The psychological impact of traffic injuries sustained in a road crash by bicyclists: A prospective study

Objective: The objective of this study was to investigate the psychological impact of traffic injuries in bicyclists (cyclists) in comparison to car occupants who also sustained traffic injuries. Factors predictive of elevated psychological distress were also investigated.

Methods: An inception cohort prospective design was used. Participants included cyclists aged ≥17 years (mean age 41.7 years) who sustained a physical injury (n = 238) assessed within 28 days of the crash, following medical examination by a registered health care practitioner. Injury included musculoskeletal and soft tissue injuries and minor/moderate traumatic brain injury (TBI), excluding severe TBI, spinal cord injury, and severe multiple fractures. Assessment also occurred 6 months postinjury. Telephone-administered interviews assessed a suite of measures including sociodemographic, preinjury health and injury factors. Psychological impact was measured by pain catastrophization, trauma-related distress, and general psychological distress. The psychological health of the cyclists was compared to that of the car occupants (n = 234; mean age 43.1 years). A mixed model repeated measures analysis, adjusted for confounding factors, was used to determine differences between groups and regression analyses were used to determine contributors to psychological health in the cyclists 6 months postinjury.

Results: Cyclists had significantly better psychological health (e.g., lower pain catastrophizing, lower rates of probable posttraumatic stress disorder [PTSD], and lower general distress levels) compared to car occupants at baseline and 6 months postinjury. Factors predictive of cyclists' psychological distress included younger age, greater perceived danger of death, poorer preinjury health, and greater amount of time in hospital after the injury.

Conclusions: These data provide insight into how cyclists perceive and adjust to their traffic injuries compared to drivers and passengers who sustain traffic injuries, as well as direction for preventing the development of severe psychological injury. Future research should examine the utility of predictors of psychological health to improve recovery.     

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.     

Investigating the effects of monthly weather variations on Connecticut freeway crashes from 2011 to 2015

IntroductionThe objective of this research is to investigate the effects of monthly weather conditions on traffic crash experience on freeways, considering the interactions between weather, traffic volumes, and roadway conditions. Methods: Data from the state of Connecticut from 2011to 2015 were used. Random parameters negative binomial models with first-order, autoregressive covariance were estimated for representative types of freeway crashes (front-to-rear, sideswipe-same-direction, and fixed-object), most severe crashes (i.e., fatal and injury crashes), and non-injury crashes (i.e., property-damage-only crashes). Results: Major findings are that variations in monthly traffic volumes, roadway geometry, and weather conditions explain much of the variations in monthly traffic crashes. Time effects exist in the panel monthly data for all types of crashes. Taking into account this effect improves model prediction results. When the raw weather measures are highly correlated, using dimension reduction techniques helps to extract more interpretable weather factors. By considering the interaction effects between roadway condition variables, additional findings were found. In general, lower temperature, more heavy fog days, decreased precipitation, lower wind speed, higher monthly traffic volumes, and narrower inside shoulder were found to be associated with higher monthly crashes. The effects of area type and outside shoulder width change dramatically as the number of through lanes changes. Practical applications: The findings of this research could help researchers and general readers gain a better understanding of the effects of monthly weather conditions and other roadway factors on freeway crashes and give engineers practical guidelines on improving freeway safety.     

Risky behaviors and helmet use among young adolescent motorcyclists in Southern Thailand

Background: In Thailand, road traffic injuries are the leading cause of death for youth ages 15–19 years, with 80% of the injuries and deaths from motorcycle accidents. Objectives: To determine the prevalence of child and young adolescent motorcyclists in Hat Yai municipality and their risk behaviors. Method: A cross-sectional study was conducted between June 2011 and March 2012 in which 2,471 students, ages 8 to 18 years, were recruited from 9 primary and secondary schools in Hat Yai municipality. The questionnaire included questions on being a motorcycle rider or passenger, risky behaviors, and helmet use while riding. Results: Of the total, 1,573 (63.7%) were riders and 898 (36.3%) were pillion passengers. The majority of the riders younger than 15 years rode their motorcycle mainly only in narrow streets for a short trip. Only 30% of the riders wore a helmet every time they rode a motorcycle. About 10% of the participants riding or a passenger on a motorcycle had consumed alcohol at least once before riding their motorcycle. Multiple logistic regression analysis found that motorcycle injuries were significantly associated with speeds greater than 60 km/h, not wearing a helmet while riding, and alcohol consumption before riding (odds ratios 1.63, 1.59, and 3.09, respectively). Conclusion: Nearly two thirds of young adolescents in Hat Yai municipality were motorcycle riders. These young adolescents were at risk of traffic injuries because more than 50% of them had ridden at high speed or not worn a helmet while riding, and some of them had consumed alcohol before riding.     

