Grandparents and child passenger safety

Purpose

This study compares child passenger safety (CPS) practices of grandparents versus parents and determines grandparents’ opinions on car safety seats (CSS), barriers to use, and ways to transport grandchildren safely.

Methods

Observational surveys were conducted on a convenience sample of drivers transporting children younger than sixteen years at 25 locations by certified child passenger safety technicians observing children in motor vehicles and recorded use of child passenger restraints. The drivers were surveyed on their knowledge, attitudes, beliefs, and practices regarding CPS. Data from drivers identifying themselves as grandparents were analyzed; also, three grandparent focus groups provided opinions on CPS practices.

Results

During the study 1758 parents transporting 2713 children and 284 grandparents transporting 391 grandchildren were included. While most drivers were restrained and used child occupant restraints, almost 25% of parents and grandparents chose the incorrect seat to transport the child, and greater than 68% had at least one harness error. Grandparents were more likely to have looser lower anchor straps or seat belts and have children younger than thirteen years in the front seat.The focus group-grandparents had a favorable attitude toward CSS. Grandparents acknowledged the need for CSS but opined that CSS were difficult to use. Physical barriers included arthritis, back pain, mobility, decreased strength, and vision problems.

Conclusions

Grandparents and parents were equally likely to use CSS and choose correct seats. Compared to parents, grandparents were more likely to travel with their grandchildren with CSS installed with looser harnesses or an installed CSS with looser seat belt or lower anchors. Additionally, grandparents were more likely to have a child younger than thirteen years in the front seat. The use of community resources such as permanent fitting stations could help grandparents improve a grandchild's travel safety.     

Obstructive sleep apnoea among professional taxi drivers: A pilot study

Purpose

This study aimed to describe the distribution of risk factors for obstructive sleep apnoea syndrome (OSAS) among taxi drivers, and to investigate differences by ethnicity in OSAS symptoms among drivers.

Methods

A two-page postal questionnaire was completed by 241 professional taxi drivers from Wellington, New Zealand. Obstructive sleep apnoea syndrome was defined as having an estimated 15 or more respiratory disturbances, per hour of sleep (Respiratory Disturbance Index (RDI) ≥ 15) and self-reported daytime sleepiness.

Results

Pacific and Māori taxi drivers were more likely to have symptoms and risk factors for OSAS, compared to non-Māori non-Pacific drivers. In particular, Pacific drivers had a significantly increased pre-test probability of having moderate-severe OSA (RDI ≥ 15).

Conclusions

Some professional taxi drivers are at increased risk for moderate-severe OSAS, especially Pacific and Māori taxi drivers. Untreated OSAS increases motor vehicle crash risk, so these findings have implications for the health and safety of drivers and their passengers. They suggest a need for more comprehensive research to guide policy on medical examinations required for licensing professional drivers as fit to drive.     

The acute effects of 3,4-methylenedioxymethamphetamine and methamphetamine on driving: A simulator study

Objectives

Illicit drugs such as MDMA and methamphetamine are commonly abused drugs that have also been observed to be prevalent in drivers injured in road accidents. Their exact effect on driving and driving behavior has yet to be thoroughly investigated.

Methods

Sixty-one abstinent recreational users of illicit drugs comprised the participant sample, with 33 females and 28 males, mean age 25.45 years. The three testing sessions involved oral consumption of 100 mg MDMA, 0.42 mg/kg methamphetamine, or a matching placebo. The drug administration was counter-balanced, double-blind, and medically supervised. At each session driving performance was assessed 3 h and 24 h post drug administration on a computerized driving simulator.

Results

At peak concentration overall impairment scores for driving (F_2,118 = 9.042, p < 0.001) and signaling (F_2,118 = 4.060, p = 0.020) were significantly different for the daytime simulations. Performance in the MDMA condition was worse than both the methamphetamine (p = 0.023) and placebo (p < 0.001) conditions and the methamphetamine condition was also observed to be worse in comparison to the placebo (p = 0.055). For signaling adherence, poorer signaling adherence occurred in both the methamphetamine (p = 0.006) and MDMA (p = 0.017) conditions in comparison to placebo in the daytime simulations.

Conclusions

The findings of this study have for the first time illustrated how both MDMA and methamphetamine effect driving performance, and provide support for legislation regarding testing for the presence of illicit drugs in impaired or injured drivers as deterrents for driving under the influence of illicit drugs.     

