Long-term effects of legislation and local promotion of child restraint use in motor vehicles in Sweden

The main objective is to study long-term effects of legislation and promotion of child-restraint use in motor vehicles. Subgoals are to describe the level of restraint use in cars and changes in mortality and morbidity patterns in regard to differences among age groups and geographical areas (morbidity). The study areas were; ‘The First Four’, ‘The Six Counties’, ‘The Rest of Sweden’, and ‘Sweden as a whole’, and the population were two age groups — 0–6 and 7–14 years. The incidence of restraint use comes from observations of car-seat-belt usage. Outcome evaluation was based on hospital-discharge data 1978–1996 and mortality statistics 1970–1996. The level of restraint use for children in the front seat was 97% in 1988 and was equal to 1995. Mortality data shows a decrease of 2.8% on an average per year, 76% over the study period. A significant change over time in the two intervention areas was shown (annual changes of −2.8 and −1.8%), but not in the rest of Sweden. The local authorities that started early with preventive programs, such as safety seat loan schemes and those having an organised safety-promotion program showed a much better improvement than the rest of Sweden. There is a need for appropriate information for local action on childhood injury prevention to accompany national legislation.     

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.     

激光经纬仪在检定机动车前照灯检测仪中的应用

根据机动车前照灯检测仪及校准器的特点,分析了校准器位置对前照灯检测仪检定结果的影响.详细介绍了激光经纬仪在前照灯检测仪检定中的几种应用方法,使复杂、费时的校准器安置,变得操作简单.并通过实验数据,证明该方法调整精度高,速度快;且安置重复性好.     

Injuries to children in automobiles in relation to seating location and restraint use

Findings in this study are based on 26,971 passengers less than 15 years of age in reported crashes in 1967 and later model year automobiles in North Carolina during calendar years 1973 and 1974. (1) Children least likely to be injured in crashes are restrained and in the back seat; those most likely to be injured are unrestrained and are in the front seat. Unrestrained children in the front right seat have the highest injury rate. (2) More than 90% of the children in the surveyed crashes were found unprotected by restraints—paralleling earlier findings for those in cars in general. (3) Back seat location reduced the injury rate by 28% among unrestrained children and 18% among restrained children. Use of restraints reduced the injury rate by 39% in the front seat and 31% in back. (4) Among unrestrained children, back seat location is advantageous for both males and females, for both younger and older children, and in automobiles of various sizes. The advantage of back seat location is most pronounced in frontal impacts.     

Falls from moving motor vehicles in New Zealand

Injuries due to falls from moving motor vehicles have received relatively little attention from the research community. Injury events of this type in New Zealand were examined using national injury mortality and hospitalisation data from the New Zealand National Health Statistics Centre (NHSC). Also used were data obtained from the New Zealand Post Motor Registration Centre and from coroner's investigation reports held by the Department of Justice. Fifty-six fatal falls from moving motor vehicles occurred during the period 1977–1986 (0.18 per 100,000 population per year). The average age of fatalities was 23. The total potential years of life lost due to these fatalities was 2,696, or an average of 48 years per person. Thirty-nine persons (70%) fell while riding on the exterior of a vehicle. None of the 56 fatalities was using a belt restraint when he/she fell. Four hundred and twenty-three admissions to hospital occurred during 1986 and 1987 (6.5 per 100,000 persons per year). The average age of those hospitalised was 18. Incidence rates were highest in the 0–4, 15–19, and 20–24 year age groups. In the case of both deaths and hospitalisations, the incidence rate for males was approximately double the rate for females. In addition, the rate of falls (per unit registered motor vehicle) from trucks was significantly higher than the rate offalls from cars. Means of preventing falls from motor vehicles are discussed.     

Studies of child safety restraint use in motor vehicles--some methodological considerations

Despite the effectiveness of safety restraints in reducing the risk of death or injury in motor vehicle accidents, many children still travel unrestrained. Two methodological issues related to child restraint studies which had not been adequately addressed were identified: firstly, the accuracy of parental self-reports of restraint use with their children; and secondly, the consistency of observational data over time. These issues were investigated in the present research. The data indicate that parents' report is inaccurate, suggesting that if self-report measures are used, there is a need to compare them with direct observational measures to obtain information on reporting bias. A single observation of a child's restraint use appears to provide an accurate reflection of restraint use on other occasions in the same setting.     

