Exposure factors of Victoria's active motorcycle fleet related to serious injury crash risk

Objective: The purpose of this study was to describe the nature and extent of current powered 2-wheeler (PTW) risk exposures in order to support future efforts to improve safety for this mode of transport.

Methods: A cross-sectional analysis of the control arm of a population-based case-control study was conducted. The control sample was selected from 204 sites on public roads within 150 km of the city of Melbourne that were locations of recent serious injury motorcycle crashes. Traffic observations and measurements at each site were sampled for a mean of 2 h on the same type of day (weekday, Saturday, or Sunday) and within 1 h of the crash time. Photographs of passing riders during this observation period recorded data relating to characteristics of PTWs, age of riders, travel speed of PTWs and all vehicles, time gaps between vehicles, visibility, and protective clothing use.

Results: Motorcycles and scooters represented 0.6% of all traffic (compared with 4% of all vehicle registrations). Riders were significantly more likely to have larger time gaps in front and behind when compared to other vehicles. The average travel speed of motorcycles was not significantly different than the traffic, but a significantly greater proportion were exceeding the speed limit when compared to other vehicles (6 vs. 3%, respectively). The age of registered owners of passing motorcycles was 42 years. Over half of riders were wearing dark clothing with no fluorescent or reflective surfaces. One third of motorcyclists had maximum coverage of motorcycle-specific protective clothing.

Conclusions: A very low prevalence of motorcyclists combined with relatively higher rates of larger time gaps to other vehicles around motorcycles may help explain their overrepresentation in injury crashes where another vehicle fails to give way. An increased risk of injury in the event of a crash exists for a small but greater proportion of motorcyclists (compared to other vehicle types) who were exceeding the speed limit. An apparent shift toward older age of the active rider population may be reducing injury crash risk relative to exposure time. There is significant scope to improve the physical conspicuity of motorcyclists and the frequency of motorcycle specific protective clothing use. These results can be used to inform policy development and monitor progress of current and future road safety initiatives.     

Risk of serious injury of occupants involved in frontal crashes of cab-over-type trucks

Objectives: Truck vehicles (TVs) have a different structure and stiffness than non-TVs and are used commercially for transporting goods. This study aimed to analyze whether truck occupants have a greater risk of serious injury than those of other types of vehicles.

Methods: Crash data were obtained from the Korean In-Depth Data Analysis Study (KIDAS) for calendar years 2011–2016. Vehicles involved in frontal crash were included and classified into TVs and non-TVs (passenger cars and sports utility vehicles). We compared the demographic characteristics and serious injuries by body region between the 2 groups and analyzed factors that contributed to the serious injury severity from frontal crashes.

Results: The analysis was based on 884 occupants; 177 (20.0%) were in TVs and 707 (80.0%) were in non-TVs. Non-TVs had more frontal airbags deployments than TVs (50.9% vs. 3.4%, P <.01). TV occupants were 4.8 times more likely to have a serious lower extremity (LE) injury (adjusted odds ratio [AOR] = 4.820; 95% confidence interval [CI], 2.407–9.653) and 2.5 times to have a serious abdominal injury (AOR = 2.465; 95% CI, 1.108–5.487) compared to non-TV occupants.

Conclusions: Truck occupants had more serious LE and abdominal injuries than those of other types of vehicles in frontal crashes. Structural improvement and legislative efforts to develop safety systems are necessary to improve the safety of truck occupants.     

Injury risks for on-road farm equipment and horse and buggy crashes in Pennsylvania: 2010–2013

Objective: The purpose of this study was to investigate characteristics associated with farm equipment and horse and buggy roadway crashes in relation to person, incident, and injury characteristics to identify appropriate points for injury incident prevention.

Methods: Information on crashes occurring on public roads during the years 2010–2013 was obtained from the Pennsylvania Department of Transportation (PennDOT) and analyzed.

