SAFEST TO TRAVEL BY BICYCLE,CAR, OR BIG TRUCK?

This study compares highway crash incidence, injuries, and costs by vehicle type. Annual crash and injury incidence were estimated using Crashworthiness Data System (1988-1991), National Automotive Sampling System (1982-1986), General Estimates System (1992-1993), and Fatal Analysis Reporting System (1993) data. Costs were computed based on restraint use, body region, and threat-to-life severity of the injury. Costs were then allocated between vehicle types using three different methods in order to answer comparative safety questions. Motor vehicle and bicycle crash costs total $389 billion annually; 75% resulting from passenger vehicles. Motorcycles and bicycles have the highest costs per 1000 vehicle and passenger miles; costs per victim are highest for pedestrians, bicyclists, and motorcyclists. Costs per vehicle mile for heavy trucks and passenger cars are comparable but exceed costs for light trucks. Passenger vehicle occupants are safest if a crash occurs. Light truck, other single truck, and bus occupants have the lowest cost per passenger mile, but higher costs than air and rail travelers. Motorcyclists face the greatest risks. Combination trucks may not impose an excess risk to other drivers, but their drivers face large risks.     

A virtual test system representing the distribution of pedestrian impact configurations for future vehicle front-end optimization

Objectives: The purpose of this study is to define a computationally efficient virtual test system (VTS) to assess the aggressivity of vehicle front-end designs to pedestrians considering the distribution of pedestrian impact configurations for future vehicle front-end optimization. The VTS should represent real-world impact configurations in terms of the distribution of vehicle impact speeds, pedestrian walking speeds, pedestrian gait, and pedestrian height. The distribution of injuries as a function of body region, vehicle impact speed, and pedestrian size produced using this VTS should match the distribution of injuries observed in the accident data. The VTS should have the predictive ability to distinguish the aggressivity of different vehicle front-end designs to pedestrians.

Methods: The proposed VTS includes 2 parts: a simulation test sample (STS) and an injury weighting system (IWS). The STS was defined based on MADYMO multibody vehicle to pedestrian impact simulations accounting for the range of vehicle impact speeds, pedestrian heights, pedestrian gait, and walking speed to represent real world impact configurations using the Pedestrian Crash Data Study (PCDS) and anthropometric data. In total 1,300 impact configurations were accounted for in the STS. Three vehicle shapes were then tested using the STS. The IWS was developed to weight the predicted injuries in the STS using the estimated proportion of each impact configuration in the PCDS accident data. A weighted injury number (WIN) was defined as the resulting output of the VTS. The WIN is the weighted number of average Abbreviated Injury Scale (AIS) 2+ injuries recorded per impact simulation in the STS. Then the predictive capability of the VTS was evaluated by comparing the distributions of AIS 2+ injuries to different pedestrian body regions and heights, as well as vehicle types and impact speeds, with that from the PCDS database. Further, a parametric analysis was performed with the VTS to assess the sensitivity of the injury predictions to changes in vehicle shape (type) and stiffness to establish the potential for using the VTS for future vehicle front-end optimization.

Results: An STS of 1,300 multibody simulations and an IWS based on the distribution of impact speed, pedestrian height, gait stance, and walking speed is broadly capable of predicting the distribution of pedestrian injuries observed in the PCDS database when the same vehicle type distribution as the accident data is employed. The sensitivity study shows significant variations in the WIN when either vehicle type or stiffness is altered.

Conclusions: Injury predictions derived from the VTS give a good representation of the distribution of injuries observed in the PCDS and distinguishing ability on the aggressivity of vehicle front-end designs to pedestrians. The VTS can be considered as an effective approach for assessing pedestrian safety performance of vehicle front-end designs at the generalized level. However, the absolute injury number is substantially underpredicted by the VTS, and this needs further development.     

