Road traffic injuries among riders of electric bike/electric moped in southern China

Objective: Electric bike/moped-related road traffic injuries have become a burgeoning public health problem in China. The objective of this study was to identify the prevalence and potential risk factors of electric bike/moped-related road traffic injuries among electric bike/moped riders in southern China.

Methods: A cross-sectional study was used to interview 3,151 electric bike/moped riders in southern China. Electric bike/moped-related road traffic injuries that occurred from July 2014 to June 2015 were investigated. Data were collected by face-to-face interviews and analyzed between July 2015 and June 2017.

Results: The prevalence of electric bike/moped-related road traffic injuries among the investigated riders was 15.99%. Electric bike/moped-related road traffic injuries were significantly associated with category of electric bike (adjusted odds ratio [AOR] = 1.36, 95% confidence interval [CI], 1.01–1.82), self-reported confusion (AOR = 1.77, 95% CI, 1.13–2.78), history of crashes (AOR = 6.14, 95% CI, 4.68–8.07), running red lights (AOR = 3.57, 95% CI, 2.42–5.25), carrying children while riding (AOR = 1.96, 95% CI, 1.37–2.85), carrying adults while riding (AOR = 1.68, 95% CI, 1.23–2.28), riding in the motor lane (AOR = 2.42, 95% CI, 1.05–3.93), and riding in the wrong traffic direction (AOR = 1.63, 95% CI, 1.13–2.35). In over 77.58% of electric bike/moped-related road traffic crashes, riders were determined by the police to be responsible for the crash. Major crash-causing factors included violating traffic signals or signs, careless riding, speeding, and riding in the wrong lane.

Conclusion: Traffic safety related to electric bikes/moped is becoming more problematic with growing popularity compared with other 2-wheeled vehicles. Programs need to be developed to prevent electric bike/moped-related road traffic injuries in this emerging country.     

An evaluation scheme for assessing the effectiveness of intersection movement assist (IMA) on improving traffic safety

Objective: Intersection movement assist (IMA) has been recognized as one of the prominent countermeasures to reduce angle crashes at intersections, which constitute 22% of total crashes in the United States. Utilizing vehicle-based sensors, vehicle-to-vehicle (V2V), and vehicle-to-infrastructure (V2I) communications, IMA offers extended vision to provide early warning for an imminent crash. However, most of IMA-related research implements their methods and strategies only in simulations, test tracks, or driving simulator studies that have quite a few assumptions and limitations and hence the effectiveness evaluations reported may not be transferable or comparable.

Methods: This study seeks to develop a generalized evaluation scheme that can be used not only to assess the effectiveness of IMA on improving traffic safety at intersections but to facilitate comparisons across similar studies. The proposed evaluation scheme utilizes the concepts of traffic conflict in terms of time-to-collision (TTC) as a crash surrogate. This approach avoids the issue of having insufficient crash frequency data for system evaluation. To measure the effectiveness of IMA on reducing traffic conflicts, a relative risk is calculated for comparing the risk of with/without using the IMA. As a proof-of-concept study, this study applied the proposed evaluation scheme and reported the effectiveness of IMA on improving traffic safety in a field operation test (FOT). Seven test scenarios were conducted at 4 intersections, and a total of 40 participants were recruited to use the IMA for 6 months.

Results: It was estimated that IMA users have 26% fewer conflicts with TTC less than 5 s and have 15% fewer conflicts with TTC less than 4 s. However, the results vary across different sites and different definitions of conflicts in terms of TTC.

Conclusions: Overall, IMA is promising to effectively reduce angle crashes related to sight obstruction and has potential to reduce not only crash frequency but crash severity.     

A new approach to managing work-related road traffic injury: The development of a health investment framework

Objective: Statistics indicate that employees commuting or traveling as part of their work are overrepresented in workplace injury and death. Despite this, many organizations are unaware of the factors within their organizations that are likely to influence potential reductions in work-related road traffic injury.

Methods: This article presents a multilevel conceptual framework that identifies health investment as the central feature in reducing work-related road traffic injury. Within this framework, we explore factors operating at the individual driver, workgroup supervisor, and organizational senior management levels that create a mutually reinforcing system of safety.

Results: The health investment framework identifies key factors at the senior manager, supervisor, and driver levels to cultivating a safe working environment. These factors are high-performance workplace systems, leader–member exchange and autonomy, trust and empowerment, respectively. The framework demonstrates the important interactions between these factors and how they create a self-sustaining organizational safety system.

Conclusions: The framework aims to provide insight into the future development of interventions that are strategically aligned with the organization and target elements that facilitate and enhance driver safety and ultimately reduce work-related road traffic injury and death.     

Identifying risky drivers with simulated driving

Objective: The present study aimed to examine whether high-risk drivers differ from low-risk drivers in driving behavior in a simulated environment.

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.     

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.     

Characteristics and clinical outcomes of head-injured cyclists with and without helmets in urban and rural areas of Taiwan: A 15-year study

Objective: Bicycle riding is increasingly popular in Taiwan, but the number of cyclists injured and cyclists' death rates are both increasing. The aim of this study was to investigate the different characteristics and clinical outcomes of traffic accident–related head injuries among cyclists in urban and rural areas.

