Estimation of the real number of road casualties in Europe

Within this research, the police under-reporting of non-fatal road accident casualties in eight European countries was examined by means of a common methodology applied in each country. Eight national studies were carried out using the common methodology, and this allowed to prepare valid estimates of the level of under-reporting of non-fatal road casualties in Europe in a disaggregate form (namely by country, road user type and injury severity). This provided an insight into the variation of road casualty under-reporting in Europe. Moreover, a new common definition for road casualty severity was proposed that makes use of internationally recognised medical standards. This was established by examining two different injury severity standards, the casualty’s length of stay in hospital and the casualty’s maximum AIS score. The under-reporting coefficients developed within this research were applied to estimate the real number of non-fatal serious road accident casualties, according to the new proposed common definition. For almost all countries, the actual number of serious casualties according to the new proposed definition was found lower than the number of police-recorded serious casualties. With the newly estimated number of serious casualties, the values of the ratio of serious casualties to fatalities are much less widespread across countries. These remaining differences can thus be attributed to real differences in road safety between the countries, after having controlled for the different under-reporting levels and injury severity definitions.     

Protective effect of different types of bicycle helmets

The effectiveness of bicycle helmets in preventing head injuries is well documented. There are different opinions about the effectiveness of helmets in preventing face injuries, and few studies have analyzed the effect of different types of helmets. This study was performed to examine the effect of different helmet types to head and face injuries. The use of helmets was analyzed in cyclists with head or face injuries and compared with two control groups. The main control group was cyclists that had injuries not including the head or neck, and another control group was cyclists that had been involved in an accident, regardless of whether they had sustained any injury. Cross-table and logistic regression analyses were applied to analyze the protective effect of helmets. A total of 991 injured patients served as a basis for this study. Most of the accidents, (82%) were single accidents with no other persons involved. Of patients with injuries to the head, excluding face, 11.4% had been using hard shell helmets, and 9.6% had been using foam helmets at the time of the accident. Among the emergency room controls, the proportion of hard shell helmet users and foam helmet users was 26.4% and 11.4%, respectively. Compared to non-helmet users, this gave an odds ratio of 0.36 (CI = 0.21-0.60) for getting head injuries if the cyclists had been using hard shell helmets at the time of the injury, and 0.83 (CI = 0.41-1.67) for users of foam helmets. The odds ratio for getting face injuries was 0.90 (CI = 0.58-1.41) among users of hard shell helmets, and 1.87 (CI = 1.03-3.40) for users of foam helmets. The use of hard shell helmets reduced the risk of getting injuries to the head. Children less than nine years old that used foam helmets had an increased risk of getting face injuries. All bicyclists should be recommended to use hard shell bicycle helmets while cycling.     

Protective Effect of Different Types of Bicycle Helmets

The effectiveness of bicycle helmets in preventing head injuries is well documented. There are different opinions about the effectiveness of helmets in preventing face injuries, and few studies have analyzed the effect of different types of helmets. This study was performed to examine the effect of different helmet types to head and face injuries. The use of helmets was analyzed in cyclists with head or face injuries and compared with two control groups. The main control group was cyclists that had injuries not including the head or neck, and another control group was cyclists that had been involved in an accident, regardless of whether they had sustained any injury. Cross-table and logistic regression analyses were applied to analyze the protective effect of helmets. A total of 991 injured patients served as a basis for this study. Most of the accidents, (82%) were single accidents with no other persons involved. Of patients with injuries to the head, excluding face, 11.4% had been using hard shell helmets, and 9.6% had been using foam helmets at the time of the accident. Among the emergency room controls, the proportion of hard shell helmet users and foam helmet users was 26.4% and 11.4%, respectively. Compared to non-helmet users, this gave an odds ratio of 0.36 (CI = 0.21–0.60) for getting head injuries if the cyclists had been using hard shell helmets at the time of the injury, and 0.83 (CI = 0.41–1.67) for users of foam helmets. The odds ratio for getting face injuries was 0.90 (CI = 0.58–1.41) among users of hard shell helmets, and 1.87 (CI = 1.03–3.40) for users of foam helmets. The use of hard shell helmets reduced the risk of getting injuries to the head. Children less than nine years old that used foam helmets had an increased risk of getting face injuries. All bicyclists should be recommended to use hard shell bicycle helmets while cycling.     