Urban crash-related child pedestrian injury incidence and characteristics associated with injury severity

Objective

Describe age-based urban pedestrian versus auto crash characteristics and identify crash characteristics associated with injury severity.

Materials and methods

Secondary analysis of the 2004–2010 National Highway and Traffic Safety Administration database for Illinois. All persons in Chicago crashes with age data who were listed as pedestrians (n = 7175 child age ≤19 yo, n = 16,398 adult age ≥20 yo) were included. Incidence and crash characteristics were analyzed by age groups and year. Main outcome measures were incidence, crash setting, and injury severity. Multivariate logistic regression analysis was performed to estimate injury severity by crash characteristics.

Results

Overall incidence was higher for child (146.6 per 100,000) versus adult (117.3 per 100,000) pedestrians but case fatality rate was lower (0.7% for children, 1.7% for adults). Child but not adult pedestrian injury incidence declined over time (trend test p < 0.0001 for <5 yo, 5–9 yo, and 10–14 yo; p < 0.05 for 15–19 yo, p = 0.96 for ≥20 yo). Most crashes for both children and adults took place during optimal driving conditions. Injuries were more frequent during warmer months for younger age groups compared to older (χ²p < 0.001). Midblock crashes increased as age decreased (p < 0.0001 for trend). Most crashes occurred at sites with sub-optimal traffic controls but varied by age (p < 0.0001 for trend). Crashes were more likely to be during daylight on dry roads in clear weather conditions for younger age groups compared to older (χ²p < 0.001). Daylight was associated with less severe injury (child OR 0.93, 95% CI 0.87–0.98; adult OR 0.90, 95% CI 0.87–0.93).

Conclusion

The incidence of urban pedestrian crashes declined over time for child subgroups but not for adults. The setting of pedestrian crashes in Chicago today varies by age but is similar to that seen in other urban locales previously. Injuries for all age groups tend to be less severe during daylight conditions. Age-based prevention efforts may prove beneficial.     

Evaluation of the Boost ‘em in the Back Seat Program: Using fear and efficacy to increase booster seat use

Objectives

Recent research supports the use of high-threat messages when they are targeted appropriately and designed to promote high efficacy as well as fear. This research examined the effectiveness of using a novel threat-appeal approach to encourage parents to place their children in booster seats and rear seats of vehicles.

Method

A 6-min video-intervention was created and evaluated at after-school/daycare centers via an interrupted time series design with similar control sites for comparison. Caregivers (N = 226) completed knowledge and practice surveys and fear and efficacy estimations related to childhood motor vehicle hazards. Researchers observed booster-seat and rear-seat use in study site parking lots.

Results

Compared to baseline and control assessments, the treatment groups’ child passenger safety knowledge, risk-reduction attitudes, behavioral intentions, sense of fear related to the hazard, and sense of efficacy related to the recommended behaviors increased significantly. Further, observed overall restraint use and booster-seat use increased significantly following the intervention.

Conclusions

Applying high-threat messages to child passenger safety interventions is promising and has the potential to be adapted to other health risk areas.     

Increased patterns of risky behaviours among helmet wearers in skiing and snowboarding

Background

There has been an ongoing debate as to whether wearing helmets in skiing and snowboarding increases the risk tolerance of participants.

Objective

To investigate the roles of demographic and personality variables, and helmet usage in predicting risk taking behaviours in a cross-sectional sample of intermediate and proficient skiers and snowboarders.

Methods

Risk taking in skiing was measured using a validated 10-item self-report measure which was designated as the outcome variable in a three step hierarchical regression. Independent predictors included age, sex, education, sport, ability, helmet usage, and personality traits that have been associated with risk taking: impulsivity and sensation seeking.

Results

In the final regression model, helmet use significantly predicted variance in risk taking (standardized β = .10, p = .024), and the relationship remained after accounting for variance due to demographic variables and general trait measures. The partial relationship between risk taking and sex, ability, impulsivity, and sensation seeking were also significant (p < .05).

Conclusion

High sensation seeking, high impulsivity, male sex, and proficiency were associated with increased patterns of risky behaviours in skiers and snowboarders, and after accounting for these factors, helmet use was a significant predictor of risk taking. The relationship between helmet use and risk taking was modest suggesting that the costs of increased risk taking is not likely to outweigh the protective benefits of a helmet.     

Incidence and characteristics of school bus crashes and injuries

Objective

Studies of school bus crashes have focused on the biomechanics of catastrophic collisions, with very few examining crash incidence.

