Comparison of epidemiology and injury profile between vulnerable road users and motor vehicle occupants in road traffic fatalities

Objective: Road traffic injuries (RTIs) are a major global health issue causing a global burden of mortality and morbidity. Half of all fatalities on the world’s roads are vulnerable road users (VRUs). The targeted intervention strategies based on fatality analysis focusing on VRUs can effectively contribute to reducing RTIs. This study aimed to compare VRUs and motor vehicle occupants (MVOs) in terms of epidemiology and injury profile.

Methods: We utilized a nationwide, prospective database of RTI-related mortality cases for patients who visited 23 emergency departments between January 2011 and December 2015. All fatalities due to RTIs in the prehospital phase or in-hospital were eligible, excluding patients with unknown mode of transport and those admitted to general wards. The primary and secondary outcomes were fracture injuries and visceral injuries diagnosed using the International Classification of Diseases, Tenth Revision (ICD-10). We compared fracture injuries between VRUs and MVOs using Abbreviated Injury Scale (AIS) 2? and 2+ classification.

Results: Among a total 3,694 road traffic fatalities (RTFs), 43.3% were pedestrians, followed by MVOs (27.0%), motorcyclists (18.9), bicyclists (6.6%), and agricultural vehicle users (4.2%). The elderly (>60 years old) accounted for 54.9% of VRU fatalities. RTFs occurred most frequently in the autumn and the VRU group and the MVO group showed significant differences in weekly and diurnal variation in RTFs. The injury severities (AIS 2+) of the head, neck, and thorax were significantly different between the 2 groups (P?Conclusions: Elderly pedestrians should be targeted for decreases in RTFs, and road traffic safety interventions for VRUs should be made based on the analysis of temporal epidemiology and injury profiles of RTFs.     

Pedestrian Casualties and Fatalities in Road Traffic Crashes in a South African Municipality

A study of the pedestrian casualties and fatalities in road traffic crashes in Durban, a South African municipality, for 1999 was undertaken using official road traffic accident data. The pedestrians age 25 to 44, although only 23.9% of the population, were 39.3% of the casualties and 48.2% of the fatalities. The most vulnerable pedestrians were those 30 to 34 years old who were 6.1% of the population, 11.7% of the casualties, and 14.6% of the fatalities; 35- to 39-year-olds who were 6% of the population, 8.8% of the casualties, and 13.5% of the fatalities; and the 40- to 44-year-olds who were 4.9% of the population, 7.5% of the casualties, and 10.2% of the fatalities. Cars were involved in 52% of the vehicle-pedestrian crashes but had fewer crashes than minibuses and buses, and fewer casualties and fatalities than minibuses, buses, and motorcycles. Minibuses recorded the most crashes at 1,037 per 100 million km, the highest casualty rate of 268 per 100 million km, and highest fatality rate of 17 per 100 million km. Buses, which were involved in 3% of the vehicle-pedestrian crashes, had 951 crashes per 100 million km, 182 casualties per 100 million km, and 11 fatalities per 100 million km. Motorcycles were involved in 1% of the vehicle-pedestrian crashes and had per 100 million km 508 crashes, 192 casualties, and 7 fatalities. There was no statistically significant difference in the monthly distribution of the road traffic crashes.     

Pedestrian casualties and fatalities in road traffic crashes in a South African municipality

A study of the pedestrian casualties and fatalities in road traffic crashes in Durban, a South African municipality, for 1999 was undertaken using official road traffic accident data. The pedestrians age 25 to 44, although only 23.9% of the population, were 39.3% of the casualties and 48.2% of the fatalities. The most vulnerable pedestrians were those 30 to 34 years old who were 6.1% of the population, 11.7% of the casualties, and 14.6% of the fatalities; 35- to 39-year-olds who were 6% of the population, 8.8% of the casualties, and 13.5% of the fatalities; and the 40- to 44-year-olds who were 4.9% of the population, 7.5% of the casualties, and 10.2% of the fatalities. Cars were involved in 52% of the vehicle-pedestrian crashes but had fewer crashes than minibuses and buses, and fewer casualties and fatalities than minibuses, buses, and motorcycles. Minibuses recorded the most crashes at 1,037 per 100 million km, the highest casualty rate of 268 per 100 million km, and highest fatality rate of 17 per 100 million km. Buses, which were involved in 3% of the vehicle-pedestrian crashes, had 951 crashes per 100 million km, 182 casualties per 100 million km, and 11 fatalities per 100 million km. Motorcycles were involved in 1% of the vehicle-pedestrian crashes and had per 100 million km 508 crashes, 192 casualties, and 7 fatalities. There was no statistically significant difference in the monthly distribution of the road traffic crashes.     

