The role of alcohol in Thailand motorcycle crashes

In order to identify motorcycle accident cause factors and countermeasures in Thailand, a large prospective study was undertaken. Researchers conducted on-scene, in-depth investigation and reconstruction of 969 collisions involving 1082 motorcycle riders. Accidents were randomly sampled and included all levels of injury severity. Alcohol proved to be the most outstanding cause factor, with 393 drinking riders in crashes. Alcohol accidents were distinctly different from non-alcohol crashes. Alcohol accidents were more frequent on weekends and particularly at night, usually when the rider was on his way home. Drinking riders were more likely to lose control of the motorcycle, usually by running off the road. They were more likely to be in a single vehicle accident, to violate traffic control signals, and to be in non-intersection collisions. Males were far more likely to drink and ride than females. Drinking riders were far more likely to be inattentive to the driving task just before they crashed, and to be the primary or sole cause of the accident. One-fourth of all riders did not go to the hospital, and another 42% needed only treatment in the emergency room. Drinking riders were more likely to be hospitalized and far more likely to be killed. The higher hospitalization and fatality rates of drinking riders resulted from the kinds of accidents in which they were involved, not from the minimal differences in speeds and helmet use. Problems with balance and coordination were about equally rare among drinking and non-drinking riders. Inattention was a far greater contributing factor.     

A study of reported injury accidents among novice motorcycle riders in a Scottish region

A study is reported of the effect of sex, age, cubic capacity, and training on the rate of reported injury accidents in a cohort of 304 first time learner motorcycle riders resident in the Lothian and Borders of Scotland in 1983. Motorcycle in this paper includes all types of registerable two wheeled motor vehicle. Injury accidents as reported by the police were observed in this cohort over an average period of one year. The overall reported injury accident rate within the cohort was 8.2 per hundred riders. This rate does not seem to be markedly different to the Scottish rate for all riders. It was found that the cubic capacity of the motorcycle was the single most important risk factor of the four studied. The risk was disproportionately high in the 200+ cc category. Lower reported injury accident rates were observed for females and trained riders but these differences did not reach statistical significance mainly due to the low numbers of these two categories within the cohort. Contrary to popular assumption, younger riders within this cohort did not have higher injury accidents. A large proportion of the riders who had been involved in injury accidents within the cohort and who had registered 50 cc motorcycles were found to be riding higher capacity (mainly 200+ cc) motorcycles at the time of accident. There was a very low uptake of motorcycle training (7.3%) by the cohort. Approximately 15% of the cohort was female, a higher percentage than those reported by other studies.     

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.     

Sex and age distribution in transport-related injuries in Tehran

Intercountry or regional differences in patterns of injury by the road user type have significant implication for prevention policies. In order to have an estimate from the existing conditions of transport-related injuries (TRIs) and especially to evaluate sex and age distribution of traffic accident victims, we analyzed information of 8426 hospitalized trauma patients during 13 months of data gathering process. Forty-five percent of the injuries were related to car accidents and men/women ratio in these patients was 4.2/1. The highest men/women ratio was (16/1) for motorcyclists, while the lowest ratio (1/1), was for rear seat car passengers. Mean (+/-S.D.) age of the patients was 31 (+/-18), and men were nearly 2 years younger than women (33 versus 31). Sixty-seven percent of the females' and 44% of the males' injuries were related to pedestrian crashes. Motorcycle-related injuries in men and car passenger related injuries in women were the second most common type of crash (42 and 22%, respectively). The use of protective devices in our population was worrisome. In only 6% of the male motorcyclists helmet use was reported, and 3% of the male car occupants had used seatbelts at the time of the accident. The condition in the female population was much worse and no use of the protective devices was reported in this group of the patients. Crude mortality rate in men was nearly two times that of women (6.2% versus 3.8%). After adjustment for age, injury severity score (ISS) and category of the road users, men and women had similar mortality rate.     

Risk factors for injury accidents among moped and motorcycle riders

Objective

To study and quantify the effect of factors related to the riders of powered two-wheelers on the risk of injury accident involvement.

Methodology

Based on national data held by the police from 1996 to 2005, we conducted a case–control study with responsibility for the accident as the event of interest. We estimated the odds ratios for accident responsibility. Making the hypothesis that the non-responsible riders in the study are representative of all the riders on the road, we thus identified risk factors for being responsible for injury accidents. The studied factors are age, gender, helmet wearing, alcohol consumption, validity of the subject's driving licence and for how long it has been held, the trip purpose and the presence of a passenger on the vehicle. Moped and motorcycle riders are analyzed separately, adjusting for the main characteristics of the accident.

