Road safety in China: Analysis of current challenges

Introduction

China has the world's largest population, and is the second largest automobile market. China's economy is booming, resulting in a rapid increase in both the road infrastructure and access to private vehicles. Along with economic growth, the ownership of motorized vehicles has almost quadrupled in the past 10 years, from 42.2 million in 1997 to 159.7 million in 2007. However, at the same time, China also has a very high number of road fatalities compared to other countries, with about 100,000 reported fatalities each year.

Method

This study analyzes the Chinese road-fatality situation to identify areas in which the total harm caused by crashes can be substantially and readily reduced. It provides a comprehensive analysis of the current road-fatality situation in China using conventional indices and the likely future trends.

Results

Four areas were identified in which countermeasures have the most potential to substantially reduce fatalities in China: pedestrians and other non-motorists, nighttime driving, vehicle passengers, and motorcycles.

Conclusion

While China faces unprecedented road safety issues, this report identifies major areas in which there are opportunities to greatly reduce total harm.     

Injury crashes with bicyclists at roundabouts: influence of some location characteristics and the design of cycle facilities

Problem

Previous research indicated that conversions of intersections into roundabouts appear to increase the number of injury crashes with bicyclists. However, it was assumed that the effectiveness of roundabouts could vary according to some differences in design types of cycle, facilities and other geometrical factors.

Method

Regression analyses on effectiveness-indices resulting from a before-and-after study of injury crashes with bicyclists at 90 roundabouts in Flanders, Belgium.

Results

Regarding all injury crashes with bicyclists, roundabouts with cycle lanes appear to perform significantly worse compared to three other design types (mixed traffic, separate cycle paths, and grade-separated cycle paths). Nevertheless, an increase of the severest crashes was noticed, regardless of the design type of the cycle facilities. Roundabouts that are replacing signal-controlled intersections seem to have had a worse evolution compared to roundabouts on other types of intersections.

Impact on industry

The results might affect design guidelines for roundabouts, particularly for the accommodation of bicyclists.     

Required hours of practice for learner drivers: A comparison between two Australian jurisdictions

Problem

This study considers whether requiring learner drivers to complete a set number of hours while on a learner license affects the amount of hours of supervised practice that they undertake. It compares the amount of practice that learners in Queensland and New South Wales report undertaking. At the time the study was conducted, learner drivers in New South Wales were required to complete 50 hours of supervised practice while those from Queensland were not.

Method

Participants were approached outside driver licensing centers after they had just completed their practical driving test to obtain their provisional (intermediate) license. Those agreeing to participate were interviewed over the phone later and asked a range of questions to obtain information including socio-demographic details and amount of supervised practice completed.

Results

There was a significant difference in the amount of practice that learners reported undertaking. Participants from New South Wales reported completing a significantly greater amount of practice (M = 73.3 hours, sd = 29.12 hours) on their learner license than those from Queensland (M = 64.1 hours, sd = 51.05 hours). However, the distribution of hours of practice among the Queensland participants was bimodal in nature. Participants from Queensland reported either completing much less or much more practice than the New South Wales average.

Summary

While it appears that the requirement that learner drivers complete a set number of hours may increase the average amount of hours of practice obtained, it may also serve to discourage drivers from obtaining additional practice, over and above the required hours.

Impact on Industry

The results of this study suggest that the implications of requiring learner drivers to complete a set number of hours of supervised practice are complex. In some cases, policy makers may inadvertently limit the amount of hours learners obtain to the mandated amount rather than encouraging them to obtain as much practice as possible.     

Validity of police-reported alcohol involvement in fatal motor carrier crashes in the United States between 1982 and 2005

Objective

To examine the validity of police-reported alcohol data for drivers involved in fatal motor carrier crashes.

Material and Methods

We determined the availability of blood alcohol concentration (BAC) and police-reported alcohol data on 157,702 drivers involved in fatal motor carrier crashes between 1982 - 2005 using Fatality Analysis and Reporting System (FARS) data. Drivers were categorized as motor carrier drivers if they operated a vehicle with a gross vehicle weight rating of greater than 26,000 pounds. Otherwise, they were classified as non motor carrier drivers. The sensitivity and specificity of police-reported alcohol involvement were estimated for both driver types.

