Methods: Data were collected from police collision files for 53 crashes, 27 of which involved a truck (≥3.5 tonnes) and a pedal cycle. A systematic case review approach was used to identify the infrastructure, vehicle road user, and management factors that contributed to these crashes and injuries and how these factors interacted.
Results: Trucks turning left conflicting with pedal cyclists traveling straight ahead was a common crash scenario. Key contributory factors identified included the pedal cyclists not being visible to the truck drivers, road narrowing, and inappropriate positioning of pedal cyclists.
Conclusions: Crashes involving trucks and pedal cyclists are complex events that are caused by multiple interacting factors; therefore, multiple measures are required to prevent them from occurring. 相似文献
Method: Finite element (FE) analyses using models of a cyclist, bicycle, and car were conducted. In the simulations, the Total Human Model of Safety (THUMS) occupant model was employed as a cyclist, and the simulation was set up such that the cyclist was hit from its side by a car. Three representative postures of the lower extremities of the cyclist were examined, and the kinematics and injury risk of the cyclist were compared to those obtained by a pedestrian FE model. The risk of a lower extremity injury was assessed based on the knee shear displacement and the tibia bending moment.
Results: When the knee position of the cyclist was higher than the hood leading edge, the hood leading edge contacted the leg of the cyclist, and the pelvis slid over the hood top and the wrap-around distance (WAD) of the cyclist's head was large. The knee was shear loaded by the hood leading edge, and the anterior cruciate ligament (ACL) ruptured. The tibia bending moment was less than the injury threshold. When the cyclist's knee position was lower than the hood leading edge, the hood leading edge contacted the thigh of the cyclist, and the cyclist rotated with the femur as the pivot point about the hood leading edge. In this case, the head impact location of the cyclist against the car was comparable to that of the pedestrian collision. The knee shear displacement and the tibia bending moment were less than the injury thresholds.
Conclusion: The knee height of the cyclist relative to the hood leading edge affected the global kinematics and the head impact location against the car. The loading mode of the lower extremities was also dependent on the initial positions of the lower extremities relative to the car structures. In the foot up and front posture, the knee was loaded in a lateral shear direction by the hood leading edge and as a result the ACL ruptured. The bicycle frame and the struck-side lower extremity interacted and could influence the loadings on lower extremities. 相似文献
Methods: The study investigated near-miss situations captured by drive recorders installed in passenger cars. Because similarities in the approach patterns between near-miss incidents and real-world fatal cyclist accidents in Japan were confirmed, we analyzed the 229 near-miss incident data via video capturing bicycles crossing the road in front of forward-moving cars. Using a video frame captured by a drive recorder, the time to collision (TTC) was calculated from the car's velocity and the distance between the car and bicycle at the moment when the bicycle initially appeared.
Results: The average TTC in the cases where bicycles emerged from behind obstructions was shorter than that in the cases where drivers had unobstructed views of the bicycles. In comparing the TTC of car-to-bicycle near-miss incidents to the previously obtained results of car-to-pedestrian near-miss incidents, it was determined that the average TTC in car-to-bicycle near-miss incidents was significantly longer than that in car-to-pedestrian near-miss incidents.
Conclusions: When considering the TTC in the test protocol of evaluation for safety performance of active safety devices, we propose individual TTCs for evaluation of cyclist and pedestrian detections, respectively. In the test protocols, the following 2 scenarios should be employed: bicycle emerging from behind an unobstructed view and bicycle emerging from behind obstructions. 相似文献
Methods: A total of 339 company-employed truck drivers completed a questionnaire that measured their perceptions of safety climate, crash record, speed choice, and aberrant driving behaviors (errors, lapses, and violations).
Results: Although there was no direct relationship between the drivers' perceptions of safety climate and crash involvement, safety climate was a significant predictor of engagement in risky driving behaviors, which were in turn predictive of crash involvement.
Conclusions: This research shows that safety climate may offer an important starting point for interventions aimed at reducing risky driving behavior and thus fewer vehicle collisions. 相似文献
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. 相似文献
Methods: A retrospective review of the trauma databases was completed to identify patients meeting inclusion criteria. Four hundred sixty patients were identified and their records were compared with the district attorney's records for DUI charges and convictions.
Results: The conviction rate for this study was 8.7%, demonstrating continued low rates of conviction despite growing interest and public awareness of drinking and driving.
