Differences between males and females in traffic accident risk in France

BACKGROUND: In France 7,720 people were killed in traffic accidents in 2001, 75% of which were men; the number of injured people is estimated at 153,945, of which 65% were men. The objective of the study is to describe differences between males and females regarding accidents, and to explain the main reasons for these differences. METHODS: Analysis is conducted from both national police data (2001) and data from the Rhone medical road accident trauma Register (1996-2001). RESULTS: The male/female incidence rate is 3.1 for mortality (95% CI: 3.0-3.3) and 1.7 for morbidity (95% CI: 1.7-1.8). Two-wheel motorised vehicle accidents are very specific to males, which explains part of this overrepresentation. The fatality rate and the severe injuries rate among survivors are higher for males. This is true for every main user group (car users, motorised two-wheelers, cyclists, pedestrians) after adjusting for accident circumstances and age of casualties. Males are more severely injured for all body regions and have more often severe after-effects. CONCLUSIONS: This paper shows the mechanisms leading to this unfavourable outcome for men. They correspond to differences in the number of trips, in the choice of road transport types, and moreover to differences in risk-taking behaviours. Underlying these behaviours, deep-rooted, strong and rather invariant differences between genders are to be found in the values associated with risk-taking on the road.     

急诊道路交通事故伤的监测与政府干预措施的制定

目的探讨道路交通事故伤发生时的详细情况,便于政府部门及时制定干预措施。方法对广州某所医院的311例急诊交通事故伤患者进行流行病学问卷调查。结果伤者中,摩托车驾驶员及搭乘者占44.2%,行人占33.4%,骑自行车者占15.8%和汽车中人员占8.3%.60.7%的伤者由摩托车车祸造成。伤者中,43.8%的行人和29.5%的骑自行车者未在人行过道横过马路时被机动车撞伤,且多发生在人行横道、天桥或过街隧道较少,而路面较宽的路段。91.4%的伤者在伤后1小时内到达医院就诊。结论动态监测急诊交通事故伤发生时的详细情况,有助于在社区范围内及时发现伤害的常见原因和地点,以便政府有关部门采取预防措施,如大举兴建隧道天桥方便市民过横道,减少伤害的继续发生。     

Traumatic brain injury: differences among pedestrians and motor vehicle occupants]

OBJECTIVE: The purpose of this study was to discover the differences among victims who had traumatic brain injury due to traffic accidents. METHODS: Medical record of the head injury patients were analyzed according to their classification as traffic accident victims (pedestrian, motorcyclist or passenger and other motor vehicle deriver or passenger), age, gender, admission type (admitted from scene of the injury or from another hospital), duration of hospitalization, type of head injury, types of lesions present in other body segments and mortality. Patient's injury severity was measured by Injury Severity Score and head injury severity was analyzed using the ranking on the Glasgow Coma Scale, recorded by neurosurgeons during their first neuro assessment. All head injured patients admitted to a trauma center in S. Paulo city over a four-month period from March through June 1993, were included in the study. The sample was of 156 victims, with subsets of 80 pedestrians, 26 occupants of motorcycles and 50 occupants of other motor vehicles. RESULTS AND CONCLUSION: The results of this study showed that the mortality rate was higher in the pedestrian subset (25.0%) than among other victims and higher for motorcycle occupants (19.2%) than for motor vehicle victims (8.0%). Statistical differences between the subsets were established when the head injury severity variable was analyzed using the Glasgow Coma Scale. On the other hand, the differences between the three subsets was not statistically significant when the measurement used was the Injury Severity Score. Analyses of other variables showed important differences among subset distributions.     