Fatal and serious injuries related to vulnerable road users in Canada

IntroductionThe goals of this study were to analyze possible trends of fatal and serious injuries related to vulnerable road users in Canada (pedestrians, cyclists and motorcyclists) from 1990 to 2012 and the role of alcohol and drugs in these cases. Drugs have rarely been documented with respect to vulnerable road users.MethodThe Traffic Injury Research Foundation's National Fatality and Serious Injury Databases and the Public Health Agency of Canada's Canadian Hospitals Injury Reporting and Prevention Program databases were used. Numbers and rates of fatalities and serious injuries among vulnerable road users were analyzed and regression models were used to assess changes over time.ResultsThe analyses show that while the absolute number of fatalities and the rate per 100,000 population among vulnerable road users may be decreasing, no such trends are apparent when looking at the proportions of these road user fatalities out of all motor-vehicle fatalities. The trend for the proportion of motorcyclist fatalities is significantly increasing (coef. = 0.16, p < 0.001). The elderly (76 years or older) are overrepresented among pedestrian fatalities, and serious injuries (they represent 18.5% of all pedestrian fatalities but only 5.8% of the population), while those 15 years or younger are overrepresented among cyclists (they represent 23.3% of cyclist fatalities but 19.5% of the population), and those 16 to 25 years old are overrepresented among motorcyclists (27.2% of motorcyclists fatalities and 13.6% of population). Alcohol and drug use among fatally injured vulnerable road users were significant problems, especially among pedestrians. Among fatally injured pedestrians tested for alcohol and drugs, 39.7% and 43.4% tested positive, respectively.ConclusionsWith the promotion of walking and cycling as forms of exercise and the popularity of motorcycling, the safety of vulnerable road users is an important issue. The results corroborate previous research and extend our understanding about the influence of alcohol and drugs in vulnerable road user injuries.Practical applicationsThese findings can help better inform prevention and mitigation initiatives for vulnerable road users.     

Hierarchical ordered model for injury severity of pedestrian crashes in South Korea

Introduction: The high percentage of fatalities in pedestrian-involved crashes is a critical social problem. The purpose of this study is to investigate factors influencing injury severity in pedestrian crashes by examining the demographic and socioeconomic characteristics of the regions where crashes occurred. Method: To understand the correlation between the unobserved characteristics of pedestrian crashes in a defined region, we apply a hierarchical ordered model, in which we set crash characteristics as lower-level variables and municipality characteristics as upper-level. Pedestrian crash data were collected and analyzed for a three-year period from 2011 to 2013. The estimation results show the statistically significant factors that increase injury severity of pedestrian crashes. Results: At the crash level, the factors associated with increased severity of pedestrian injury include intoxicated drivers, road-crossing pedestrians, elderly pedestrians, heavy vehicles, wide roads, darkness, and fog. At the municipality level, municipalities with low population density, lower level of financial independence, fewer doctors, and a higher percentage of elderly residents experience more severe pedestrian crashes. Municipalities ranked as having the top 10% pedestrian fatality rate (fatalities per 100,000 residents) have rates 7.4 times higher than municipalities with the lowest 10% rate of fatalities. Their demographic and socioeconomic characteristics also have significant differences. The proposed model accounts for a 7% unexplained variation in injury severity outcomes between the municipalities where crashes occurred. Conclusion: To enhance the safety of vulnerable pedestrians, considerable investments of time and effort in pedestrian safety facilities and zones should be made. More certain and severe punishments should be also given for the traffic violations that increase injury severity of pedestrian crashes. Furthermore, central and local governments should play a cooperative role to reduce pedestrian fatalities. Practical applications: Based on our study results, we suggest policy directions to enhance pedestrian safety.     