Results: There were 344 farm equipment and 246 horse and buggy crashes during the 4-year study period. These crashes involved 666 and 504 vehicles and 780 and 838 people, respectively. In incidents with farm equipment, the non-farm equipment drivers had an almost 2 times greater injury risk than farm equipment operators. Horse and buggy crashes were almost 3 times more injurious to the horse and buggy drivers than the drivers of the other vehicles.

Conclusions: The average crash rate for farm equipment was 198.4 crashes per 100,000 farm population and for horse and buggy the crash rate was calculated as 89.4 crashes per 100,000 Amish population per year. This study suggests that road safety and public health programs should focus not only on farm equipment operators and horse and buggy drivers but on other motorists sharing the roadway with them.     

Observed activation status of lane departure warning and forward collision warning of Honda vehicles at dealership service centers

Objective: There are little objective data on whether drivers with lane departure warning and forward collision warning systems actually use them, but self-report data indicate that lane departure warning may be used less and viewed less favorably than forward collision warning. The current study assessed whether the systems were turned on when drivers brought their vehicles to dealership service stations and whether the observational protocol is a feasible method for collecting similar data on various manufacturers' systems.

Methods: Observations of 2013–2015 Honda Accords, 2014–2015 Odysseys, and 2015 CR-Vs occurred at 2 U.S. Honda dealerships for approximately 4 weeks during Summer 2015.

Results: Of the 265 vehicles observed to have the 2 systems, 87 (32.8%) had lane departure warning turned on. Accords were associated with a 66% increase in the likelihood that lane departure warning was turned on compared with Odysseys, but the rate was still only about 40% in Accords. In contrast, forward collision warning was turned on in all but one of the observed vehicles.

Conclusions: Observations found that the activation rate was much higher for forward collision warning than lane departure warning. The observation method worked well and appears feasible for extending to other manufacturers.     

Effects of vehicle power on passenger vehicle speeds

Objectives: During the past 2 decades, there have been large increases in mean horsepower and the mean horsepower-to–vehicle weight ratio for all types of new passenger vehicles in the United States. This study examined the relationship between travel speeds and vehicle power, defined as horsepower per 100 pounds of vehicle weight.

Methods: Speed cameras measured travel speeds and photographed license plates and drivers of passenger vehicles traveling on roadways in Northern Virginia during daytime off-peak hours in spring 2013. The driver licensing agencies in the District of Columbia, Maryland, and Virginia provided vehicle information numbers (VINs) by matching license plate numbers with vehicle registration records and provided the age, gender, and ZIP code of the registered owner(s). VINs were decoded to obtain the curb weight and horsepower of vehicles. The study focused on 26,659 observed vehicles for which information on horsepower was available and the observed age and gender of drivers matched vehicle registration records. Log-linear regression estimated the effects of vehicle power on mean travel speeds, and logistic regression estimated the effects of vehicle power on the likelihood of a vehicle traveling over the speed limit and more than 10 mph over the limit.

Results: After controlling for driver characteristics, speed limit, vehicle type, and traffic volume, a 1-unit increase in vehicle power was associated with a 0.7% increase in mean speed, a 2.7% increase in the likelihood of a vehicle exceeding the speed limit by any amount, and an 11.6% increase in the likelihood of a vehicle exceeding the limit by 10 mph. All of these increases were highly significant.

Conclusions: Speeding persists as a major factor in crashes in the United States. There are indications that travel speeds have increased in recent years. The current findings suggest the trend toward substantially more powerful vehicles may be contributing to higher speeds. Given the strong association between travel speed and crash risk and crash severity, this is cause for concern.     

Seat strength in rear body block tests

Purpose: This study collected and analyzed available testing of motor vehicle seat strength in rearward loading by a body block simulating the torso of an occupant. The data were grouped by single recliner, dual recliner, and all belts to seat (ABTS) seats.

Methods: The strength of seats to rearward loading has been evaluated with body block testing from 1964 to 2008. The database of available tests includes 217 single recliner, 65 dual recliner, and 18 ABTS seats. The trends in seat strength were determined by linear regression and differences between seat types were evaluated by Student's t-test. The average peak moment and force supported by the seat was determined by decade of vehicle model year (MY).

