Analyzing injury severity factors at highway railway grade crossing accidents involving vulnerable road users: A comparative study

Objective: The main objective of this study is to identify the main factors associated with injury severity of vulnerable road users (VRUs) involved in accidents at highway railroad grade crossings (HRGCs) using data mining techniques.

Methods: This article applies an ordered probit model, association rules, and classification and regression tree (CART) algorithms to the U.S. Federal Railroad Administration's (FRA) HRGC accident database for the period 2007–2013 to identify VRU injury severity factors at HRGCs.

Results: The results show that train speed is a key factor influencing injury severity. Further analysis illustrated that the presence of illumination does not reduce the severity of accidents for high-speed trains. In addition, there is a greater propensity toward fatal accidents for elderly road users compared to younger individuals. Interestingly, at night, injury accidents involving female road users are more severe compared to those involving males.

Conclusions: The ordered probit model was the primary technique, and CART and association rules act as the supporter and identifier of interactions between variables. All 3 algorithms' results consistently show that the most influential accident factors are train speed, VRU age, and gender. The findings of this research could be applied for identifying high-risk hotspots and developing cost-effective countermeasures targeting VRUs at HRGCs.     

Risk factors for being the at-fault driver: A case–control study

Objective: It is estimated that road traffic accidents are globally responsible for approximately 1.2 million deaths and 20 to 50 million injuries. About 70% of traffic incidences (TIs) occur in developing countries and among countries with high TI rates; Iran is the first. The aim of this study was to measure the association between being responsible for a traffic accident and some vehicle, human; and environmental related factors in Yasuj, a city with a high incidence of road traffic injuries and deaths in Iran.

Methods: This is a time-, date-, and place-matched case–control study conducted in 2015 using all traffic accidents registered and investigated by police during 2012. In total, 194 drivers were considered the at-fault driver in a traffic accident and the 194 drivers in the same collisions were included in the analysis.

Results: Based on the results from multivariate conditional logistic regression, significant associations between vehicle maneuver (OR_{Turn to right or left/Moving forward} = 11.10, 95% confidence interval [CI], 1.77–69.58, P = .01) and age (odds ratio [OR] = 1.11, 95% CI, 1.004–1.22, P = .04) and the chance of being an at-fault driver were found.

Conclusion: Driver behavior–related interventions including training and law enforcement seem to be more effective in reducing road traffic accidents in Iran.     

Studded and unstudded winter tires in fatal road accidents in Finland

Objective: The aim of the study was to compare the safety effects of studded and unstudded winter tires based on fatal road accidents.

Methods: The data included 958 road accidents involving a passenger car or van that occurred in Finland from November to March between 1997 and 2012.

Results: Comparing the proportions of winter tire type in accidents and in general traffic showed that the overall effect of tire type on the number of accidents was not significant, although studded tires reduced fatal accidents by 10–15%. Compared to unstudded tires, studded tires reduced accidents significantly only on bald ice in 2005–2012. Drivers using unstudded tires were more experienced and their profession was more frequently related to driving. In addition, the vehicle age was lower for vehicles with unstudded tires. On the other hand, the state of repair was less pertinent for unstudded than for studded tires. These confounding factors offset their effects to some degree.

Conclusions: The risk of fatal road accidents in winter between studded and unstudded tires does not differ significantly. However, the accident risk has recently been substantially higher on bald ice for unstudded than for studded tires. The magnitude of this risk difference is difficult to determine without specific information on exposure by road surface.     

Development of a method to predict crash risk using trend analysis of driver behavior changes over time

Objective: This study aimed at identifying and predicting in advance the point in time with a high risk of a virtual accident before a virtual accident actually occurs using the change of behavioral measures and subjective rating on drowsiness over time and the trend analysis of each behavioral measure.

Methods: Behavioral measures such as neck bending angle and tracking error in steering maneuvering during the simulated driving task were recorded under the low arousal condition of all participants who stayed up all night without sleeping. The trend analysis of each evaluation measure was conducted using a single regression model where time and each measure of drowsiness corresponded to an independent variable and a dependent variable, respectively. Applying the trend analysis technique to the experimental data, we proposed a method to predict in advance the point in time with a high risk of a virtual accident (in a real-world driving environment, this corresponds to a crash) before the point in time when the participant would have encountered a crucial accident if he or she continued driving a vehicle (we call this the point in time of a virtual accident).

Results: On the basis of applying the proposed trend analysis method to behavioral measures, we found that the proposed approach could predict in advance the point in time with a high risk of a virtual accident before the point in time of a virtual accident.

Conclusion: The proposed method is a promising technique for predicting in advance the time zone with potentially high risk (probability) of being involved in an accident due to drowsy driving and for warning drivers of such a drowsy and risky state.     

Analysis of car-to-bicycle approach patterns for developing active safety devices

Objective: To reduce the severity of injuries and the number of cyclist deaths in traffic accidents, active safety devices providing cyclist detection are considered to be effective countermeasures. The features of car-to-bicycle collisions need to be known in detail to develop such safety devices.

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.     