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.     

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.     

An empirical bayes safety evaluation of tram/streetcar signal and lane priority measures in Melbourne

Objective: Streetcars/tram systems are growing worldwide, and many are given priority to increase speed and reliability performance in mixed traffic conditions. Research related to the road safety impact of tram priority is limited. This study explores the road safety impacts of tram priority measures including lane and intersection/signal priority measures.

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.     

Modeling the probability of freeway lane-changing collision occurrence considering intervehicle interaction

Objective: To better capture the relationships between lane-changing collisions and explanatory variables, a microscopic model is developed for freeway lane-changing collisions based on the interactions between lane-changing vehicles.

Methods: The model applies an intervehicle interaction structure to account for the occurrence mechanism of lane-changing collisions. The occurrence mechanism can be described as the failure of a vehicle driver of an adjacent lane in avoiding the lane-changing vehicle, which disturbs the smooth movement of the adjacent lane vehicle and requires the driver's brake action to avoid an angle collision. This model is examined using data collected from freeways in Washington State during 2010 to 2011 and validated using lane-changing collision data for the SR 520 freeway.

Results: The findings of this study show that generalized truck percentage has a significant decreasing effect on lane-changing collision risk, whereas average spacing and several roadway characteristics have significant increasing effects. The frequency of slight collisions during peak hours is higher than that during off-peak hours. Young female drivers are more likely to be involved in collisions during lane-changing than young male drivers, but the result for senior drivers is opposite, with older male drivers having a higher probability of lane-changing collisions than female drivers in the same age group.

Conclusion: The process of lane-changing collisions is a complicated maneuver. Truck percentage, average spacing, and good roadway characteristics, such as straight and level segment, in the target lane have a significant effect on the occurrence of lane-changing collisions. Age and gender are also 2 important factors contributing to the relationship between lane-changing collisions and explanatory variables.     

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.     

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).     

Importance of awareness in improving performance of emergency medical services (EMS) systems in enhancing traffic safety: A lesson from India

Objective: India has been slow in implementing a central emergency medical services (EMS) system across the country. “108 services” is one of the most popular services that is functional under the public–private partnership model. Limited available literature shows that despite access to services, many traffic crash victims are transported using private vehicles. The objective of this study is to understand the effectiveness of 108 services from a traffic safety perspective.

Method: A questionnaire survey is conducted to understand the awareness of EMS and their function. Using traffic-related fatalities as the dependent variable, a fixed effect panel data model is developed to analyze the effectiveness of the 108 services in improving the traffic safety.

Results: The results from the survey show that, in general, people are not aware of the 108 services. A majority of the population prefers taking victims to the hospital using their personal vehicles or any other vehicles available compared to calling an ambulance. Results from panel data analysis show that despite having an efficient system, these services failed to make significant improvement in the safety of road users in the states in which their services were subscribed.

Discussion: The lack of awareness of an important safety service is alarming. This could be a major reason for lower utilization of 108 services for transporting victims of traffic crashes. This article shows the importance of having efficient awareness campaigns to improve the efficiency of any similar programs that are aimed to enhance the safety of a region.     

Perceived enjoyment,concentration, intention,and speed violation behavior: Using flow theory and theory of planned behavior

Objective: Road accidents are an important public health concern, and speeding is a major contributor. Although flow theory (FLT) is a valid model for understanding behavior, currently the nature of the roles and interplay of FLT constructs within the theory of planned behavior (TPB) framework when attempting to explain the determinants of motivations for intention to speed and speeding behavior of car drivers is not yet known. The study aims to synthesize TPB and FLT in explaining drivers of advanced vehicles intentions to speed and speed violation behaviors and evaluate factors that are critical for explaining intention and behavior.

Method: The hypothesized model was validated using a sample collected from 354 fully licensed drivers of advanced vehicles, involving 278 males and 76 females on 2 occasions separated by a 3-month interval. During the first of the 2 occasions, participants completed questionnaire measures of TPB and FLT variables. Three months later, participants' speed violation behaviors were assessed.

Results: The study observed a significant positive relationship between the constructs. The proposed model accounted for 51 and 45% of the variance in intention to speed and speed violation behavior, respectively. The independent predictors of intention were enjoyment, attitude, and subjective norm. The independent predictors of speed violation behavior were enjoyment, concentration, intention, and perceived behavioral control.

Conclusions: The findings suggest that safety interventions for preventing speed violation behaviors should be aimed at underlying beliefs influencing the speeding behaviors of drivers of advanced vehicles. Furthermore, perceived enjoyment is of equal importance to driver's intention, influencing speed violation behavior.     

Traffic accident reconstruction and an approach for prediction of fault rates using artificial neural networks: A case study in Turkey

Objective: Currently, in Turkey, fault rates in traffic accidents are determined according to the initiative of accident experts (no speed analyses of vehicles just considering accident type) and there are no specific quantitative instructions on fault rates related to procession of accidents which just represents the type of collision (side impact, head to head, rear end, etc.) in No. 2918 Turkish Highway Traffic Act (THTA 1983). The aim of this study is to introduce a scientific and systematic approach for determination of fault rates in most frequent property damage–only (PDO) traffic accidents in Turkey.