Results

Of the 157,702 drivers, 18% had no alcohol information, 15% had BAC results, 42% had police-reported alcohol data, and 25% had both. Alcohol information varied significantly by driver, crash, and vehicle characteristics. For example, motor carrier drivers were significantly more likely (51%) to have BAC testing results compared to non motor carrier drivers (31%) (p < 0.001). The sensitivity of police-reported alcohol involvement for a BAC level ≥ 0.08 was 83% (95% CI 79%, 86%) for motor carrier drivers and 90% (95% CI 89%, 90%) for non motor carrier drivers. The specificity rates were 96% (95% CI 95%, 96%) and 91% (95% CI 90%, 91%), respectively.

Conclusions

The sensitivity and specificity of police-reported alcohol involvement are reasonably high for drivers involved in fatal motor carrier crashes. Further research is needed to determine the extent to which the accuracy of police-reported alcohol involvement may be overestimated because of verification bias.

Impact on the Industry

Based on the results of this study, the federal government should continue to work with states to strengthen their strategies to increase chemical testing of all drivers involved in fatal crashes.     

Injury severity analysis of accidents involving young male drivers in Great Britain

Introduction

Young male drivers are over-represented in traffic accidents; they were involved in 14% of fatal accidents from 1991 to 2003 while holding only 8% of all drivers licenses in the UK. In this study, a subset of the UK national road accident data from 1991 to 2003 has been analyzed. The primary aim is to determine how to best use monetary and progressive resources to understand how road safety measures will reduce the severity of accidents involving young male drivers in both London and Great Britain.

Method

Ordered probit models were used to identify specific accident characteristics that increase the likelihood of one of three categorical outcomes of accident severity: slight, serious, or fatal.

Results

Characteristics found to lead to a higher likelihood of serious and fatal injuries are generally similar across Great Britain and London but are different from those predicted to lead to a higher likelihood of slight injuries. Those characteristics predicted to lead to serious and fatal injuries include driving in darkness, between Friday and Sunday, on roads with a speed limit of 60 mph, on single carriageways, overtaking, skidding, hitting an object off the carriageway, and when passing the site of a previous accident. Characteristics predicted to lead to slight injuries include driving in daylight, between Monday and Thursday, on roads with a speed limit of 30 mph or less, at a roundabout, waiting to move, and when an animal is on the carriageway.

Impact on Industry

These results aid the selection of policy options that are most likely to reduce the severity of accidents involving young male drivers.     

Differences in urban and rural accident characteristics and medical service utilization for traffic fatalities in less-motorized societies

Introduction

Fatalities from traffic accidents in less-motorized societies are an important global issue. We aimed to characterize the geographic differences of fatalities in such societies to facilitate the development of targeted interventions.

Method

This study linked police reports, hospital data, and vital registration data from Taiwan with special reference to accident factors in pre-hospital deaths and medical care in hospital deaths.

Results

A higher percentage of pre-hospital deaths were observed following rural as compared to urban traffic accidents. The deaths due to rural accidents can be attributed to lower use of restraints (i.e., helmets or seat belts), lower percentage of motorcyclists, and more highway accidents. A higher percentage of victims in rural accidents were transported to distant medical centers rather than to local hospitals.

Conclusion

Specific interventions, such as intelligent emergency medical systems, campaigns for helmets and seat belt usage, enforcement of helmets and seat belt use, and speed control measures should be targeted to rural areas.

Impact on industry

Cooperation between the vehicle industry and emergency medical providers in rural traffic accident rescue teams may decrease the numbers of deaths in these regions.     

Assessing motivation for work environment improvements: Internal consistency, reliability and factorial structure

Problem

Workers' motivation to actively take part in improvements to the work environment is assumed to be important for the efficiency of investments for that purpose. That gives rise to the need for a tool to measure this motivation.

Method

A questionnaire to measure motivation for improvements to the work environment has been designed. Internal consistency and test-retest reliability of the domains of the questionnaire have been measured, and the factorial structure has been explored, from the answers of 113 employees.

Results

The internal consistency is high (0.94), as well as the correlation for the total score (0.84). Three factors are identified accounting for 61.6% of the total variance.

Discussion

The questionnaire can be a useful tool in improving intervention methods.

Impact on Industry

The expectation is that the tool can be useful, particularly with the aim of improving efficiency of companies' investments for work environment improvements.     

