 1.42-8.78), and bicycle riders (OR = 7.72; 95% CI, 2.56-23.29). In accidents that occurred from 1:00 to 5:00 h the risk of death was higher than from 6:00 to 11:00 h among pedestrians (OR = 8.88; 95% CI, 2.58-30.52), car drivers (OR = 4.95; 95% CI, 3.09-7.95), motorcycle riders (OR = 13.44; 95%CI, 2.54-71.05) and moped riders (OR = 8.76; 95% CI, 2.42-31.69). Risk of death among pedestrians, car drivers, moped, and bicycle riders was also significantly increased on roads outside the urban center. Driver's injury was strongly associated with lack of use of seat belts (OR = 13.27; 95% CI, 9.39-18.74, for fatal injury; OR = 2.49; 95% CI, 2.17-2.86, for non-fatal injury). Simple interventions focused on protecting the weakest road users and based on law enforcement, behavioral change and environmental modification might result in reducing the significant excess of road traffic accident mortality found in the study area.     

An observational study of secondary task engagement while driving on urban streets in Iranian Safe Communities

In Iran the prevalence of traffic injuries and death from vehicle collisions are high. Driver engagement in non-driving-related tasks has been previously identified as an important contributing factor to crashes. Therefore, the objective of the present study was to investigate the prevalence of drivers’ engagement in potentially distracting activities in Kashmar, Khalilabad and Bardaskan, which are three Iranian International Safe Communities. Observations took place at 12 randomly selected roadside locations in each city, which were comprised of six main streets and six side streets. In total 7979 drivers were observed. The prevalence rates of potentially distracting activities in Kashmar, Khalilabad and Bardaskan were 24.3%, 26% and 24.9%, respectively. In both Kashmar and Khalilabad the most frequently observed secondary tasks were drivers talking to passengers (10.6% and 11.5%, respectively) followed by mobile phone use (3.4% and 4.0%, respectively). Although in Bardaskan the most commonly observed secondary task was also talking to passengers (12.7%), the second most common was reaching for an object (3.2%). In all three cities younger drivers were significantly more likely to be observed engaged in a secondary task while driving. Furthermore, involvement in secondary tasks while driving was significantly higher amongst females and those driving on a working day. The percentage of drivers identified as potentially distracted in these three Safe Communities was worryingly high. Thus, interventions should be integrated into the WHO Safe Community network in these cities, including: education regarding the risks associated with engaging in secondary activities while driving, law enforcement, tougher legislation, periodic assessment, raising public awareness, as well as attracting political and social support.     

Barriers to, and factors associated, with observed motorcycle helmet use in Vietnam

This study investigated barriers to, and factors associated with, observed motorcycle helmet use among motorcyclists in Hai Duong Province, Vietnam. The findings highlighted an array of factors associated with observed helmet use namely, support for universal helmet legislation and a positive attitude towards what might be perceived as negative attributes of helmet use such as inconvenience and discomfort in hot weather. As well, older age (greater than 25 years in age), riding on a compulsory road, being a driver, trips of greater than 10 km, higher levels of education (having a university degree and higher) were found to be key determinants of helmet use. Despite over 95% of motorcyclists disagreeing with the statement that wearing a helmet does not reduce the severity of head injury in a crash, most motorcyclists believed that helmets did not need to be worn for a short trip. Overall, only 23% of motorcyclists were observed wearing a helmet. The authors conclude that efforts to increase helmet use need to focus on the necessity for universal helmet legislation in association with identifying solutions to reduce the negative attitudes towards helmet use.     

Pedestrian injuries due to mobile phone use in public places

Research shows that pedestrians, similar to drivers, experience reduced situation awareness, distracted attention and unsafe behavior when talking or texting on their mobile phones. The present study centered on injuries related to mobile phone use among pedestrians. It used data from the US Consumer Product Safety Commission on injuries in hospital emergency rooms from 2004 through 2010. It found that mobile-phone related injuries among pedestrians increased relative to total pedestrian injuries, and paralleled the increase in injuries for drivers, and in 2010 exceeded those for drivers. Pedestrian injuries related to mobile-phone use were higher for males and for people under 31 years old. Using a mobile phone while walking puts pedestrians at risk of accident, injury or death.