Results: Single recliner seats were used in motor vehicles in the 1960s to 1970s. The average strength was 918 ± 224 Nm (n = 26) in the 1960s and 1,069 ± 293 Nm (n = 65) in the 1980s. There has been a gradual increase in strength over time. Dual recliner seats started to phase into vehicles in the late 1980s. By the 2000s, the average strength of single recliner seats increased to 1,501 ± 335 Nm (n = 14) and dual recliner seats to 2,302 ± 699 Nm (n = 26). Dual recliner seats are significantly stronger than single recliner seats for each decade of comparison (P < .001). The average strength of ABTS seats was 4,395 ± 1,185 in-lb for 1989–2004 MY seats (n = 18). ABTS seats are significantly stronger than single or dual recliner seats (P < .001). The trend in ABTS strength is decreasing with time and converging toward that of dual recliner seats.

Conclusions: Body block testing is an quantitative means of evaluating the strength of seats for occupant loading in rear impacts. There has been an increase in conventional seat strength over the past 50 years. By the 2000s, most seats are 1,700–3,400 Nm moment strength. However, the safety of a seat is more complex than its strength and depends on many other factors.     

High beam headlamp use rates: Effects of rurality,proximity of other traffic,and roadway curvature

Objective: The few observational studies of the prevalence of high beam use indicate the rate of high beam use is about 25% when vehicles are isolated from other vehicles on unlit roads. Recent studies were limited to 2-lane rural roads and used measurement methods that likely overestimated use. The current study examined factors associated with the rate of high beam use of isolated vehicles on a variety of roadways in the Ann Arbor, Michigan area.

Methods: Twenty observation sites were categorized as urban, rural, or on a rural/urban boundary and selected to estimate the effects of street lighting, road curvature, and direction of travel relative to the city on high beam use. Sites were selected in pairs so that a majority of traffic passing one site also passed through the other. Measurement of high beams relied on video data recorded for 2 nights at each site, and the video data also were used to derive a precise measure of the proximity of other traffic. Nearly 3,200 isolated vehicles (10 s or longer from other vehicles) were observed, representing 1,500-plus vehicle pairs.

Results: Across the sample, 18% of the vehicles used high beams. Seventy-three percent of the 1,500-plus vehicle pairs used low beams at each paired site, whereas 9% used high beams at both sites. Vehicles at rural sites and sites at the boundaries of Ann Arbor were more likely to use high beams than vehicles at urban sites, but use in rural areas compared with rural/urban boundary areas did not vary significantly. Rates at all sites were much lower than expected, ranging from 0.9 to 52.9%. High beam use generally increased with greater time between subject vehicles and leading vehicles and vehicles in the opposing lane. There were mixed findings associated with street lighting, road curvature, and direction of travel relative to the city.

Conclusion: Maximizing visibility available to drivers from headlights includes addressing the substantial underuse of high beam headlamps. Advanced technologies such as high beam assist, which switches automatically between high and low beam headlamps depending on the presence of other traffic, can help to address this problem.     

How motorcycle helmets affect trauma mortality: Clinical and policy implications

Background: Motorcycles are the most popular vehicles in Taiwan, where more than 14.8 million motorcycles (1 motorcycle per 1.6 people) are in service. Despite the mandatory helmet law passed in 1997, less than 80% of motorcyclists in Taiwan wear helmets.

Objective: The objective of this study was to analyze the effect of using motorcycle helmets on fatality rates.

Methods: A clinical data set including 2,868 trauma patients was analyzed; the cross-sectional registration database was administered by a university medical center in Central Taiwan. A path analysis framework and multiple logistic regressions were used to estimate the marginal effect of helmet use on mortality.