Railroad injury: Causes, costs, and comparisons with other transport modes

Safety regulators in the railroad industry need comprehensive injury costs by cause, and cost comparisons to other modes of transport to gain policy insights. This study links case-level data from the Federal Railroad Administration to monetary costs and consequences of specific injuries. Lost quality of life was estimated from physicians' ratings of injury impairment and the value of fatal risk reduction. Railroad injuries and illnesses cause an average of $3 billion in fatality costs and $650 million in nonfatal incident costs annually. Impacts at rail-highway crossings impose three times as much cost as the next highest cause. Commercial air travel is the safest per passenger mile. Trains, second lowest, have injury costs six times higher, but only one-fifth as high as cars. The relative safety of trains and airplanes in transport means highway modes enjoy implicit price subsidies. Better injury cost recovery through taxation or insurance would make the subsidies explicit. More informed modal choices and thus enhanced economic efficiency would result.     

Personal injury recovery cost of pedestrian–vehicle collisions in New South Wales,Australia

Background: There is a need for routine estimates of injury recovery costs from pedestrian collisions using hospital separation records for economic evaluations.

Objective: To estimate the cost of injury recovery following pedestrian–vehicle collisions using the personal injury recover cost (PIRC) equation using key demographic and injury characteristics.

Method: An estimation of the costs of on-road pedestrian–vehicle collisions involving individuals who were injured and hospitalized in New South Wales (NSW), Australia, from 2002 to 2011 using the PIRC equation. The PIRC estimates individual injury recovery costs and does not include costs associated with property damage, vehicle repair, or rescue services. Individual recovery costs associated with severe traumatic brain injury (TBI) were estimated. The injured individual's mean, median, and total injury recovery costs are described for key demographic, injury, and crash characteristics.

Results: There were 9,781 pedestrians who were injured, costing an estimated total of $2.4 billion in personal injury recovery costs, an annual cost of $243 million. Males had a total injury recovery cost 1.7 times higher than females. The median injury recovery cost decreased with increasing age. TBI ($248,491) and spinal cord and vertebral column injuries ($264,103) had the highest median injury recovery costs for the body region of the most severe injury. TBI accounted for 22.6% of the total injury recovery costs for the most severe injury sustained. Just over one third of pedestrians sustained 4 or more injuries, with a median cost of $243,992, which was 1.6 times higher than the cost for a pedestrian who sustained a single injury ($153,682).

Conclusions: Personal injury recovery costs following pedestrian–vehicle collisions where a pedestrian is injured are substantial in NSW. The PIRC equation enables the economic cost burden of road traffic injury to be calculated using hospital separation data. The PIRC enables comprehensive personal injury recovery costs to be estimated and would aid in economic evaluations of preventive strategies in road safety.     

Non-occupational injuries caused by transport packaging: Residential and retail hazards

BackgroundBackground: Pallets are key components of domestic supply chains, and yet present unique hazards when used by homeowners and retailers for unintended uses. No previous works have investigated non-occupational injuries that occur due to unintentional contact with pallets. This study sought to describe the incidence and epidemiology of non-occupational pallet-related injuries as seen in United States emergency departments (EDs). Method: The National Electronic Injury Surveillance System database was used to derive national, weighted estimates of pallet-related injuries by age, sex, injured body part, and location where injury occurred. Data for the years 2014 to 2018 were analyzed with all relevant narratives reviewed. Results: From 2014 to 2018, there were an estimated 30,493 persons who visited an ED for a pallet-related injury. The yearly incidence of pallet injuries rose during this period. The 35–44 age group (n = 5,481) was most likely to be injured, but about 3,000 children and youth under 18 years of age were injured and more than 4,000 persons 65 years of age or older suffered injuries. The elderly were especially likely to suffer injuries from slip, trip and fall incidents. The lower extremities were the most commonly injured body parts. An estimated 3,964 persons, accounting for approximately 14% of all pallet-related injuries, were treated for injuries incurred while at a retail establishment. African Americans, Hispanics, and the elderly appeared to be disproportionately more likely to have pallet-related injuries in retail locations. Conclusions: Non-occupational pallet-related injuries affect a wide range of patients and cause a variety of injuries, with the elderly being especially vulnerable to tripping incidents. Retailer prevention strategies should focus on the misuse of pallets for merchandising purposes. Industry should maintain control of pallets so they are not used for unintended purposes. Practical applications: Retailers should limit the use of pallets for floor-level merchandising purposes and remove pallets from customer-facing locations where unintentional contact could occur. Owners of pallets should maintain them in a controlled supply chain so that they don’t leak out into the hands of homeowners. Policy-makers should educate the public about the dangers of used pallets.     