Cyclist casualty severity at roundabouts – To what extent do the geometric characteristics of roundabouts play a part?

Introduction: In general, priority junctions are converted into roundabouts to increase capacity and reduce vehicle accidents. However, previous research has indicated that roundabouts are dangerous for vulnerable users, especially cyclists. Method: This paper investigates which design factors influence cyclist casualty severity at give way (non-signalized) roundabouts with mixed traffic, using the UK STATS19 National dataset of cyclist casualties. First, the correlation matrix was generated to observe the relationship between variables. Second, dimension reduction was applied to geometric design variables in order to reduce the number of variables and generate the factors. Finally, the binary logistic regression method, with serious and slight casualties as dependent variables, was applied in three steps. The first Binary Logistic Regression Model (BLRM) included speed limit, sociodemographic, and meteorological conditions. The variables in the second BLRM consisted of geometric design variables. The third BLRM included the factors that were generated by dimension reduction. Results: The correlation matrix revealed that the number of lanes on approach and half width on approach were statistically significantly correlated, while the variables, such as geometric design (entry path radius, number of arms, number of flare lanes on approach, type of roundabout and number of circulating lanes), sociodemographic (casualty gender and age), speed limit and meteorologically related factors (daylight, weather and road surface condition), did not show any statistical significance. From the dimension reduction process, two main factors were identified, including Approach Capacity (Factor 1) and Size of Roundabout (Factor 2), and they were subsequently used as independent variables in the logistic regression analysis. The subsequent BLRMs showed that a higher speed limit reduces the safety for cyclists at roundabouts. The probability of a serious casualty increases by approximately five times (odds ratio 4.97) for each additional number of lanes on approach and by 4% (odds ratio 1.04) with a higher entry path radius. It was also found that Factor 2 (Approach Capacity) increases the casualty severity (odds ratio 1.86) for cyclists at roundabouts. Practical applications: While this research studied roundabouts in the UK, the methodological approach and statistical analysis techniques are applicable to other countries and the findings are likely to be of value to decision makers worldwide.     

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.     

Commentary: Status of road safety in Asia

Objectives: The objective of this article is to assess the status of road safety in Asia and present accident and injury prevention strategies based on global road safety improvement experiences and discuss the way forward by indicating opportunities and countermeasures that could be implemented to achieve a new level of safety in Asia.

Methods: This study provides a review and analyses of data in the literature, including from the World Health Organization (WHO) and World Bank, and a review of lessons learned from best practices in high-income countries. In addition, an estimation of costs due to road transport injuries in Asia and review of future trends in road transport is provided.

Results: Data on the global and Asian road safety problem and status of prevention strategies in Asia as well as recommendations for future actions are discussed. The total number of deaths due to road accidents in the 24 Asian countries, encompassing 56% of the total world population, is 750,000 per year (statistics 2010). The total number of injuries is more than 50 million, of which 12% are hospital admissions. The loss to the economy in the 24 Asian countries is estimated to around US$800 billion or 3.6% of the gross domestic product (GDP).