Development of a method to rate the primary safety of vehicles using linked New Zealand crash and vehicle licensing data

Objective: Vehicle safety rating systems aim firstly to inform consumers about safe vehicle choices and, secondly, to encourage vehicle manufacturers to aspire to safer levels of vehicle performance. Primary rating systems (that measure the ability of a vehicle to assist the driver in avoiding crashes) have not been developed for a variety of reasons, mainly associated with the difficult task of disassociating driver behavior and vehicle exposure characteristics from the estimation of crash involvement risk specific to a given vehicle. The aim of the current study was to explore different approaches to primary safety estimation, identifying which approaches (if any) may be most valid and most practical, given typical data that may be available for producing ratings.

Methods: Data analyzed consisted of crash data and motor vehicle registration data for the period 2003 to 2012: 21,643,864 observations (representing vehicle-years) and 135,578 crashed vehicles. Various logistic models were tested as a means to estimate primary safety: Conditional models (conditioning on the vehicle owner over all vehicles owned); full models not conditioned on the owner, with all available owner and vehicle data; reduced models with few variables; induced exposure models; and models that synthesised elements from the latter two models.

Results: It was found that excluding young drivers (aged 25 and under) from all primary safety estimates attenuated some high risks estimated for make/model combinations favored by young people. The conditional model had clear biases that made it unsuitable. Estimates from a reduced model based just on crash rates per year (but including an owner location variable) produced estimates that were generally similar to the full model, although there was more spread in the estimates. The best replication of the full model estimates was generated by a synthesis of the reduced model and an induced exposure model.

Conclusions: This study compared approaches to estimating primary safety that could mimic an analysis based on a very rich data set, using variables that are commonly available when registered fleet data are linked to crash data. This exploratory study has highlighted promising avenues for developing primary safety rating systems for vehicle makes and models.     

Does the improved stability offered by motorcycle antilock brakes (ABS) make sliding crashes less common? In-depth analysis of fatal crashes involving motorcycles fitted with ABS

Objective: This research investigated the following issue. Though several tests indicate that motorcycle ABS may increase motorcycle stability, thus reducing the risk of a sliding crash involving braking (i.e., the rider is separated from the motorcycle and slides along the road surface prior to collision), there is limited research showing to what extent sliding crashes are reduced by ABS in real-life conditions.

Methods: The Swedish Transport Administration (STA) and the Norwegian Public Roads Administration (NPRA) carry out in-depth studies for all road fatalities. A total of 38 in-depth studies with ABS motorcycles were included: 22 in Sweden and 16 in Norway (2005–2014). These were compared with 98 cases in Sweden and 32 in Norway involving motorcycles of the same types but without ABS. The data sets were analyzed separately and also merged together. The difference between the proportions of sliding crashes regardless braking was analyzed; selective recruitment was handled with a sensitivity analysis. Induced exposure was used to calculate the reduction of all crashes and those involving braking.

Results: Four ABS cases (11%) involved falling off the motorcycle prior to collision, and 35% of the non-ABS crashes were sliding (P =.004). The sensitivity analysis showed that the results were stable, with a relative difference of sliding crashes ranging between 65 and 78%.

None of the 4 sliding crashes with ABS occurred during braking; that is, all ABS riders who braked prior to collision crashed in an upright position. In the 4 sliding cases with ABS, the riders lost control of their motorcycles: 2 while accelerating on asphalt with very poor friction, 1 while negotiating a curve with an excessive lean angle, and 1 by abruptly releasing the throttle in the middle of a curve.