Walking, cycling and transport safety: an analysis of child road deaths

OBJECTIVE: To examine trends in road death rates for child pedestrians, cyclists and car occupants. DESIGN: Analysis of road traffic injury death rates per 100 000 children and death rates per 10 million passenger miles travelled. SETTING: England and Wales between 1985 and 2003. PARTICIPANTS: Children aged 0-14 years. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Death rates per 100,000 children and per 10 million child passenger miles for pedestrians, cyclists and car occupants. RESULTS: Death rates per head of population have declined for child pedestrians, cyclists and car occupants but pedestrian death rates remain higher (0.55 deaths/100,000 children; 95% confidence interval [CI] 0.42 to 0.72 deaths) than those for car occupants (0.34 deaths; 95% CI 0.23 to 0.48 deaths) and cyclists (0.16 deaths; 95% CI 0.09 to 0.27 deaths). Since 1985, the average distance children travelled as a car occupant has increased by 70%; the average distance walked has declined by 19%; and the average distance cycled has declined by 58%. Taking into account distance travelled, there are about 50 times more child cyclist deaths (0.55 deaths/10 million passenger miles; 0.32 to 0.89) and nearly 30 times more child pedestrian deaths (0.27 deaths; 0.20 to 0.35) than there are deaths to child car occupants (0.01 deaths; 0.007 to 0.014). In 2003, children from families without access to a vehicle walked twice the distance walked by children in families with access to two or more vehicles. CONCLUSIONS: More needs to be done to reduce the traffic injury death rates for child pedestrians and cyclists. This might encourage more walking and cycling and also has the potential to reduce social class gradients in injury mortality.     

Traffic accidents resulting in injuries: underreporting,characteristics, and case fatality rate

In order to describe traffic accidents in a medium-sized Brazilian city and compare the risks of injury and death among different types of vehicles and pedestrians, all traffic accidents identified through police and hospital emergency records were registered for two years Deaths by such accidents were identified and confirmed through the coroner's office. The number of registered vehicles in the municipality was obtained through the State traffic authority. Morbidity and mortality rates were calculated and tests of association between selected variables performed. There was a relevant underreporting of accidents by the police (up to 53%), which varied according to the type of accident and time of occurrence. The highest case fatality rate was observed among bicyclists and pedestrians (around 5%), followed by motorcyclists (3%). Pedestrians formed the highest contingent of deaths. Motorcyclists had an eightfold risk of dying, a fourfold risk of injury, and a twofold risk of running over pedestrians as compared to automobile drivers. We conclude that pedestrians and motorcyclists are priority groups for interventions aimed at reducing injury and death from traffic accidents.     

Characteristics of the victims of traffic accidents in a city of the southern region of Brazil

OBJECTIVE: To evaluate the magnitude of morbidity and mortality and describe some of the characteristics of road accident victims. METHODS: The study population was composed of 3,643 victims of road accidents which occurred in Londrina, PR (Brazil), during the first semester of 1996. There were included victims from accidents registered by the Military Police, those who died at the accident scenario or on their way to the hospital, those who received emergency care or were hospitalized through the Unified Care System. It was observed a period of 180 days for death verification. RESULTS: The mean incidence and mortality rates were 1,582.2 and 29. 0 per 100,000 inhabitants, respectively. These rates, however, have demonstrated great variability in relation to several characteristics (place of residence, gender, age and the victim's mode of transport). The majority of victims were motorcyclists, followed by cyclists and pedestrians who, altogether, accounted for 76.9% of the total, and 81.5% of those who died. CONCLUSIONS: These results suggest that road accidents constitute a major cause of morbidity and mortality and that specific preventive measures should be considered in order to reduce such accidents, especially those that involve the most vulnerable road passers.     

Traveling by Bus Instead of Car on Urban Major Roads: Safety Benefits for Vehicle Occupants,Pedestrians, and Cyclists

Some studies have estimated fatality and injury rates for bus occupants, but data was aggregated at the country level and made no distinction between bus types. Also, injured pedestrians and cyclists, as a result of bus travel, were overlooked. We compared injury rates for car and city bus occupants on specific urban major roads, as well as the cyclist and pedestrian injuries associated with car and bus travel. We selected ten bus routes along major urban arterials (in Montreal, Canada). Passenger-kilometers traveled were estimated from vehicle counts at intersections (2002–2010) and from bus passenger counts (2008). Police accident reports (2001–2010) provided injury data for all modes. Injury rates associated with car and bus travel were calculated for vehicle occupants, pedestrians, and cyclists. Injury rate ratios were also computed. The safety benefits of bus travel, defined as the number of vehicle occupant, cyclist, and pedestrian injuries saved, were estimated for each route. Overall, for all ten routes, the ratio between car and bus occupant injury rates is 3.7 (95% CI [3.4, 4.0]). The rates of pedestrian and cyclist injuries per hundred million passenger-kilometers are also significantly greater for car travel than that for bus travel: 4.1 (95% CI [3.5, 4.9]) times greater for pedestrian injuries; 5.3 (95% CI [3.8, 7.6]) times greater for cyclist injuries. Similar results were observed for fatally and severely injured vehicle occupants, cyclists, and pedestrians. At the route level, the safety benefits of bus travel increase with the difference in injury rate associated with car and bus travel but also with the amount of passenger-kilometers by bus. Results show that city bus is a safer mode than car, for vehicle occupants but also for cyclists and pedestrians traveling along these bus routes. The safety benefits of bus travel greatly vary across urban routes; this spatial variation is most likely linked to environmental factors. Understanding the safety benefits of public transit for specific transport routes is likely to provide valuable information for mobilizing city and transportation planners.     