An ethnography of low-income mothers' safeguarding efforts

Problem

Children living in lower-income environments are at greater risk for unintentional injuries. However, little is known about the safety practices of mothers living in low-income situations.

Method

This ethnographic study explored the child safeguarding experiences of low-income mothers using in-home interviews and observations.

Results

Mothers' safeguarding efforts included cognitive and emotional work, child directed work, and work directed at the physical and social environments. Factors that influenced the women's safeguarding included the quality of the indoor space, availability of safe play space, traffic hazards, sibling interactions, child care supports, relationships with neighbors, and trust in community services.

Discussion

These findings have implications for the conceptualization of safeguarding practices and provide insight about the experiences of mothers living on low-incomes.

Impact on Industry

When developing safety interventions, program planners should consider the views and practices of mothers as well as contextual factors in the physical and social environments.     

The Long Beach/Fort Lauderdale relative risk study

Problem

The role of alcohol as a major factor in traffic crash causation has been firmly established. However, controversy remains as to the precise shape of the relative risk function and the BAC at which crash risk begins to increase.

Methods

This study used a case-control design in two locations: Long Beach, California, and Fort Lauderdale, Florida. Data were collected on 2,871 crashes of all severities and a matched control group of drivers selected from the same time, location, and direction of travel as the crash drivers. Of the 14,985 sample drivers, 81.3% of the crash drivers and 97.9% of the controls provided a valid BAC specimen.

Results

When adjusted for covariates and nonparticipation bias, increases in relative risk were observed at BACs of .04-.05, and the elevations in risk became very pronounced when BACs exceeded .10.

Discussion

The results provide strong support for .08 per se laws and for state policies that increase sanctions for BACs in excess of .15.

Impact on Industry

This study provides further precision on the deleterious effects of alcohol on driving and, by implication, on other complex tasks.     

The conspicuity of first-responder safety garments

Introduction

This study compared the conspicuity of three types of first-responder safety garments (NFPA 1971-2007 turnout gear coats, and ANSI/ISEA 107 and 207 safety vests).

Method

Participants drove instrumented vehicles on a closed track during both daytime and nighttime, indicating when they could first detect pedestrians in a simulated emergency response scene. Pedestrians wore one of the safety garments and stood on either side of the emergency scene, facing or perpendicular to oncoming traffic, and either stationary or walking in place.

Results

All three garment standards provided equal levels of conspicuity, in that the distances at which the pedestrians were detected were equivalent. Time of day was a significant factor, with longer mean detection distances being observed in daytime. Pedestrian orientation was significant, with mean detection distances being longest when facing traffic. Pedestrian motion did not result in significant differences in detection distance.

Discussion

The results suggest that all three garment types studied are equivalent in making first responders conspicuous as pedestrians when working an emergency response scene in close proximity to traffic.

Impact on Industry

Whether an NFPA or ANSI/ISEA compliant is worn, first responders are equally likely to be detected by passing motorists, and as such these garments should be considered to be equivalent.     

Preferred modes of travel among older adults: What factors affect the choice to walk instead of drive?

Introduction

There are many factors that influence older adults' travel choices. This paper explores the associations between mode of travel choice for a short trip and older adults' personal characteristics.

Methods

This study included 406 drivers over the age of 64 who were enrolled in a large integrated health plan in the United States between 1991 and 2001. Bivariate analyses and generalized linear modeling were used to examine associations between choosing to walk or drive and respondents' self-reported general health, physical and functional abilities, and confidence in walking and driving.

Results

Having more confidence in their ability to walk versus drive increased an older adult's likelihood of walking to make a short trip by about 20% (PR = 1.22; 95% CI: 1.06-1.40), and walking for exercise increased the likelihood by about 50% (PR = 1.53; 95% CI = 1.22-1.91). Reporting fair or poor health decreased the likelihood of walking, as did cutting down on the amount of driving due to a physical problem.

Discussion

Factors affecting a person's decision to walk for exercise may not be the same as those that influence their decision to walk as a mode of travel. It is important to understand the barriers to walking for exercise and walking for travel to develop strategies to help older adults meet both their exercise and mobility needs. Impact on Industry: Increasing walking over driving among older adults may require programs that increase confidence in walking and encourage walking for exercise.     

