Psychosocial function of driving as predictor of risk-taking behaviour

This study examined the relation between risk-taking behaviour while driving, the psychosocial function of driving, leisure time activities, car oriented peer group interaction and educational attainment. Two thousand four hundred seventeen drivers aged 18-25, randomly selected from the Danish Driving Licence Register, participated in the study. Data was collected through a mail survey. The response rate was 60.4%. A positive significant effect on risk-taking behaviour based on the score on the psychosocial function of driving was found (p<0.001). A positive significant effect on risk-taking behaviour was also found based on driving related interaction with friends. Low structure/high impulsivity leisure time activities such as playing PC-games, doing body building and partying with friends were found to be related to increased risk-taking behaviour (p<0.01). Although risk-taking behaviour is generally condemned by society results show that risk-taking behaviour while driving can also be functional in the lives of the young drivers. Consequently, other motives than safety motives are at stake when engaging in risk-taking behaviour. Implications for preventive efforts are discussed.     

The role of risk-taking and errors in children's liability to unintentional injury

There is likely to be heterogeneity in the processes putting children at risk of injury. This paper examines whether errors may form a dissociable process from risk-taking. We further examine whether these constructs mediate the links between emotional and behavioural problems and unintentional injury. We designed the parent-report Children's Injury Related Behaviour (CIRB) questionnaire to measure errors and risk-taking in everyday activities. The sample consisted of 499 children aged 4-11 years recruited from the community. Principal components analysis showed that a two factor solution was appropriate and provided scales to measure risk and error with good psychometric properties. Both risk and error scales were independently related to injury history. Errors were associated with conduct problems, emotional problems and hyperactivity. Risk-taking was associated with conduct problems and hyperactivity only. Risk-taking and errors accounted for the links of conduct problems and hyperactivity with injury involvement. The distinction between risk and error has implications for research and interventions to reduce childhood injuries.     

Alcohol, illicit and non-illicit psychoactive drug use and road traffic injury in Thailand: A case-control study

The objective of this study was to determine the relationship between alcohol use, psychoactive drug use and road traffic injury (RTI). A case-control study was conducted among drivers in Bangkok, Thailand. Two hundred cases and 849 controls were enrolled between February and November 2006. Cases who sustained a RTI were matched with four controls recruited from petrol stations within a 1-km radius of the reported crash site of the case.A positive alcohol breath test (≥50 mg/dl), and positive tests for the presence of illicit (amphetamine, cocaine, marijuana) and non-illicit psychoactive drugs (antihistamine, benzodiazepine, antidepressants), using gas chromatography/mass spectrometry (GC/MS) were documented as primary measures.There were significantly higher odds of an alcohol breath test ≥50 mg/dl (adjusted odds ratio (OR) 63.6 (95% CI: 25.5-158.9)), illicit psychoactive drugs (adjusted OR 3.4 (95% CI: 1.7-6.6)) and non-illicit psychoactive drug (adjusted OR 3.1 (95% CI: 1.5-6.3)) among cases than controls.Even though driving under the influence of psychoactive drugs has been significantly linked to RTI, its contribution to road safety is much lower than driving under the influence of alcohol. With limited resources, the priority for RTI prevention should be given to control of driving under the influence of alcohol.     

Using multiple datasets to understand trends in serious road traffic casualties

Accurate information on the incidence of serious road traffic casualties is needed to plan and evaluate prevention strategies. Traditionally police reported collisions are the only data used. This study investigate the extent to which understanding of trends in serious road traffic injuries is aided by the use of multiple datasets. Health and police datasets covering all or part of Great Britain from 1996-2003 were analysed. There was a significantly decreasing trend in police reported serious casualties but not in the other datasets. Multiple data sources provide a more complete picture of road traffic casualty trends than any single dataset. Increasing availability of electronic health data with developments in anonymised data linkage should provide a better platform for monitoring trends in serious road traffic casualties.     

