Features of fatal injuries in older cyclists in vehicle–bicycle accidents in Japan

Objective: The purpose of this study was to identify and better understand the features of fatal injuries in cyclists aged 75 years and over involved in collisions with either hood- or van-type vehicles.

Methods: This study investigated the fatal injuries of cyclists aged 75 years old and over by analyzing accident data. We focused on the body regions to which the fatal injury occurred using vehicle–bicycle accident data from the Institute for Traffic Accident Research and Data Analysis (ITARDA) in Japan. Using data from 2009 to 2013, we examined the frequency of fatally injured body region by gender, age, and actual vehicle travel speed. We investigated any significant differences in distributions of fatal injuries by body region for cyclists aged 75 years and over using chi-square tests to compare with cyclists in other age groups. We also investigated the cause of fatal head injuries, such as impact with a road surface or vehicle.

Results: The results indicated that head injuries were the most common cause of fatalities among the study group. At low vehicle travel speeds for both hood- and van-type vehicles, fatalities were most likely to be the result of head impacts against the road surface.

The percentage of fatalities following hip injuries was significantly higher for cyclists aged 75 years and over than for those aged 65–74 or 13–59 in impacts with hood-type vehicles. It was also higher for women than men in the over-75 age group in impacts with these vehicles.

Conclusions: For cyclists aged 75 years and over, wearing a helmet may be helpful to prevent head injuries in vehicle-to-cyclist accidents. It may also be helpful to introduce some safety measures to prevent hip injuries, given the higher level of fatalities following hip injury among all cyclists aged 75 and over, particularly women.     

Occupational fatalities due to electrocutions in the construction industry

Introduction

Occupational fatalities due to contact with electricity account for approximately 9% of all deaths in the construction industry and is the fourth leading cause of death in this industry.

Method

Differences in the proportions of electrocutions in the construction industry are significantly different from other industries based upon the age of the worker and the source of the electricity.

Results

This study found that, in the construction industry, the proportion of occupational fatalities due to contact with electric current is significantly higher for workers in the 16 to 19 years old age group. Contact with overhead power lines occurred more frequently with younger workers, while contact with electric wiring, transformers, and related equipment was found to occur more frequently with older workers. The proportion of fatalities due to this event was also found to account for a significantly greater proportion of fatalities in the construction industry overall.

Impact on industry

The proportions of electrocution fatalities in the construction industry were found to be significantly higher for younger workers when compared to all other industries. Focusing prevention measures toward younger workers who work near overhead power lines could have a significant impact upon death rates. For older workers, the focus should be on those who work on or near transformers, electrical wiring, and components. Across the construction industry, implementation of effective lockout-tagout programs, and verification of energy isolation, can prevent approximately 125 fatalities per year in the construction industry.     

基于成本收益分析的油气管道风险控制决策过程

为实现对油气管道风险的有效控制,结合油气管道的特点,基于成本收益分析方法改进风险控制决策过程。首先,确定风险控制目标,对所建议的措施进行初步筛选,并根据行业现状确定基线场景;之后,量化筛选后的措施的成本与收益,通过计算成本收益率(CBR)或规避事故隐含成本(ICAF)来确定相应措施的合理性;最后,依据上述分析制定风险控制决策。结果表明:不同措施的CBR或ICAF值不同,CBR或ICAF值较低的措施应被优先实施;而当CBR或ICAF值超过标准值时,相应措施是不合理的,应不予以实施。     

The need to improve information on road user type in National Vital Statistics System mortality data

Objectives: Both the National Vital Statistics System (NVSS) and the Fatality Analysis Reporting System (FARS) can be used to examine motor vehicle crash (MVC) deaths. These 2 data systems operate independently, using different methods to collect and code information about the type of vehicle (e.g., car, truck, bus) and road user (e.g., occupant, motorcyclist, pedestrian) involved in an MVC. A substantial proportion of MVC deaths in NVSS are coded as “unspecified” road user, which reduces the utility of the NVSS data for describing burden and identifying prevention measures. This study aimed to describe characteristics of unspecified road user deaths in NVSS to further our understanding of how these groups may be similar to occupant road user deaths.

Methods: Using data from 1999 to 2015, we compared NVSS and FARS MVC death counts by road user type, overall and by age group, gender, and year. In addition, we examined factors associated with the categorization of an MVC death as unspecified road user such as state of residence of decedent, type of medical death investigation system, and place of death.

