Before the crash: A systematic analysis of police narratives to determine the prevalence of pre-crash factors in fatality road transport crashes

Abstract

Objectives: The objectives of this study were to identify the prevalence of pre-crash factors that were present in fatal road transport crashes for the deceased and counterpart road user.

Methods: The study is a retrospective population-based case series study of transport-related deaths reported to coroners in Australia from 2013 to 2016. Data was extracted from the National Coronial Information System.

Results: In total, 6,137 fatality crashes occurred during the study period. Police reports were available for 5,523 crashes (89.9%). The most frequently reported pre-crash factors reported behaviour specifically drivers (e.g., driving without a license or while license was disqualified). Presence of intoxicating substances were also reported in the deceased and counterparts. Analyses of toxicology reports are continuing to determine if rates are comparable to level of use in community.

Conclusions: Coronial report provide detailed information that may be pertinent to understanding and potentially preventing crashes. Also emerging from the data is the extent of pre-crash factors that relate to illegal or deviant behavior and whether these are contextual or contributory factors.     

Shipyard fatalities in Turkey

The objective of this paper is to investigate causes and incidence rates of 115 fatalities between 2000 and 2010 in Turkish shipyards and to propose mitigation measures. The fatality rate in Turkish shipbuilding industry is unacceptably high, being 3.5 times the average of all industry groups. Classification of fatal occupational accidents revealed five major fatality reasons for the shipbuilding industry; falling from higher elevation to a lower level, exposed to electric shock, fire and/or explosion, being struck by or struck against objects, and caught in between. The highest number of cases of fatal accidents was found among welders, blasters, painters and substructure workers. Statistically analyzed data showed that working on Mondays and Saturdays have special impact on the fatality probability. Also, the number of fatalities is highest in working temperatures above average 25 °C, which covers from June through September. Strategies recommended to minimize the fatalities at shipyards are discussed. Furthermore a risk framework of fatal occupational accidents were drawn so that when working conditions are within the high risk region, extra precautions can be taken in order to minimize the occurrence of accidents and fatalities.     

Alcohol is a predictor of mortality in motor vehicle collisions

IntroductionIt is well recognized that driving while intoxicated increases the probability of a motor-vehicle collision (MVC). The effect of alcohol on the chance of surviving the MVC is less clear. Method: Using data from the Fatality Analysis Reporting System (FARS) we conducted analyses for the outcome of mortality using alcohol and other variables as predictors. We also selected alcohol positive (AP) and alcohol negative (AN) persons from the same MVC and vehicle to control for confounding characteristics. Results: The odds ratio (OR) for mortality for alcohol positive drivers was 2.57, (p < 0.001 for all the following OR). Other harmful predictive factors were age OR 1.01 per year, vehicle age OR 1.05 per year, male sex OR 1.23, avoidance maneuver OR 1.09, speed related OR 2.89, rollover mechanism OR 2.75, and collision with a fixed object OR 6.70. Protective factors were proper restraint use – OR 0.19 and collision with another moving vehicle, OR 0.21. In the multivariate analysis the OR of mortality for AP vs AN was 1.46. Proper restraint use (OR 0.27) remained protective along with collision with another moving vehicle. When AP and AN persons from the same MVC and the same vehicle were compared, the adjusted OR’s for mortality were 1.46 and 2.08, respectively. Conclusions: Alcohol is an independent predictor of mortality in an MVC. Proper restraint use is the strongest protective factor. This finding allows a more complete understanding of the risks of driving while intoxicated, not only a higher probability of an MVC, but decreased survival once the MVC occurs. Practical Applications: Identification of alcohol as an independent predictor of mortality in an accident may improve risk assessment and influence drivers to avoid driving while intoxicated.     

Administrative license suspension: Does length of suspension matter?

Objective: Administrative license revocation (ALR) laws, which provide that the license of a driver with a blood alcohol concentration at or over the illegal limit is subject to an immediate suspension by the state department of motor vehicles, are an example of a traffic law in which the sanction rapidly follows the offense. The power of ALR laws has been attributed to how swiftly the sanction is applied, but does the length of suspension matter? Our objectives were to (a) determine the relationship of the ALR suspension length to the prevalence of drinking drivers relative to sober drivers in fatal crashes and (b) estimate the extent to which the relationship is associated to the general deterrent effect compared to the specific deterrent effect of the law.

