A multinomial logit analysis of factors associated with severity of motorcycle crashes in Ghana

Objective: The objective of this study was to explore the factors affecting motorcycle crash severity in Ghana.

Methods: A retrospective analysis of motorcycle crash data between 2011 and 2015 was conducted using a motorcycle crash data set extracted from the National Road Traffic Crash Database at the Building and Road Research Institute (BRRI) in Ghana. Injury severity was classified into 4 categories: Fatal, hospitalized, injured, and damage only. A multinomial logit modeling framework was used to identify the possible determinants of motorcycle crash severity.

Results: During the study period, a total of 8,516 motorcycle crashes were recorded, of which 22.9% were classified as fatal, 42.1% were classified as hospitalized injuries, 29.4% were classified as slight injuries, and 5.6% were classified as damage-only crashes. The estimation results indicate that the following factors increase the probability of fatal injuries: At a junction; weekend; signage; poor road shoulder; village settlement; tarred and good road surface; and collision between motorcycle and heavy goods vehicle (HGV). Motorcycle crashes occurring during the daytime and on the weekend increases the probability of hospitalized injury. The results also suggest that motorcycle crashes occurring during the daytime, in curves or inclined portions of roads, or in unclear weather conditions decrease the probability of fatal injury.

Conclusions: This study provides further empirical evidence to support motorcycle crash modeling research, which is lacking in developing countries. The ability to understand the various factors that influence motorcycle crash severity is a step forward in providing an appropriate basis upon which informed motorcycle crash policies can be developed. Particular attention should be given to the provision of road signage at junctions and speed humps and controlling traffic during the weekend. In addition, road maintenance should be carried out periodically to address motorcycle safety in Ghana.     

Trauma demography and clinical epidemiology of motorcycle crash–related head injury in a neurosurgery practice in an African developing country

Objective: Though motor vehicle crashes (MVCs) were the main cause of head trauma from road traffic injuries (RTIs), motorcycle crashes (MCCs) are now a major cause of RTI-related head injury (HI) in many developing countries.

Methods: Using a prospective database of HIs from a neurosurgical practice in a sub-Saharan African developing country, a cross-sectional survey was conducted for the trauma demography and clinical epidemiology of this MCC-related HI.

Results: Motorcycle crashes accounted for 57% (473/833) of all RTI-related HIs in this registry. The victims, with a mean age of 33.1 years (SD = 18.3), consisted mainly of males (83.1%), those of low socioeconomic status (>90%), and those aged between 20 and 40 years old (56%). MCCs involved only riders in 114 cases (114/473, 32.1%), of which 69% were motorcycle–motorcycle crashes. The HI was moderate–severe in 50.8%; clinical symptomatology of significant HI included loss of consciousness (92%), anisocoria (35%), Abbreviated Injury Scale head (AIS–head) score > 3 (28%), and CT-Rotterdam score > 3 (30%). Extracranial systemic injury involved the limbs most frequently, with an Injury Severity Score (ISS) >25 in 49%. The fatality rate was 24%.

MCC-related HI among pedestrian victims involved more vulnerable age groups (the young and elderly) but have lower mean ISS compared to motorcycle passengers (mean ISS = 23.5 [11.6] vs. 27.4 [13.0]; 95% confidence interval [CI], 1.27–6.49; P = .004). In addition, compared to a contemporary cohort of MVC-related HIs in our registry, MCC victims were older (mean age 34.8 years [18.0] vs. 30.8 [18.4]; P = .002); had higher proportions of certain extracranial trauma like long bone fractures (71 vs. 29%; P = .02); and suffered fewer surgical brain lesions (25.5 vs. 17.2%; P = .004).

Conclusions: Motorcycle crashes are now a significant threat to the heads, limbs, and lives of vulnerable road users in developing countries.     