Society's aggression level as a predictor of traffic fatality rate

This research investigated the relationship of violence/aggression and other societal variables to traffic accidents. In the first of two studies, multiple regression was applied to 1977 data from each of the 50 states and the District of Columbia. Traffic fatalities per registered vehicle was the dependent variable. The independent variables were homicide rate, suicide rate, fatality rate from other causes, unemployment rate, personal income, density of physicians, alcohol consumption, motor vehicles per capita, road mileage per vehicle, sex and age distribution of drivers, and attained education. The main finding was that the homicide rate (but not the suicide rate) predicted the traffic fatality rate; additional significant predictors were the proportion of young drivers and the fatality rate from non-motor-vehicle accidents. The two primary predictors (homicides and young drivers) accounted for 64 % of the variance of traffic fatalities. In the second study, validation was performed by using the 1977 regression coefficients to estimate 1978 traffic fatalities. The results indicate that when the 1977 regression coefficients were applied to the 1978 values for homicides and young drivers, they accounted for 49 % of the variance of the 1978 traffic fatalities. The findings are discussed in terms of how society's violence/aggression may contribute to traffic accidents.     

Road traffic mortality in the Slovak Republic in 1996–2014

Objective: Road traffic mortality takes an enormous toll in every society. Transport safety interventions play a crucial role in improving the situation. In the period 1996–2014 several road safety measures, including a complex new road traffic law in 2009, were implemented in the Slovak Republic, introducing stricter conditions for road users.

The aim of this study is to describe and analyze the trends in road user mortality in the Slovak Republic in individual age groups by sex during the study period 1996–2014.

Methods: Data on overall mortality in the Slovak Republic for the period 1996–2014 were obtained from the Statistical Office of the Slovak Republic. Mortality rates were age-adjusted to the European standard population. Joinpoint regression was used to assess the statistical significance of change in time trends of calculated standardized mortality rates.

Results: Mortality rates of all types of road users as well as all age groups and both sexes in the Slovak Republic in the period 1996–2014 are decreasing. The male : female ratio decreased from 4:1 in 1996 to 2:1 in 2014. Motor vehicle users (other than motorcyclists) and pedestrians have the highest mortality rates among road user groups. Both of these groups show a significant decline in mortality rates over the study period. Within the age groups, people age 65 years and over have the highest mortality rates, followed by the age groups 25–64 and 15–24 years old.

Joinpoint regression confirmed a steady, significant decline in all mortality rates over the study period. A statistically significant decrease in mortality rates in the last years of the study period was observed in the age group 25–64 and in male motorcycle users.

Assessing the impact of the 2009 road traffic law, a drop was observed in the average standardized mortality rate of all road traffic users from 14.56 per 100,000 person years in the period 1996–2008 to 7.69 per 100,000 person years in the period 2009–2014. A similar drop in the average standardized mortality rate was observed in all individual road user groups.

Conclusions: The implementation of the new traffic regulations may have contributed significantly to the observed decrease in mortality rates of road users in the Slovak Republic. A significant decrease in mortality was observed in all population groups and in all groups of road users. The introduction of a new comprehensive road traffic law may have expedited the decrease of road fatalities, especially in the age group 25–64 years old. This type of evidence-based epidemiology data can be used for improved targeting of future public health measures for road traffic injury prevention.     

Mortality from road traffic accidents in a rapidly urbanizing Chinese city: A 20-year analysis in Shenzhen, 1994–2013

Objective: This study aimed to describe the trends of motorization and mortality rates from road traffic accidents and examine their associations in a rapidly urbanizing city in China, Shenzhen.