Methods: In this study, data (police reports, skid marks, deformation, crush depth, etc.) collected from the most frequent and controversial accident types (4 sample vehicle–vehicle scenarios) that consist of PDO were inserted into a reconstruction software called vCrash. Sample real-world scenarios were simulated on the software to generate different vehicle deformations that also correspond to energy-equivalent speed data just before the crash. These values were used to train a multilayer feedforward artificial neural network (MFANN), function fitting neural network (FITNET, a specialized version of MFANN), and generalized regression neural network (GRNN) models within 10-fold cross-validation to predict fault rates without using software. The performance of the artificial neural network (ANN) prediction models was evaluated using mean square error (MSE) and multiple correlation coefficient (R).

Results: It was shown that the MFANN model performed better for predicting fault rates (i.e., lower MSE and higher R) than FITNET and GRNN models for accident scenarios 1, 2, and 3, whereas FITNET performed the best for scenario 4. The FITNET model showed the second best results for prediction for the first 3 scenarios. Because there is no training phase in GRNN, the GRNN model produced results much faster than MFANN and FITNET models. However, the GRNN model had the worst prediction results. The R values for prediction of fault rates were close to 1 for all folds and scenarios.

Conclusions: This study focuses on exhibiting new aspects and scientific approaches for determining fault rates of involvement in most frequent PDO accidents occurring in Turkey by discussing some deficiencies in THTA and without regard to initiative and/or experience of experts. This study yields judicious decisions to be made especially on forensic investigations and events involving insurance companies. Referring to this approach, injury/fatal and/or pedestrian-related accidents may be analyzed as future work by developing new scientific models.     

Factors associated with prehospital death among traffic accident patients in Osaka City,Japan: A population-based study

Objective: Although it is important to assess the factors associated with traffic accident fatalities to decrease them as a matter of public health, such factors have not been fully identified.

Methods: Using a large-scale data set of ambulance records in Osaka City, Japan, we retrospectively analyzed all traffic accident patients transported to hospitals by emergency medical service personnel from 2013 to 2014. In this study, prehospital death was defined as that occurring at the scene or in the emergency department immediately after hospital arrival. We assessed prehospital factors associated with prehospital death due to traffic accidents by logistic regression models.

Results: This study enrolled 28,903 emergency patients involved in traffic accidents, of whom 68 died prehospital. In a multivariate model, elderly patients aged ≥75 years (adjusted odds ratio [AOR] = 4.34; 95% confidence interval [CI], 2.29–8.23), nighttime (AOR = 2.75; 95% CI, 1.65–4.70), and type of injured person compared to bicyclists such as pedestrians (AOR = 9.58; 95% CI, 5.07–17.99), motorcyclists (AOR = 2.75; 95% CI, 1.21–6.24), and car occupants (AOR = 2.98; 95% CI, 1.39–6.40) were significantly associated with prehospital death due to traffic accidents. In addition, the AOR for automobile versus nonautomobile as the collision opponent was 4.76 (95% CI, 2.30–9.88).

Conclusions: In this population, the factors associated with prehospital death due to traffic accidents were elderly people, nighttime, and pedestrian as the type of patient. The proportion of prehospital deaths due to traffic accidents was also high when the collision component was an automobile.     

Difficulties in emotion regulation and risky driving among Lithuanian drivers

Background: Risky driving is a common cause of traffic accidents and injuries. However, there is no clear evidence of how difficulties in emotion regulation contribute to risky driving behavior, particularly in small post-Soviet countries. The present study aimed to investigate the relationship between difficulties in emotion regulation and self-reported risky driving behavior in a sample of Lithuanian drivers.

Methods: A total of 246 nonprofessional Lithuanian drivers participated in a cross-sectional survey. Difficulties in emotion regulation were assessed using the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer 2004), and risky driving behavior was assessed using the Manchester Driver Behaviour Questionnaire (DBQ; Lajunen et al. 2004).

Results: Males scored higher than females in aggressive violations and ordinary violations. Females scored higher for the nonacceptance of emotional responses, whereas males had more difficulties with emotional awareness than females. More difficulties in emotion regulation were positively correlated with driving errors, lapses, aggressive violations, and ordinary violations for both males and females. Structural equation modeling showed that difficulties in emotion regulation explained aggressive and ordinary violations more clearly than lapses and errors. When controlling for interactions among the distinct regulation difficulties, difficulties with impulse control and difficulties engaging in goal-directed behavior predicted risky driving. Furthermore, nonacceptance of emotional responses and limited access to emotion regulation strategies were related to less violations and more driving errors.

Conclusion: Emotion regulation difficulties were associated with the self-reported risky driving behaviors of Lithuanian drivers. This provides useful hints for improving driver training programs in order to prevent traffic injuries.     

Transport company safety climate—The impact on truck driver behavior and crash involvement

Objective: The present study investigated the relationships between safety climate and driving behavior and crash involvement.

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.