Conclusions: This article clearly shows that road safety is causing large problems and high costs in Asia, with an enormous impact on the well-being of people, economy, and productivity. In many Asian low- and middle-income countries, the yearly number of fatalities and injuries is increasing. Vulnerable road users (pedestrians, cyclists, and motorcyclists combined) are particularly at risk. Road safety in Asia should be given rightful attention, including taking powerful, effective actions. This review stresses the need for reliable accident data, because there is considerable underreporting in the official statistics. Reliable accident data are imperative to determine evidence-based intervention strategies and monitor the success of these interventions and analyses. On the other hand, lack of good high-quality accident data should not be an excuse to postpone interventions. There are many opportunities for evidence-based transport safety improvements, including measures concerning the 5 key risk factors: speed, drunk driving, not wearing motorcycle helmets, not wearing seat belts, and not using child restraints in cars, as specified in the Decade of Action for Road Safety 2011–2020. In this commentary, a number of additional measures are proposed that are not covered in the Decade of Action Plan. These new measures include separate roads or lanes for pedestrians and cyclists; helmet wearing for e-bike riders; special attention to elderly persons in public transportation; introduction of emerging collision avoidance technologies, in particular automatic emergency braking (AEB) and alcohol locks; improved truck safety focusing on the other road user (including blind spot detection technology; underride protection at the front, rear, and side; and energy-absorbing fronts); and improvements in motorcycle safety concerning protective clothing, requirements for advanced braking systems, improved visibility of motorcycles by using daytime running lights, and better guardrails.     

Road accident fatality risks for “vulnerable” versus “protected” road users in northern Ghana

Background: Road traffic injuries (RTIs) are a serious epidemic that claims more than a million lives across the globe each year. The burden of RTIs is particularly pronounced in Africa and other low- and middle-income countries. The unfavorable disparity of the burden of road trauma in the world is largely attributable to unsafe vehicles, lack of appropriate road infrastructure, and the predominance of vulnerable road users (VRUs) in developing countries. However, little research exists in northern Ghana to highlight the scale and risk of death among road users.

Objective: The objective of this research was to establish the relative risk of death among road users in northern Ghana.

Methods: Crash data from police reports between 2007 and 2011 were analyzed for the Upper Regions of Ghana. Conditional probabilities and multivariable logistic regression techniques were used to report proportions and adjusted odds ratios (AORs), respectively.

Results: Generally, crashes in northern Ghana were extremely severe; that is, 35% of all injury related collisions were fatal. The proportion of fatal casualties ranged between 21% among victims of sideswipe collisions and 41% among pedestrians and victims of rear-end collisions. Though males were 6 times more likely to die than females overall, females were more likely to die as pedestrians (90% of all female casualty deaths) and males were more likely to die as riders/drivers (78% of all male casualty deaths). Pedestrians were 3 times more likely to die (odds ratio [OR] = 3.1; 95% confidence interval [CI], 2.4 to 4.1) compared with drivers/riders. Compared with drivers, the odds of death among cyclists was about 4 times higher (AOR = 3.6; 95% CI, 2.3 to 5.6) and about 2 times higher among motorcyclists (AOR = 1.6; 95% CI, 1.2 to 2.2). Compared with casualties aged between 30 and 59 years, children under 10 years and those aged 60 years and above were independently 2 times more likely to die in traffic collisions.

Conclusion: Provision of requisite road infrastructure is vital for the safety of VRUs in northern Ghana. Cycle paths and lanes (for cyclists) as well as sidewalks (for pedestrians) in particular will separate VRUs from motorists and improve their safety. Enforcement of traffic laws particularly regarding helmet use, speeding, and alcohol use will be beneficial. Introduction of the demerit points system in the enforcement of traffic regulations may have significant deterrent effects on road users who have the penchant for violating traffic regulations. Road safety education is also required to create responsible road users.     

Predicting bicycle helmet wearing intentions and behavior among adolescents

INTRODUCTION: Cycling accidents in Australia, especially those resulting in head injuries, are a substantive cause of death and disability; but despite legislation and evidence that helmets reduce the risk of head injury, few adolescents wear them. METHOD: This study employed a revised version of the Theory of Planned Behavior (TPB; [Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211]) to investigate the determinants of helmet use among a sample of adolescents. Participants in the initial data collection were 294 high school students in Year 8 and Year 11, with 266 completing a follow-up questionnaire measuring behavior over the previous two weeks. RESULTS: Social norms, perceptions of control, and past behavior significantly predicted intentions to use helmets and perceptions of control and past behavior predicted actual helmet use. CONCLUSIONS: Strengthening the routine of helmet use and building young people's confidence that they can overcome any perceived barriers to helmet use will improve adherence to helmet wearing behavior.     