Methods: Data comparing the impact of ALR law implementation and ALR law suspension periods were analyzed using structural equation modeling techniques on the ratio of drinking drivers to nondrinking drivers in fatal crashes from the Fatality Analysis Reporting System (FARS).

Results: States with an ALR law with a short suspension period (1–30 days) had a significantly lower drinking driver ratio than states with no ALR law. States with a suspension period of 91–180 days had significantly lower ratios than states with shorter suspension periods, while the three states with suspension lengths of 181 days or longer had significantly lower ratios than states with shorter suspension periods.

Discussion: The implementation of any ALR law was associated with a 13.1% decrease in the drinking/nondrinking driver fatal crash ratio but only a 1.8% decrease in the intoxicated/nonintoxicated fatal crash ratio. The ALR laws and suspension lengths had a significant general deterrent effect, but no specific deterrent effect.

Practical Implications: States might want to keep (or adopt) ALR laws for their general deterrent effects and pursue alternatives for specific deterrent effects. States with short ALR suspension periods should consider lengthening them to 91 days or longer.     

The effects of a mandatory motorcycle helmet law on helmet use and injury patterns among motorcyclist fatalities

BACKGROUND: The National Highway Traffic Safety Administration (NHTSA) has found that motorcycle helmets are 37% effective in preventing death and 65% effective in preventing brain injuries in a crash. Unfortunately, in 1995 Congress lifted federal sanctions against states without helmet laws and since then there have been a number of primary motorcycle helmet laws repealed or weakened. More lives could be saved and serious injuries avoided if there was increased helmet use throughout the United States. METHODS: This study analyzed helmet use and injury patterns among motorcycle riders in the United States involved in fatal crashes from 1995 through 2003 and compared the results between states with and without a primary helmet law. Age, sex, injury severity and helmet use are some of the variables obtained from the Fatality Analysis Reporting System (FARS). RESULTS: In the 20 states and the District of Columbia, which currently have a primary helmet law, 84.0% of fatally injured riders were wearing a helmet. In the 27 states with a secondary helmet law, 36.2% of fatalities used a helmet, and in the remaining three states with no law at all, helmet use dropped to 17.6%. In the two states (Arkansas and Texas) that changed from a primary helmet law to a secondary helmet law in 1997, helmet use decreased from 78.2% in 1996 to 31.7% in 2000. CONCLUSION: If all states were to enact a primary motorcycle helmet law, helmet use would dramatically increase while decreasing the number of motorcyclist head injuries and fatalities. IMPACT ON INDUSTRY: The results of this study will hopefully persuade law makers to enact primary helmet laws in all states throughout the nation. Helmet manufacturers can use this data to design more comfortable helmets while also improving upon the protective qualities of these safety devices.     

Relative Risk of Fatal Injury in “High-Performance-Small-Motorcycle” Crashes in Malaysia

This study presents an analysis of injuries (severe and fatal) sustained by “high-performance-small-motorcycle” users in Malaysia and establishes the relationship between fatality risk and human factors, exposure and vehicle factors resulting from motorcycle crashes. From the data gathered a statistical model based on logistic regression modeling technique has been developed. Five variables found to have a significant influence on fatality risk (p < 0.05) were age, location sites, engine capacity, object/vehicle struck and collision types.     

Investigating traffic fatality trends and restraint use among rear-seat passengers in the United States, 2000–2016

