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. 相似文献
Monitoring of benzene, toluene and xylenes (BTEX) was conducted along with traffic counts at 17 roadside sites in urban areas of HoChiMinh. Toluene was the most abundant substance, followed by p,m-xylenes, benzene, o-xylene and ethylbenzene. The maximum observed hour-average benzene concentration was 254 μg/m3 . Motorcycles contributed to 91% of the traffic fleet. High correlations among BTEX species, between BTEX concentrations and the volume of on-road motorcycles, and between inter-species ratios in air and in gasoline indicate the motorcycle-exhaust origin of BTEX species. Daily concentrations of benzene, toluene, ethylbenzene, p,m-xylenes and o-xylene were 56, 121, 21, 64 and 23 μg/m 3 , respectively. p,m-xylenes possess the highest ozone formation potential among the BTEX family. 相似文献
INTRODUCTION: Motorcycling is recognized to be a relatively risky activity. Powered two wheelers (PTW) are classified as mopeds, light, and heavy motorcycles, the first two categories being denoted light PTWs. This paper reviews the scientific literature on accident risks and traffic behavior among users of light PTWs with the aim of clarifying the current state of knowledge. METHOD: Based on a risk analytical and an anthropological perspective on motorcycling, the paper discusses the significance of cultural and social factors as important aspects of safety. More targeted and effective safety measures, for example better training programs, are needed to prevent motorcycle accidents. This means developing a deeper understanding of the rider as an individual, and the individuals within different groups and settings. Why and how motorcyclists approach the road, its function as a social arena, the varieties of goals and values, and the motorcyclists' own perceptions of the behavior that ensures their "achievements" or "successes", are some of the issues. Today, this kind of knowledge is scarce and almost entirely absent from the scientific literature. RESULTS: We conclude that the massive quantities of data on numbers of accidents, the categorization of situations, the causal explanations related to speed, gender, age, lack of concentration so forth, can only be employed as support for safety measures as long as they are linked to social and cultural factors. IMPACT ON INDUSTRY: Risk informed decision making has become an integral part of authorities' and manufacturers' implementation of safety measures. This tendency is strengthened by the fact that the responsibility of product safety rests upon the manufacturers, cf. for example EU safety regulations. Therefore it is paramount that a thorough understanding of social and cultural factors related to the PTW driving is necessary for the industry to develop targeted and efficient safety measures. 相似文献
Objective: Currently only 5 out of the 50 states in the United States have laws restricting the age of passengers permitted to ride on a motorcycle. This study sought to characterize the visits by patients under the age of 16 to U.S. emergency departments (EDs) for injuries sustained as a passenger on a motorcycle.
Methods: In this retrospective cohort study, data were obtained from the Nationwide Emergency Department Sample (NEDS) for the years 2006 to 2011. Pediatric patients who were passengers on a motorcycle that was involved in a crash were identified using International Classification of Diseases, Ninth Revision (ICD-9) External Cause of Injury codes. We also examined gender, age, disposition, regional differences, common injuries, and charges.
Results: Between 2006 and 2011 there were an estimated 9,689 visits to U.S. EDs by patients under the age of 16 who were passengers on a motorcycle involved in a crash. The overall average patient age was 9.4 years, and they were predominately male (54.5%). The majority (85%) of these patients were treated and released. The average charges for discharged patients were $2,116.50 and amounted to roughly $17,500,000 during the 6 years. The average cost for admission was $51,446 per patient and totaled over $54 million. The most common primary injuries included superficial contusions; sprains and strains; upper limb fractures; open wounds of head, neck, and trunk; and intracranial injuries.
Conclusion: Although there were only about 9,700 visits to U.S. EDs for motorcycle crashes involving passengers less than 16 years old for 2006 to 2011, the total cost of visits that resulted in either ED discharge or hospital admission amounted to over $71 million. 相似文献
Objective: Our study measured the change in head injuries and deaths among motorcycle users in Cu Chi district, a suburban district of Ho Chi Minh City.
Methods: Hospital records for road traffic injuries (RTIs) were collected from the Cu Chi Trauma Centre and motorcycle-related death records were obtained from mortality registries in commune health offices. Head injury severity was categorized using the Abbreviated Injury Score (AIS). Rate ratios (RRs) were used to compare rates pre- and post-law (2005/2006–2009/2010). Cu Chi's population, stratified by year, age, and sex, was used as the denominator.