Methods

Crashes in the state of Iowa were examined from January 2002 through December 2005. School bus crashes were identified through the Iowa Crash Data, a comprehensive database of all reported crashes in the State of Iowa. School bus mileage data were provided by the Iowa Department of Education. School bus crash, fatality, and injury rates were calculated and differences in crash and injury characteristics between school buses and other vehicles were examined.

Results

The school bus crash, fatality and non-fatal injury rates were 320.7, 0.4 and 13.6 per 100 million bus miles travelled, respectively. School bus crash fatality and injury rates were 3.5 and 5.4 times lower than overall all vehicle crash fatality and injury rates, respectively. Drivers of other vehicles were more likely to have caused the crash than the bus driver (P < 0.001).

Conclusions

School buses experience low crash rates, and the majority of crashes do not lead to injury. Buses are among the safest forms of road transportation, and efforts to educate drivers of other vehicles may help reduce crashes with buses.     

Young novice drivers and the risky behaviours of parents and friends during the Provisional (intermediate) licence phase: A brief report

Purpose

While there is research indicating that many factors influence the young novice driver's increased risk of road crash injury during the earliest stages of their independent driving, there is a need to further understand the relationship between the perceived risky driving behaviour of parents and friends and the risky behaviour of drivers with a Provisional (intermediate) licence.

Method

As part of a larger research project, 378 drivers aged 17–25 years (M = 18.22, SD = 1.59, 113 males) with a Provisional licence completed an online survey exploring the perceived riskiness of their parents’ and friends’ driving, and the extent to which they pattern (i.e. base) their driving behaviour on the driving of their parents and friends.

Results

Young drivers who reported patterning their driving on their friends, and who reported they perceived their friends to be risky drivers, reported more risky driving. The risky driving behaviour of young male drivers was associated with the perceived riskiness of their fathers’ driving, whilst for female drivers the perceived riskiness of their mothers’ driving approached significance.

Conclusions

The development and application of countermeasures targeting the risky behaviour of same-sex parents appears warranted by the robust research findings. In addition, countermeasures need to encourage young people in general to be non-risky drivers; targeting the negative influence of risky peer groups specifically. Social norms interventions may minimise the influence of potentially-overestimated riskiness.     

Does wearing helmets reduce motorcycle-related death? A global evaluation

Background

The high risk of injury and death of motorcycle riders is a major global health problem. This study aimed to evaluate the effect of helmet wearing on motorcycle riders’ death rates on a global level.

Methods

Data for motorcycle riders were collected from 70 countries. These data included motorcycle-related death rates per 100 000 population, helmet non-usage percentage, Gross National Income per capita (GNI), number of registered motorized 2–3 wheelers, the effectiveness of law enforcement in each country, and whether there was standards for helmets use or not. Correlations between studied variables were done using Pearson correlation. Multiple linear regression models were used to define factors affecting motorcycle-related death rates.

Results

The correlation between motorcycle-related death rate and helmet non-usage, was almost significant (p = 0.056, r = 0.28). Helmet non-usage percentage was significantly correlated with GNI (p < 0.0001, r = −0.61) and effectiveness of the law (p < 0.0001, r = −0.73). A multiple linear regression model which was highly significant (adjusted R-squared = 0.3, F = 6.69, p < 0.001) has shown that helmet non-usage percentage (p = 0.003), motorcycle per person ratio (p = 0.01) and the presence of helmet standards (p = 0.05) were positively associated with motorcycle-related death rates. A simple linear regression model between helmet usage and road traffic death rate has shown that for each 10% increase in helmet usage, one life per 1 000 000 inhabitants can be saved per year.

Conclusion

Helmet non-usage percentage was the most significant factor affecting motorcyclists’ death rate. Wearing a motorcycle helmet reduces the risk of death from a motorcycle crash. Enforcement of motorcycle helmet laws should be effectively supported by motorcycle safety programs.     

BikeSafe: Evaluating a bicycle safety program for middle school aged children

Purpose

The purpose of this study is to measure the effectiveness of a bicycle safety education curriculum for middle school age children in order to reduce the number of injuries and fatalities of bicyclists hit by cars in Miami-Dade County.