Results

For both moped and motorcycle riders, being male, not wearing a helmet, exceeding the legal limit for alcohol and travelling for leisure purposes increased the risk of accident involvement. The youngest and oldest users had a greater risk of accident involvement. The largest risk factor was alcohol, and we identified a dose–effect relationship between alcohol consumption and accident risk, with an estimated odds ratio of over 10 for motorcycle and moped riders with a BAC of 2 g/l or over. Among motorcycle users, riders without a licence had twice the risk of being involved in an accident than those holding a valid licence. However, the number of years the rider had held a licence reduced the risk of accident involvement. One difference between moped and motorcycle riders involved the presence of a passenger on the vehicle: while carrying a passenger increased the risk of being responsible for the accident among moped riders, it protected against this risk among motorcycle riders.

Conclusion

This analysis of responsibility has identified the major factors contributing to excess risk of injury accidents, some of which could be targeted by prevention programmes.     

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.     

Modeling fault among accident—Involved pedestrians and motorists in Hawaii

Using a comprehensive database of police-reported accidents in Hawaii, we describe the nature of pedestrian accidents over the period 2002–2005. Approximately 36% of the accidents occur in residential areas, while another 34% occur in business areas. Only 41.7% of the pedestrian accidents occur at intersections. More pedestrian crashes occur at non-intersection locations—including midblock locations, driveways, parking lots, and other off roadway locations. Approximately 38.2% of the crashes occur at crosswalk locations, while proportionately more (61.8%) of the pedestrian accidents occur at non-crosswalk locations. Using this database the human, temporal, roadway, and environmental factors associated with being “at-fault” for both pedestrians and drivers are also examined. Using techniques of logistic regression, several different explanatory models are constructed, to identify the factors associated with crashes producing fatalities and serious injuries. Finally, two pedestrian models (drunk males and young boys) and one driver model (male commuters) are developed to provide further understanding of pedestrian accident causation. Drunk male pedestrians who were jaywalking were in excess of 10× more likely than other groups to be at-fault in pedestrian accidents. Young boys in residential areas were also more likely to be at-fault. Male commuters in business areas in the morning were also found to have higher odds of being classified at-fault when involved in pedestrian accidents. The results of this study indicate that there should be a combination of enforcement and educational programs implemented for both the pedestrian and drivers to show those at-fault the consequences of their actions, and to reduce the overall number of accidents.     

Safety effects of blue cycle crossings: a before-after study

This paper presents a before-after accident study of marking blue cycle crossings in 65 signalised junctions. Corrections factors for changes in traffic volumes and accident/injury trends are included using a general comparison group in this non-experimental observational study. Analysis of long-term accident trends point towards no overall abnormal accident counts in the before period. The safety effect depends on the number of blue cycle crossings at the junction. One blue cycle crossing reduces the number of junction accidents by 10%, whereas marking of two and four blue cycle crossings increases the number of accidents by 23% and 60%, respectively. Larger reduction and increases are found for injuries. Safety gains at junctions with one blue cycle crossing arise because the number of accidents with cyclists and moped riders that may have used the blue cycle crossing in the after period and pedestrians in the pedestrian crossing parallel and just next to the blue marking was statistically significant reduced. Two or four blue cycle crossings especially increase the number of rear-end collisions only with motor vehicles involved and right-angle collisions with passenger cars driving on red traffic lights.     

Moped injuries among adolescents: a significant forgotten problem?

OBJECTIVES: The study's objective is to investigate the size of the problem of moped injuries among children and young adults. DESIGN: A comprehensive prospective injury registration has been carried out at the Central Hospital and Emergency Clinic in Rogaland county in Norway. Out of this system we selected cases of traffic injuries occurring from 1990 to 1996 among a defined population aged 0-24 years and analyzed incidence of traffic injury by the type of transport of the victim. RESULTS: Moped injuries represented 9% (85 per 100,000 person-years) of all (hospitalized and non-hospitalized) traffic related injuries among people under 25 years and 44% of all cases among persons aged 16 and 17 years. Moped injuries represented 13% of hospitalized cases altogether and 50% of hospitalized traffic injuries among persons aged 16 and 17 years. The overall male:female moped injury incidence rate ratio was 2.7 (95% CI 2.0-3.7). Police records captured only 40% of the moped injuries overall. 43% of moped injuries were lone accidents and 40% occurred in a moped-car collision. CONCLUSION: Moped injuries represent a major source of serious traffic injury among older children. This risk seems to be partially overlooked. Significantly higher attention seems to be warranted to reduce the risk of moped injury in populations where the moped is a popular means of transport among older children.     