Although based on a limited number of cases, the distributions of sliding and upright collisions among crashes without braking were similar, thus suggesting that the crash posture would not be affected by ABS if no braking occurred. The calculations with induced exposure showed that upright crashes with braking were also reduced by ABS; all fatal crashes, regardless of braking, were reduced by 52%.

Conclusions: Though this research was based on a limited material, it confirmed that sliding fatal crashes are significantly decreased by ABS. Considering that ABS will soon be mandatory in the European Union on all new motorcycles with engine displacement over 125cc, these findings should be taken into account in the future design and testing of motorcycle-friendly road barriers and integrated protection systems.     

The useful field of view assessment predicts simulated commercial motor vehicle driving safety

Objective: The Useful Field of View (UFOV) assessment, a measure of visual speed of processing, has been shown to be a predictive measure of motor vehicle collision (MVC) involvement in an older adult population, but it remains unknown whether UFOV predicts commercial motor vehicle (CMV) driving safety during secondary task engagement. The purpose of this study is to determine whether the UFOV assessment predicts simulated MVCs in long-haul CMV drivers.

Method: Fifty licensed CMV drivers (M_age = 39.80, SD = 8.38, 98% male, 56% Caucasian) were administered the 3-subtest version of the UFOV assessment, where lower scores measured in milliseconds indicated better performance. CMV drivers completed 4 simulated drives, each spanning approximately a 22.50-mile distance. Four secondary tasks were presented to participants in a counterbalanced order during the drives: (a) no secondary task, (b) cell phone conversation, (c) text messaging interaction, and (d) e-mailing interaction with an on-board dispatch device.

Results: The selective attention subtest significantly predicted simulated MVCs regardless of secondary task. Each 20 ms slower on subtest 3 was associated with a 25% increase in the risk of an MVC in the simulated drive. The e-mail interaction secondary task significantly predicted simulated MVCs with a 4.14 times greater risk of an MVC compared to the no secondary task condition. Subtest 3, a measure of visual speed of processing, significantly predicted MVCs in the email interaction task. Each 20 ms slower on subtest 3 was associated with a 25% increase in the risk of an MVC during the email interaction task.

Conclusions: The UFOV subtest 3 may be a promising measure to identify CMV drivers who may be at risk for MVCs or in need of cognitive training aimed at improving speed of processing. Subtest 3 may also identify CMV drivers who are particularly at risk when engaged in secondary tasks while driving.     

Potentially preventable prehospital deaths from motor vehicle collisions

Background: In 2011, about 30,000 people died in motor vehicle collisions (MVCs) in the United States. We sought to evaluate the causes of prehospital deaths related to MVCs and to assess whether these deaths were potentially preventable.

Methods: Miami–Dade Medical Examiner records for 2011 were reviewed for all prehospital deaths of occupants of 4-wheeled motor vehicle collisions. Injuries were categorized by affected organ and anatomic location of the body. Cases were reviewed by a panel of 2 trauma surgeons to determine cause of death and whether the death was potentially preventable. Time to death and hospital arrival times were determined using the Fatality Analysis Reporting System (FARS) data from 2002 to 2012, which allowed comparison of our local data to national prevalence estimates.

Results: Local data revealed that 39% of the 98 deaths reviewed were potentially preventable (PPD). Significantly more patients with PPD had neurotrauma as a cause of death compared to those with a nonpreventable death (NPD) (44.7% vs. 25.0%, P =.049). NPDs were significantly more likely to have combined neurotrauma and hemorrhage as cause of death compared to PPDs (45.0% vs. 10.5%, P <.001). NPDs were significantly more likely to have injuries to the chest, pelvis, or spine. NPDs also had significantly more injuries to the following organ systems: lung, cardiac, and vascular chest (all P <.05). In the nationally representative FARS data from 2002 to 2012, 30% of deaths occurred on scene and another 32% occurred within 1 h of injury. When comparing the 2011 FARS data for Miami–Dade to the remainder of the United States in that year, percentage of deaths when reported on scene (25 vs. 23%, respectively) and within 1 h of injury (35 vs. 32%, respectively) were similar.