Bicycle helmet use among persons 5 years and older in the United States, 2012

IntroductionIn 2013, injuries to bicyclists accounted for 925 fatalities and 493,884 nonfatal, emergency department-treated injuries in the United States. Bicyclist deaths increased by 19% from 2010 to 2013. The greatest risk of death and disability to bicyclists is head injuries. The objective of this study was to provide estimates of prevalence and associated factors of bicycle riding and helmet use among children and adults in the United States.MethodCDC analyzed self-reported data from the 2012 Summer ConsumerStyles survey. Adult respondents (18 + years) were asked about bicycle riding and helmet use in the last 30 days for themselves and their children (5 to 17 years). For bicycle riders, CDC estimated the prevalence of helmet use and conducted multivariable regression analyses to identify factors associated with helmet use.ResultsAmong adults, 21% rode bicycles within the past 30 days and 29% always wore helmets. Respondents reported that, of the 61% of children who rode bicycles within the past 30 days, 42% always wore helmets. Children were more likely to always wear helmets (90%) when their adult respondents always wore helmets than when their adult respondents did not always wear helmets (38%). Children who lived in states with a child bicycle helmet law were more likely to always wear helmets (47%) than those in states without a law (39%).ConclusionsDespite the fact that bicycle helmets are highly effective at reducing the risk for head injuries, including severe brain injuries and death, less than half of children and adults always wore bicycle helmets while riding.Practical applicationStates and communities should consider interventions that improve the safety of riding such as policies to promote helmet use, modeling of helmet wearing by adults, and focusing on high risk groups, including Hispanic cyclists, occasional riders, adults, and children ages 10 to 14.     

基于改进的YOLOv4安全帽佩戴检测研究

为了加强建筑工人佩戴安全帽情况的检测,防止安全事故的发生,提出1种改进的轻量级YOLOv4安全帽佩戴检测算法,用于运行在移动设备端,降低现场部署的条件;制作1个8 000幅图像的数据集,用于训练和评估安全帽检测算法;为了评估改进的YOLOv4的性能,从5个不同建筑工地采集到600张施工人员图像和60条施工视频作为验证集;根据建筑工地不同的视觉条件对图像进行分类,用于验证本文算法在不同外界环境下的性能。结果表明:改进后的模型检测速度是YOLOv4的3.4倍,可用于实时检测施工人员在不同施工现场条件下是否佩戴安全帽的情况,有利于提高安全检查和监督水平。     

The determinants of motorcyclists helmet use: Urban arterial road in Khon Kaen City,Thailand

IntroductionCurrently, Thailand incurs the highest death toll of motorcyclists in the world. The aim of this study was to explore the factors influencing helmet use of motorcyclists in Khon Kaen City, Thailand by using the Logistic regression analysis.MethodThe samples, consisting of 27,977 riders and 6,947 riding passengers, were collected by CCTV installed at several signalized intersections along urban arterial roads.ResultsThe observation results reveal that only 67% of motorcyclists wore the helmets. The analysis results reveal that the helmet use of motorcyclists was significantly associated with the riding status, number of passengers, apparent age, motorcycle class, time of day, the presence of police booths at intersections and, especially, red light running behavior. The riders tended to wear helmets at 2.7 times higher rates than passengers. Adult motorcyclists tended to wear the helmets at 2.8 times higher rates than children. The motorcyclists riding the motorcycles over 125 cc tended to wear the helmets 1.9 times higher than those riding motorcycles under 125 cc. The motorcyclists riding in the morning and the afternoon tended to wear the helmets 5.0 and 3.8 times higher than in the evening. The motorcyclists riding through intersections with police booths tended to wear the helmets 2.2 times higher than those riding through intersection without police booths. However, the red light running riders intend to wear the helmets 0.6 times less than the legal riders.ConclusionsThe outcome of this study could determine the factors influencing motorcyclist's helmet use.Practical ImplicationsIt will be useful for a development of 100% helmet use program designed to lessen the fatality of motorcyclists along the urban arterial roads.     