Fatally injured drivers in Norway 2005–2015—Trends in substance use and crash characteristics

Objective: Norway introduced a “Vision Zero” strategy in 2001, using multiple approaches, aiming toward a future in which no one will be killed or seriously injured in road traffic crashes (RTCs). Official statistics show that the number of fatally injured road users has declined substantially from 341 deaths in 2000 to 117 in 2015. In-depth crash investigations of all fatal RTCs started in Norway in 2005. The aim of this study was to investigate whether fatal crash characteristics, vehicle safety features, and prevalence of drugs and/or alcohol among fatally injured drivers and riders has changed during 2005–2015, accompanying the reduction in road fatalities.

Methods: Data on all car/van drivers and motorcycle/moped riders fatally injured in RTCs during 2005–2015 were extracted from Norwegian road traffic crash registries and combined with forensic toxicology data.

Results: The proportion of cars and motorcycles with antilock braking systems and cars with electronic stability control, increased significantly during the study period. The prevalence of nonuse of seat belts/helmets and speeding declined among both fatally injured drivers and riders. In addition, the prevalence of alcohol declined, though no significant change in the total prevalence of other substances was noted.

Conclusion: The observed changes toward more safety installations in cars and motorcycles and lower prevalence of driver-related risk factors like alcohol use, speeding, and nonuse of seat belts/helmets among fatally injured drivers/riders may have contributed to the decrease in road traffic deaths.     

Impact of perceptual countermeasures on driving behavior at curves using driving simulator

Objective: The probability of crash occurrence on horizontal curves is 1.5 to 4 times higher than that on tangent sections. A majority of these crashes are associated with human errors. Therefore, human behavior in curves needs to be corrected.

Methodology: In this study, 2 different road marking treatments, optical circles and herringbone patterns, were used to influence driver behavior while entering a curve on a 2-lane rural road section. A driving simulator was used to perform the experiment. The simulated road sections are replicas of 2 real road sections in Flanders.

Results: Both treatments were found to reduce speed before entering the curve. However, speed reduction was more gradual when optical circles were used. A herringbone pattern had more influence on lateral position than optical circles by forcing drivers to maintain a safe distance from opposing traffic in the adjacent lane.

Conclusion: The study concluded that among other low-cost speed reduction methods, optical circles are effective tools to reduce speed and increase drivers’ attention. Moreover, a herringbone pattern can be used to reduce crashes on curves, mainly for head-on crashes where the main problem is inappropriate lateral position.     

Factors associated with driving under the influence of alcohol

Objective: This study examined the risk factors of driving under the influence of alcohol (DUI) among drivers of specific vehicle categories (DSC). On the basis of this research, the variables related to DUI and involvement in traffic crashes were defined. The analysis was conducted for car drivers, bicyclists, motorcyclists, bus drivers, and truck drivers.

Method: The research sample included drivers involved in traffic crashes on the territory of Serbia in 2016 (60,666). Two types of analyses were conducted in this study. Logistic regression established the correlation between DUI and DSC and the The Technique for Order of Preference by Similarity to Ideal Solution (Multi-criteria decision making) method was applied to consider the scoring and explore the potential for the prevalence of DUI on the basis of 2 data sets (DUI and non DUI).

Results: The study results showed that driver error and male drivers were the 2 most significant risk factors for DUI, with the highest scores and potential for prevalence. The nonuse of restraint systems, driver experience, and driver age are the factors with a significant prediction of involvement in an accident and an insignificant prediction of DUI.

Conclusions: Following the development of the logistic prediction models for DUI drivers, testing of the model was conducted for 3 control driver groups: Car, motorcycle, and bicycle. The prediction model with a probability greater than 50% showed that 77% of car drivers were under the influence of alcohol. Similarly, the prediction percentage for motorcyclists and bicyclists amounted to 71 and 67%, respectively. The recommendation of the study is that drivers whose DUI probability is above 50% should be potentially suspected of DUI. The results of this study can help to understand the problem of DUI among specific driver categories and detect DUI drivers, with the aim of creating successful traffic safety policy.     

Motorcycle helmet visor–related facial injury and its potential mechanism of injury: Evidence-based case study

Objectives: We encountered an unusual facial laceration wound in relation to motorcycle helmet visor use during our clinical practice. We aimed to assess the prevalence of this unusual facial injury among motorcyclists who sustained facial injuries in selected hospitals and to determine the possible mechanism involved.