Conclusions: Nationally, FARS data demonstrated that two thirds of all MVC deaths occurred within 1 h of injury. Over a third of prehospital MVC deaths were potentially preventable in our local sample. By examining injury patterns in PPDs, targeted intervention may be initiated.     

Analysis of naturalistic driving videos of fleet services drivers to estimate driver error and potentially distracting behaviors as risk factors for rear-end versus angle crashes

Objective: The objective of this study was to estimate the prevalence and odds of fleet driver errors and potentially distracting behaviors just prior to rear-end versus angle crashes.

Methods: Analysis of naturalistic driving videos among fleet services drivers for errors and potentially distracting behaviors occurring in the 6 s before crash impact. Categorical variables were examined using the Pearson's chi-square test, and continuous variables, such as eyes-off-road time, were compared using the Student's t-test. Multivariable logistic regression was used to estimate the odds of a driver error or potentially distracting behavior being present in the seconds before rear-end versus angle crashes.

Results: Of the 229 crashes analyzed, 101 (44%) were rear-end and 128 (56%) were angle crashes. Driver age, gender, and presence of passengers did not differ significantly by crash type. Over 95% of rear-end crashes involved inadequate surveillance compared to only 52% of angle crashes (P < .0001). Almost 65% of rear-end crashes involved a potentially distracting driver behavior, whereas less than 40% of angle crashes involved these behaviors (P < .01). On average, drivers spent 4.4 s with their eyes off the road while operating or manipulating their cell phone. Drivers in rear-end crashes were at 3.06 (95% confidence interval [CI], 1.73–5.44) times adjusted higher odds of being potentially distracted than those in angle crashes.

Conclusions: Fleet driver driving errors and potentially distracting behaviors are frequent. This analysis provides data to inform safe driving interventions for fleet services drivers. Further research is needed in effective interventions to reduce the likelihood of drivers' distracting behaviors and errors that may potentially reducing crashes.     

Exposure factors of Victoria's active motorcycle fleet related to serious injury crash risk

Objective: The purpose of this study was to describe the nature and extent of current powered 2-wheeler (PTW) risk exposures in order to support future efforts to improve safety for this mode of transport.

Methods: A cross-sectional analysis of the control arm of a population-based case-control study was conducted. The control sample was selected from 204 sites on public roads within 150 km of the city of Melbourne that were locations of recent serious injury motorcycle crashes. Traffic observations and measurements at each site were sampled for a mean of 2 h on the same type of day (weekday, Saturday, or Sunday) and within 1 h of the crash time. Photographs of passing riders during this observation period recorded data relating to characteristics of PTWs, age of riders, travel speed of PTWs and all vehicles, time gaps between vehicles, visibility, and protective clothing use.

Results: Motorcycles and scooters represented 0.6% of all traffic (compared with 4% of all vehicle registrations). Riders were significantly more likely to have larger time gaps in front and behind when compared to other vehicles. The average travel speed of motorcycles was not significantly different than the traffic, but a significantly greater proportion were exceeding the speed limit when compared to other vehicles (6 vs. 3%, respectively). The age of registered owners of passing motorcycles was 42 years. Over half of riders were wearing dark clothing with no fluorescent or reflective surfaces. One third of motorcyclists had maximum coverage of motorcycle-specific protective clothing.

Conclusions: A very low prevalence of motorcyclists combined with relatively higher rates of larger time gaps to other vehicles around motorcycles may help explain their overrepresentation in injury crashes where another vehicle fails to give way. An increased risk of injury in the event of a crash exists for a small but greater proportion of motorcyclists (compared to other vehicle types) who were exceeding the speed limit. An apparent shift toward older age of the active rider population may be reducing injury crash risk relative to exposure time. There is significant scope to improve the physical conspicuity of motorcyclists and the frequency of motorcycle specific protective clothing use. These results can be used to inform policy development and monitor progress of current and future road safety initiatives.