Measurement method for objective cyclist behavior parameters

Abstract

Objective: The objective of this research is to study the feasibility of measuring behavioral indicators that reflect effects of infrastructure and interaction with other road users.

Methods: An observation study was performed using 6 cameras above a separated cycle path next to a road which included a crossing with both cyclists and cars. A learning method based on Single Shot MultiBox Detector was applied to automatically detect the cyclists, and cyclist tracks were determined. Next, kinematic parameters were calculated from the cyclists’ tracks. Amongst others, the cyclists’ intensity, speed, position on the cycle path, and the distance to each other were analyzed for a busy period as well as for a quiet period of the day.

Results: With the measurement method developed in this study it is possible to analyze the cyclists’ intensity, the space they use at the cycle path, their average velocity, waiting times, the space and velocity amongst each other, and red light negation. However, collisions were not seen in the dataset analyzed, and the data is not sufficiently accurate to analyze sudden braking actions.

Conclusion: It can be concluded that the developed measurement method provides insight of the cyclists’ behavior in such a way that it can already be used for obtaining information to make changes to the infrastructure that will improve the comfort and safety of cyclists. The method could be further developed for doing qualitative comfort and safety analyses, and for doing analyses of the interaction between various types of road participants.     

Risk compensation? The relationship between helmet use and cycling speed under naturalistic conditions

Introduction: An argument against mandatory helmet use is based on the idea of risk compensation, which means that cyclists might ride faster when wearing a helmet (Lardelli-Claret et al., 2003). However, questionnaire and experimental studies were unable to find evidence for this assumption (Fyhri et al., 2012; Fyhri & Philipps, 2013). Simultaneously, other factors with a potential role in helmet use and cycling speed, such as trip length and rider characteristics have been neglected in such considerations. The goal of the analysis presented in this paper was therefore to investigate the relationship between helmet use and cycling speed under naturalistic conditions while taking characteristics of cyclists and bicycles into account. Method: As part of a naturalistic cycling study, we equipped the bicycles of conventional and e-bike riders with data acquisition systems to record speed and trip distance. It included two cameras (one for the face of the participant, another one for the forward scenery). For the analysis presented in this paper, we used the data of 76 participants (28 conventional bicycles, 48 e-bikes). Results: In total, participants used their helmet for 56% of all trips. Helmets were used more frequently for longer trips. A linear mixed model, in which trip length, helmet use, bicycle type, age, and gender were used as predictors showed that helmet use did not play a significant role for cycling speed. Instead, all other factors that were analyzed, with the exception of gender, had a significant relationship to cycling speed. Discussion: The assumption of risk compensation as a result of the use of a helmet could not be confirmed. Instead, the findings seem to support the suggestion that cyclists who undertake trips at potentially higher speed levels are aware of their increased risk, and actively try to reduce it through the use of a helmet.     