Assessment of medical care costs of injuries due to alcohol-related motor vehicle crashes

The purpose of this study was to estimate the total medical care costs of individuals injured in motor vehicle crashes and in crashes where alcohol was involved. Crashes were studied that involved 2,728 vehicle occupants and 191 pedestrians with injuries as reported in 1979 by the National Accident Sampling System, a probability sample of all motor vehicle crashes occurring in the united States. Medical care costs were assigned by using Abbreviated Injury Scale codes in accordance with other published research. Determination of alcohol involvement was based on crash characteristics. Results indicate that 20.2 % of medical care costs for motor vehicle crash injuries may be due to crashes where alcohol was involved. It was estimated that alcohol-related motor vehicle crashes cost between $434 million and $483 million in medical care alone in the United States in 1979.     

Work-related deaths in Washington State, 1998-2002

INTRODUCTION: In Washington State, 87 workers are killed each year, on average, while in work status. To understand these incidents and to assist in focusing on and development of potential prevention measures, they must be well characterized. METHODS: Work-related fatalities between the years 1998 and 2002 are described by the demographics of the victims, types of incidents, the victims' occupations, and industries and location in which they worked. RESULTS: Motor vehicle- and machinery-related incidents accounted for nearly 33% and 14% of the incidents, respectively. Agriculture, forestry, fishing, hunting, and mining (n=87), and construction (n=83) had the most fatalities. Fatality rates per 100,000 workers for these industries were 25.7 and 8.7, respectively, compared to the state-wide average of 3.1 fatalities/100,000 workers. DISCUSSION: These data indicate numerous areas for prevention of work-related traumatic injuries and fatalities.     

Severity of passenger injuries on public buses: A comparative analysis of collision injuries and non-collision injuries

Introduction: Although public buses have been demonstrated as a relatively safe mode of transport, the number of injuries to public bus passengers is far from negligible. Existing studies of public bus safety have focused primarily on injuries caused by collisions. Surprisingly, limited effort has been devoted to identifying factors that increase the severity of passenger injuries in non-collision incidents. Method: Our study therefore investigated the injury risk of public bus passengers involved in collision incidents and non-collision incidents comparatively, based on a police-reported dataset of 17,383 passengers injured on franchised public buses over a 10-year period in Hong Kong. A random parameters logistic model was established to estimate the likelihood of fatal and severe injuries to passengers as a function of various factors. Results: Our results indicated substantial inconsistences in the effects of risk factors between models of non-collision injuries and collision injuries. The severity of passenger injuries tended to increase significantly when non-collision incidents occurred due to excessive speed of bus drivers, on double-decker buses, in less urbanized areas, in winter, in heavy rains, during daytime, and at night without street lighting. Elderly female passengers were also found more likely to be fatally or severely injured in non-collision incidents if they lost their balance while boarding, alighting from, or standing on a bus. In comparison, the following factors were associated with a greater likelihood of fatal or severe injuries in collision incidents: elderly female passengers, standing passengers who lost balance, buses out of driver control, double-decker buses, collisions with vehicles or objects, and less urbanized areas. Practical Applications: Based on our comparative analysis, more targeted countermeasures, namely “4E” (engineering, enforcement, emergency, and education) and “3A” (awareness, appreciation, and assistance), were recommended to mitigate collision injuries and non-collision injuries to public bus passengers, respectively.     