Methods: We used our prospective cross-sectional substudy involving injured motorcyclists presenting at major trauma hospitals in Southern Klang Valley, Malaysia, between March 2010 and March 2011. of 391 subjects with facial injuries, 2 male motorcyclists sustained this laceration. The wounds were assessed and we believed that each was associated with the helmet visor. One of the visors was collected and the edge was inspected using scanning electron microscopy (SEM).

Results: The prevalence of this unusual injury was 0.51% (95% confidence interval, 0.002–0.012) among motorcyclists who sustained facial injuries. Both cases were involved in a head-on collision with their colliding partners and their helmets were intact throughout the crash. The visor in case 1 was intact, but the visor in case 2 was broken. SEM analysis showed that the visor in case 1 had a potential cutting surface.

We postulated that with helmet rotation in the forward and downward position and with some degree of visor bending or with a dislodged visor, the sharp-edged visor could potentially severely lacerate the face.

Conclusion: This injury affects facial aesthetics and early referral to the facial surgery team is advocated. Documentation of the mechanism of injury, the patient’s helmet and visor is obligatory, so that this information can be delivered to the regional road safety authority for preventive measures.     

Driving while impaired by alcohol: An analysis of drink-drivers involved in UK collisions

Objective: Drink-driving represents a critical issue on international organizations’ agendas as one of the key behavioral risk factors in road traffic safety, alongside speed and nonuse of motorcycle helmets, seat belts, and child restraints. Changing road user behaviors regarding these 5 factors is a critical component in reducing road traffic injuries and casualties. The objective of this study is the identification of drivers who are more likely to contribute to crashes in the UK while impaired by alcohol to design targeted drink drive compliance campaigns.

Method: To profile drivers with the factor “impaired by alcohol” assigned in collisions, an extensive data set is used, including all reported injury collisions between 2011 and 2015 in the UK (police records), merged with the Experian Mosaic Database. A multilevel mixed-effects logistic regression is conducted, utilizing the hierarchical nature of the data (drivers within Mosaic types).

Results: Using multilevel mixed-effects logistic regression analysis, the finding is that some driver profiles are more likely to contribute to crashes and are assigned the contributory factor “impaired by alcohol.” Drink-related crashes are more common in some circumstances or for some crash-involved driver groups than others. For instance, alcohol-related crashes are more likely to occur on single carriageways and among males and 25- to 35-year-olds. Drink-drive-related crashes are found to be strongly associated with dark lighting conditions and, more specifically, with late night hours (the interval between 3:00 a.m. and 4:00 a.m. accounts for a third of the drink-drive-related collisions). Using the Experian Mosaic Database which divides the UK population into 66 types based on demographic, lifestyle, and behavior characteristics, the finding is that, among crash-involved drivers, some Mosaic types are significantly more likely (e.g., pocket pensions, dependent greys, streetwise singles) and others are significantly less likely (e.g., crowded kaleidoscope, cultural comfort, penthouse chic) to contribute to a drink-related crash.

Conclusions: The outcome is a more nuanced understanding of drivers contributing to drink-related crashes in the UK. The study concludes by discussing the implications for governments and other interested bodies for better targeting and delivery of public education campaigns and interventions.     

Identifying the crash characteristics on freeway segments based on different ramp influence areas

Objective: This study aimed to explore the relationship between crash types and different freeway segments and identify the factors contributing to crashes on different freeway segments. Unlike most of the previous studies on freeway segments, this study separately investigates basic freeway segments, single ramp influence segments, and multiple ramp influence segments.

Methods: Nonlinear canonical correlation analysis (NLCCA) and proportionality test were used to identify the relationship between crash types and different freeway segments. The data sets for the different freeway segments accumulated for this study consist of 9,867 crash samples with complete information on all 22 chosen variables. A multinomial logit model (MNL) was used to estimate the influence of crash factors on different freeway segments.