Evaluation of a healthcare safety climate measurement tool

Problem

Psychometrically validated measurement tools are needed to evaluate an organization's safety climate. In 2000, Gershon and colleagues published a new healthcare safety climate measurement tool to determine its relationship to safe work behavior (Gershon, R., Karkashian, C., Grosch, J., Murphy, L., Escamilla-Cejudo, A., Flanagan, P., et al. (2000). Hospital safety climate and its relationship with safe work practices and workplace exposure incidents. American Journal of Infection Control, 28, 211-21). The present study evaluated the psychometric properties of the Gershon tool when modified to address respiratory rather than bloodborne pathogen exposures.

Method

Medical practitioners, nurses, and nurse aides (n = 460) were surveyed using the modified Gershon tool. Data were analyzed by factor analysis and psychometric properties of the tool evaluated.

Results

Eight safety climate dimensions were extracted from 25 items (Cronbach's alpha range: 0.62 - 0.88). Factor extractions and psychometric properties were reasonably consistent with those of the Gershon tool.

Impact on Industry

The Gershon safety climate tool appears to have sufficient reliability and validity for use by healthcare decision makers as an indicator of employee perceptions of safety in their institution.     

The effect of work hours on adverse events and errors in health care

Introduction

We studied the relationship between registered nurses' extended work duration with adverse events and errors, including needlestick injuries, work-related injuries, patient falls with injury, nosocomial infections, and medication errors.

Method

Using bivariate and multivariate logistic regression, this secondary analysis of 11,516 registered nurses examined nurse characteristics, work hours, and adverse events and errors.

Results

All of the adverse event and error variables were significantly related to working more than 40 hours in the average week. Medication errors and needlestick injuries had the strongest and most consistent relationships with the work hour and voluntary overtime variables.

Discussion

This study confirms prior findings that increased work hours raise the likelihood of adverse events and errors in healthcare, and further found the same relationship with voluntary overtime.

Impact on Industry

Legislation has focused on mandatory overtime; however, this study demonstrated that voluntary overtime could also negatively impact nurse and patient safety.     

Influence of daytime running lamps on visual reaction time of pedestrians when detecting turn indicators

Introduction

This article describes one experiment that studied the influence of Daytime Running Lamps (DRL) on pedestrian detection of turn indicators.

Method

An experimental device including one DRL and one turn indicator was used in order to determine Visual Reaction Times (VRT) of 148 observers in different situations involving turn indicator activation. Such situations were combinations of three main variables: color of DRL, separation between DRL and Turn Indicator, and observation angle.

Results

Significant changes in VRT were found depending on the configurations above, especially the observation angle and the color of DRL. This second result demonstrates that amber DRLs inhibit the detection of Turn Indicators.

Impact on industry

One of the main targets of this paper is to recommend that carmakers introduce only white DRLs on new vehicles. We also intend to advise regulatory bodies working on automotive regulation about the consequences of allowing amber DRLs and also about the danger of introducing constrains on the distance between DRL and Turn Indicator without further experimental evidences.     

The relationship between recruitment processes, familiarity, trust, perceived risk and safety

Introduction and Method

Participants′ perceptions of the safety-related aspects of their organization′s recruitment processes were examined, as were their perceptions of safety aspects associated with new recruits.

Results

One hundred and fifty-four professional fire fighters indicated the trust they held in the safety-related aspects of their organizations′ selection and pre-start training. Perceived trust in pre-start training was negatively correlated (r = -.24, p < .01) with the risk associated with new recruits, and positively correlated (r = .50, p < .01) with ratings of trust in recruits to immediately work safely. Furthermore, trust in recruits to immediately work safely was negatively correlated (r = -.21, p < .01) with crews′ safety behavior toward recruits.

Conclusions

These results are interpreted as particularly dangerous for workers, as new recruits lack familiarity with aspects of their new workplace that cannot be addressed by either selection or pre-start training, making them a risk.

Impact on Industry

Organizations should actively identify new recruits, and encourage existing team members not to immediately trust new recruits to work safely.     

Continued progress in the prevention of nail gun injuries among apprentice carpenters: What will it take to see wider spread injury reductions?

Problem

Nail guns are a common source of acute, and potentially serious, injury in residential construction.