Physical,psychological and economic burden of two-wheel users after a road traffic injury: Evidence from intensive care units of three EU countries

Introduction: This study aimed to assess the physical, psychological, and economic burden shouldered by severely injured two-wheel users in three European countries as well as the cost resulting from their hospitalization. Methods: A total of seven public hospitals were involved in three countries: Greece, Italy, and Germany. Participants enrolled during a 12-month period starting in April 2013. Eligibility criteria included an injury sustained at Road Traffic Crashes (RTC) irrespective of the type of vehicle, hospitalization 1 day in the Intensive Care Unit (ICU) or sub-ICU, and age 18 years or over. Patients were interviewed at 1, 6, and 12 months upon admission. The study used widely recommended classifications for injury severity (Abbreviated Injury Severity [AIS]; Maximum Abbreviated Injury Severity [MAIS]) and standardized measures such as the Disability Assessment Schedule II (WHODAS 2.0), “Impact of Event Scale” (IES-R), Center for Epidemiological Studies Depression Scale (CES-D Scale). Health Care Expenditure was assessed through the Monash University Accident Research Centre (MUARC's) framework, which included measures of ‘Direct’ and ‘Indirect’ costs. Diagnosis-related groups (DRGs) were used to estimate hospitalization costs. Results: A total of 54 two-wheel users enrolled in the study in all the countries and 32 completed all follow-up questionnaires. Physical disability increased over 12 months following the injury. Post Traumatic Stress Disorder (PTSD) symptoms of avoidance remained at high levels over the study period. PTSD symptoms of intrusion improved significantly during the second half of the year under investigation. The total annual cost of injury for the two-wheel users who were hospitalized in the selected ICU of all the partner countries for severe injury in 2013/2014, was estimated at €714,491 made up of €123,457 direct and €591,034 indirect costs. Men, aged 50–64 years and those who sustained slight injuries primarily at the lower extremities presented higher indirect costs per person. A total of €1032.092 was spent on hospitalization payments. Women, aged 65 + and those who sustained severe injuries at the central body region presented higher direct costs per person. Women, aged 50–64 years, those with severe injuries and a major injury at the central body and the upper body region presented the highest hospitalization costs per person. Conclusions: There is a need for effective strategies to early detect and treat groups at risk of being confronted with prolonged psychosocial and economic consequences. Practical implications: A holistic understanding of the impact of injury on individuals is important in order to achieve effective treatment of psychological co-morbidities in a timely manner.     

The direct cost burden of 13 years of disabling workplace injuries in the U.S. (1998–2010): Findings from the Liberty Mutual Workplace Safety Index

Introduction: Although occupational injuries are among the leading causes of death and disability around the world, the burden due to occupational injuries has historically been under-recognized, obscuring the need to address a major public health problem. Methods: We established the Liberty Mutual Workplace Safety Index (LMWSI) to provide a reliable annual metric of the leading causes of the most serious workplace injuries in the United States based on direct workers compensation (WC) costs. Results: More than $600 billion in direct WC costs were spent on the most disabling compensable non-fatal injuries and illnesses in the United States from 1998 to 2010. The burden in 2010 remained similar to the burden in 1998 in real terms. The categories of overexertion ($13.6B, 2010) and fall on same level ($8.6B, 2010) were consistently ranked 1st and 2nd. Practical application: The LMWSI was created to establish the relative burdens of events leading to work-related injury so they could be better recognized and prioritized. Such a ranking might be used to develop research goals and interventions to reduce the burden of workplace injury in the United States.     

Cervical and thoracic spine injury in pediatric motor vehicle crash passengers

Objective: Motor vehicle occupants aged 8 to 12 years are in transition, in terms of both restraint use (booster seat or vehicle belt) and anatomical development. Rear-seated occupants in this age group are more likely to be inappropriately restrained than other age groups, increasing their vulnerability to spinal injury. The skeletal anatomy of an 8- to 12-year-old child is also in developmental transition, resulting in spinal injury patterns that are unique to this age group. The objective of this study is to identify the upper spine injuries commonly experienced in the 8- to 12-year-old age group so that anthropomorphic test devices (ATDs) representing this size of occupant can be optimized to predict the risk of these injuries.

Methods: Motor vehicle crash cases from the National Trauma Data Bank (NTDB) were analyzed to characterize the location and nature of cervical and thoracic spine injuries in 8- to 12-year-old crash occupants compared to younger (age 0–7) and older age groups (age 13–19, 20–39).