Results: The results show that weaving and diverge overlap influence segments (WD) are more likely to have injury or fatal crashes; diverge and diverge overlap influence segments (DD) are more likely to have property damage–only (PDO) crashes; merge and merge overlap influence segments (MM) are more likely to have sideswipe crashes; and WD have non-sideswipe crashes; WD and weaving overlap influence segments (MW) are more likely to have rear end crashes; and MM segments are less likely to have hit object crashes. The contributing factors are identified by MNL and the results show that different traffic variables, environmental variables, vehicle variables, driver variables, and geometric variables significantly affected the likelihood of crashes on different freeway segments.

Conclusions: Investigation of crash types and factors contributing to crashes on different freeway segments is based on multiple ramp influence segments, which can promote a better understanding of the safety performance of various freeway segments.     

A semi-automated tool for identifying agricultural roadway crashes in crash narratives

Objective: Crash reports contain precoded structured data fields and a crash narrative that can be a source of rich information not included in the structured data. The narrative can be useful for identifying vulnerable roadway users, such as agricultural workers. However, using the narratives often requires manual reviews that are time consuming and costly. The objective of this research was to develop a simple and relatively inexpensive, semi-automated tool for screening crash narratives and expediting the process of identifying crashes with specific characteristics, such as agricultural crashes.

Methods: Crash records for Louisiana from 2010 to 2015 were obtained from the Louisiana Department of Transportation (LaDOTD). Records with narratives were extracted and stratified by vehicle type. The majority of analyses focused on a vehicle type of farm equipment (Type T). Two keyword lists, an inclusion list and an exclusion list, were created based on the published literature, subject-matter experts, and findings from a pilot project. Next, a semi-automated tool was developed in Microsoft Excel to identify agricultural crashes. Lastly, the tool’s performance was assessed using a gold standard set of agricultural narratives identified through manual review.

Results: The tool reduced the search space (e.g., number of narratives that need manual review) for narratives requiring manual review from 6.7 to 59.4% depending on the research question. Sensitivity was high, with 96.1% of agricultural crash narratives being correctly classified. Of the gold standard agricultural narratives, 58.3% included an equipment keyword and 72.8% included a farm equipment brand.

Conclusion: This article provides information on how crash narratives can supplement structured crash data. It also provides an easy-to-implement method to facilitate incorporating narratives into safety research along with keyword lists for identifying agricultural crashes.     

Reliability and validity of the Multidimensional Driving Style Inventory in Chinese drivers

Objective: The Multidimensional Driving Style Inventory (MDSI) has been widely used in assessing the associations between driving styles and traffic violations and accidents in different cultural contexts. Due to the lack of a valid instrument to assess driving style, studies concerning driving style and its influence factors are limited in China. Thus, this study aimed to adapt and validate a Chinese version of the MDSI.

Methods: Seven hundred and sixty drivers aged from 19 to 60 years old were asked to complete the MDSI and a personality scale (trait anger, sensation seeking, altruism, and normlessness). Exploratory factory analysis (EFA) and confirmatory factor analysis (CFA) were used to obtain the factorial structure of the MDSI. The external validity of the MDSI was then evaluated by examining the associations between driving styles and personality traits, demographic variables, and traffic violations and crashes.

Results: EFA revealed a 6-factor structure of the MDSI (i.e., risky, anxious, angry, distress reduction, careful, and dissociative driving styles). CFA confirmed that the model fit of the MDSI was acceptable. The MDSI factors were moderately or weakly correlated with trait anger, sensation seeking, altruism, and normlessness. Significant gender and age differences in driving styles were found. Moreover, drivers who had traffic violations or crashes in the past year scored higher on risky and angry driving styles and lower on careful driving style than those who had not have traffic violations or crashes.

Conclusions: The Chinese version of the MDSI proved to be a reliable, valid, and highly useful instrument. It could be used to assess Chinese drivers who are at risk due to their maladaptive driving styles.     

High blood alcohol concentration associated with traumatic brain injury among traffic injury patients during New Year festivals in Thailand

Objective: Road traffic injury (RTI) is one of the most significant public health problems in Thailand, especially during New Year and Songkran (Thai traditional New Year) holidays, which have the highest traffic density during the entire year. Drunk driving was reported to be one of the leading causes of RTI in Thailand. This study aimed to investigate the prevalence of patients with high blood alcohol concentration (BAC) and the association of BAC and specific organ injury during New Year and Songkran (Thai traditional New Year) holidays.