Factors associated with rear seating of children in motor vehicles: a study in two low-income, predominantly Hispanic communities

This study examined child seating patterns in two predominantly low-income, Hispanic communities in Massachusetts. The purpose was to determine the factors associated with child rear seating in the community as a whole and for a subset of Hispanic motorists. Five hundred and five vehicles carrying child passengers and no adult other than the driver were observed in parking lots of fast food restaurants and grocery stores. Four hundred and thirty-two vehicle drivers agreed to be interviewed. A child was defined as a passenger younger than age 12 as determined by appearance and height (head below the vehicle headrest when seated). Variables under study included driver gender, age, ethnicity, and educational attainment; driver shoulder belt use; driver perception of passenger-side airbag presence; and the number and ages of children in the car. Overall, 51% of vehicles were observed with all children seated in the rear. In a bivariate analysis, child rear seating was strongly associated with female drivers ( P = 0.01), younger drivers ( P = 0.02) driver shoulder belt use ( P < 0.00), perceived presence of a passenger-side airbag ( P < 0.00), all children in the vehicle 相似文献   

Toll road crashes of commercial and passenger motor vehicles

Revenue-collection data from toll roads allow for accurate estimates of miles driven by vehicle type and, when combined with crash data, valid estimates of crash involvements per mile driven. Data on vehicle-miles traveled and collisions were obtained from toll road authorities in Florida. Kansas, and New York. In addition, state crash files and published vehicle-miles of travel were obtained for toll roads in Illinois. Indiana, Ohio, and Pennsylvania. Large commercial motor vehicles were significantly underinvolved in single-vehicle crashes on all state toll roads. In five states, commercial motor vehicles were significantly overinvolved in multiple-vehicle crashes relative to passenger vehicles; the exceptions were Kansas, where they had significantly lower multiple-vehicle involvement rates, and Indiana. where there were no significant differences in multiple-vehicle involvements by vehicle type. The risk of commercial motor vehicle involvement in multiple-vehicle crashes resulting in deaths or serious injuries was double that of passenger vehicles in the two states (Ohio and Pennsylvania) that identified serious injuries. Whether crash rates, on toll roads of commercial motor vehicles are higher or lower than those of passenger vehicles appears to depend on the type of crash, specific toll road. and traffic density.     

Injuries to belted older children in motor vehicle crashes

Context

The American Academy of Pediatrics and the National Highway Traffic Safety Administration currently recommend that, unless they are under 57 in. in height, 8–12-year-old children use seat belts and all should ride in the rear seats of vehicles. These recommendations assume that the vehicle seat belt should provide adequate protection for these older children in the event of a crash.

Objectives

To describe characteristics of older children in the rear seat using seat belts in crashes, to estimate their risk and body region distribution of injury, and to identify risk factors for injury.

Methods

A representative sample of 6680 seat belt-restrained occupants, 8–12 years of age, seated in the rear seat during crashes involving insured vehicles in 16 US states between December 1998 and December 2007. A telephone interview was conducted with the driver of each vehicle. The main outcome was the parent-reported injury defined as Abbreviated Injury Scale (AIS) 2 or greater injuries.

Results

The risk of injury for belted 8–12 year olds in the rear seat was 1.3%. Head injury was the most common injury (60%), followed by injuries to the face (9%), upper extremity (9%) and abdomen (9%). One out of five (21%) 8–12 year olds either did not use the shoulder portion of the vehicle seat belt or placed it incorrectly behind their back or under their arm. Bivariate analyses indicated a higher risk of injury for these children (1.8%) as compared to children using both the lap and shoulder portions of the seat belt (1.1%). However, this difference was not statistically significant when other risk factors such as crash severity and characteristics of the driver were considered.