Methods

The University of Miami BikeSafe^® program includes a four day off-bike middle school curriculum that follows a train-the-trainer model, where a small number of staff trains a larger group of grades 6th–8th physical education teachers from various schools to teach the bike safety curriculum to their students. Subjects in this study included 193 students from 18 classes (3 per school) at 6 selected middle schools. Measures included a knowledge assessment of the curriculum that was administered to students pre- and post-curriculum implementation. Data were collected and analyzed with school and class period examined as predictors of post-score.

Results

A significant difference (p < .001) was found between pre- and post-test conditions across all subjects. In addition, there was no significant difference between testing from class periods (p > .05), suggesting that a standard intervention was applied.

Conclusion

The BikeSafe educational curriculum was found to improve the bike safety knowledge of middle school aged children. Future efforts will focus on sustaining and expanding this program throughout Miami-Dade County and other high risk communities.     

Pediatric anthropometrics are inconsistent with current guidelines for assessing rider fit on all-terrain vehicles

Background/purpose

This study sought to establish objective anthropometric measures of fit or misfit for young riders on adult and youth-sized all-terrain vehicles and use these metrics to test the unproved historical reasoning that age alone is a sufficient measure of rider-ATV fit.

Methods

Male children (6-11 years, n = 8; and 12-15 years, n = 11) were selected by convenience sampling. Rider-ATV fit was quantified by five measures adapted from published recommendations: (1) standing-seat clearance, (2) hand size, (3) foot vs. foot-brake position, (4) elbow angle, and (5) handlebar-to-knee distance.

Results

Youths aged 12-15 years fit the adult-sized ATV better than the ATV Safety Institute recommended age-appropriate youth model (63% of subjects fit all 5 measures on adult-sized ATV vs. 20% on youth-sized ATV). Youths aged 6-11 years fit poorly on ATVs of both sizes (0% fit all 5 parameters on the adult-sized ATV vs 12% on the youth-sized ATV).

Conclusions

The ATV Safety Institute recommends rider-ATV fit according to age and engine displacement, but no objective data linking age or anthropometrics with ATV engine or frame size has been previously published. Age alone is a poor predictor of rider-ATV fit; the five metrics used offer an improvement compared to current recommendations.     

The effect of external non-driving factors,payment type and waiting and queuing on fatigue in long distance trucking

Introduction

The aim of this study was to explore the effects of external influences on long distance trucking, in particular, incentive-based remuneration systems and the need to wait or queue to load or unload on driver experiences of fatigue.

Methods

Long distance truck drivers (n = 475) were recruited at truck rest stops on the major transport corridors within New South Wales, Australia and asked to complete a survey by self-administration or interview. The survey covered demographics, usual working arrangements, details of the last trip and safety outcomes including fatigue experiences.

Results

On average drivers’ last trip was over 2000 km and took 21.5 h to complete with an additional 6 h of non-driving work. Incentive payments were associated with longer working hours, greater distances driven and higher fatigue for more drivers. Drivers required to wait in queues did significantly more non-driving work and experienced fatigue more often than those who did not. Drivers who were not paid to wait did the longest trips with average weekly hours above the legal working hours limits, had the highest levels of fatigue and the highest levels of interference by work with family life. In contrast, drivers who were paid to wait did significantly less work with shorter usual hours and shorter last trips. Multivariate analysis showed that incentive-based payment and unpaid waiting in queues were significant predictors of driver fatigue.

Conclusions

The findings suggest that mandating payment of drivers for non-driving work including waiting would reduce the amount of non-driving work required for drivers and reduce weekly hours of work. In turn this would reduce driver fatigue and safety risk as well as enhancing the efficiency of the long distance road transport industry.     

Dominant role of drivers’ attitude in prevention of road traffic crashes: A study on knowledge,attitude, and practice of drivers in Iran

Objective

Evaluating the relation between Iranian drivers’ knowledge, attitude, and practice (KAP) regarding traffic regulations, and their deterministic effect on road traffic crashes (RTCs).

Setting

Two cities of Tehran and Zahedan, Iran.

Methods

A cross-sectional study was designed. Using a simplified cluster sampling design, 2200 motor vehicle drivers including 1200 in Tehran and 1000 in Zahedan were selected. Sixty locations in Tehran and 50 in Zahedan were chosen. In each pre-identified location, 20 adult drivers were approached consecutively. A questionnaire developed by researchers was filled by each participant. The questionnaire had four sections including items assessing the demographics, knowledge, attitude and practice of drivers toward traffic regulations. Logistic regression analysis was used to evaluate the relationship between the RTCs and KAP variables.