Results: Spinal injuries in this trauma center data set tended to occur at more inferior vertebral levels with older age, with patients in the 8- to 12-year-old group diagnosed with thoracic injury more frequently than cervical injury, in contrast to younger occupants, for whom the proportion of cases with cervical injury outnumbered the proportion of cases with thoracic injury. With the cervical spine, a higher proportion of 8- to 12-year-olds had upper spine injury than adults, but a substantially lower proportion of 8- to 12-year-olds had upper spine injury than younger children. In terms of injury type, the 8- to 12-year-old group’s injury patterns were more similar to those of teens and adults, with a higher relative proportion of fracture than younger children, who were particularly vulnerable to dislocation and soft tissue injuries. However, unlike for adults and teens, catastrophic atlanto-occipital dislocations were still more common than any other type of dislocation for 8- to 12-year-olds and vertebral body fractures were particularly frequent in this age group.

Conclusions: Spinal injury location in the cervical and thoracic spine moved downward with age in this trauma center data set. This shift in injury pattern supports the need for measurement of thoracic and lower cervical spine loading in ATDs representing the 8- to 12-year-old age group.     

Differences in Long-term Medical Consequences Depending on Impact Direction Involving Passenger Cars

Objective: There is limited knowledge of the long-term medical consequences for occupants injured in car crashes in various impact directions. Thus, the objective was to evaluate whether injuries leading to permanent medical impairment differ depending on impact direction.

Methods: In total, 36,743 injured occupants in car crashes that occurred between 1995 and 2011 were included. All initial injuries (n = 61,440) were classified according to the Abbreviated Injury Scale (AIS) 2005. Injured car occupants were followed for at least 3 years to assess permanent medical impairment. The data were divided into different groups according to impact direction and levels of permanent impairment. The risk of permanent medical impairment was established for different body regions and injury severity levels, according to AIS.

Results: It was found that almost 12% of all car occupants sustained a permanent medical impairment. Given an injury, car occupants involved in rollover crashes had the highest overall risk to sustain a permanent medical impairment. Half of the head injuries leading to long-term consequences occurred in frontal impacts. Far-side occupants had almost the same risk as near-side occupants. Occupants who sustained a permanent medical impairment from cervical spine injuries had similar risk in all impact directions (13%) except from rollover (17%). However, these injuries occurred more often in rear crashes. Most of the injuries leading to long-term consequences were classified as minor injuries by AIS for all impact directions.

Conclusions: Studying crash data from a perspective of medical impairment is important to identify injuries that might not be prioritized only considering the AIS but might lead to lower quality of life for the occupant and also costs for society. These results can be used for road transport system strategies and for making priority decisions in vehicle design.     

Analysis of injury mechanism of the elderly and non-elderly groups in minor motor vehicle accidents

Abstract

Objective: The purpose of this study is to investigate the injury patterns of noncatastrophic accidents by individual age groups.

Methods: Data were collected from the Korean In-Depth Accident Study database based on actual accident investigation. The noncatastrophic criteria were classified according to U.S. experts from the Centers for Disease Control and Prevention’s recommendations for field triage guidelines of high-risk automobile crash criteria by vehicle intrusions more than 12 in. on occupant sites (including the roof) and more than 18 in. on any site. The Abbreviated Injury Scale (AIS) was used to determine injury patterns for each body region. Severely injured patients were classified as Maximum Abbreviated Injury Scale (MAIS) 3 or higher.

Results: In this study, the most significant injury regions were the head and neck, extremities, and thorax. In addition, the incidence of severe injury among elderly patients was nearly 1.6 times higher than that of non-elderly patients. According to age group, injured body regions among the elderly were the thorax, head and neck, and extremities, in that order. For the non-elderly groups, these were head and neck, extremities, and thorax. Severe injury rates were slightly different for the elderly group (head and neck, abdomen) and non-elderly group (thorax, head and neck).

Conclusions: In both age groups, the rate of severe injury is proportional to an increase in crush extent zone. Front airbag deployment may have a relatively significant relationship to severe injuries.     