Methods: A cross-sectional study was performed to analyze the database from the Thai Governmental Road Safety Evaluation Project. Patient data on RTIs were collected from 26 main provincial hospitals during the New Year Festival 2003 and 2004 and Songkran Festival in 2003. Patient characteristics, type of organ injured, and BAC levels were mainly analyzed.

Results: During those long holidays, 2,642 RTI patients were identified, among whom 1,341 patients had high BAC levels. High BAC levels were associated with motorcycle users, male sex, middle age, teenagers, being riders or drivers, and not using protective devices. Moreover, high BAC levels were associated with brain injury.

Conclusion: Excessive alcohol consumption and RTIs occurred on New Year and Songkran Festival in Thailand. Legislation should be strictly used during these long holidays to control driving under the influence of alcohol, particularly among motorcyclists.     

Trends in the use of psychoactive substances by truck drivers in São Paulo State,Brazil: A time-series cross sectional roadside survey (2009–2016)

Objective: Truck drivers represent a group that is susceptible to the use of stimulant substances to reduce the symptoms of fatigue, which may be caused by a stressful and exhausting work environment. The use of psychoactive substances may increase the risk for involvement in road traffic crashes. Previous studies have demonstrated that amphetamine, cocaine, and cannabis are the 3 main drugs used by Brazilian truck drivers. We studied the prevalence of amphetamine, benzoylecgonine (indicating use of cocaine), and Δ-9-tetrahydrocannabinol-9-carboxylic acid (THC-COOH; indicating use of cannabis) in urine samples from truck drivers in the state of São Paulo, Brazil, using the same methodology during 8 years (2009–2016).

Methods: Samples were collected during a health program supported by the Federal Highway Police. Toxicological analyses were performed using immunoassays and gas chromatography–mass spectrometry.

Results: The total prevalence of illicit drugs was 7.8%. Benzoylecgonine was the most prevalent substance (3.6%), followed by amphetamine (3.4%) and THC-COOH (1.6%). We found the highest drug prevalence in 2010 (11.3%) and the lowest in 2011 (6.1%). We could detect a slight change in the pattern of stimulant use: until 2010, amphetamine was the most prevalent substance; however, in 2011 benzoylecgonine became the most frequently detected substance. This lasted until 2015, probably due to changes in Brazilian legislation regarding appetite suppressants; the most common one is metabolized to amphetamine.

Conclusion: These data show that the use of psychoactive substances by truck drivers in Brazil did not decrease during the study period. This reinforces the need for further preventive measures to reduce drug use among drivers, which could lead to a decrease in traffic crashes in Brazil.     

A clustering approach to integrate traffic safety in road maintenance prioritization

Objectives: We combine data on roads and crash characteristics to identify patterns in road traffic crashes with regard to road characteristics. We illustrate how combined analysis of data regarding road maintenance, maintenance costs, road characteristics, crash characteristics, and geographical location can enrich road maintenance prioritization from a traffic safety perspective.

Methods: The study is based on traffic crash data merged with road maintenance data and annual average daily traffic (AADT) collected in Denmark. We analyzed 3,964 crashes that occurred from 2010 to 2015. A latent class clustering (LCC) technique was used to identify crash clusters with different road and crash characteristics. The distribution of crash severity and estimated road maintenance costs for each cluster was found and cluster differences were compared using the chi-square test. Finally, a map matching procedure was used to identify the geographical distribution of the crashes in each cluster.

Results: Results showed that based on road maintenance levels there was no difference in the distribution of crash severity. The LCC technique revealed 11 crash clusters. Five clusters were characterized by crashes on roads with a poor maintenance level (levels 4 and 3). Only a few of these crashes included a vulnerable road user (VRU) but many occurred on roads without barriers. Four clusters included a large share of crashes on acceptably maintained roads (level 2). For these clusters only small variations in road characteristics were found, whereas the differences in crash characteristics were more dominant. The last 2 clusters included crashes that mainly occurred on new roads with no need for maintenance (level 1). Injury severity, estimated maintenance costs, and geographical location were found to be differently distributed for most of the clusters.

