Tiring job and work related injury road crashes in the GAZEL cohort

The objective was to describe at-work and commuting crashes occurring in a cohort of French employees and to investigate occupational risk factors. The subjects were employees of the French national electricity and gas companies, Électricité de France and Gaz de France (EDF–GDF), who volunteered to join a research cohort (the GAZEL cohort which included 20,625 participants in 1989). Only crashes with injuries were considered. Crashes for the periods 1989–2001 were recorded together with the type of journey (commuting, work, private), the type of road-user, self-estimated responsibility, and injuries sustained by the subject. Annual incidences for gender/age groups and socio-occupational groups were computed for each of the two types of work related crashes. Occupational risk factor analyses were conducted using a Cox proportional hazards regression model with time-dependent covariates adjusting for the main confounders. A total of 146,285 person years at work were observed. Two indicators of self-reported work fatigue were associated with the occurrence of at-work crashes: “nervously tiring work” for males (RR = 1.6, 95% CI [1.1; 2.3]), sustained standing for females (RR = 3.0, 95% CI [1.0; 8.4]), adjusting for health status, location of residence, type of family, transport mode and mileage. As regards crashes while commuting, a self-reported uncomfortable position at work was a risk factor among women (RR = 1.9, 95% CI [1.1; 3.3]). On the other hand, these occupational factors were not linked to road crashes in private trips. Work related road crashes seem then to be a matter for a specific prevention. Preventing employees from becoming exhausted should be considered as the first way to initiate such a prevention.     

Vertebral fractures in motor vehicle accidents–a medical and technical analysis of 33,015 injured front-seat occupants

Spinal injuries pose a considerable risk to life and quality of life. In spite of improvements in active and passive safety of motor vehicles, car accidents are regarded as a major cause for vertebral fractures. The purpose of this study was to evaluate the current incidence of vertebral fractures among front-seat occupants in motor vehicle accidents, and to identify specific risk factors for sustaining vertebral fractures in motor vehicle accidents. Data from an accident research unit were accessed to collect collision details, preclinical data, and clinical data. We included all data on front-seat occupants. Hospital records were retrieved, and radiological images were evaluated.     

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.     

Characteristics of low speed accidents with buses in public transport

Low-speed accidents with buses in public transport in the city of Uppsala during the years 1986-2000 are coded in 17 variables concerning mainly physical properties of the accident. The taxonomy uses classifications from existing schemes, but some are altered and some new are added to capture common features of reports of bus accidents in this population. It is found that side contacts and singles are the most common accidents, and that more than a quarter of all accident involvements occurs at bus stops. Inter-rater reliability calculations for the categories show that all except one have reliabilities above 80%. The level of internal validity, calculated as agreement of frequencies between time periods, is acceptable, despite many possible sources of change and bias. It is argued that the validity of this database far exceeds that of the, for research purposes normally used, non-company self-reports, state- and police-archives, due to more extensive reporting and corroborating evidence. The practical usefulness of these results and accident taxonomies in general is discussed.     

Stop versus yield on pedestrian-involved fatal crashes in the United States

In an effort to improve pedestrian safety, several states in the United States changed their pedestrian laws by changing the requirement that drivers yield to pedestrians in crosswalks to a requirement that drivers stop for pedestrians in crosswalks. This study examined whether this change had an effect on pedestrian safety in the United States, with its focus on low-speed roads. To examine the association between changes in pedestrian laws and changes in pedestrian-involved fatal crashes, three approaches were employed: before–after analysis, time-series analysis, and cross-sectional analysis. Pedestrian-involved fatal traffic crashes on low-speed roads were extracted from the U.S. national fatal crash database, the Fatality Analysis Reporting System (FARS), from 1980 through 2005. This study found no statistically significant reduction in pedestrian-involved fatal crashes attributable to changes in the laws, yet this finding is not definitive because of study limitations such as the omission of relevant exposure data.     