An analysis of 6215 hospitalized unintentional injuries among children aged 0-14 in northwest China

The aim of this study was to analyze the sorts and the external causes of hospitalized unintentional injuries among children aged 0-14 so as to learn the status of children's unintentional injuries in northwest China and then to give some references for the prevention. As many as 6215 abstracts of the discharged medical records of hospitalized children for unintentional injuries from 31 hospitals in northwest China from January 1, 2002 to December 31, 2003 were analyzed, especially for the different external causes and sorts of injuries according to ages, genders and locations. We identified 2081 (33.5%) fractures, 1279 (20.6%) scald/burns, 1125 (18.1%) internal organ injuries and 611 (9.8%) open injuries among the 6215 hospitalized children for unintentional injuries. Boy's cases were 2.2 times as many as those of girl's. The age characteristics of each injury was as follows: scald/burns occurred mostly in children under 3 (53.8%), especially in children under 1 year (58.5%); fractures occurred mostly in children above 4 (38.2%), especially in children aged 7-14 years (41.0%). The proportion of traffic accidents and falls were the highest among children aged 7-14, with 28.5% for traffic accidents and 34.4% for falls, respectively. The total cost of hospitalization was US $1 033 876.0, with a mean cost of US $166.3 per case. The total length of stay in hospital was 106 915.2 days, with a mean of 17.2 days per case. A large proportion of fall, traffic accident, and fire/explosion induced fractures, scald/burns, internal organ and encephalic injuries characterize the childhood unintentional injuries in northwest China. From the analyses of external causes, prevention strategies for different external causes should be correspondingly specific.     

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.     

Evaluating the North Carolina safety belt wearing law

The North Carolina Seat Belt Law required an evaluation of the effectiveness of the act with a report of the findings to the Legislature three years after the law went into effect. This paper addresses changes in statewide belt usage and in occupant injury associated with that law. Observational data collected bimonthly from a probability sample of 72 sites stratified by geographic region, rural/urban location, road type, and time of day show that belt use rose from a baseline rate of 25% to a warning ticket phase rate of 45%. Belt use then reached 78% upon enforcement and is now nearly 64%. Time series analysis showed that statistically significant reductions in percentages of moderate and serious injuries occurred at the beginning of both the warning ticket and the enforcement phases. Forecasts of injuries and deaths were also developed from the time series models and were compared with observed totals. Warning tickets brought about a modest 5.4% reduction in serious injuries; fatalities among occupants covered by the law showed no change. In contrast, the subsequent enforcement phase saw a reduction of 11.6% in fatalities and 14.6% in serious or worse injuries. This represents an estimated annual savings of 131 lives and over 2,300 serious injuries in North Carolina during the 18 months following onset of enforcement.     

Factors contributing to young moped rider accidents in Denmark

Young road users still constitute a high-risk group with regard to road traffic accidents. The crash rate of a moped is four times greater than that of a motorcycle, and the likelihood of being injured in a road traffic accident is 10–20 times higher among moped riders compared to car drivers. Nevertheless, research on the behaviour and accident involvement of young moped riders remains sparse.Based on analysis of 128 accident protocols, the purpose of this study was to increase knowledge about moped accidents. The study was performed in Denmark involving riders aged 16 or 17. A distinction was made between accident factors related to (1) the road and its surroundings, (2) the vehicle, and (3) the reported behaviour and condition of the road user. Thirteen accident factors were identified with the majority concerning the reported behaviour and condition of the road user. The average number of accident factors assigned per accident was 2.7. Riding speed was assigned in 45% of the accidents which made it the most frequently assigned factor on the part of the moped rider followed by attention errors (42%), a tuned up moped (29%) and position on the road (14%). For the other parties involved, attention error (52%) was the most frequently assigned accident factor. The majority (78%) of the accidents involved road rule breaching on the part of the moped rider.The results indicate that preventive measures should aim to eliminate violations and increase anticipatory skills among moped riders and awareness of mopeds among other road users. Due to their young age the effect of such measures could be enhanced by infrastructural measures facilitating safe interaction between mopeds and other road users.     