Methods: Using data from the Shenzhen Deaths Registry between 1994 and 2013, we calculated the annual mortality rates of road traffic accidents, in addition to the age- and sex-specific mortality rates and their annual percentage changes (APCs) for the period of 2000–2013. We also examined the associations between mortality rate of road traffic accidents and traffic growth with Spearman's rank correlation analysis and a log-linear model derived from Smeed's law.

Results: A total of 20,196 deaths due to road traffic accidents, including 14,391 (71.3%) male deaths and 5,805 (28.7%) female deaths, were recorded in Shenzhen from 1994 to 2013. The annual mortality rates in terms of deaths per population and deaths per vehicle changed in similar patterns, demonstrating an increase since 1994 and peaking in 1997, followed by a steady decrease thereafter. The decrease in mortality was faster in individuals aged 20 year or older compared to those younger than 20 years. The mortality rates in term of deaths per population were positively correlated with the total number of vehicles per kilometer of road but negatively correlated with the motorization rate in term of vehicles per population. The estimated model for deaths due to road traffic accidents in relation to the total population and the number of registered vehicles was ln (deaths/10,000 vehicles) = ?1.902 × ln (vehicles/population) ? 1.961. The coefficient was statistically significant (P < .001) and the coefficient of determination was 0.966, indicating a good model fit.

Conclusions: We described a generally decreasing trend in the mortality rates of road traffic accidents in a rapidly urbanizing Chinese city based observations in the 20-year period from 1994 to 2013. The decreased mortality rate may be explained by the expansion of road network construction, improved road safety regulations and management, as well as more accessible ambulance services in recent years. Nevertheless, road traffic accidents remain a universal problem of great public health concern in the whole population.     

Road traffic accident severity analysis: A census-based study in China

Background: In China, despite the decrease in average road traffic fatalities per capita, the fatality rate and injury rate have been increasing until 2015. Purpose: This study aims to analyze the road traffic accident severity in China from a macro viewpoint and various aspects and illuminate several key causal factors. From these analyses, we propose possible countermeasures to reduce accident severity. Method: The severity of traffic accidents is measured by human damage (HD) and case fatality rate (CFR). Different categorizations of national road traffic census data are analyzed to evaluate the severity of different types of accidents and further to demonstrate the key factors that contribute to the increase in accident severity. Regional data from selected major municipalities and provinces are also compared with national traffic census data to verify data consistency. Results: From 2000 to 2016, the overall CFR and HD of road accidents in China have increased by 19.0% and 63.7%, respectively. In 2016, CFR of freight vehicles is 33.5% higher than average; late-night accidents are more fatal than those that occur at other periods. The speeding issue is severely becoming worse. In 2000, its CFR is only 5.3% higher than average, while in 2016, the number is 42.0%. Conclusion and practical implementation: A growing trend of accident severity was found to be contrasting to the decline of road traffic accidents. From the analysis of casual factors, it was confirmed that the release way of the impact energy and the protection worn by the victims are key variables contributing to the severity of road traffic accidents.     

Urban street structure and traffic safety

IntroductionThis paper reports the influence of road type and junction density on road traffic fatality rates in U.S. cities.MethodThe Fatality Analysis Reporting System (FARS) files were used to obtain fatality rates for all cities for the years 2005–2010. A stratified random sample of 16 U.S. cities was taken, and cities with high and low road traffic fatality rates were compared on their road layout details (TIGER maps were used). Statistical analysis was done to determine the effect of junction density and road type on road traffic fatality rates.ResultsThe analysis of road network and road traffic crash fatality rates in these randomly selected U.S. cities shows that, (a) higher number of junctions per road length was significantly associated with a lower motor- vehicle crash and pedestrian mortality rates, and, (b) increased number of kilometers of roads of any kind was associated with higher fatality rates, but an additional kilometer of main arterial road was associated with a significantly higher increase in total fatalities. When compared to non-arterial roads, the higher the ratio of highways and main arterial roads, there was an association with higher fatality rates.ConclusionsThese results have important implications for road safety professionals. They suggest that once the road and street structure is put in place, that will influence whether a city has low or high traffic fatality rates. A city with higher proportion of wider roads and large city blocks will tend to have higher traffic fatality rates, and therefore in turn require much more efforts in police enforcement and other road safety measures.Practical applicationsUrban planners need to know that smaller block size with relatively less wide roads will result in lower traffic fatality rates and this needs to be incorporated at the planning stage.     