Conclusions: We find that focusing solely on road maintenance and crash severity does not provide clear guidance of how to prioritize between road maintenance efforts from a traffic safety perspective. However, when combined with geographical location and crash characteristics, a more nuanced picture appears that allows consideration of different target groups and perspectives.     

Effects of mobile phone use on driving performance in a multiresource workload scenario

Objective: This study explores the influence of mobile phone secondary tasks on driving from the perspective of visual, auditory, cognitive, and psychomotor (VACP) multiple resource theory, and it is anticipated to benefit the human-centered design of mobile phone use while driving.

Methods: The present study investigated 6 typical phone use scenarios while driving and analyzed the effects of phone use distractions on driving performance. Thirty-six participants were recruited to participate in this experiment. We abandoned traditional secondary tasks such as conversations or dialing, in which cognitive resources can become interference. Instead, we adopted an arrow secondary task and an n-back delayed digit recall task.

Results: The results show that all mobile phone use scenarios have a significant influence on driving performance, especially on lateral vehicle control. The visual plus psychomotor resource occupation scenario demonstrated the greatest deterioration of driving performance, and there was a significant deterioration of driving speed and steering wheel angle once the psychomotor resource was occupied.

Conclusions: Phone use distraction leads to visual, cognitive, and/or motor resource functional limitations and thus causes lane violations and traffic accidents.     

Behavioral influences on driver crash risks in Ghana: A qualitative study of commercial passenger drivers

Objectives: Though there is a growing body of literature on crash risks in the developed world, little is known about how well these models apply to motoring in developing countries, the context in which the majority of road traffic fatalities occur. This qualitative study explores factors perceived to influence crash risks for commercial drivers in Ghana.

Method: Twenty commercial drivers of varied ages and experience were sampled from 7 major lorry terminals in 3 regions (Greater Accra, Ashanti, and Volta) of Ghana. Data were collected through semistructured interviews.

Results: The participants identified some issues that are shared with drivers in the developed world, though moderated by the Ghanaian context. These included work pressures (e.g., fatigued driving), speeding, distracted driving, and inadequate vehicle maintenance. Other factors identified by participants are less frequently considered in research addressing driving behavior in developed countries. These included aggressive competition over passengers and corruption (e.g., improper licensing practices), among others.

Conclusion: The findings have implications for building a research base to support the development of road safety policy and interventions in developing countries.     

Population-based assessment of a vehicle fleet with seat belts providing lower shoulder belt forces than today

Objective: The objective of this study was to quantify the population-based effects of a lower shoulder belt load limit on front row occupants in frontal car crashes.

Method: Crashes of modern vehicles from the GIDAS (German In-Depth Accident Study) are corrected for bias and projected to the national level. Injury risk functions are computed for the injury severity levels Maximum Abbreviated Injury Scale (MAIS) 2+, MAIS 3+, and fatal, stratified by 2 age cohorts (16–44 years of age and 45 years or older). To assess the field effectivity of a “softer belt,” the projected crash frequency data are modified separately for the 2 age cohorts such that its risk structure represents the risk of a softer belt. Given those 2 samples, the field effectivity of a softer belt is derived for several shares of the younger age cohort according to the injury severity levels MAIS 2+, MAIS 3+, and fatal.

Results: The injury risk distribution of the projected crash frequency data, represented here by the injury risk functions obtained, fits well into the injury risk distribution of other data sets (Sweden, United States, and Japan) given in the literature. The relative effects of a lower belt force are stable over the different ratios of the younger and old age cohorts. At the MAIS 2+ level, a lower belt force can significantly reduce the number of injuries (about 10%). A lower belt force does not significantly affect the number of MAIS 3+ injuries. A lower belt force can, however, more than double the number of fatal injuries.

Conclusions: Because the number of fatal injuries rises dramatically due to lower belt force, the reduction in the number of MAIS 2+ injuries comes at a very high cost. Therefore, whether reducing the belt force limit is the right approach is questionable.