Self-reported motorcycle riding behaviour among school children in India

Studies on traffic accidents among underage users of motorcycles are seldom seen in literature. This study was done in Yamunanagar, India where boys as young as 8 years ride motorcycles. It attempts to find out the behavioural and non-behavioural factors leading to motorcycle use and the predisposition to accidents among male school children aged between 10 and 16 years. A questionnaire was used to evaluate those factors among 1760 subjects in 38 schools. Fifteen percent of subjects had had an accident while riding motorcycle. Most of the behavioural and all the non-behavioural factors have a statistically significant influence on accident proneness. Aggressive behaviour and previous encounter with the police are the two strong predictors of accidents (p<0.001). Children as riders are exposed to higher risks of accident and longer life with disability. It also explains how these children behaviourally take up adult roles and seek adult risk taking attitudes. The implications of child motorcycle riders upon children themselves and on the society are discussed for a greater discourse on road safety motorcycle riding policy and to highlight the behavioural and non-behavioural factors that are associated with traffic accidents.     

Characteristics of three- and four-wheeled all-terrain vehicle accidents in Quebec

During a seven-month survey from May to November 1985, 624 victims injured from three- or four-wheeled all-terrain vehicles (ATVs) were observed in the emergency rooms of 10 regional hospitals in Quebec. A total of 1,100 injuries were identified, including 3 fatal and 104 serious to critical injuries (AIS greater than or equal to 3). These injuries were to the lower limb (29%), the upper limb (28%), the head, neck, and face (26%), and the thorax, abdomen, and pelvis (18%). Close to one-half (45%) of the victims were 19 years old and less; 54% reported wearing helmets. Ten percent of the victims were hospitalized for an average period of 8 days. In 70% of the cases, the vehicle overturned: half of these vehicles turned on the side, 27% toward the back, and 19% flipped forward. Two-thirds of persons injured were involved in accidents in which no external objects were hit by the vehicle; these accidents typically involved vehicle overturns, both on hills and on level ground. Ninety-five percent of the vehicles were in good mechanical condition. The use of these vehicles presents a danger whether used by a child or an adult, by an experienced or an inexperienced rider. The average user may not be aware that three- and four-wheel ATVs demand considerable skill and caution. We suggest the use of accident reconstruction studies for possible engineering solutions.     

Motorcycle riders' perception of helmet use: complaints and dissatisfaction

In accidents which involve two-wheeled vehicles the helmet plays a life-saving role, but very little is known about the motorcycle rider's perception of the helmet. We evaluated the relationships between having been involved in an accident and dissatisfaction with the helmet, and between the perception of motorcycle riders and the objective features of the helmet. This was a case-control study: riders of motorized two-wheelers who had been involved in accidents (accident cases) were compared against a similarly interviewed sample of riders that had not been in accidents (control cases). Information about the driver, the vehicle and the helmet was collected in all interviews. To evaluate the relationships, logistic regressions were carried out. The majority of drivers were dissatisfied with their helmets, but no evidence was found to link this dissatisfaction with having been involved in an accident. The two most common complaints related to noisiness, followed by the helmet visor. Complaints did not seem to be statistically associated with physical features of the helmet.     

Road traffic accidents and the Abbreviated Injury Scale (ais) in Japan

Although in Japan the number of casualties from road traffic accidents decreased substantially during a period of improvement of safety measures, in recent years it has remained rather constant. To decrease accidents still further it is necessary to investigate the circumstances of road traffic accidents and the severity of resulting casualties in detail. For this purpose 167,721 cases of road traffic accident casualties occurring between February and April 1979, throughout Japan were analyzed. (1) It was found that 74.2% of all the cases suffered injuries corresponding to AIS-1; 30% of these involved neck injuries. (2) There were 2,654 fatal cases, 67% of which involved head injuries, chiefly cerebral contusion, cranial base fracture, and intracranial hemorrhage. There were fatal cases in the categories of AIS-3 or below which are generally considered not fatal, but those were due to complications. (3) The chief sites of injury varied according to the victim's mode of transport: in an automobile the neck was the site most frequently injured; on a motorcycle the legs and head were usually involved; on a bicycle or walking the head and legs were most at risk. (4) Injuries to pedestrians often fell under the severer AIS-4 or higher codes and constituted 43% of total deaths. (5) Accidents with automobiles changing lanes tended to cause serious injuries and many deaths. Other characteristics of road traffic accidents in Japan are analyzed and discussed.     