Trends and patterns in fatal US motorcycle crashes, 2000–2016

Objective: To investigate trends of motorcyclist fatalities and identify at-risk populations by motorcyclist demographics and crash characteristics.

Methods: We used the Fatality Analysis Reporting System (FARS) database (2000–2016) to track fatality rate trends, which were quantified by using Poisson mixed-effects regression models comparing 2000–2001 and 2007–2008, as well as 2009–2010 and 2015–2016.

Results: The overall fatality rate per 100,000 population increased from 2000 to 2016, defined by two trend lines—before and after the economic recession in 2008–2009. The overall fatality rate ratio between 2000–2001 and 2007–2008 was 1.60 [95% Confidence Interval (CI): 1.51–1.70], and between 2009–2010 and 2015–2016 was 1.09 (95% CI: 1.02–1.18). Fatality rates increased among all age groups, particularly for motorcyclists aged 60 and older. Those aged 18–29 had the highest fatality rates overall. Age-and-sex standardized state fatality rates were consistently highest in Wyoming, South Dakota, and South Carolina and lowest in Massachusetts, New York and New Jersey.

Conclusion: Motorcycle fatality rates increased overall and across all age groups between 2000 and 2016. Fatalities for the oldest riders showed the steadiest increasing trends. Results highlight the continued public health burden of motorcyclist fatalities and, by extension, the importance of improving motorcycle safety.     

Road traffic injuries to foreigners in the People's Republic of China, 2000-2008

Introduction: China's rapid motorization has resulted in significant challenges in road safety. Method: Using official national statistics, this study examines road traffic injuries (RTIs) experienced by foreigners in China. The number of foreigners entering China has increased 2.4 times over the study period, from 10.16 million in 2000 to 24.33 million in 2008. Results: From 2000- 2008, the number of road traffic fatalities among foreigners similarly increased 2.5 fold, including 49 fatalities reported in 2008. Nonfatal RTIs during this same time frame increased by a magnitude of 1.8 (126 nonfatal injuries in 2000 to 223 in 2008). Conclusions: This study suggests that the total number of foreigners working or visiting China each year who suffer fatal and nonfatal road traffic injuries is relatively low. Impact on Industry: This study provided evidence suggesting that foreigners visiting or working in China face a relatively low risk of road traffic injuries.     

Temporal factors in motor-vehicle crash deaths: Ten years later

ObjectiveTo assess trends in traffic fatalities on several temporal scales: year to year, by month, by day of week, and by time of day, to determine why some times correspond with higher rates of crash deaths, and to assess how these trends relate to age, the role of the deceased, and alcohol consumption.MethodTraffic fatalities were identified using the Fatality Analysis Reporting System (FARS) for 1998 through 2014 and assessed for their time of occurrence. Three days that, on average, contained particularly high numbers of crash deaths were then assessed in greater detail, considering the age of the deceased, role of the deceased (vehicle occupant, bicyclist, motorcyclist, or pedestrian), and the blood alcohol content of either the driver (for passenger vehicle occupants) or the deceased.ResultsAnnual crash fatality totals were much lower in 2014 than in 1998, but the decrease was not steady; a marked drop in crash deaths occurred after 2007 and continued until 2014. On average the most fatalities per day occurred in July and August (116 per day), followed closely by June, September, and October. During the week, the greatest number of fatalities on average occur on weekend days, and during the day the most fatalities tend to occur between the hours of 3 p.m. and 7 p.m. Holidays like Independence Day and New Year's Day show elevated crash fatalities, and a greater percentage of these crashes involved alcohol, when compared with adjacent days.ConclusionCertain days and times of year stand out as posing an elevated crash risk, and even with the decrease in average daily fatalities over the past decade, these days and times of year have remained consistent.Practical applicationThese results indicate focused areas for continued efforts to reduce fatal crashes.     