Method

Data on nail gun injuries, hours worked and hours of tool use were collected in 2008 from union apprentice carpenters (n = 464) through classroom surveys; this completed four years of serial cross-sectional data collection from apprentices. A predictive model of injury risk was constructed using Poisson regression.

Results

Injury rates declined 55% from baseline measures in 2005 with early training and increased use of tools with sequential actuation. Injury rates declined among users of tools with both actuation systems, but the rates of injury were consistently twice as high among those using tools with contact trip triggers.

Discussion and impact

Nail gun injuries can be reduced markedly through early training and use of tools with sequential actuation. These successful efforts need to be diffused broadly, including to the non-union sector.     

Work injuries and disability

Problem

This study estimated the hazard ratio for disability pension retirement (DPR) for persons who have experienced a work injury causing absence lasting at least one day after the accidental injury occurred and to estimate the fraction of DPR attributable to work injuries.

Methods:

A total of 4,217 male and 4,105 female employees from a national survey were followed up for subsequent DPR.

Results and impact on industry and government:

Having had a work injury was a strong predictor of DPR among men. After control for age, smoking, body mass index, body postures, and physical demands, the hazard ratio (HR) among those employees who had ever experienced a work injury was 1.80 (95% confidence interval (CI): 1.20-2.68). No association was found among women.

Summary:

Having had a reportable work injury is a strong predictor of subsequent DPR for men.     

Falls from height during the floor slab formwork of buildings: Current situation in Spain

Problem

One of the phases with the highest risk of falls from a height in the construction of a building is during the floor slab formwork stage. This paper analyzes this particular risk, as well as the most frequently used fall-protection systems.

Method

A survey was carried out to define the current situation in Spain with regard to falls from a height during floor slab formwork and the fall-protection systems used to prevent such a risk.

Results

The results of the survey clarified the current situation in Spain with regard to this risk, and made it clear that there is considerable risk of falling from a height during the floor slab formwork stage.

Discussion

All the safety systems analyzed presented a series of weak points that should be studied in detail before they can be used on building sites.

Impact on industry

The risk of falling associated with floor slab formwork and the most frequently used protection systems are analyzed. As no research had been carried out to date on this type of risk, we consider the research presented in this article to be a pioneer in the field.     

Time trends and predictive factors for safety perceptions among incoming South Australian university students

Problem

Young workers are over-represented in injury statistics. In order to develop injury prevention strategies, this study investigated time trends and predictive factors relating to safety skills, confidence, and attitudes.

Method

Annual surveys were conducted from 2006-2009 among incoming students at the University of Adelaide. The questions addressed safety training, injury experience, and health and safety perceptions.

Results

Time trends in training, perceived safety skills, confidence, and attitudes were not significant. In terms of skills and confidence, the most important correlate was safety training outside of high school (odds ratio = 1.6), especially when repeated, assessed, or in face to face mode. Feeling strongly about safety issues was best predicted by injury experience (OR = 1.7) and gender.

Discussion

These results emphasize the value of assessed training, but they are also consistent with published U.S. data, indicating no improvement over time. It is suggested that there be a more integrated approach in safety education, involving schools and workplaces.

Impact on industry

By developing an understanding of student safety perceptions and experiences, this research aims to target strategies to reduce the excess injury rate for young workers. Workplaces should be more aware of the limitations of school-based safety education and a more integrated and evidence-based approach should be developed, involving schools and workplaces.     

“Safety is everyone's job:” The key to safety on a large university construction site

Problem

Construction risk management is challenging.

Method

We combined data on injuries, costs, and hours worked, obtained through a Rolling Owner-Controlled Insurance Program (ROCIP), with data from focus groups, interviews, and field observations, to prospectively study injuries and hazard control on a large university construction project.

Results

Lost-time injury rates (1.0/200,000 hours worked) were considerably lower than reported for the industry, and there were no serious falls from height. Safety was considered in the awarding of contracts and project timeline development; hazard management was iterative. A top-down management commitment to safety was clearly communicated to, and embraced by, workers throughout the site.

Discussion and Impact

A better understanding of how contracting relationships, workers' compensation, and liability insurance arrangements influence safety could shift risk management efforts from worker behaviors to a broader focus on how these programs and relationships affect incentives and disincentives for workplace safety and health.