Results: Of records identifying the transportation mode at the time of injury, motorcyclists accounted for most injuries (3,035, 87%) and deaths (238, 90%). Head injuries accounted for 70% of motorcycle-related hospitalizations. Helmet use was not recorded in any death records and not in 97% of medical records. Males accounted for most injuries (73%) and deaths (88%). The median age was 28 years and 32 years for injuries and deaths, respectively. Compared to the pre-law period, rates of motorcycle injuries (RR = 0.53; 95% confidence interval [CI], 0.49–0.58), head injuries (RR = 0.35; 95% CI, 0.31–0.39), severe head injuries (RR = 0.47; 95% CI, 0.34–0.63), and deaths (RR = 0.69; 95% CI, 0.53–0.89) significantly decreased in the post-law period.
Conclusions: Rates of head injuries and deaths among motorcycle riders decreased significantly after implementation of the mandatory helmet law in Vietnam. To further examine the impact of the motorcycle helmet law, including compliance and helmet quality, further emphasis should be placed on gathering helmet use data from injured motorcyclists. 相似文献
Objective: The objective of this study was to identify and quantify the motorcycle crash population that would be potential beneficiaries of 3 crash avoidance technologies recently available on passenger vehicles.
Methods: Two-vehicle crashes between a motorcycle and a passenger vehicle that occurred in the United States during 2011–2015 were classified by type, with consideration of the functionality of 3 classes of passenger vehicle crash avoidance technologies: frontal crash prevention, lane maintenance, and blind spot detection. Results were expressed as the percentage of crashes potentially preventable by each type of technology, based on all known types of 2-vehicle crashes and based on all crashes involving motorcycles.
Results: Frontal crash prevention had the largest potential to prevent 2-vehicle motorcycle crashes with passenger vehicles. The 3 technologies in sum had the potential to prevent 10% of fatal 2-vehicle crashes and 23% of police-reported crashes. However, because 2-vehicle crashes with a passenger vehicle represent fewer than half of all motorcycle crashes, these technologies represent a potential to avoid 4% of all fatal motorcycle crashes and 10% of all police-reported motorcycle crashes.
Discussion: Refining the ability of passenger vehicle crash avoidance systems to detect motorcycles represents an opportunity to improve motorcycle safety. Expanding the capabilities of these technologies represents an even greater opportunity. However, even fully realizing these opportunities can affect only a minority of motorcycle crashes and does not change the need for other motorcycle safety countermeasures such as helmets, universal helmet laws, and antilock braking systems. 相似文献
Various indicators of health have been shown to be associated with traffic crash involvement. As general health is also related to absence from work, the latter variable may be more strongly related to crashes, especially for professional drivers.
Method
Bus driver absence from work was analyzed in association with their crash records. Two British samples and one Swedish sample were used.
Results
One of the British samples yielded fair correlations between crash record and absence, while for the other the effect was restricted to the first three months of driving. The Swedish data had effects in the expected direction but these were not significant.
Discussion
The use of an indirect, overall measurement of health, may be a viable method for predicting the traffic crash involvement for professional drivers, although replications are needed in larger samples and other populations.
Impact on industry
The use of absence records for the identification of at risk drivers would seem to be a simple and useful method for companies with major fleets, and it also shows the importance of promoting employee health and well being at work as a potential method of reducing the cost, not only of absenteeism, but also of crashes in company vehicles. 相似文献
Motor-vehicle crashes are a leading cause of death in the United States. In the event of a crash, seat belts are highly effective in preventing serious injury and death.
Methods
Data from the 2006 Behavioral Risk Factor Surveillance System were used to calculate prevalence of seat belt use by state and territory and by type of state seat belt law (primary vs. secondary enforcement).
Results
In 2006, seat belt use among adults ranged from 58.3% to 91.9% in the states and territories. Seat belt use was 86.0% in states and territories with primary enforcement laws and 75.9% in states with secondary enforcement laws.
Discussion
Seat belt use continues to increase in the United States. Primary enforcement laws remain a more effective strategy than secondary enforcement laws in getting motor-vehicle occupants to wear their seat belts. 相似文献