我国区域道路交通安全形势对比与影响因素分析

根据2007年的政府统计数据,将全国划分为4个社会经济发展区域,并对比各区域道路交通的发展状况与安全形势,然后运用SPSS统计软件分析道路交通安全评价参数与社会经济发展水平之间的相关性。发现社会经济发展梯次靠前的区域,其道路交通与安全状况也相对较好;GDP、人口、机动车保有量、机动车驾驶证普及率、道路条件和交通运输规模等因素分别对交通事故的死亡人数、万车死亡率、亿元GDP死亡率和百公里道路死亡率等指标具有显著影响。针对各区域的道路交通安全现状,必须进一步加快交通基础与安全设施建设,建立和完善交通事故紧急救援体系,加强交通安全宣传、教育、管理以及区域间的交流与合作。     

The sources of the Kuznets relationship between the road deaths to road injuries ratio and economic growth

Introduction: Past empirical studies indicated that there is a Kuznets or reverse U-shaped relationship between road deaths and per capita income, such that the number of road death increases at a low level of per capita reverse U-shaped relationship was observed between road injuries and per capita income. While these studies explored the impact of per capita income on road deaths and road injuries, no studies have examined the relationship between per capita income and road death to road injury ratio (DPI). Method: Using a fixed effects panel regression analysis from 67 countries spanning over a period of five decades (1960–2013), the present study sought to explore the impact of per capita gross domestic product (per capita GDP) on the DPI ratio and the underlying factors responsible for the relationship. Results: Our result suggests that per capita GDP followed a reverse U-shaped relationship with DPI. Moreover, the relative improvements in higher mobility roads as compared to improvements in higher accessibility roads, motorcycle ownership to passenger car ownership ratio, percentage of population living in an urban area, infant mortality rate, and the percentage of population below 15 years of age and above 64 years of age contributed to this relationship. Practical Applications: This implies that, at lower level of economic growth where road deaths exceed road injuries, countries should implement low-cost measures to combat road deaths cases. Such measures include mandating wearing of quality helmets and daytime running headlights for motorcycles. On the other hand, at higher level of economic growth where road injuries surpass road deaths, countries are encouraged to devote more resources to improving medical technology and services to treat road injury victims, mandating seatbelt use, as well as enhancing and promoting public transportation service.     

Investigating safety of vulnerable road users in selected EU countries

Problem: Vulnerable road users comprise over half of all road accident victims in the EU and their safety situation is not improving as fast as for motorists. The paper examines factors affecting fatality risk of pedestrians, cyclists, motorcyclists, and moped riders in seven EU countries using data from CARE database. Method: Comparing accident severity indicators between countries is problematic because of data quality issues, different degree of underreporting, and different exposure levels. To avoid bias arising from these issues, fatality risk is modeled with binary logistic regression. Risk factors considered include accident location by area type, junction type, and traffic control, as well as lighting condition. Results are presented as odds ratios of fatal accident outcome in different countries under specific circumstances compared to reference conditions. It is shown that the error in OR values due to underreporting is small. Results and discussion: Wide confidence intervals of the odds ratios in some countries confirm problems with accident data quality. Fatality risk is always higher for non-urban versus urban area and for darkness versus daylight conditions, but the odds ratios are different for different countries. Inconsistent results are obtained for accident location with respect to junction and its control type. Possible reasons for these differences are suggested and discussed. Practical applications: The proposed method avoids the data quality bias of accident severity indicators, thus, it can be used in international comparisons of vulnerable road user accidents. The article findings also support the concept of changes in legislation, such as reducing the speed limit in urban areas in Poland at night. Generally, the experience of countries with low VRU fatality risk identified in the article can be transferred to those with a higher risk.     

Effect of the zero-tolerance drinking and driving law on mortality due to road traffic accidents according to the type of victim,sex, and age in Rio de Janeiro,Brazil: An interrupted time series study

Objective: The objective of this study was to estimate the effect of the Brazilian zero-tolerance drinking and driving law on mortality rates due to road traffic accidents according to the type of victim, sex, and age.