A new approach to road accident rescue

Objective: This article develops and validates a new methodology and tool for rescue assistance in traffic accidents, with the aim of improving its efficiency and safety in the evacuation of people, reducing the number of victims in road accidents.

Method: Different tests supported by professionals and experts have been designed under different circumstances and with different categories of damaged vehicles coming from real accidents and simulated trapped victims in order to calibrate and refine the proposed methodology and tool.

Results: To validate this new approach, a tool called App_Rescue has been developed. This tool is based on the use of a computer system that allows an efficient access to the technical information of the vehicle and sanitary information of the common passengers. The time spent during rescue using the standard protocol and the proposed method was compared.

Conclusion: This rescue assistance system allows us to make vital information accessible in posttrauma care services, improving the effectiveness of interventions by the emergency services, reducing the rescue time and therefore minimizing the consequences involved and the number of victims. This could often mean saving lives. In the different simulated rescue operations, the rescue time has been reduced an average of 14%.     

Using negative emotional feedback to modify risky behavior of young moped riders

Objective: The aim of this research was to investigate whether the use of messages with negative emotional content is effective in promoting safe behavior of moped riders and how exactly these messages modulate rider behavior.

Methods: Participants received negative feedback when performing risky behaviors using a computer task. The effectiveness of this treatment was subsequently tested in a riding simulator.

Results: The results demonstrated how riders receiving negative feedback had a lower number of traffic accidents than a control group. The reduction in accidents was accompanied by a set of changes in the riding behavior. We observed a lower average speed and greater respect for speed limits. Furthermore, analysis of the steering wheel variance, throttle variance, and average braking force provided evidence for a more even and homogenous riding style. This greater abidance of traffic regulations and friendlier riding style could explain some of the causes behind the reduction in accidents.

Conclusions: The use of negative emotional feedback in driving schools or advanced rider assistance systems could enhance riding performance, making riders aware of unsafe practices and helping them to establish more accurate riding habits. Moreover, the combination of riding simulators and feedback—for example, in the training of novice riders and traffic offenders—could be an efficient tool to improve their hazard perception skills and promote safer behaviors.     

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.     

Factors affecting conviction rates of intoxicated driver patients in two large trauma centers

Objective: Outcomes from previous studies report the driving under the influence (DUI) conviction rates for trauma patients in several cities within Canada and the United States over the last 2 decades. This study reports charge, conviction, and prosecution rates for trauma patients at 2 level I trauma centers servicing a large metropolitan city.

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.     

Analyzing injury severity of bus passengers with different movements

Objective: Though public transport vehicles are rarely involved in mass casualty accidents, when they are, the number of injuries and fatalities is usually high due to the high passenger capacity. Of the few studies that have been conducted on bus safety, the majority focused on vehicle safety features, road environmental factors, as well as driver characteristics. Nevertheless, few studies have attempted to investigate the underlying risk factors related to bus occupants. This article presents an investigation aimed at identifying the risk factors affecting injury severity of bus passengers with different movements.

Method: Three different passenger movement types including standing, seated, and boarding/alighting were analyzed individually using classification and regression tree (CART) method based on publicly available accident database of Great Britain.

Results: According to the results of exploratory analyses, passenger age and vehicle maneuver are associated with passenger injury severity in all 3 types of accidents. Moreover, the variable “skidding and overturning” is associated with injury severity of seated passengers and driver age is correlated with injury severity of standing and boarding/alighting passengers.

Conclusions: The CART method shows its ability to identify and easily explain the complicated patterns affecting passenger injury severity. Several countermeasures to reduce bus passenger injury severity are recommended.     

Analysis of posttraumatic stress disorder in children with road traffic injury in Wenzhou,China

Objective: Road traffic accidents are the leading health threat to children and cause significant long-term mental health problems. This study aimed to characterize posttraumatic stress disorder (PTSD) in children suffering from road traffic injuries (RTIs) in Wenzhou, China.

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.     

The role of drug and alcohol use and the risk of motor vehicle crashes in Shiraz,Iran, 2014: A case–crossover study

Background: Traffic accidents and traffic-related injuries and mortality have become a major public health concern in Iran. This study aimed to examine the role of drug and alcohol use in motor vehicle accidents in Iran.

Methods: This case–crossover study was conducted on 441 drivers who survived a road traffic crash and were taken to the emergency department of Shahid Rajaee trauma hospital in Shiraz, southern Iran. Data were collected using checklists that included demographic characteristics and drug and alcohol use prior to driving. Alcohol and drug use was identified through self-report, and cannabis, morphine, and methamphetamine urine tests were used to confirm drug abuse among drivers.

Results: In total 17.9% of drivers reported using drugs (cannabis, opium, or metamphetamine) and 8.84% of drivers reported consuming alcohol prior to the collision. The crude odds ratios (ORs) for having a crash for opium, cannabis, and metamphetamine were 1.94 (95% interval confidence [CI], 1.11–3.38), 2.37 (95% CI, 1.03–5.42), 5.5 (95% CI, 1.21–24.81), respectively, and for all drugs was 3.83 (95% CI, 2.28–6.43). The OR for alcohol was 3.5 (95% CI, 1.73–7.06) based on self-report.