Analysis of recent trends in bus and coach safety in Britain

We examine in detail trends from 1966 to 1990 and the fitting of statistical models to assess whether significant changes have taken place in casualty rates since local bus deregulation in 1986.The major source of data is the ‘Stats 19’ collated from police reports by the Department of Transport.The evidence indicates that no significant change in casualty rates for bus and coach occupants (defined as those killed or seriously injured) has occurred since local bus deregulation, although the previous trend of reduction in fatality rates has not been maintained.International comparisons have been made between Britain and a sample of other West European countries. Britain appears to have a higher occupant fatality rate. However, other countries′ data do not always include casualties to bus and coach occupants other than those in which vehicular collisions occur. Better comparative data is available for accidents involving buses and coaches with other road users, notably for Britain and Germany. These suggest that such accidents tend to reflect the national pattern of road casualty rates — for example, Germany has a higher level of collisions between buses and coaches, and other road vehicles, while Britain has a relatively high incidence of casualties involving pedestrians.Differences in accident rates between Britain and other European countries and the extent to which they reflect real differences, as distinct from those due to differences in recording of data, are evaluated, along with policy implications.     

A 6-year survey of road traffic accidents in Southwest China: Emphasis on traumatic brain injury

Background: The objective of this study is to provide an up-to-date overview of the patterns of injuries, especially traumatic brain injury (TBI) caused by RTAs and to discuss some of the public health consequences. Methods: A scientific team was established to collect road traffic accidents occurring between 2013 and 2018 in Chongqing, Southwest China. For each accident, the environment-, vehicle-, and person- variables were analyzed and determined. The overall injury distribution and TBI patterns of four types of road users (driver, passenger, motorcyclist and pedestrian) were compared. The environmental and time distribution of accidents with TBI were shown by bar and pie chart. The risks of severe brain injury whether motorcyclist wearing helmets or not were compared and the risk factors of severe TBI in pedestrian were determined by odds ratio analysis. Results: This study enrolled 2131 accidents with 2741 persons of all kind of traffic participants, 1149 of them suffered AIS1+ head injury and 1598(58%) died in 7 days. The most common cause of deaths is due to head injury with 714(85%) and 1266(79%) persons died within 2 hours. Among 423 persons suffered both skull fracture and intracranial injury, 102 (24.1%) have an intracranial injury but no skull fractures, while none of the skull fractures without intracranial injury was found. Besides, motorcyclists without a helmet were at higher risks for all the brain injury categories. The risk of pedestrian suffering severe TBI at an impact speed of more than 70 km/h is 100 times higher than that with an impact speed of less than 40 km/h. Conclusion: It is urgently needed to develop a more reliable brain injury evaluation criterion for better protection of the road users. We believe that strengthening the emergency care to head injury at the scene is the most effective way to reduce traffic fatality.     

Are you an ambitious cyclist? Results of the cyclist profile questionnaire in Germany

Abstract

Objective: A number of studies have already grouped cyclists according to different aspects of their mobility behavior. This could be used e.g., to improve the bicycle infrastructure planning, to detect critical spots and, to reduce obstacles for cycling. This wide, preexisting, range of cyclist typologies usually concentrates on one or two influence factors and differs, content-wise, in both factors used, as well as, methodically. Based on existing cyclist typologies we extracted all possible influence factors to integrate them in one single questionnaire. The objective of this study, using an empirical, based approach, is to compare this typology of cyclists with existing ones, integrating all known influence factors of recent studies.

Methods: To address these issues, we conducted a Germany-wide online survey on cycling behavior, covering all relevant aspects we derived from both literature and especially, former cyclist typology studies including: social factors; the impact of environmental, individual; and route factors; as well as motives. The main goal was to identify distinct types of cyclists, and describe them as detailed as possible. The heterogeneous sample included a total of 10,294 responses.

Results: Using factor and cluster analyses, a multidimensional typology with four groups of cyclists was derived which were interpreted as: ambitious, functional, pragmatic, and passionate cyclists. In addition, socio-economic factors, cyclist’s motivation, and crash history were analyzed.

Conclusion: The results produced by grouping different characteristics of cyclists can lead to policy recommendations or communal bicycle traffic planning. Policy planners can estimate reactions of the different types on interventions and adjust their decisions which can serve to support already passionate cyclists or, encourage normally under-represented infrequent cyclists to cycle more. The extent of perceived safety plays here an important role in the classification, e.g., the handling of high-risk areas for crashes.     