Bicyclist injury severities in bicycle-motor vehicle accidents

This research explores the factors contributing to the injury severity of bicyclists in bicycle-motor vehicle accidents using a multinomial logit model. The model predicts the probability of four injury severity outcomes: fatal, incapacitating, non-incapacitating, and possible or no injury. The analysis is based on police-reported accident data between 1997 and 2002 from North Carolina, USA. The results show several factors which more than double the probability of a bicyclist suffering a fatal injury in an accident, all other things being kept constant. Notably, inclement weather, darkness with no streetlights, a.m. peak (06:00 a.m. to 09:59 a.m.), head-on collision, speeding-involved, vehicle speeds above 48.3 km/h (30 mph), truck involved, intoxicated driver, bicyclist age 55 or over, and intoxicated bicyclist. The largest effect is caused when estimated vehicle speed prior to impact is greater than 80.5 km/h (50 mph), where the probability of fatal injury increases more than 16-fold. Speed also shows a threshold effect at 32.2 km/h (20 mph), which supports the commonly used 30km/h speed limit in residential neighborhoods. The results also imply that bicyclist fault is more closely correlated with greater bicyclist injury severity than driver fault.     

The relationship between liquor outlet density and injury and violence in New Mexico

This study used an ecologic design based on data from 1990 to 1994 gathered from forensic, vital statistic, census, law enforcement and liquor licensing agencies to assess the relationship between liquor outlet density and alcohol-related health outcomes in New Mexico. Linear regression models show that suicide, alcohol-related crash, and alcohol-related crash fatality (adjusted for age, sex, and minority status) are significantly associated with liquor outlet density. Data also show that, compared with the first tertile, suicide and alcohol-related crash rates increase about 50% and the alcohol-related crash fatality rate two-fold with the third tertile of liquor outlet density. Greater availability of liquor outlets is associated with higher rates of suicide, alcohol-related crash, and alcohol-related crash fatality.     

The fatality and injury risk of light truck impacts with pedestrians in the United States

In the United States, passenger vehicles are shifting from a fleet populated primarily by cars to a fleet dominated by light trucks and vans (LTVs). Because light trucks are heavier, stiffer, and geometrically more blunt than passenger cars, they pose a dramatically different type of threat to pedestrians. This paper investigates the effect of striking vehicle type on pedestrian fatalities and injuries. The analysis incorporates three major sources of data, the Fatality Analysis Reporting System (FARS), the General Estimates System (GES), and the Pedestrian Crash Data Study (PCDS). The paper presents and compares pedestrian impact risk factors for sport utility vehicles, pickup trucks, vans, and cars as developed from analyses of US accident statistics. Pedestrians are found to have a two to three times greater likelihood of dying when struck by an LTV than when struck by a car. Examination of pedestrian injury distributions reveals that, given an impact speed, the probability of serious head and thoracic injury is substantially greater when the striking vehicle is an LTV rather than a car.     

Defining the "older" crash victim: the relationship between age and serious injury in motor vehicle crashes

OBJECTIVE: Age is often used as a predictor of injury and mortality in motor vehicle crashes (MVCs), however, the age that defines an "older" occupant in terms of injury-risk remains unclear, as do specific injury patterns associated with increasing age. The objective of this study was to evaluate the relationship between age and serious injury (including injury patterns) for occupants involved in MVCs. METHODS: This was a retrospective cohort study using a national population-based cohort of adult front-seat occupants involved in MVCs and included in the National Automotive Sampling System Crashworthiness Data System database from 1995 to 2006. The primary outcome was serious injury, defined as an abbreviated injury scale (AIS) score >/=3 in any body region. Anatomic injury patterns were also assessed by age. RESULTS: One hundred thousand one hundred and fifty-six adult front-seat occupants were included in the analysis, of which 14,128 (2%) were seriously injured. Age was a strong predictor of serious injury using a variety of different age covariates (categorical, continuous, and polynomial) in multivariable regression models (p<0.0001 for all). There was evidence of a strong non-linear relationship between age and serious injury (p<0.001 for comparison of non-linear to linear representation of age). There was no age that clearly defined an "older" occupant by injury risk, as the odds of injury increased with increasing age across all age groups. The proportion of serious head and extremity injuries gradually increased with increasing age, while serious chest injuries markedly increased after 60 years. CONCLUSIONS: Age is a strong predictor of serious injury from motor vehicle trauma, the risk of which increases in non-linear fashion as age increases. There is no specific age that clearly defines an "older" occupant by injury risk.     