A note on modeling pedestrian-injury severity in motor-vehicle crashes with the mixed logit model

Pedestrian-injury severity has been traditionally modeled with approaches that have assumed that the effect of each variable is fixed across injury observations. This assumption ignores possible unobserved heterogeneity which is likely to be particularly important in pedestrian injuries because unobserved physical health, strength, and behavior may significantly affect the pedestrians’ ability to absorb collision forces. To address such unobserved heterogeneity, this research applies a mixed logit model to analyze pedestrian-injury severity in pedestrian-vehicle crashes. Using police-reported collision data from 1997 through 2000 from North Carolina, several factors were found to more than double the average probability of fatal injury for pedestrians in motor-vehicle crashes including: darkness without streetlights (400% increase in fatality probability), vehicle is a truck (370% increase), freeway (330% increase), speeding involved (360% increase), and collisions involving a motorist who had been drinking (250% increase). It was also found that the effect of pedestrian age was normally distributed across observations, and that as pedestrians became older the probability of fatal injury increased substantially. Heterogeneity in the mean of the random parameters for the freeway and pedestrian-solely-at-fault collision indicators was related to pedestrian gender, and heterogeneity in the mean of the random parameters for the traffic-sign and motorist-back-up indicators was related to pedestrian age.     

Treated injuries in Northern Vermont

Objectives: To study characteristics of injury events and injuries requiring treatment in a Vermont population. Method: A one year 30% prospective sample was studied of persons from 22 communities who received first physician care for injury at the Medical Center Hospital of Vermont. Results: Modal injuries were—superficial involving skin only among children below age 10, overexertion injuries among 10–59 year olds, and fractures among older persons. Among interviewed males ages 20–59, 31% of injuries were work related. Among females 26% were work related. Examining hospitalized cases only would have overemphasized falls, chemical injuries, leg fractures, transportation and nursing home injuries, and undercounted overexertion injuries, especially to the back, arm fractures, and injuries during recreation, work and home activities. Most common products/materials in use when injured were recreational equipment (24%) and motor vehicles (9%). Those most often causing injury were ground (20%) and home structures/construction materials (17%). No product was involved in 39% of injury event initiation and 15% of injury causation. Conclusion: In order to adequately reflect the distribution of treated injuries in the community by anatomical area, age, and event type studies must examine both emergency department and hospitalized cases and use a data collection system capable of recording several parameters to describe injury events and products/materials involved.     

Health status recovery at one year in children injured in a road accident: A cohort study

Despite the frequency of traumatic injuries due to road accidents and potential importance of identifying children at risk of impaired recovery one year after a road accident, there is a lack of data on long-term recovery of health status, except in children with severe traumatic brain injury. The aim of the present study was to evaluate predictive factors of recovery in children one year after road traffic injuries. The prospective cohort study was composed of children aged <16 years, admitted to public or private sector hospitals in the Rhône administrative area of France following a road accident. Recovery of health status one year after the accident and information concerning quality of life and the consequences of the accident for the child or family 1 year after the accident were collected by questionnaire, usually completed by the parents. Victims were in majority male (64.6%) and had mild or moderate injuries (81.9% with Maximum Abbreviated Injury Scale (M-AIS) <3). One year after the accident, 75.0% of the mild-to-moderate and 34.8% of the severe cases estimated health status as fully recovered. After adjustment, severity score (M-AIS ≥ 3) and lower limb injury (AIS > 1) were associated with incomplete recovery of health status: weighted odds ratio (OR_w), 4.3 [95% confidence interval (95% CI), 1.3–14.6] and OR_w, 6.5 [95% CI, 1.9–21.7], respectively. Recovery status correlated significantly with quality of life physical scores (r = 0.46), especially body pain (r = 0.48) and role/social–physical (r = 0.50) and, to a lesser extent, quality of life psychosocial scores (r = 0.21). In a cohort of children injured in a road accident, those with high injury severity score and those with lower limb injuries are less likely to recover full health status by 1 year. Impaired health status was associated with a lower physical quality of life score at 1 year.