A research model--forecasting incident rates from optimized safety program intervention strategies

INTRODUCTION/PROBLEM: Property damage incidents, workplace injuries, and safety programs designed to prevent them, are expensive aspects of doing business in contemporary industry. The National Safety Council (2002) estimated that workplace injuries cost $146.6 billion per year. Because companies are resource limited, optimizing intervention strategies to decrease incidents with less costly programs can contribute to improved productivity. METHOD: Systematic data collection methods were employed and the forecasting ability of a time-lag relationship between interventions and incident rates was studied using various statistical methods (an intervention is not expected to have an immediate nor infinitely lasting effect on the incident rate). RESULTS/SUMMARY: As a follow up to the initial work, researchers developed two models designed to forecast incident rates. One is based on past incident rate performance and the other on the configuration and level of effort applied to the safety and health program. Researchers compared actual incident performance to the prediction capability of each model over 18 months in the forestry operations at an electricity distribution company and found the models to allow accurate prediction of incident rates. IMPACT ON INDUSTRY: These models potentially have powerful implications as a business-planning tool for human resource allocation and for designing an optimized safety and health intervention program to minimize incidents. Depending on the mathematical relationship, one can determine what interventions, where and how much to apply them, and when to increase or reduce human resource input as determined by the forecasted performance.     

Reducing primary and secondary impact loads on the pelvis during side impact

OBJECTIVE: The objective of the study was to determine which vehicle factors are significantly related to pelvic injury in side impact collisions. Identification of relevant parameters could aid in the reduction of these injuries. METHOD: Side impact crashes from the CIREN database were separated into those in which the occupant sustained a pelvic fracture and those in which no pelvic fracture occurred, although all occupants had serious injuries. A multibody MADYMO model was created of a USDOT SINCAP (U.S. Department of Transportation Side Impact New Car Assessment Program) test of a vehicle with a large center console. RESULTS: From a study of 113 side impact crashes in the ciren database, nearside occupants with pelvic fractures (n = 78) had (i) more door intrusion (mean, 37 vs. 32 cm, p = 0.02) than those who had serious injuries, but not pelvic fractures (ii) a greater likelihood that the lower border of the door intruded more than the upper part (40% vs. 18%, p < 0.025); and (iii) a greater likelihood that their vehicle had a center console (47 vs. 17%, p < 0.005). Other parameters such as occupant age, weight, gender, vehicle weight, and struck vehicle speed change were not significantly different. MADYMO modeling showed that with a center console, an initial positive pelvic acceleration occurred at about 30 msec, followed at about 45 msec by a second acceleration peak in the opposite direction. Reducing console stiffness reduced the second acceleration but not the initial peak. Allowing the seat to translate laterally when contacted by the door reduced the initial pelvic acceleration by 50% and eliminated the second acceleration peak. CONCLUSIONS: Redesigning the center console using less stiff materials and allowing some lateral translation of the seat could aid in reducing pelvic injuries in side impact collisions.     

Motor vehicle restraint system use and risk of spine injury

OBJECTIVE: Motor vehicle collision (MVC)-related spinal injury is a severe and often permanently disabling injury. In addition, strain injuries have been reported as a common outcome of MVCs. Although advances in automobile crashworthiness have reduced both fatalities and severe injuries, the impact of varying occupant restraint systems (seatbelts and airbags) on thoracolumbar spine injuries is unknown. This study examined the relationship between the occurrence of mild to severe cervical and thoracolumbar spine injury and occupant restraint systems among front seat occupants involved in frontal MVCs. METHODS: A retrospective cohort study was conducted among subjects obtained from the 1995-2004 National Automotive Sampling System. Cases were identified based on having sustained a spine injury of >/=1 on the Abbreviated Injury Scale (AIS), 1990 Revision. Risk risks (RRs) and 95% confidence intervals (CIs) were computed comparing occupant restraint systems with unrestrained occupants. RESULTS: We found an overall incidence of AIS1 cervical (11.8%) and thoracolumbar (3.7%) spinal injury. Seatbelt only restraints were associated with increased cervical AIS1 injury (RR = 1.40, 95% CI 1.04-1.88). However, seatbelt only restraints showed the greatest risk reduction for AIS2 spinal injuries. Airbag only restraints reduced thoracolumbar AIS1 injuries (RR = 0.29, 95% CI 0.08-1.04). Seatbelt combined with airbag use was protective for cervical AIS3+ injury overall (RR = 0.29, 95% CI 0.14-0.58), cervical neurological injury (RR = 0.19, 95% CI 0.05-0.81), and thoracolumbar AIS3+ injury overall (RR = 0.20, 95% CI 0.05-0.70). CONCLUSIONS: The results of this study suggest that seatbelts alone or in combination with an airbag increased the incidence of AIS1 spinal injuries, but provide protection against more severe injury to all regions of the spine. Airbag deployment without seatbelt use did not show increased protection relative to unrestrained occupants.     