Conclusions: We discuss legal considerations that providers should consider when treating patients who have been drinking and driving. 相似文献
Methods: Data were extracted from studies of cyclists in Seattle; Victoria and New South Wales, Australia; and The Netherlands. Estimates of helmet use were used as exposure to compute relative risks for Seattle and Victorian data. Cycling distance data are routinely collected in The Netherlands; however, these data cannot be disaggregated by helmet use, which makes it unsuitable for estimating helmet effectiveness. Alternative controls were identified from larger cohorts for the Seattle and New South Wales cases.
Results: Estimates of helmet effectiveness were similar from odds ratios (ORs) using hospital controls or from relative risks (RRs) using helmet use estimates (Seattle: OR = 0.339, RR = 0.444; Victoria: OR = 0.500, RR = 0.353). Additionally, the odds ratios using hospital controls were similar when controls were taken from a larger cohort for head injury of any severity (Seattle: OR = 0.250, alt OR = 0.257; NSW: OR = 0.446, alt OR = 0.411) and for serious head injury (Seattle: OR = 0.135, alt OR = 0.139; NSW: OR = 0.335, alt OR = 0.308). Although relevant exposure data were unavailable for The Netherlands, the odds ratio for helmet effectiveness of those using racing, mountain, or hybrid bikes was similar to other estimates (OR = 0.371).
Conclusions: Despite potential weaknesses with case–control study designs, the best available evidence suggests that helmet use is an effective measure of reducing cycling head injury. 相似文献
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. 相似文献
Methods: Records of 812 patients (533 urban and 279 rural) admitted to 27 hospitals in Taipei City and Hualien County as the result of a traumatic head injury while bicycling between 1998 and 2013 were retrieved for study. Demographics, details about the accident, protective helmet use, and clinical outcomes were then subjected to analysis.
Results: Urban victims were more likely to be injured during morning and early evening rush hours and rural victims during the day; most urban victims were between 19 and 34 years of age and injured in the slow lane; rural victims tended to be younger or older and were injured in the fast lane (all P ≤.001). Riders who wore a helmet were less likely to suffer loss of consciousness (odds ratio [OR] = 0.31), amnesia (OR = 0.069), neurological disorders (OR = 0.205), or facial fractures (OR = 0.369). Older age, more severe head injuries, and bicycle–motor vehicle collisions influenced the severity of symptoms on admission and the residual effects at discharge.
Conclusions: Differences in the characteristics of injuries in urban and rural areas and the utilization of protective helmets may help government authorities adopt appropriate policies to promote safer and more enjoyable cycling. 相似文献
Background: Health care providers play a key role in addressing driving safety and driving retirement with older adults, but conversations about driving can be difficult. Guides exist for family members and providers, but to date less is known about the types of communication and messages older drivers want from their health care providers.
Design: A qualitative metasynthesis of studies published on or before October 10, 2014, in databases (PubMed, CINAHL, PsycINFO, and Web of Science) and grey literature was performed.
Review Methods: Twenty-two published studies representing 518 older adult drivers met the following inclusion criteria: the study (1) was about driving; (2) involved older drivers; (3) was qualitative (rather than quantitative or mixed methods); and (4) contained information on older drivers' perspectives about communication with health care providers.
Results: We identified 5 major themes regarding older adults' communication preferences: (1) driving discussions are emotionally charged; (2) context matters; (3) providers are trusted and viewed as authority figures; (4) communication should occur over a period of time rather than suddenly; and (5) older adults desire agency in the decision to stop driving.
Conclusion: Various stakeholders involved in older driver safety should consider older drivers' perspectives regarding discussions about driving. Health care providers can respect and empower older drivers—and support their family members—through tactful communication about driving safety and mobility transitions during the life course. 相似文献
Method: The 2 risk groups including 36 drivers (18 males and 18 females) performed driving tasks in a simulated environment. The simulated driving behaviors are compared between the 2 risk groups.
Results: The high-risk drivers drove much faster and exhibited larger offsets of the steering wheel than did the low-risk drivers in events without incidents. Additionally, the high-risk drivers used turn signals and horns less frequently than the low-risk drivers.
Conclusions: The present study revealed that the high-risk group differed from the low-risk group in driving behavior in a simulated environment. These results also suggest that simulated driving tasks might be useful tools for the evaluation of drivers’ potential risks. 相似文献
Method: With the assistance of police, systematic random sampling was used to collect data at roadblocks using a cross-sectional study design. Breathalyzers were used to screen whether motorists had detectable alcohol in their breath and follow-up breath tests were conducted to measure the actual breath alcohol levels among positive participants.