Characteristics of low speed accidents with buses in public transport: part II

A number of accident characteristics of bus crashes are analyzed in relation to each other using data from 2237 accident involvements in the city of Uppsala (Sweden) during the years 1986-2000. The breakdown of accidents into sub-categories show, for example, that injury was common in intersection accidents, that bus stops present large risk for shunts and side contacts, while single vehicle accidents were seldom preceded by the loss of control or a skid. The treatment of accident data is discussed in terms of methodology, statistics and data reduction strategies.     

Alcohol-related traffic accidents with fatal outcomes in the city of Sao Paulo

Aims

The aims of the present study were to characterize fatal traffic accident victims in a major urban center in Brazil and their association with alcohol consumption.

Methods

Cross-sectional study of 907 fatal traffic accident victims in Sao Paulo, in 2005.

Results

Adult males between the ages of 25 and 54 represented the majority of cases with positive blood alcohol concentrations (BAC). Overall, males had a higher proportion of BAC and mean BAC than females. Pedestrians, particularly those with no detectable BAC, were typically older than other victims. Most accidents (total and BAC-positive) happened on weekends between midnight and 6 a.m. Considering all victims, 39.4% were positive (BAC over 0.1 g/l). When only drivers (automobile, motorcycle and bicycle) were evaluated, 42.3% had BAC over the legal limit (0.6 g/l).

Conclusions

Alcohol is associated with nearly half of all traffic accident deaths in the city of Sao Paulo, especially for days and times associated with parties and bars (weekends between 12 a.m. and 6 a.m.).     

The stability of driver acceleration behavior, and a replication of its relation to bus accidents

The reliability over time of a method for measuring driver acceleration behavior was tested on bus drivers in regular traffic. Also, a replication of an earlier finding of a correlation between driver acceleration behavior and accident frequency for the individual drivers was made. It was found that the split-half correlation is probably around 0.50 for the mean (of accelerations) of a 30-min drive, and similar for the test-retest of 2.5h measured about a month apart. With such reliability, the sample was probably too small to reliably determine any association with accidents, but some significant correlations were found. Some ways of holding constant the differences in exposure and driving environment were tried with mixed success. Alternate ways of analyzing the data and several methodological problems were briefly discussed. It was concluded that the measurements of acceleration behavior, for bus drivers, are fairly reliable over at least a few months. However, some strange discrepancies between samples make all interpretations concerning the link to accidents tentative.     

Models relating traffic safety with road environment and traffic flows on arterial roads in Addis Ababa

This paper presents the study carried out to develop accident predictive models based on the data collected on arterial roads in Addis Ababa. Poisson and negative binomial regression methods were used to relate the discrete accident data with the road and traffic flow explanatory variables. Significant accident predictive models were found with a number of significant explanatory variables. The results show that the existing inadequate road infrastructure and poor road traffic operations are the potential contributors of this ever-growing challenge of the road transport in Addis Ababa. The results also indicate that improvements in roadway width, pedestrian facilities, and access management are effective in reducing road traffic accidents.     

Distribution and characteristics of road traffic crashes in the Chaoyang District of Beijing, China

In many developing urban settings, economic growth and motorization are coupled with increasing rates of road traffic injuries (RTIs). By highlighting typical sites and circumstances at/in which car crashes occur, more specific targets for prevention can be identified. The study is based on police data for a 1-year period and covers the Chaoyang District, the biggest district of Beijing City. Focus is placed on crash patterns and their distribution by types of road and areas. Both fatal and non-fatal crashes are considered (n=754). In the main, the crashes occurred in relatively favorable driving circumstances (e.g., sunny weather, flat and straight roads, asphalted roads, and good traffic signals and road markings). They were also quite evenly distributed over time of day, day of week and season. Five crash patterns were highlighted, of which three were strongly associated with specific areas and four with specific types of road. The study supports the idea that type of road and RTI severity or pattern are closely related. It contributes to the development of context-relevant prevention measures aimed at reducing road crashes and minimizing their consequences and also supports safe planning of the road traffic environment.     