Conclusions

Injuries to the head, face, abdomen and upper extremity are the most common injuries to target for improved protection among 8–12 year olds in seat belts. Driver and crash characteristics are important risk factors for injury. A recent federal motor vehicle safety standard requiring lap and shoulder belts in all rear seat positions has the potential to further decrease the risk of injury to older children using seat belts.     

Shoulder belts in motor vehicle crashes: a statewide analysis of restraint efficacy

The purpose of our study was to evaluate the impact of shoulder belt use on motor vehicle crash ejection, morbidity and mortality. We analyzed motor vehicle crash records linked to hospital inpatient data for front seat occupants of passenger cars in Utah between 1994 and 1996 (n = 103,035). Stochastic simulations were used to adjust for possible seatbelt misclassification. There were 276 (0.3%) occupants coded as using only a shoulder belt. The adjusted odds of ejection for shoulder only belted occupants was higher compared to lap-shoulder belted (odds ratio (OR) = 18.9; 95% confidence interval (CI) = 15.1, 25.1) and lap only belted occupants (OR = 4.3; 95% Cl = 2.9, 7.7). There was no difference in the odds of ejection for an occupant using a shoulder belt only and an occupant using no seatbelt (OR = 1.1; 95% CI = 1.0, 1.3). Occupants using a shoulder belt only were more likely to sustain a fatal or hospitalizing injury than lap-shoulder belted (OR = 2.3; 95% Cl = 1.9, 3.0), and lap only belted occupants (OR = 1.8; 95% CI = 1.3, 2.7), while controlling for other covariates. Occupants using only a shoulder belt had the same odds of a fatal or hospitalizing injury as unbelted occupants (OR = 1.1; 95% Cl = 0.9, 1.4). Average hospital inpatient length of stay, charges and injury severity scores were similar for all restraint types. These results stress the need for the use of a lap belt in conjunction with the shoulder belt.     

A prospective study of children aged <16 years in motor vehicle collisions in Norway: Severe injuries are observed predominantly in older children and are associated with restraint misuse

Objective

The implementation of the compulsory wearing of seat belts (SBs) for children and improvements in child restraint systems have reduced the number of deaths and severe injuries among children involved in motor vehicle (MV) collisions (MVCs). Establishing the characteristics predictive of such injuries may provide the basis for targeted safety campaigns and lead to a further reduction in mortality and morbidity among children involved in MVCs. This study performed a multidisciplinary investigation among child occupants involved in MVCs to elucidate injury mechanisms, evaluate the safety measures used and determine the characteristics that are predictive of injury.

Methods

A prospective study was conducted of all child occupants aged <16 years involved in severe MVCs in south-eastern Norway during 2009–2013. The exterior and interior of the MVs were investigated and the injured children were medically examined. Supplementary information was obtained from witnesses, the crash victims, police reports, medical records and reconstructions. Each case was reviewed by a multidisciplinary team to assess the mechanism of injury.

Results

In total, 158 child occupants involved in 100 MVCs were investigated, of which 27 (17%) exhibited Abbreviated Injury Scale (AIS) scores of 2+ injuries and 15 (9%) exhibited AIS 3+ injuries. None of the children died. Of those with AIS 2+ injuries (n = 27), 89% (n = 24) were involved in frontal impact collisions and 11% (3/27) were involved in side impacts. Multivariate analysis revealed that restraint misuse, age, the prevailing lighting conditions and ΔV were all independently correlated with AIS 2+ injuries. Safety errors were found in 74% (20/27) of those with AIS 2+ injuries and 93% (14/15) of those with AIS 3+ injuries. The most common safety error was misuse of restraints, and in particular loose and/or improperly positioned SBs.

Conclusion

The risk of injury among child occupants is significantly higher when the child occupants are exposed to safety errors within the interior of the vehicle. Future campaigns should focus on the prevention of restraint misuse and unsecured objects in the passenger compartment or boot.     