Results: In all, 9.7% of the 789 participants had detectable alcohol, among whom 6% exceeded the legal BAC limit of 0.08%. The prevalence of alcohol-impaired driving/riding was highest among cyclists (10% of all cyclists breath-tested) followed by truck drivers (9%) and motorcyclists (7% of all motorcyclists breath-tested). The occurrence of a positive BAC among cyclists was about 8 times higher (odds ratio [OR] = 7.73; P < .001) and it was 2 times higher among motorcyclists (OR = 2.30; P = .039) compared to private car drivers. The likelihood for detecting a positive BAC among male motorists/riders was higher than that among females (OR = 1.67; P = .354). The odds for detecting a positive BAC among weekend motorists/riders was significantly higher than on weekdays (OR = 2.62; P = .001).
Conclusion: Alcohol-impaired driving/riding in Ghana is high by international standards. In order to attenuate the harmful effects of alcohol misuse such as alcohol-impaired driving/riding, there is the need to educate road users about how much alcohol they can consume and stay below the legal limit. The police should also initiate random breath testing to instill the deterrence of detection, certainty of apprehension and punishment, and severity and celerity of punishment among drink-driving motorists and riders. 相似文献
Methods: The overview of current knowledge on disabilities following a road crash is based on a literature review. The health burden of serious road injuries is quantified in terms of years lived with disability (YLD), by combining incidence data from the Dutch hospital discharge register with information about temporary and lifelong disability.
Results: Literature shows that road traffic injuries can have a major impact on victims' physical and psychological well-being and functioning. Reported proportions of people with disability vary between 11 and 80% depending on the type of casualties, time elapsed since the crash, and the health impacts considered. Together, all casualties involving serious injuries in The Netherlands in 2009 account for about 38,000 YLD, compared to 25,000 years of life lost (YLL) of fatalities. Ninety percent of the burden of injury is due to lifelong consequences that are experienced by 20% of all those seriously injured in road accidents. Lower leg injuries and head injuries represent a high share in the total burden of injury as have cyclists that are injured in a crash without a motorized vehicle. Pedestrians and powered 2-wheeler users show the highest burden of injury per casualty.
Conclusion: Given their major impacts and contribution to health burden, road policy making should also be aimed at reducing the number of serious road injuries and limiting the resulting health impacts. 相似文献
Methods: We conducted a retrospective study of 537 children (aged 1 to 13 years old) with RTIs. The epidemiological features, PTSD incidence, clinical manifestation, and risk factors were analyzed based on a customized PTSD risk factor questionnaire. The outcome factors were also evaluated by means of the logistic regression method.
Results: The PTSD incidence was 24.77% in children with RTIs. The incidence of PTSD was related to the personality, family environment, and family care of the children. It was found that early psychological intervention and reasonable family care from the family might promote physical and mental welfare as well as contribute to the development of more effective treatments to prevent PTSD.
Conclusion: For susceptible children, in addition to dealing with the somatic injury, psychological intervention and family care should be carried out as early as possible. 相似文献
Methods: In the current study, a previously developed technique (ultrafast ultrasound imaging) was used as the basis to develop a protocol to observe the internal response of abdominal organs in situ at high imaging rates. The protocol was applied to 3 postmortem human surrogates to observe the liver and the colon during impacts delivered to the abdomen.
Results: The results show the sensitivity of the liver motion to the impact location. Compression of the colon was also quantified and compared to the abdominal compression.
Conclusions: These results illustrate the feasibility of the approach. Further tests and comparisons with simulations are under preparation. 相似文献
Methods: The Swedish Transport Administration (STA) and the Norwegian Public Roads Administration (NPRA) carry out in-depth studies for all road fatalities. A total of 38 in-depth studies with ABS motorcycles were included: 22 in Sweden and 16 in Norway (2005–2014). These were compared with 98 cases in Sweden and 32 in Norway involving motorcycles of the same types but without ABS. The data sets were analyzed separately and also merged together. The difference between the proportions of sliding crashes regardless braking was analyzed; selective recruitment was handled with a sensitivity analysis. Induced exposure was used to calculate the reduction of all crashes and those involving braking.
Results: Four ABS cases (11%) involved falling off the motorcycle prior to collision, and 35% of the non-ABS crashes were sliding (P =.004). The sensitivity analysis showed that the results were stable, with a relative difference of sliding crashes ranging between 65 and 78%.
None of the 4 sliding crashes with ABS occurred during braking; that is, all ABS riders who braked prior to collision crashed in an upright position. In the 4 sliding cases with ABS, the riders lost control of their motorcycles: 2 while accelerating on asphalt with very poor friction, 1 while negotiating a curve with an excessive lean angle, and 1 by abruptly releasing the throttle in the middle of a curve.