Injury surveillance trends in career–technical education: New Jersey 1999–2018

Introduction: Adolescents engaging in school-sponsored work experiences may be at risk of injury due to factors such as inexperience. This article examines trends in 20 years of reported injuries among New Jersey (NJ) adolescents engaging in school-sponsored work experiences, and compares a transition from paper to online reporting format. Methods: New Jersey requires reporting of injuries occurring during school-sponsored work experiences to the NJ Department of Education. Injuries reported by NJ schools from 1999 to 2018 (n = 2,119) were examined; incidence rates for 2008 to 2018 (n = 743) were calculated using publicly available NJ Department of Education enrollment data for the denominator, including for specific groups of students: career and technical education; special healthcare needs. Results: A downward trend in reported injuries in NJ schools was observed. However, the year online reporting became required by code (2013), an increase of nearly 50% was seen from 2012 (59–89), followed by a decline in reported incidents 2014 to 2018 (mean = 65, range 76 down to 47). Injury rate trends over time paralleled those of reported incidents. Conclusions: This study suggested worker safety and public health benefits of improvements from State of NJ code required training programs and online injury surveillance report form. Practical Applications: One potential method to address the safety and health of adolescents engaging in work experiences is the use of online reporting forms, to aid in surveillance efforts, coupled with occupational safety and health training specifically geared toward teachers and administrators who both supervise young, relatively inexperienced and vulnerable workers and who make relatively frequent worksite visits. Incorporation of specific details of the instructions on the use of a reporting form into required trainings, in addition to providing a clear, accessible guidance manual online, could further help improve youth worker safety surveillance efforts.     

Turning at intersections and pedestrian injuries

OBJECTIVE: To evaluate if precrash vehicle movement is associated with the severity of pedestrian injury. METHODS: We used comprehensive information on pedestrian, vehicle, and injury-related characteristics gathered in the Pedestrian Crash Data Study (PCDS), conducted by the National Highway Traffic Safety Administration (NHTSA) (1994-1998). The odds ratio of severe injuries (injury severity score >/= 15) and crash fatality rate for right- and left-turn collisions at intersection compared with straight vehicle movement were compared using a logistic regression model and taking into consideration the type of vehicle and age of the pedestrians as potential effect modifiers. Later we evaluated the intermediate effect of impact speed on the association by adding it to the logistic regression model. RESULTS: Of 255 collisions eligible for this analysis, the proportion of pedestrian hit during straight movement, right turns, and left turns were 48%, 32%, and 10%, respectively. Sixty percent of the pedestrians in left-turn crashes and 67% of them in right-turn collisions were hit from their left side. For straight movements the pedestrians were equally likely to be struck beginning from the left or right side of the street.After adjustment for pedestrian's age, vehicle movement was a significant predictor of severe injuries (p < 0.0001) and case fatality (p = 0.003). The association between vehicle precrash movement and severe injuries (p = 0.551) and case fatality (p = 0.912) vanished after adjusting for impact speed. This indicated that the observed association was probably the result of the difference in impact speed and not the precrash movement of the vehicle. CONCLUSION: Pedestrian safety interventions that aim at environmental modifications, such as crosswalk repositioning, might be the most efficient means in reducing right- or left-turn collisions at intersection, while pedestrians' behavioral modifications should be the priority for alleviating the magnitude of the collisions that happen in vehicles' straight movements.