应用影像对正法的前照灯检测技术

前照灯是汽车安全检测的重要内容之一，其检测技术在国内已经发展了十几年，但随着汽车工业的快速发展，既有的一些前照灯检测技术已显落后，不能满足新的需求。本文针对我国机动车前照灯的配光模式以及结构形式的变化，分析了传统前照灯检测方法存在的不足，提出了一种应用影像对正法的前照灯检测新技术并阐述了其定标方法。     

Knowledge and practice of childhood motor vehicle restraint use in Nova Scotia: Phase II

Objective

To examine changes to knowledge and practice of childhood motor vehicle restraint (CMVR) use in Nova Scotia after the implementation of stricter car seat and new booster seat (BS) legislation in 2007.

Methods

A random telephone survey of households (at least one child <12 years) was performed in 2004 and 2010. Logistic regression determined variables independently associated with correct knowledge and/or practice of CMVR use.

Results

Families were surveyed in the pre- (N = 426 families, 728 children) and post- (N = 453 families, 723 children) legislative periods. Reported appropriate use of forward-facing car seats (FFCSs) and BSs increased significantly (74–92% and 58–95%, respectively). After adjusting for covariates, the post-law period remained a significant predictor of increased knowledge of when to graduate to a BS or a seat belt alone (SB) (OR:1.4(95% CI:1.0–2.0) and 1.9(1.4–2.7), respectively), which was significantly associated with correct use. The strongest independent predictor of the correct use of FFCSs and BSs was the post-law period (OR:14(3.0–68) and 43(17–114), respectively). With regards to rear-facing car seats (RFCSs), new legislation and associated social marketing on graduating from a rear-facing car seat was not associated with increases in correct practice.

Conclusions

Legislation, combined with social marketing at the time of introduction, is an effective means to educate parents on when to graduate from a FFCS and the importance of BSs while also influencing parents to use them, though not for RFCS graduation. The known protective effect of BSs dictates the need for all regions in Canada to adopt comprehensive BS legislation.     

Premature graduation of children in child restraint systems: an observational study

This study investigated the use and misuse of child restraint systems (CRS) in Flanders (Belgium). Observations were conducted at a random sample of primary school and recreation areas. In total 1376 children were observed. A logistic regression model was constructed in order to determine the variables involved. The parameter-estimates of this model have shown that children are more often restrained when the driver buckles up, the ride takes less than 1h, the children are younger, the children sit in the front seat of the car, a recreational area is the destination of the trip and there are less than five children in the car. Also premature graduation to CRS was analysed. More than half of the children are not appropriately restrained, according to their age, weight or height. Improper shoulder belt use (putting the shoulder belt behind the back or under the arm) was observed in 8.99% of the children being restrained with high back booster seats, in 32.73% of the children being restrained with backless booster seats and finally in 19.07% of the children being restrained with seat belts. The risk of incorrectly using the shoulder belt increases when children are prematurely graduated in a CRS. The results are discussed in the light of other studies on this matter.     

Psychosocial aspects of children and families treated with hemodialysis

Introduction: The aim of this study was to analyze the selected psychosocial aspects of chronic kidney disease in children treated with hemodialysis (HD). Methods: The study included 25 children treated with HD aged 2 to 18 years and their parents. Data concerning the illness and socio‐demographic parameters was collected. We used the Paediatric Quality of Life Inventory (PedsQL) for patients and for their parents the PedsQL‐proxy version, General Health Questionnaire (GHQ‐12), Berlin Social Support Scales (BSSS), and the Caregivers Burden Scale (CBS) to evaluate health‐related quality of life (QoL) of HD children and their primary caregivers. Findings: In the PedsQL test, the QoL of HD children was lower than in healthy children. Children treated with HD assessed their QoL on the PedsQL questionnaire higher than the primary caregivers, on all subscales as well as an overall health‐related QoL. Scoring below 2 on the GHQ‐12 test was reported in 56% of mothers, which may indicate that psychological symptoms have intensified. There was no correlation between BSSS, CBS, and GHQ‐12. Discussion: The assessment of QoL in pediatric patients would allow for the earliest possible identification of their nonsomatic problems and irregularities. This could, consequently, contribute to improving QoL in both children with chronic kidney disease and their families.     