Conclusion: Drug and alcohol use are increasing the risk of traffic crashes in Iran. Risk-reducing programs must be designed and implemented.     

Modeling faults among e-bike-related fatal crashes in China

Objectives: This article aims to model fault in e-bike fatal crashes in a county-level city in China.

Method: Three-year crash data are retrieved from the crash reports (2012–2014) from the Taixing Police Department. A mixed logit model is introduced to explore significant factors associated with fault assignment, as well as accounting for similarity among fault assignment and heterogeneity within unobserved variables.

Results: The modeling results indicate some interesting new findings. First, precrash behaviors of both drivers and e-bike riders are found to be significant to fault assignment. Second, bike lane and median type are significantly associated with e-bike rider fault commitment. Third, specific groups of e-bike riders (low-educated and older) and drivers (heavy good vehicles) are more likely to be at fault in e-bike crashes. Last, crash location and the built environment have significant correlations with faulty behaviors of e-bike riders.

Conclusions: Safety countermeasures are proposed including (1) the deployment of traffic design and control elements including physically separated bike lanes, medians, video surveillance systems for e-bike riders, and left-turning treatments for nonmotorists (e.g., a 2-step e-bike left turning); (2) the amendment of the current traffic regulations on drunk e-bike riders and child e-bike passengers; (3) the development of a license system for specific e-bike rider groups (older and low-educated) and a safety campaign for drivers (to increase safety awareness when parking on-street or driving heavy good vehicles). Some interesting future research topics are also suggested: e-bike riders' behaviors at unsignalized intersections and mid-block openings, e-bike safety in suburban areas, and an in-depth study of the effect of the built environment on e-bike safety.     

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.     

Investigation of powered 2-wheeler accident involvement in urban arterials by considering real-time traffic and weather data

Objective: Understanding the various factors that affect accident risk is of particular concern to decision makers and researchers. The incorporation of real-time traffic and weather data constitutes a fruitful approach when analyzing accident risk. However, the vast majority of relevant research has no specific focus on vulnerable road users such as powered 2-wheelers (PTWs). Moreover, studies using data from urban roads and arterials are scarce. This study aims to add to the current knowledge by considering real-time traffic and weather data from 2 major urban arterials in the city of Athens, Greece, in order to estimate the effect of traffic, weather, and other characteristics on PTW accident involvement.

Methods: Because of the high number of candidate variables, a random forest model was applied to reveal the most important variables. Then, the potentially significant variables were used as input to a Bayesian logistic regression model in order to reveal the magnitude of their effect on PTW accident involvement.

Results: The results of the analysis suggest that PTWs are more likely to be involved in multivehicle accidents than in single-vehicle accidents. It was also indicated that increased traffic flow and variations in speed have a significant influence on PTW accident involvement. On the other hand, weather characteristics were found to have no effect.

Conclusions: The findings of this study can contribute to the understanding of accident mechanisms of PTWs and reduce PTW accident risk in urban arterials.     

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.     

Evaluating the Brazilian zero tolerance drinking and driving law: Time series analyses of traffic-related mortality in three major cities

Objective: A zero tolerance alcohol restriction law was adopted in Brazil in 2008. In order to assess the effectiveness of this intervention, the present study compares specific mortality in 2 time series: 1980–2007 and 2008–2013.

Methods: Data on mortality and population were gathered from official Brazilian Ministry of Health information systems. Segmented regression analyses were carried out separately for 3 major Brazilian capitals: Belo Horizonte, Rio de Janeiro, and São Paulo.

Results: In 2 cities (Belo Horizonte and Rio de Janeiro) there were no significant changes in mortality rate trends in 2 periods, 1980 to 2007 and 2008 to 2013, where the observed rates did not differ significantly from predicted rates. In São Paulo, a decreasing trend until 2007 unexpectedly assumed higher levels after implementation of the law.

Conclusion: There is no evidence of reduced traffic-related mortality in the 3 major Brazilian capitals 5.5 years after the zero tolerance drinking and driving law was adopted.     

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.     

Representativity and univocity of traffic signs and their effect on trajectory movement in a driving simulation task: Warning signs

Objective: The effect of traffic signs on the behavior of drivers is not completely understood. Knowing about how humans process the meaning of signs (not just by learning but instinctively) will improve reaction time and decision making when traveling. The economic, social, and psychological consequences of car accidents are well known.

Methods: This study sounds out which traffic signs are more ergonomic for participants, from a cognitive point of view, and determines, at the same time, their effect in participants' movement trajectories in a driving simulation task.

Results: Results point out that the signs least representative of their meaning produce a greater deviation from the center of the road than the most representative ones.

Conclusions: This study encourages both an in-depth analysis of the effect on movement of roadside signs and the study of how this effect can be modified by the context in which these signs are presented (with the aim to move the research closer to and analyze the data in real contexts). The goal is to achieve clarity of meaning and lack of counterproductive effects on the trajectory of representative signs (those that provoke fewer mistakes in the decision task).