Results: Using a helmet did not directly reduce the mortality rate but rather indirectly reduced the mortality rate through intervening variables such as the severity of head injuries, number of craniotomies, and complications during therapeutic processes. Wearing a helmet can reduce the fatality rate by 1.3%, the rate of severe head injury by 34.5%, the craniotomy rate by 7.8%, and the rate of complications during therapeutic processes by 1.5%. These rates comprise 33.3% of the mortality rate for people who do not wear helmets, 67.3% of the severe head injury rate, 60.0% of the craniotomy rate, and 12.2% of the rate of complications during therapeutic processes.

Discussion: Wearing a helmet and trauma system designation are crucial factors that reduce the fatality rate.     

Epidemiology and patterns of facial fractures due to road traffic accidents in Taiwan: A 15-year retrospective study

Objective: The facial region is a commonly fractured site, but the etiology varies widely by country and geographic region. To date, there are no population-based studies of facial fractures in Taiwan.

Methods: We conducted a retrospective study of patients diagnosed with facial fracture and registered in the National Health Insurance Research Database of Taiwan between 1997 and 2011. The epidemiological characteristics of this cohort were analyzed, including the etiology, fracture site, associated injuries, and sex and age distributions.

Results: A total of 6,013 cases were identified that involved facial fractures. Most patients were male (69.8%), aged 18–29 years (35.8%), and had fractures caused by road traffic accidents (RTAs; 55.2%), particularly motorcycle accidents (31.5%). Falls increased in frequency with advancing age, reaching 23.9% among the elderly (age > 65 years). The most common sites of involvement were the malar and maxillary bones (54.0%), but nasal bone fractures were more common among those younger than 18 years.

Conclusion: Most facial injuries in Taiwan occur in young males and typically result from RTAs, particularly involving motorcycles. However, with increasing age, there is an increase in the proportion of facial injuries due to falls.     

Emergency braking is affected by the use of cruise control

Objective: We compared the differences in the braking response to vehicle collision between an active human emergency braking (control condition) and cruise control (CC) or adaptive cruise control (ACC).

Methods: In 11 male subjects, age 22 to 67 years, we measured the active emergency braking response during manual driving using the accelerator pedal (control condition) or in condition mimicking CC or ACC. In both conditions, we measured the brake reaction time (BRT), delay to produce the peak braking force (PBD), total emergency braking response (BRT + PBD), and peak braking force (PBF). Electromyograms of leg and thigh muscles were recorded during braking. The tonic vibratory response (TVR), Hoffman reflex (HR), and M-waves were recorded in leg muscles to explore the change in sensorimotor control.

Results: No difference in PBF, TVR amplitude, HR latency, and H_max/M_max ratio were found between the control and CC/ACC conditions. On the other hand, BRT and PBD were significantly lengthened in the CC/ACC condition (240 ± 13 ms and 704 ± 70 ms, respectively) compared to control (183 ± 7 ms and 568 ± 36 ms, respectively). BRT increased with the age of participants and the driving experience shortened PBD and increased PBF.

Conclusions: In male subjects, driving in a CC/ACC condition significantly delays the active emergency braking response to vehicle collision. This could result from higher amplitude of leg motion in the CC/ACC condition and/or by the age-related changes in motor control. Car and truck drivers must take account of the significant increase in the braking distance in a CC/ACC condition.     

Development of cycling skills in 7- to 12-year-old children

Objective: Cycling is a complex skill consisting of motor skills such as pedalling, braking, and steering. Because the ability to perform cycling skills is based on the age-related development of the child, experience and age-related reference values are of interest in light of customized testing and training.

Methods: One hundred thirty-eight children from the second (7–8 years), fourth (9–10 years), and sixth (11–12 years) grades performed a practical bicycle test consisting of 13 test items with specific points of interest. Moreover, age at onset of cycling, cycling to and from school, independent mobility, and minutes cycling per week were estimated using a parental questionnaire.

Results: It is found that cycling skills are strongly related to age with 11- to 12-year-old children outperforming 7- to 8-year-old children for 11 test items and 9- to 10-year-old children for 8 test items.

Conclusions: Next to age, age at onset of cycling also contributed to cycling skills. Therefore, our results suggest that cycling skills are associated with physical and mental maturation. Subsequently, age-related reference values are provided to customize testing and training.     