Results

The study sample consisted of 619 (28.1%) occupational and 1580 (71.8%) private drivers. Among them, 86.4% were male. The median age was 33.6 ± 10.83. Drivers in Tehran and Zahedan had no significant differences between their mean scores of KAP items of the questionnaire. Higher knowledge, safer attitude, and safer practice were associated with a decreased number of RTC. After adjusting for possible confounders, increase of one standard deviation in attitude and practice scores (but not knowledge) resulted in 26.4% and 18.5% decrease in RTC, respectively. Finally, considering knowledge, attitude and practice of drivers in one model to assess their mutual effect, it was shown that only attitude is significantly associated with a decrease of RTC (OR = 0.76, P = 0.007).

Conclusion

Increase in attitude and practice accompanied with decreased number of RTCs in Iranian drivers. Specifically, drivers’ attitude had the crucial effect. It is not knowledge and standard traffic education; rather it is how such education is registered as an attitude that translates what is being learned into actions. Without safer attitude, even safer self-reported practice will not result in lower RTCs.     

Driving errors of learner teens: Frequency,nature and their association with practice

Background

Despite demonstrating basic vehicle operations skills sufficient to pass a state licensing test, novice teen drivers demonstrate several deficits in tactical driving skills during the first several months of independent driving. Improving our knowledge of the types of errors made by teen permit holders early in the learning process would assist in the development of novel approaches to driver training and resources for parent supervision.

Methods

The purpose of the current analysis was to describe driving performance errors made by teens during the permit period, and to determine if there were differences in the frequency and type of errors made by teens: (1) in comparison to licensed, safe, and experienced adult drivers; (2) by teen and parent-supervisor characteristics; and (3) by teen-reported quantity of practice driving. Data for this analysis were combined from two studies: (1) the control group of teens in a randomized clinical trial evaluating an intervention to improve parent-supervised practice driving (n = 89 parent-teen dyads) and (2) a sample of 37 adult drivers (mean age 44.2 years), recruited and screened as an experienced and competent reference standard in a validation study of an on-road driving assessment for teens (tODA). Three measures of performance: drive termination (i.e., the assessment was discontinued for safety reasons), safety-relevant critical errors, and vehicle operation errors were evaluated at the approximate mid-point (12 weeks) and end (24 weeks) of the learner phase. Differences in driver performance were compared using the Wilcoxon rank sum test for continuous variables and Pearson's Chi-square test for categorical variables.

Results

10.4% of teens had their early assessment terminated for safety reasons and 15.4% had their late assessment terminated, compared to no adults. These teens reported substantially fewer behind the wheel practice hours compared with teens that did not have their assessments terminated: tODA_early (9.0 vs. 20.0, p < 0.001) and tODA_late (19.0 vs. 58.3, p < 0.001). With respect to critical driving errors, 55% of teens committed a total of 85 critical errors (range of 1–5 errors per driver) on the early tODA; by comparison, only one adult committed a critical error (p < 0.001). On the late tODA, 54% of teens committed 67 critical errors (range of 1–8 errors per driver) compared with only one adult (p < 0.001). No differences in teen or parent gender, parent/teen relationship type or parent prior experience teaching a teen to drive were observed between teens who committed a critical error on either route and teens that committed no critical errors. A borderline association between median teen-reported practice quantity and critical error commission was observed for the late tODA. The overall median proportion of vehicle operation errors for teens was higher than that of adults on both assessments, though median error proportions were less than 10% for both teens and adults.

Conclusion

In comparison to a group of experienced adult drivers, a substantially higher proportion of learner teens committed safety-relevant critical driving errors at both time points of assessment. These findings, as well as the associations between practice quantity and the driving performance outcomes studied suggest that further research is needed to better understand how teens might effectively learn skills necessary for safe independent driving while they are still under supervised conditions.     

Pedestrian crossing situations: Quantification of comfort boundaries to guide intervention timing

Introduction

Technical systems that warn or brake for vehicle–pedestrian encounters reduce injuries more effectively the earlier an intervention is initiated. However, premature intervention can irritate drivers, leading to system deactivation and, consequently, no injury reduction whatsoever. It has been proposed that no intervention should be initiated as long as attentive drivers are within their comfort zones. This study aims at quantifying driver comfort boundaries for pedestrian crossing situations to offer guidance for the appropriate timing of interventions.