Results: The number of MVC occupant deaths in NVSS was smaller than that in FARS in each year and the number of unspecified road user deaths in NVSS was greater than that in FARS. The sum of the number of occupant and unspecified road user deaths in NVSS, however, was approximately equal to the number of FARS occupant deaths. Age group and gender distributions were roughly equivalent for NVSS and FARS occupants and NVSS unspecified road users. Within NVSS, the number of MVC deaths listed as unspecified road user varied across states and over time. Other categories of road users (motorcyclists, pedal cyclists, and pedestrians) were consistent when comparing NVSS and FARS.

Conclusions: Our findings suggest that the unspecified road user MVC deaths in NVSS look similar to those of MVC occupants according to selected characteristics. Additional study is needed to identify documentation and reporting challenges in individual states and over time and to identify opportunities for improvement in the coding of road user type in NVSS.     

Impact of human development on safety consciousness in construction

The International Labour Organization (ILO) reports that the risk of fatal occupational injuries in developing countries is almost twice as high as in developed countries, indicating a potential relationship between the fatality rates and the development level. The human development index (HDI), based on life expectancy, knowledge level and purchasing power parity, endorsed by the United Nations Development Programme, is a widely accepted measure of the development level. This study investigates the relationship between the HDI and the fatality rates reported by the ILO. A 23-country data set is used to demonstrate the general trend of the relationship followed by country-specific analyses for Australia, Spain, Hungary and Turkey. The study conducted is limited to fatal occupational injuries in construction, where the accidents are notoriously high. The results demonstrate a statistically significant inverse relationship between the fatality rates and the HDI.     

Trends in occupational injuries and fatality in Turkey

Introduction. The aim of this study was to evaluate the trend of occupational injuries in Turkey using epidemiologic criteria such as incidence mortality and fatality/all injuries recorded – rates. Materials and methods. Safety and health data were obtained from the Annual Statistic Books of the Social Insurance Institution (1988–2006) and Social Security Institution (2007–2011) of Turkey. Results. The results from the official data showed that although total employment is increasing the number of occupational injuries and incidence and mortality rates are decreasing. The results also demonstrate that occupational fatality/all injuries recorded – rate is increasing. The fatality/all injuries recorded – rate per 1000 injuries increased to 25.5 in 2011 from 8.6 in 1988. Each work day an average of five people died because of occupational injuries. Discussion and conclusions. The fatality/all injuries recorded – rate (the number of fatal cases per 1000 occupational injuries) is an important indicator of the injury rate for a country. Systems of occupational injury and illness surveillance constitute a critical resource for the management and reduction of occupational injuries and illness.     

Estimated trends and patterns of road traffic fatalities in China, 2002–2012

Objective: This study examined the time trends and age distribution patterns of estimated road traffic fatalities (RTFs) in China over the period 2002–2012. Methods: Data on age-, sex-, and region-specific RTF rates were provided by the Chinese Ministry of Health. The crude rates were standardized and the Mann-Kendall test was used to test the significance of time trends. Annual number of RTFs was calculated. To minimize the effect of yearly variations, magnitude of changes in and age distribution patterns of the RTFs were examined using mean values of 2 years. Results: RTFs increased significantly in China during the study period. Several features were identified for the RTFs in China. First, RTF rates skyrocketed in rural areas including towns and counties. Second, a significant increase in RTFs was also observed in cities even though the change in RTF rates was not statistically significant there. Third, individuals aged 20–24, 40–49, and 55–64, especially in rural areas, were particularly at risk for RTFs in recent years. Finally, RTFs became more common among middle-aged and older adults than young Chinese, with roughly 57% of all RTFs occurring among individuals aged 45 and above during 2011–2012. Conclusions: RTFs increased dramatically in China during the past decade, especially in rural areas. Age distribution patterns of RTFs have changed there. Community-based public health education and intervention programs are warranted.     

Are there higher pedestrian fatalities in larger cities?: A scaling analysis of 115 to 161 largest cities in the United States

Objective: In 2012, 4,743 pedestrians were killed in the United States, representing 14% of total traffic fatalities. The number of pedestrians injured was higher at 76,000. Therefore, 36 out of 52 of the largest cities in the United States have adopted a citywide target of reducing pedestrian fatalities. The number of cities adopting the reduction goal during 2011 and 2012 increased rapidly with 8 more cities. We examined the scaling relationship of pedestrian fatality counts as a function of the population size of 115 to 161 large U.S. cities during the period of 1994 to 2011. We also examined the scaling relationship of nonpedestrian and total traffic fatality counts as a function of the population size.