The casualties from electric bike and motorized scooter road accidents

Objective: The objective of this study was to describe demographic and injury characteristics of hospitalized injured patients involved in e-bike and motorized scooter accidents at a national level in Israel divided by different road user groups: riders and pedestrians.

Methods: This was a retrospective study based on data from the National Trauma Registry, between January 1, 2013, and December 31, 2015. All hospitalized casualties due to the involvement of an e-bike or motorized scooter were included. The type of hospitalized road user was further categorized and described by different variables.

Results: During the study period, the Israel Trauma Registry identified 795 hospitalized patients due to an e-bike or motorized scooter accident, with a dramatic 6-fold increase from 2013 to 2015. Although the majority of the injured patients were riders, 8% were pedestrians. Among the total casualties, 33% were children aged 0–14 years and among pedestrians 42% were children and 33% were seniors (ages 60+). Five persons died in hospital, 3 riders and 2 pedestrians.

Conclusions: E-bike and motorized scooter riders represent the majority of patients hospitalized due to related traffic incident. This finding questions the social and economic advantages of electric-powered 2-wheeled vehicles.     

Repeatability of a dynamic rollover test system

Objective: The goal of this study was to characterize the rollover crash and to evaluate the repeatability of the Dynamic Rollover Test System (DRoTS) in terms of initial roof-to-ground contact conditions, vehicle kinematics, road reaction forces, and vehicle deformation.

Methods: Four rollover crash tests were performed on 2 pairs of replicate vehicles (2 sedan tests and 2 compact multipurpose van [MPV] tests), instrumented with a custom inertial measurement unit to measure vehicle and global kinematics and string potentiometers to measure pillar deformation time histories. The road was instrumented with load cells to measure reaction loads and an optical encoder to measure road velocity. Laser scans of pre- and posttest vehicles were taken to provide detailed deformation maps.

Results: Initial conditions were found to be repeatable, with the largest difference seen in drop height of 20 mm; roll rate, roll angle, pitch angle, road velocity, drop velocity, mass, and moment of inertia were all 7% different or less. Vehicle kinematics (roll rate, road speed, roll and pitch angle, global Z′ acceleration, and global Z′ velocity) were similar throughout the impact; however, differences were seen in the sedan tests because of a vehicle fixation problem and differences were seen in the MPV tests due to an increase in reaction forces during leading side impact likely caused by disparities in roll angle (3° difference) and mass properties (2.2% in moment of inertia [MOI], 53.5 mm difference in center of gravity [CG] location).

Conclusions: Despite those issues, kinetic and deformation measures showed a high degree of repeatability, which is necessary for assessing injury risk in rollover because roof strength positively correlates with injury risk (Brumbelow 2009). Improvements of the test equipment and matching mass properties will ensure highly repeatable initial conditions, vehicle kinematics, kinetics, and deformations.     

The use and safety of medications known to affect driving in Jordan: A cross-sectional study

Objectives: The aim of this study was to estimate the main driving-impairing medications used by drivers in Jordan, the reported frequency of medication side effects, the frequency of motor vehicle crashes (MVCs) while using driving-impairing medicines, as well as factors associated with MVCs.

Methods: A cross-sectional study involving 1,049 individuals (age 18–75 years) who are actively driving vehicles and taking at least one medication known to affect driving (anxiolytics, antidepressants, hypnotics, antiepileptics, opioids, sedating antihistamines, hypoglycemic agents, antihypertensives, central nervous system [CNS] stimulants, and herbals with CNS-related effects) was conducted in Amman, Jordan, over a period of 8 months (September 2013–May 2014) using a structured validated questionnaire.