Methods: An interrupted time series design was used to compare yearly mortality rates due to road traffic accidents in Rio de Janeiro, Brazil, before and after the zero-tolerance drinking and driving law came into effect on June 19, 2008. Yearly mortality rates were compared according to the type of victim: pedestrian, cyclist, motorcyclist, and vehicle occupant. We used the Prais-Winsten procedure of autoregression in the analysis of time series; the outcome of this analysis was the annual percentage change in the rates. Overall and stratified analyses were conducted to investigate whether the zero-tolerance drinking and driving law may have had a distributional effect on mortality rates due to road traffic accidents depending on sex and age group; a significance level of P < .01 was accepted.

Results: From 1999 to 2016, there were 15,629 deaths due to road traffic accidents in Rio de Janeiro. The effect of the zero-tolerance drinking and driving law on overall mortality rates due to road traffic accidents in Rio de Janeiro was not statistically significant. However, among cyclists and motorcyclists aged ≥60 years and among pedestrians of both sexes and aged ≥20 years, the effect of the zero-tolerance drinking and driving law was to decrease mortality due to road traffic accidents at a yearly rate.

Conclusion: There is evidence of reduced mortality rates due to road traffic accidents among cyclists and motorcyclists aged ≥60 years and among pedestrians of both sexes aged ≥20 years in the second major Brazilian capital 9 years after the zero-tolerance drinking and driving law was adopted.     

Can fear of going to jail reduce the number of road fatalities? The Spanish experience

The goal of this article is to evaluate the impact of the drastic Spanish Penal Code reform on the number of road deaths in Spain and the time that the effects might last. This is achieved by means of multivariate unobserved component models set up in a state space framework estimated using maximum likelihood. In short, with this reform Spain might be considered to be closing the final gap that kept it apart from other developed countries as far as the road accident rate is concerned. We have found two different types of effects on Spanish road traffic fatalities. Initially, a month before the reform was passed there was a 24.7 percent fall in Spanish road deaths. After the Bill had been passed and for the following thirteen months, the reduction stayed at a constant sixteen percent. This reform has reduced Spanish road fatalities by 534 in all between November 2007 and December 2008 and the effects will foreseeably continue during 2009.     

An estimate of the effectiveness of an in-vehicle automatic collision notification system in reducing road crash fatalities in South Australia

Objectives: The aim of this study was to estimate the potential effectiveness of an in-vehicle automatic collision notification (ACN) system in reducing all road crash fatalities in South Australia (SA).

Methods: For the years 2008 to 2009, traffic accident reporting system (TARS) data, emergency medical services (EMS) road crash dispatch data, and coroner's reports were matched and examined. This was done to initially determine the extent to which there were differences between the reported time of a fatal road crash in the mass crash data and the time EMS were notified and dispatched. In the subset of fatal crashes where there was a delay, injuries detailed by a forensic pathologist in individual coroner's reports were examined to determine the likelihood of survival had there not been a delay in emergency medical assistance.

Results: In 25% (N = 53) of fatalities in SA in the period 2008 to 2009, there was a delay in the notification of the crash event, and hence dispatch of EMS, that exceeded 10 min. In the 2-year crash period, 5 people were likely to have survived through more prompt crash notification enabling quicker emergency medical assistance. Additionally, 3 people potentially would have survived if surgical intervention (or emergency medical assistance to sustain life until surgery) occurred more promptly.

Conclusions: The minimum effectiveness rate of an ACN system in SA with full deployment is likely to be in the range of 2.4 to 3.8% of all road crash fatalities involving all vehicle types and all vulnerable road users (pedestrians, cyclists, and motorcyclists) from 2008 to 2009. Considering only passenger vehicle occupants, the benefit is likely to be 2.6 to 4.6%. These fatality reductions could only have been achieved through earlier notification of each crash and their location to enable a quicker medical response. This might be achievable through a fully deployed in-vehicle ACN system.