Methods: For the data source of fatality measures we used Traffic Safety Facts Fatality Analysis Reporting System/General Estimates System annual reports published each year from 1994 to 2011 by the NHTSA. Using the data source we conducted both annual cross-sectional and panel data bivariate and multivariate regression models. In the construction of the estimated functional relationship between traffic fatality measures and various factors, we used the simple power function for urban scaling used by Bettencourt et al. (2007 Bettencourt LMA, Lobo J, Helbing D, Kühnert C, West GB. Growth, innovation, scaling and the pace of life in cities. Proc Natl Acad Sci USA. 2007;104:7301–7306.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar], 2010 Bettencourt LMA, Lobo J, Strumsky D, West GB. Urban scaling and its deviations: revealing the structure of wealth, innovation and crime across cities. PLoS ONE. 2010;5:e13541.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) and the refined STIRPAT (stochastic impacts by regression on population, affluence, and technology) model used in Dietz and Rosa (1994 Dietz T, Rosa EA. Rethinking the environmental impacts of population, affluence and technology. Human Ecology Review. 1994;1:277–300. [Google Scholar], 1997 Dietz T, Rosa EA. Effects of population and affluence on CO₂ emissions. Proc Natl Acad Sci USA. 1997;94:175–179.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) and York et al. (2003 York R, Rosa EA, Dietz T. STIRPAT, IPAT and IMPACT: analytic tools for unpacking the driving forces of environmental impacts. Ecol Econ. 2003;46:351–365.[Crossref], [Web of Science ®] , [Google Scholar]).

Results: We found that the scaling relationship display diseconomies of scale or sublinear for pedestrian fatalities. However, the relationship displays a superlinear relationship in case of nonpedestrian fatalities. The scaling relationship for total traffic fatality counts display a nearly linear pattern. When the relationship was examined by the 4 subgroups of cities with different population sizes, the most pronounced sublinear scaling relationships for all 3 types of fatality counts was discovered for the subgroup of megacities with a population of more than 1 million.

Conclusions: The scaling patterns of traffic fatalities of subgroups of cities depend on population sizes of the cities in subgroups. In particular, 9 megacities with populations of more than 1 million are significantly different from the remaining cities and should be viewed as a totally separate group. Thus, analysis of the patterns of traffic fatalities needs to be conducted within the group of megacities separately from the other cities with smaller population sizes for devising prevention policies to reduce traffic fatalities in both megacities and smaller cities.     

Road traffic mortality in the Slovak Republic in 1996–2014

Objective: Road traffic mortality takes an enormous toll in every society. Transport safety interventions play a crucial role in improving the situation. In the period 1996–2014 several road safety measures, including a complex new road traffic law in 2009, were implemented in the Slovak Republic, introducing stricter conditions for road users.

The aim of this study is to describe and analyze the trends in road user mortality in the Slovak Republic in individual age groups by sex during the study period 1996–2014.

Methods: Data on overall mortality in the Slovak Republic for the period 1996–2014 were obtained from the Statistical Office of the Slovak Republic. Mortality rates were age-adjusted to the European standard population. Joinpoint regression was used to assess the statistical significance of change in time trends of calculated standardized mortality rates.

Results: Mortality rates of all types of road users as well as all age groups and both sexes in the Slovak Republic in the period 1996–2014 are decreasing. The male : female ratio decreased from 4:1 in 1996 to 2:1 in 2014. Motor vehicle users (other than motorcyclists) and pedestrians have the highest mortality rates among road user groups. Both of these groups show a significant decline in mortality rates over the study period. Within the age groups, people age 65 years and over have the highest mortality rates, followed by the age groups 25–64 and 15–24 years old.

Joinpoint regression confirmed a steady, significant decline in all mortality rates over the study period. A statistically significant decrease in mortality rates in the last years of the study period was observed in the age group 25–64 and in male motorcycle users.

Assessing the impact of the 2009 road traffic law, a drop was observed in the average standardized mortality rate of all road traffic users from 14.56 per 100,000 person years in the period 1996–2008 to 7.69 per 100,000 person years in the period 2009–2014. A similar drop in the average standardized mortality rate was observed in all individual road user groups.

Conclusions: The implementation of the new traffic regulations may have contributed significantly to the observed decrease in mortality rates of road users in the Slovak Republic. A significant decrease in mortality was observed in all population groups and in all groups of road users. The introduction of a new comprehensive road traffic law may have expedited the decrease of road fatalities, especially in the age group 25–64 years old. This type of evidence-based epidemiology data can be used for improved targeting of future public health measures for road traffic injury prevention.