Results: Sixty-three percent of participants noticed a link between a medicine taken and feeling sleepy and 57% stated that they experience at least one adverse effect other than sleepiness from their medication. About 22% of the participants reported having a MVC while on medication. Multiple logistic regression analysis showed that among the participants who reported having a crash while taking a driving-impairing medication, the odds ratios were significantly higher for the use of inhalant substance (odds ratio [OR] = 2.787, P = .014), having chronic conditions (OR = 1.869, P = .001), and use of antiepileptic medications (OR = 2.348, P = .008) and significantly lower for the use of antihypertensives (OR = 0.533, P = .008).

Conclusion: The study results show high prevalence of adverse effects of medications with potential for driving impairment, including involvement in MVCs. Our findings highlight the types of patient-related and medication-related factors associated with MVCs in Jordan, such as inhalant use, presence of chronic conditions, and use of antiepileptics.     

Prevalence of drink-driving among adults in China: A nationally representative survey in 2010

Objective: We examined the prevalence of and characteristics associated with drink-driving in China. We compared this study's drink-driving findings with those from the United States to explore how effective traffic safety interventions from Western cultures might be adapted for use in China.

Methods: Data from the 2010 China Chronic Disease and Risk Factor Survey were analyzed to describe the prevalence and characteristics associated with drink-driving in China.

Results: Overall, 1.5% of Chinese adults reported drink-driving in the past 30 days—3% of males and 0.1% of females. However, among males who had driven a vehicle in the past 30 days and consumed at least one alcoholic beverage in the past 30 days, 19% reported drink-driving during the 30-day period. Excessive drinking, binge drinking, nonuse of seat belts, and having been injured in a road traffic crash in the past year were most strongly associated with drink-driving among males.

Conclusions: Drink-driving is prevalent among male drivers in China. Although large differences exist between China and the United States in the proportion of adults who drive, the proportion who consume alcohol, and some of the personal characteristics of those who drink and drive, similarities between the 2 countries are present in patterns of risk behaviors among drink-driving. To reduce injuries and deaths from drink-driving, effective interventions from Western cultures need to be tailored for adoption in China.     

Risk factors affecting the severity of traffic accidents at Shanghai river-crossing tunnel

Objective: With increasing traffic volume and urban development, increasing numbers of underground tunnels have been constructed to relieve conflict between strained land and heavy traffic. However, as more long tunnels are constructed, tunnel traffic safety is becoming increasingly serious. Thus, it is necessary to acquire their implications and impacts. This study examined 4,539 traffic accidents that have occurred in 14 Shanghai river-crossing tunnels for the period 2011–2012 and analyze the correlation between potential factors and accident injury severity.

Methods: An ordered logit model was developed to examine the correlation between potential factors and accident injury severity.

Results: Results show that increased injury severity is associated with male drivers, drivers aged 65 years or older, accident time from midnight to dawn, weekends, wet road surface, goods vehicles, 3 or more vehicles, 4 or more lanes, middle speed limits (50–79 km/h), zone 3, extra-long tunnels (over 3,000 m), and maximum longitudinal gradient.

Conclusions: This article aims to provide useful information for engineers to develop interventions and countermeasures to improve tunnel safety in China.     

Powered two-wheeler riders' risk of crashes associated with filtering on urban roads

Objective: The objective of this study is to estimate the crash risk per kilometer traveled by powered two-wheeler (PTW) riders filtering through traffic on urban roads.

Methods: Using the traffic injury crashes recorded by the police over a period of 3 years on 14 sections of urban roads in the city of Marseille, France, and a campaign of observations of PTWs, the crash risk per kilometer traveled by PTWs filtering was estimated and compared to the risk of PTWs that did not filter.

Results: The results show that the risk of PTW riders being involved in injury crashes while filtering is significantly higher than the risk for riders who do not filter. For the 14 sections studied, it is 3.94 times greater (95% confidence interval [CI], 2.63, 5.89). This excess risk occurred for all PTW categories. Furthermore, no space appears to be safer than the others for filtering. Riders filtering forward along the axis of the carriageway, along bus lanes, or between traffic lanes (lane-splitting) all have a crash risk greater than the risk of those who do not filter.

Conclusions: All measures limiting the practice of filtering by PTWs on urban roads would probably contribute to improving the safety of their users.