Operational storm surge forecasting in the Netherlands: developments in the last decade

The accurate forecasting of storm surges is an important issue in the Netherlands. With the emergence of the first numerical hydrodynamic models for surge forecasting at the beginning of the 1980s, new demands and possibilities were raised. This article describes the main phases of the development and the present operational set-up of the Dutch continental shelf model, which is the main hydrodynamic model for storm surges in the Netherlands. It includes a brief discussion of applied data-assimilation techniques, such as Kalman filtering, the model calibration process and some thoughts on quality assurance in an operational environment. After further describing some select recent investigations, the paper concludes with some remarks on future developments in a European context.     

The influence of the infrastructure characteristics in urban road accidents occurrence

This paper summarizes the result of a study regarding the creation of tools that can be used in intervention methods in the planning and management of urban road networks in Portugal.     

Traffic safety assessment and development of predictive models for accidents on rural roads in Egypt

This paper starts by presenting a conceptualization of indicators, criteria and accidents' causes that can be used to describe traffic safety. The paper provides an assessment of traffic safety conditions for rural roads in Egypt. This is done through a three-step procedure. First, deaths per million vehicle kilometers are obtained and compared for Egypt, three other Arab countries and six of the G-7 countries. Egypt stands as having a significantly high rate of deaths per 100 million vehicle kilometers. This is followed by compiling available traffic and accident data for five main rural roads in Egypt over a 10-year period (1990-1999). These are used to compute and compare 13 traffic safety indicators for these roads. The third step for assessing traffic safety for rural roads in Egypt is concerned with presenting a detailed analysis of accident causes. The paper moves on to develop a number of statistical models that can be used in the prediction of the expected number of accidents, injuries, fatalities and casualties on the rural roads in Egypt. Time series data of traffic and accidents, over a 10 years period for the considered roads, is utilized in the calibration of these predictive models. Several functional forms are explored and tested in the calibration process. Before proceeding to the development of these models three ANOVA statistical tests are conducted to establish whether there are any significant differences in the data used for models' calibration as a result of differences among the considered five roads.     

Alcohol, psychoactive drugs and fatal road traffic accidents in Norway: a case-control study

A case–control study was conducted on 204 drivers fatally injured in road traffic accidents in south-eastern Norway during the period 2003–2008. Cases from single vehicle accidents (N = 68) were assessed separately. As controls, 10 540 drivers selected in a roadside survey in the same geographical area during 2005–2006 were used. Blood samples were collected from the cases and oral fluid (saliva) samples from the controls. Samples were analysed for alcohol, amphetamines, cannabis, cocaine, opioid analgesics, hypnotics, sedatives and a muscle relaxant; altogether 22 psychoactive substances. Equivalent cutoff concentrations for blood and oral fluid were used. The risk for fatal injury in a road traffic accident was estimated using logistic regression adjusting for gender, age, season of the year, and time of the week. The odds for involvement in fatal road traffic accidents for different substances or combination of substances were in increasing order: single drug < multiple drugs < alcohol only < alcohol + drugs. For single substance use: medicinal drug or THC < amphetamine/methamphetamine < alcohol. For most substances, higher ORs were found when studying drivers involved in single vehicle accidents than for those involved in multiple vehicle accidents, but confidence intervals were wider.     

Commuting by bike in Belgium, the costs of minor accidents

Minor bicycle accidents are defined as “bicycle accidents not involving death or heavily injured persons, implying that possible hospital visits last less than 24 hours”. Statistics about these accidents and related injuries are very poor, because they are mostly not reported to police, hospitals or insurance companies. Yet, they form a major share of all bicycle accidents. Official registrations underestimate the number of minor accidents and do not provide cost data, nor the distance cycled. Therefore related policies are hampered by a lack of accurate data.This paper provides more insight into the importance of minor bicycle accidents and reports the frequency, risk and resulting costs of minor bicycle accidents. Direct costs, including the damage to bike and clothes as well as medical costs and indirect costs such as productivity loss and leisure time lost are calculated. We also estimate intangible costs of pain and psychological suffering and costs for other parties involved in the accident. Data were collected during the SHAPES project using several electronic surveys. The weekly prospective registration that lasted a year, covered 1187 persons that cycled 1,474,978 km. 219 minor bicycle accidents were reported. Resulting in a frequency of 148 minor bicycle accidents per million kilometres. We analyzed the economic costs related to 118 minor bicycle accidents in detail. The average total cost of these accidents is estimated at 841 euro (95% CI: 579–1205) per accident or 0.125 euro per kilometre cycled. Overall, productivity loss is the most important component accounting for 48% of the total cost. Intangible costs, which in past research were mostly neglected, are an important burden related to minor bicycle accidents (27% of the total cost). Even among minor accidents there are important differences in the total cost depending on the severity of the injury.     