Costs of large truck-involved crashes in the United States

This study provides the estimates of the costs of highway crashes involving large trucks by type of truck involved. These costs represent the present value of all costs over the victims' expected life span that result from a crash. They include medically related costs, emergency services costs, property damage costs, lost productivity, and the monetized value of the pain, suffering, and lost quality of life that a family experiences because of death or injury. Based on the latest data available, the estimated cost of police-reported crashes involving trucks with a gross weight rating of more than 10,000 pounds averaged US$ 59,153 (in 2000 dollars). Multiple combination trucks had the highest cost per crash (US$ 88,483). The crash costs per 1000 truck miles however, were US$ 157 for single unit trucks, US$ 131 for single combination trucks, and US$ 63 for multiple combinations.     

Injury causation in the great outdoors: A systems analysis of led outdoor activity injury incidents

Despite calls for a systems approach to assessing and preventing injurious incidents within the led outdoor activity domain, applications of systems analysis frameworks to the analysis of incident data have been sparse. This article presents an analysis of 1014 led outdoor activity injury and near miss incidents whereby a systems-based risk management framework was used to classify the contributing factors involved across six levels of the led outdoor activity ‘system’. The analysis identified causal factors across all levels of the led outdoor activity system, demonstrating the framework's utility for accident analysis efforts in the led outdoor activity injury domain. In addition, issues associated with the current data collection framework that potentially limited the identification of contributing factors outside of the individuals, equipment, and environment involved were identified. In closing, the requirement for new and improved data systems to be underpinned by the systems philosophy and new models of led outdoor activity accident causation is discussed.     

Comparison of methods for auto-coding causation of injury narratives

Manually reading free-text narratives in large databases to identify the cause of an injury can be very time consuming and recently, there has been much work in automating this process. In particular, the variations of the naïve Bayes model have been used to successfully auto-code free text narratives describing the event/exposure leading to the injury of a workers’ compensation claim. This paper compares the naïve Bayes model with an alternative logistic model and found that this new model outperformed the naïve Bayesian model. Further modest improvements were found through the addition of sequences of keywords in the models as opposed to consideration of only single keywords. The programs and weights used in this paper are available upon request to researchers without a training set wishing to automatically assign event codes to large data-sets of text narratives. The utility of sharing this program was tested on an outside set of injury narratives provided by the Bureau of Labor Statistics with promising results.     

Effects of work zone presence on injury and non-injury crashes.

Work zones in the United States have approximately 700 traffic-related fatalities, 24,000 injury crashes, and 52,000 non-injury crashes every year. Due to future highway reconstruction needs, work zones are likely to increase in number, duration, and length. This study focuses on analyzing the effect of work zone duration mainly due to its policy-sensitivity. To do so, we created a unique dataset of California freeway work zones that included crash data (crash frequency and injury severity), road inventory data (average daily traffic (ADT) and urban/rural character), and work zone related data (duration, length, and location). Then, we investigated crash rates and crash frequencies in the pre-work zone and during-work zone periods. For the freeway work zones investigated in this study, the total crash rate in the during-work zone period was 21.5% higher (0.79 crashes per million vehicle kilometer (MVKM)) than the pre-work zone period (0.65 crashes per MVKM). Compared with the pre-work zone period, the increase in non-injury and injury crash rates in the during-work zone period was 23.8% and 17.3%, respectively. Next, crash frequencies were investigated using negative binomial models, which showed that frequencies increased with increasing work zone duration, length, and average daily traffic. The important finding is that after controlling for various factors, longer work zone duration significantly increases both injury and non-injury crash frequencies. The implications of the study findings are discussed in the paper.     