Methods

Sixty two volunteers drove through an intersection on a test track at 30 and 50 km/h. A pedestrian dummy was launched from behind an obstruction towards the driving path of the approaching car. Brake onset indicated discomfort. Time to collision (TTC), longitudinal and lateral distance were measured at brake onset.

Results

TTC was independent of driving speed ranging from 2.1 to 4.3 s with a median of 3.2 s. Longitudinal distance ranged from 19 to 48 meters with an apparent difference between driving speeds. Lateral distances differed slightly, but significantly between driving speeds. The median was 3.1 m (3.2 m for 30 km/h and 2.9 m for 50 km/h) and values ranged from 1.9 to 4.1 m. Lateral distance in seconds ranged from 1.9 to 4.3 s with a median value of 3.1 s (3.2 s for 30 km/h and 3.0 s for 50 km/h).

Discussion

TTC was independent of driving speed, trial order and volunteer age. It might be considered suitable to intervene in situations where, for example, 90% of drivers have exceeded their comfort boundary, i.e. when drivers have already initiated braking. This percentile value translates to intervention at a TTC of 2.5 s (95% confidence 2.4–2.7 s). The study was limited to Swedish nationals, fully aware drivers, and two driving speeds, but did not investigate behavioural changes due to system interaction.

Conclusion

This study showed that TTC at brake onset was a suitable measure for the quantification of driver comfort boundaries in pedestrian crossing situations. All drivers applied their brakes prior to 2.1 s TTC.     

The impact of a home visitation programme on household hazards associated with unintentional childhood injuries: A randomised controlled trial

Background

The continued high mortality and morbidity rates for unintentional childhood injuries remain a public health concern. This article reports on the influence of a home visitation programme (HVP) on household hazards associated with unintentional childhood injuries in a South African low-income setting.

Methods

A randomised controlled trial (n = 211 households) was conducted in a South African informal settlement. Community members were recruited and trained as paraprofessional visitors. Four intervention visits were conducted over 3 months, focusing on child development, and the prevention of burn, poison, and fall injuries. The HVP, a multi-component intervention, included educational inputs, provision of safety devices, and an implicit enforcement strategy. The intervention effect (IE) was measured with a standardised risk assessment index that compared post-intervention scores for intervention and control households.

Results

A significant reduction was observed in the hazards associated with electrical and paraffin appliances, as well as in hazards related to poisoning. Non-significant changes were observed for burn safety household practices and fall injury hazards.

Conclusions

This study confirmed that a multi-component HVP effectively reduced household hazards associated with electrical and paraffin appliances and poisoning among children in a low-income South African setting.     

Outcomes one year after a road accident: Results from the ESPARR cohort

Objective

Reducing the rates of death, trauma and sequelae associated with road accidents is the prime goal of road safety authorities, and success requires having data on victims’ outcomes in the long term. The present study examined the outcome of adult road accident victims one year after their accident.

Design

A follow-up study.

Methods

The cohort comprised 886 injured road-accident victims, aged ≥16 years, and living in the Rhône administrative Département, France (taken from the ESPARR Cohort). Data were collected on victim characteristics at the time of crash, and self-reported outcomes one year later. The population of respondents at the one-year questionnaire follow-up was divided into two categories according to injury severity, as mild-to-moderate (M.AIS < 3) or severe (M.AIS 3+). Qualitative variables were compared between these 2 groups using Chi² or Fisher exact tests.

Results

At one year post-accident, 45% of the mild-to-moderate injury group versus only 20% of severely injured subjects reported full recovery of health (p < 0.001). 20% of the cohort, as a whole, reported permanent pain. More than half of the severely injured subjects reported that the accident had had an impact on the everyday life of their family; this was twice as many as in the mild-to-moderate injury group (55% vs. 22%). Most of the severely injured reported impact on leisure, projects and emotional life: 20% reported relational difficulties in the couple, 16% reported impaired sexual life, and the rate of separation was significantly higher than in the mild-to-moderate injury group (5% vs. 1%; p < 0.001). Mean time off work was significantly longer in the severe injury group: 245 ± 158 days vs. 75 ± 104 days (p < 0.001); and 32% of the severe injury group (p < 0.001) who had stopped work had not returned at 1 year, compared to 5% of the mild-to-moderate injury group.

Conclusions

One year after a road accident, the consequences for victims remain significant. In terms of physical impact, pain frequently persists, impairing daily life for many. There is an elevated rate of chronic PTSD (post-traumatic stress disorder) and a non-negligible impact on affective and occupational life.