Although based on a limited number of cases, the distributions of sliding and upright collisions among crashes without braking were similar, thus suggesting that the crash posture would not be affected by ABS if no braking occurred. The calculations with induced exposure showed that upright crashes with braking were also reduced by ABS; all fatal crashes, regardless of braking, were reduced by 52%.
Conclusions: Though this research was based on a limited material, it confirmed that sliding fatal crashes are significantly decreased by ABS. Considering that ABS will soon be mandatory in the European Union on all new motorcycles with engine displacement over 125cc, these findings should be taken into account in the future design and testing of motorcycle-friendly road barriers and integrated protection systems. 相似文献
Methods: An inception cohort prospective design was used. Participants included cyclists aged ≥17 years (mean age 41.7 years) who sustained a physical injury (n = 238) assessed within 28 days of the crash, following medical examination by a registered health care practitioner. Injury included musculoskeletal and soft tissue injuries and minor/moderate traumatic brain injury (TBI), excluding severe TBI, spinal cord injury, and severe multiple fractures. Assessment also occurred 6 months postinjury. Telephone-administered interviews assessed a suite of measures including sociodemographic, preinjury health and injury factors. Psychological impact was measured by pain catastrophization, trauma-related distress, and general psychological distress. The psychological health of the cyclists was compared to that of the car occupants (n = 234; mean age 43.1 years). A mixed model repeated measures analysis, adjusted for confounding factors, was used to determine differences between groups and regression analyses were used to determine contributors to psychological health in the cyclists 6 months postinjury.
Results: Cyclists had significantly better psychological health (e.g., lower pain catastrophizing, lower rates of probable posttraumatic stress disorder [PTSD], and lower general distress levels) compared to car occupants at baseline and 6 months postinjury. Factors predictive of cyclists' psychological distress included younger age, greater perceived danger of death, poorer preinjury health, and greater amount of time in hospital after the injury.
Conclusions: These data provide insight into how cyclists perceive and adjust to their traffic injuries compared to drivers and passengers who sustain traffic injuries, as well as direction for preventing the development of severe psychological injury. Future research should examine the utility of predictors of psychological health to improve recovery. 相似文献
Methods: This was a qualitative study conducted in 3 major cities in Iran between March 2011 and February 2012. Participants included 31 male motorcyclists, of whom 22 participated in 4 focus groups and 9 in in-depth interviews. Findings were derived through the thematic method of analysis.
Results: Six delineated themes suggest different factors that influence riders' postcrash impressions. These include (1) opposing reactions from family and peers postcrash; (2) the motorcyclist's perception of his or her ability to handle risky road situations; (3) risk-taking attributes; (4) perceived responsibility in meeting family needs; (5) the severity of the crash-related injury; and (6) elapsed time from the crash experience.
Conclusions: Riders' postcrash impressions were formed by the opposing reactions of their family and peers to the crash experience (i.e., the index crash); the personality of riders, including being overconfident and a risk taker; familial obligations; feeling traumatized by the crash; and passage of time. These formed their perceptions, feelings, attitudes, and thoughts about the index crash.
These findings are an important step in understanding how perception and attitudes of motorcyclists are shaped and how these influence their future riding behavior. The needs for interventional studies to assess the effectiveness of road safety risk reduction programs aligned with the riders' degree of postcrash impressions are discussed. 相似文献
Method: A before–after crash study was conducted using the empirical Bayes (EB) method to provide more accurate crash impact estimates by accounting for wider crash trends and regression to the mean effects. Before–after crash data for 29 intersections with tram signal priority and 23 arterials with tram lane priority in Melbourne, Australia, were analyzed to evaluate the road safety impact of tram priority.
Results: The EB before–after analysis results indicated a statistically significant adjusted crash reduction rate of 16.4% after implementation of tram priority measures. Signal priority measures were found to reduce crashes by 13.9% and lane priority by 19.4%. A disaggregate level simple before–after analysis indicated reductions in total and serious crashes as well as vehicle-, pedestrian-, and motorcycle-involved crashes. In addition, reductions in on-path crashes, pedestrian-involved crashes, and collisions among vehicles moving in the same and opposite directions and all other specific crash types were found after tram priority implementation.
Conclusions: Results suggest that streetcar/tram priority measures result in safety benefits for all road users, including vehicles, pedestrians, and cyclists. Policy implications and areas for future research are discussed. 相似文献