Identification of vehicle components associated with severe thoracic injury in motor vehicle crashes: a CIREN and NASS analysis

INTRODUCTION: Thoracic trauma secondary to motor vehicle crashes (MVC) continues to be a major cause of morbidity and mortality. Specific vehicle features may increase the risk of severe thoracic injury when striking the occupant. We sought to determine which vehicle contact points were associated with an increased risk of severe thoracic injury in MVC to focus subsequent design modifications necessary to reduce thoracic injury. METHODS: The National Automotive Sampling System (NASS) databases from 1993 to 2001 and the Crash Injury Research and Engineering Network (CIREN) databases from 1996 to 2004 were analyzed separately using univariate and multivariate logistic regression stratified by restraint use and crash direction. The risk of driver thoracic injury, defined as an abbreviated injury scale (AIS) of score > or =3, was determined as it related to specific points of contact between the vehicle and the driver. RESULTS: The incidence of severe chest injury in NASS and CIREN were 5.5% and 33%, respectively. The steering wheel, door panel, armrest, and seat were identified as contact points associated with an increased risk of severe chest injury. The door panel and arm rest were consistently a frequent cause of severe injury in both the NASS and CIREN data. CONCLUSIONS: Several vehicle contact points, including the steering wheel, door panel, armrest and seat are associated with an increased risk of severe thoracic injury when striking the occupant. These elements need to be further investigated to determine which characteristics need to be manipulated in order to reduce thoracic trauma during a crash.     

Personality subtypes of young moped drivers, their relationship to risk-taking behavior and involvement in road crashes in an Austrian sample

Objective

This study aimed to identify subtypes of young moped drivers and analyze how these subtypes are involved in risk preferences and road crashes.

Design

A group of Austrian teenage moped drivers (213, 28% girls) completed an online questionnaire about moped usage, injuries, driving style, inattention, impulsivity, and personality according to the Five-Factor Model of Personality and Cloninger's model of personality.

Results

A cluster analysis yielded four types of moped drivers. One type was characterized by a high level of neuroticism, the second type was characterized by a risky personality and a risky driving style, the third type had a more cautious driving style, and the fourth type was characterized by a risky personality and high levels on inattention and impulsivity.

Conclusions

Our conclusions suggest that young moped drivers should not be perceived as a homogenous group, according to measures of injury prevention and intervention.     

Impact of safety belt use on road accident injury and injury type in Kuwait

The enactment of Kuwait's seat belt law in January 1994 provided an opportunity to examine the impact of seat belt use on road accident fatalities and injury types in this affluent Persian Gulf nation. Via a structured data form, the results of injurious/fatal road accidents for more than 1200 accident victims were gathered from the files of the six major government hospitals which treat most traffic accident victims. Statistical analysis of the data showed that seat belt use has had a positive effect in reducing both road traffic fatalities and multiple injuries in Kuwait. The use of seat belts has also affected the nature of the injuries resulting from road traffic accidents. Non-users of belts experienced higher frequencies of head, face, abdominal and limb injuries. Users of belts, on the other hand, suffered higher frequencies of neck and chest injuries. The interrelationship between the victim, his age, and the type of injuries resulting from road traffic accidents is also investigated.     

Antilock brakes and the risk of driver injury in a crash: a case-control study

While antilock brakes can improve steering and reduce stopping distance in some test situations, there is little evidence that they reduce the risk of crash-related injury. We sought to estimate the association between presence of antilock brakes and the risk of driver injury. We conducted a case-control study using claims data from the Insurance Corporation of British Columbia, Canada, for passenger vehicles insured during July 1, 2003, to June 30, 2004. Cases were 5000 vehicles with a driver crash injury during the study period. Controls were 49,994 vehicles insured at the mid-point of the study interval. The adjusted risk ratio for a crash with driver injury in a vehicle with antilock brakes was 1.06 (95% confidence interval, 0.95-1.17), compared with a vehicle without antilock brakes. If this estimated association is causal, antilock brakes do not prevent crash-related driver injuries.     