Record linkage for road traffic injuries in Ireland using police hospital and injury claims data

IntroductionThe study of non-fatal road traffic injuries is growing in importance. Since there are rarely comprehensive injury datasets, it is necessary to combine different sources to obtain better estimates on the extent and nature of the problem. Record linkage is one such technique.MethodIn this study, anonymized datasets from three separate sources of injury data in Ireland: hospitals, police, and injury claims are linked using probabilistic and deterministic linkage techniques. A method is proposed that creates a ‘best’ set of linked records for analysis, useful when clerical review of undecided cases is not feasible.ResultsThe linkage of police and hospital datasets shows results that are similar to those found in other countries, with significant police understatement especially of cyclist and motorcyclist injuries. The addition of the third dataset identifies a large number of additional injuries and demonstrates the error of using only the two main sources for injury data.Practical applicationThe study also underlines the risk in relying on the Lincoln–Petersen capture–recapture estimator to provide an estimate of the total population concerned.ConclusionThe data show that road traffic injuries are significantly more numerous than either police or hospital sources indicate. It is also argued that no single measure can fully capture the range of impacts that a serious injury entails.     

Fatal and serious collisions involving pedal cyclists and trucks in London between 2007 and 2011

Objective: Increased numbers of people riding pedal cycles have led to a greater focus on pedal cycle safety. The aim of this article is to explore factors that are associated with fatal and a small number of serious-injury pedal cyclist crashes involving trucks that occurred in London between 2007 and 2011.

Methods: Data were collected from police collision files for 53 crashes, 27 of which involved a truck (≥3.5 tonnes) and a pedal cycle. A systematic case review approach was used to identify the infrastructure, vehicle road user, and management factors that contributed to these crashes and injuries and how these factors interacted.

Results: Trucks turning left conflicting with pedal cyclists traveling straight ahead was a common crash scenario. Key contributory factors identified included the pedal cyclists not being visible to the truck drivers, road narrowing, and inappropriate positioning of pedal cyclists.

Conclusions: Crashes involving trucks and pedal cyclists are complex events that are caused by multiple interacting factors; therefore, multiple measures are required to prevent them from occurring.     

Motorcycle helmet use in Calicut,India: User behaviors,attitudes, and perceptions

Objectives: The objectives of this study include assessing the motorcycle helmet use pattern in Calicut, India, and analyzing the factors influencing helmet use including motorcyclists' perceptions.

Methods: Field observational studies at 15 locations were conducted to determine the helmet use rate among motorcyclists and pillion passengers. A structured questionnaire interview survey was conducted with 709 motorcyclists to evaluate the users' perceptions and opinions regarding the use of motorcycle helmets.

Results: There was a considerable difference in the level of motorcycle helmet use observed between the locations within and outside the city limits, where different levels of helmet law enforcement were exercised. The helmet use was observed at a maximum of 89% within the city and a minimum of 23% in some locations outside the city. The decreasing percentage of helmet use while moving toward the locations outside the city was confirmed statistically through t tests (t = 1.771, df = 13, P < .05). It was found that only 42% of users revealed that helmets are comfortable and 42% expressed that helmets affect hearing ability. It is important to note that 57% of users are of the opinion that there is no need to use a helmet if you drive slowly and carefully. The price of the helmet was not a deterrent for helmet use. In addition, it was observed that only 45% of helmets used by the motorist were standard helmets with an Indian Standards Institute (ISI) mark.

Conclusion: The widely varying helmet use pattern observed in the study area may be attributed due to the users' behaviors; that is, using a helmet only when the helmet law is strictly enforced rather than using a helmet as a protective device. Further, some of the problems and beliefs associated with helmet use prevent motorcyclists from using a helmet. Hence, the road safety of motorcyclists can be improved only through addressing the identified measures comprehensively.