Introduction: Motor-vehicle crash is one of the leading causes of unintentional injury death in the United States. Previous studies focused on fatalities among drivers and front-seat passengers, with a limited number of studies examining rear-seat passenger fatalities. The objectives of this study were to assess trends in rear-seat passenger motor-vehicle fatalities in the United States from 2000 to 2016 and to identify demographic factors associated with being unrestrained among fatally injured rear-seat passengers. Methods: Rear-seat passenger fatality data were obtained from the Fatality Analysis Reporting System (FARS) database. The fatality rate ratios for overall rear-seat passengers and for different age and sex groups were determined by comparing fatality rates in 2000 and 2016 using random effects models. Risk ratios of being unrestrained for age and sex groups were obtained using general estimating equations. Results: Compared to 2000, the overall rear-seat passenger fatality rate in 2016 decreased by 44% (95% confidence interval [CI]: 39–49%). In particular, the fatality rate among rear-seat passengers decreased more in males than females, and passengers aged 14–19 years experienced a larger decline than all other age groups. Fatally injured male rear-seat passengers had a higher risk of being unrestrained (adjusted risk ratio: 1.06, 95% CI: 1.04–1.07) than their female counterparts, and both youngest (≤13 years) and oldest (65–85 years) passengers were less likely to be unrestrained than those aged 20–64 years. Conclusions: Overall, fatality rates among rear-seat passengers have declined, with differential degrees of improvement by age and sex. Practical Applications: Continued restraint use enforcement campaigns targeted at teenagers and males would further preserve them from fatal injuries and improve traffic safety for the overall population.     

Age Dependence of Female to Male Fatality Risk in the Same Crash: An Independent Reexamination

A 1988 study reported that females are more likely than males to be killed by the same physical insult. This was determined by analyzing 1975–1983 data. The present study revisits this question using 123,678 fatalities from 1984–1996 data. As none of these data contributed to the earlier study, the present investigation is therefore independent of the earlier one. Female to male fatality risk ratios are calculated for 14 categories of vehicle occupants, including six light truck occupants (belted and unbelted drivers and right front passengers, and unbelted left and right rear passengers). The earlier study did not include light trucks. Close agreement is found between the results of the present and prior studies, thus solidifying the interpretation that findings are of a general nature and not dependent on specific data sets. Except at ages less than about 10 years, or older than about 55, females are more likely to be killed than males. While obtained using traffic data, the results are interpreted to reflect fundamental differences in human physiological response to blunt trauma in general, and are expected to apply to blunt trauma from falls, being struck by objects, etc.     

Exploring the circumstances surrounding flood fatalities in Australia—1900–2015 and the implications for policy and practice

This paper documents the analysis of the circumstances surrounding fatalities due to flooding in Australia between 1900 and 2015. This longitudinal investigation is important to understand changing trends in social vulnerability and to inform efficient and strategic risk reduction strategies. The basis of this analysis was PerilAUS, Risk Frontiers’ database of historical natural hazard impacts in Australia. This data was augmented and verified using coronial inquest records which provide detailed data concerning the social, demographic and environmental circumstances of each fatality. A statistical analysis of the data was undertaken, examining demographics (age, gender), location (state), seasonality, circumstances surrounding the fatality, environmental factors (e.g. the event intensity) and social factors (e.g. the decisions or actions which led to death). Overall there have been 1859 fatalities identified, with distinct trends in relation to gender, age, activity and reason behind the activity. Flood deaths have been declining. The majority of the fatalities are male (79.3%): however, since the 1960s the proportion of female to male fatalities has increased. Children and young adults (<29 years) make up the greatest proportion of the fatalities (53.8% of cases where age is known). The highest proportions of fatalities occurred while victims attempted to cross a flood-impacted bridge or road. The recommendations for emergency management policy and practice are discussed, outlining the need for a new approach that accounts for a continuum of measures including regulation and incentive, education and structural intervention.     

Occupational electrical injuries in the United States, 1992-1998, and recommendations for safety research

PROBLEM: CFOI and SOII data show that 2,287 U.S. workers died and 32,807 workers sustained days away from work due to electrical shock or electrical burn injuries between 1992 and 1998. METHOD: The narrative, work activity, job title, source of injury, location, and industry for each fatal electrical accident were examined. A primary causal factor was identified for each fatality. RESULTS: Electrical fatalities were categorized into five major groups. Overall, 44% of electrical fatalities occurred in the construction industry. Contact with overhead power lines caused 41% of all electrical fatalities. DISCUSSION: Electrical shock caused 99% of fatal and 62% of nonfatal electrical accidents. Comprising about 7% of the U.S. workforce, construction workers sustain 44% of electrical fatalities. Power line contact by mobile equipment occurs in many industries and should be the subject of focused research. Other problem areas are identified and opportunities for research are proposed. IMPACT ON INDUSTRY: Improvements in electrical safety in one industry often have application in other industries.