Misclassification of injury severity among road casualties in police reports

This study aims to evaluate the discordance between police reports of injury severity among road casualties and the length of hospital stay and the Injury Severity Scale (ISS) by linking information from the crash records of the Hong Kong Police with the trauma records of a regional hospital. Sensitivity and specificity analyses suggest that police injury grading diverges noticeably from the definition of a 12-h hospital stay. Police reports overestimate injury severity remarkably. The results of logistic regression indicate that age, the ISS, and the position of the victim significantly determine the likelihood of police injury misclassification. Furthermore, an optimal demarcation point of the length of hospital stay for serious injury is estimated.     

Analysis of injury severity of drivers involved in single- and two-vehicle crashes on highways in Ontario

This study analyzes driver's injury severity in single- and two-vehicle crashes and compares the effects of explanatory variables among various types of crashes. The study identified factors affecting injury severity and their effects on severity levels using 5-year crash records for provincial highways in Ontario, Canada. Considering heteroscedasticity in the effects of explanatory variables on injury severity, the heteroscedastic ordered logit (HOL) models were developed for single- and two-vehicle crashes separately. The results of the models show that there exists heteroscedasticity for young drivers (≤30), safety equipment and ejection in the single-vehicle crash model, and female drivers, safety equipment and head-on collision in the two-vehicle crash models. The results also show that young car drivers have opposite effects between single-car and car–car crashes, and sideswipe crashes have opposite effects between car–car and truck–truck crashes. The study demonstrates that separate HOL models for single-vehicle and different types of two-vehicle crashes can identify differential effects of factors on driver's injury severity.     

Factors influential in making an injury severity difference to older drivers involved in fixed object-passenger car crashes

To identify factors influencing severity of injury to older drivers in fixed object-passenger car crashes, two sets of sequential binary logistic regression models were developed. The dependent variable in one set of models was driver injury severity, whereas for the other it was the crash severity (most severe injury in the crash). For each set of models, crash or injury severity was varied from the least severity level (no injury) to the highest severity level (fatality) and vice versa. The source of data was police crash reports from the state of Florida. The model with the best fitting and highest predictive capability was used to identify the influence of roadway, environmental, vehicle, and driver related factors on severity. Travel speed, restraint device usage, point of impact, use of alcohol and drugs, personal condition, gender, whether the driver is at fault, urban/rural nature and grade/curve existence at the crash location were identified as the important factors for making an injury severity difference to older drivers involved in single vehicle crashes.     

Car insurance and the risk of car crash injury

Despite speculation about the role of vehicle insurance in road traffic accidents, there is little research estimating the direction or extent of the risk relationship. Data from the Auckland Car Crash Injury Study (1998–1999) were used to examine the association between driving an uninsured motor vehicle and car crash injury. Cases were all cars involved in crashes in which at least one occupant was hospitalized or killed anywhere in the Auckland region. Controls were 588 drivers of randomly selected cars on Auckland roads. Participants completed a structured interview. Uninsured drivers had significantly greater odds of car crash injury compared to insured drivers after adjustment for age, sex, level of education, and driving exposure (odds ratio 4.77, 95% confidence interval 2.94–7.75). The causal mechanism for insurance and car crash injury is not easily determined. Although we examined the effects of multiple potential confounders in our analysis including socioeconomic status and risk-taking behaviours, both of which have been previously observed to be associated with both insurance status and car crash injury, residual confounding may partly explain this association. The estimated proportion of drivers who are uninsured is between 5 and 15% in developed countries, representing a significant public health problem worthy of further investigation.