The involvement of drugs in drivers of motor vehicles killed in Australian road traffic crashes

A multi-center case-control study was conducted on 3398 fatally-injured drivers to assess the effect of alcohol and drug use on the likelihood of them being culpable. Crashes investigated were from three Australian states (Victoria, New South Wales and Western Australia). The control group of drug- and alcohol-free drivers comprised 50.1% of the study population. A previously validated method of responsibility analysis was used to classify drivers as either culpable or non-culpable. Cases in which the driver "contributed" to the crash (n=188) were excluded. Logistic regression was used to examine the association of key attributes such as age, gender, type of crash and drug use on the likelihood of culpability. Drivers positive to psychotropic drugs were significantly more likely to be culpable than drug-free drivers. Drivers with Delta(9)-tetrahydrocannabinol (THC) in their blood had a significantly higher likelihood of being culpable than drug-free drivers (odds ratio (OR) 2.7, 95% CI 1.02-7.0). For drivers with blood THC concentrations of 5 ng/ml or higher the odds ratio was greater and more statistically significant (OR 6.6, 95% CI 1.5-28.0). The estimated odds ratio is greater than that for drivers with a blood alcohol concentration (BAC) of 0.10-0.15% (OR 3.7, 95% CI 1.5-9.1). A significantly stronger positive association with culpability was seen with drivers positive to THC and with BAC > or =0.05% compared with BAC > or =0.05 alone (OR 2.9, 95% CI 1.1-7.7). Strong associations were also seen for stimulants, particularly in truck drivers. There were non-significant, weakly positive associations of opiates and benzodiazepines with culpability. Drivers positive to any psychoactive drug were significantly more likely to be culpable (OR 1.8, 95% CI 1.3-2.4). Gender differences were not significant, but differences were apparent with age. Drivers showing the highest culpability rates were in the under 25 and over 65 age groups.     

Identifying the factors that predict a Consumer's willingness to ride in various types of driverless vehicles

The current study provides data about the type of person who may be willing to ride in a driverless vehicle considering six different vehicle types. Participants from the United States were provided with hypothetical scenarios about riding in various driverless vehicles. Across two data collection sessions, they rated emotional responses to the scenarios, along with the willingness to ride. They also provided information about the familiarity, complexity, fun, and value of driverless vehicles. Regression analyses revealed seven of the 13 predictors were significant for at least one type of vehicle. Happiness and fear were significant for all vehicle types. The model fit between the two datasets was strong. These data provide a base for manufacturers attempting to match their vehicles with consumers.     

Estimating the risk of collisions between bicycles and motor vehicles at signalized intersections

Collisions between bicycles and motor vehicles have caused severe life and property losses in many countries. The majority of bicycle-motor vehicle (BMV) accidents occur at intersections. In order to reduce the number of BMV accidents at intersections, a substantial understanding of the causal factors for the collisions is required. In this study, intersection BMV accidents were classified into three types based on the movements of the involved motor vehicles and bicycles. The three BMV accident classifications were through motor vehicle related collisions, left-turn motor vehicle related collisions, and right-turn motor vehicle related collisions. A methodology for estimating these BMV accident risks was developed based on probability theory. A significant difference between this proposed methodology and most current approaches is that the proposed approach explicitly relates the risk of each specific BMV accident type to its related flows. The methodology was demonstrated using a 4-year (1992-1995) data set collected from 115 signalized intersections in the Tokyo Metropolitan area. This data set contains BMV accident data, bicycle flow data, motor vehicle flow data, traffic control data, and geometric data for each intersection approach. For each BMV risk model, an independent explanatory variable set was chosen according to the characteristics of the accident type. Three negative binomial regression models (one corresponding to each BMV accident type) were estimated using the maximum likelihood method. The coefficient value and its significance level were estimated for each selected variable. The negative binomial dispersion parameters for all the three models were significant at 0.01 levels. This supported the choice of the negative binomial regression over the Poisson regression for the quantitative analyses in this study.