Work-related road traffic collisions in the UK

Road traffic collisions while at work are the single largest cause of occupational fatality in the United Kingdom. Work-related road collisions do not comprise a homogenous group, but take many forms, encompassing the use of varying types of vehicle used for diverse purposes. A sample of over 2000 collision cases was considered, over 1000 in detail, from UK police forces, involving drivers/workers of all ages, and covering the years 1996-2004 inclusive. There were three key findings. (1) There were six main classes of collision-involved vehicles. These were company cars, vans/pickups, large goods vehicles (LGVs), buses (PCVs or ‘passenger carrying vehicles’), taxis/minicabs, and emergency vehicles (police, fire/rescue and ambulance). (2) The drivers of company cars, vans/pickups, and large goods vehicles (LGVs) all appeared to have a high ‘blameworthiness ratio’ in their collision involvement. Company car drivers showed excess speed as a causal factor, whereas van drivers showed more observational failures, and LGV drivers showed more fatigue and vehicle defects as factors. (3) The drivers of buses (PCVs), taxis/minicabs, and emergency vehicles showed a low ‘blameworthiness ratio’ in their collision involvement. Their problems seemed to be primarily with the other drivers/parties with whom they share the road. While they made a variety of mistakes or errors, they were more likely to become the victim of another party's mistake or error.     

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.     

驾驶员与儿童事故倾性研究

文章通过对全国部分城市驾驶员交通事故和儿童意外伤害事故的流行病学研究结果发现：（１）驾驶员交通事故和儿童意外伤害事故检出率不存在地区性差异；（２）驾驶员交通事故和儿童意外伤害事故的检出率无显著性的年龄差异；（３）不同年龄段驾驶员和儿童，男性事故检出率均高于女性事故检出率；（４）极少数的事故人群具有事故倾向性：在驾驶人群中有６％～８％的事故倾性驾驶员，其引起的交通事故数占总事故数的３０％～４０％，在１～１４岁儿童中有１％～２％的事故倾性儿童，其发生的意外伤害数占意外伤害总数的２５％～３５％；（５）事故倾性驾驶员和事故倾性儿童再发事故的比率均比对照组高。文章从流行病学角度证实了事故倾性人群的存在，并对事故倾性的本质作了初步探讨。     

驾驶员与儿童事故倾性研究

文章通过对全国部分城市驾驶员交通事故和儿童意外伤害事故的流行病学研究结果发现 :(1 )驾驶员交通事故和儿童意外伤害事故检出率不存在地区性差异 ;(2 )驾驶员交通事故和儿童意外伤害事故的检出率无显著性的年龄差异 ;(3 )不同年龄段驾驶员和儿童 ,男性事故检出率均高于女性事故检出率 ;(4 )极少数的事故人群具有事故倾向性 :在驾驶人群中有 6%～ 8%的事故倾性驾驶员 ,其引起的交通事故数占总事故数的 3 0 %～ 40 % ,在 1～ 1 4岁儿童中有 1 %～ 2 %的事故倾性儿童 ,其发生的意外伤害数占意外伤害总数的2 5 %～ 3 5 % ;(5 )事故倾性驾驶员和事故倾性儿童再发事故的比率均比对照组高。文章从流行病学角度证实了事故倾性人群的存在 ,并对事故倾性的本质作了初步探讨。