Pattern of Pedestrian Injuries in the City of Nairobi: Implications for Urban Safety Planning

Pedestrians are overrepresented in road traffic injuries and deaths in Nairobi, the capital city of Kenya, yet little research has been done to provide better understanding of the characteristics of pedestrian injuries. This paper presents the data obtained from road traffic injury admissions to Kenyatta National Hospital (KNH) over a 3-month period starting from 1 June to 31 August 2011. A total of 176 persons involved road traffic injuries in Nairobi were admitted to KNH during this period. Pedestrians comprised the highest (59.1 %) proportion of road traffic injury admissions, followed by motor vehicle passengers (24.4 %) and motor cyclists (9.7 %). Bicyclists and drivers accounted for 5.1 and 1.7 %, respectively. Cars (39.4 %) were the leading category of motorized four-wheeler vehicles that were involved in collisions with pedestrians, followed by matatus (35.5 %). Seventy percent of pedestrians were hit while crossing the road, 10.8 % while standing by the road, and 8.1 % while walking along the road. The highest proportion of pedestrian crashes occurred on Saturdays (25.5 %) and Sundays (16.7 %). Most of the pedestrian injuries (67.7 %) affected the limbs. The paper argues that safety of pedestrians should be a priority in road safety efforts in the city of Nairobi. Urban road safety planners should adopt existing cost-effective interventions to improve the safety of pedestrians such as area-wide traffic calming to limit the speeds of motor vehicles to 30 km/h, providing sidewalks for pedestrians, traffic calming in residential neighborhoods, people-and-not-car-oriented urban road designs, traffic education, and enforcement of traffic regulations.     

珠海市交通事故意外伤害人群分析

目的分析交通事故意外伤害人群特点,为健康教育提供参考.方法从珠海市公安交通警察支队获取近4 a的交通意外伤害资料,进行统计分析.结果在交通意外伤害中,男性的死伤百分比是女性的2～3倍;16～40岁之间的5个年龄组段,车祸死伤百分比较高,超过了10%;机动车司机死伤人员中,二轮摩拖车司机占的百分比最高;非机动车驾驶者死伤人员中,以骑自行车所占百分比最高;在交通事故中,马路上步行者比乘车者更易引起死亡;以外来工为主的外地人在交通事故中的死伤百分比和死伤率(每10万)均高于本地人.结论应根据珠海市交通事故死亡人员的人群特点有针对性的加强健康教育.     

广州市14岁以下儿童步行者道路交通事故伤害流行特征分析

目的描述儿童步行者交通事故伤害的流行特征,分析与步行者交通事故伤害相关的人、车、路因素。方法利用广州市公安交警系统收集的2000-2004年0～14岁儿童步行者交通伤害数据,用描述流行病学分析儿童步行者伤害的特征。结果2000-2004年共1440名儿童步行者发生交通事故,伤害年均发生率、死亡率和致死率分别为17．63／10万、1．78／10万、10．07％。5～9岁组年发生率和死亡率最高,分别为26．80／10万、2．57／10万;0～4岁组致死率最高,为13．29％。男孩步行者伤害年发生率(20．98／10万)和死亡率(2．00／10万)均高于女孩(分别为13．83／10万、1．52／10万)(P值均<0．05)。儿童步行者交通伤害最常见的部位是多部位(40．34％)、头部(26．75％)、下肢(21．53％)。死亡、重伤和轻伤所占的比例分别为10．07％、66．18％、23．75％。伤害主要由机动车驾驶员(57．50％)和步行者(33．47％)过失造成。导致伤害事故的主要车辆是客车、两轮摩托车和货车,分别占40．14％、34．38％、22．15％。结论儿童步行者交通伤害严重危害儿童的生命和健康,在人、车、路系统中,司机和步行者过失是儿童步行者伤害的主要原因,必须加强对机动车司机的教育以及儿童的看护。     

酗酒——伤害发生重要而共同的危险因素

目的 分析饮酒对伤害发生的影响及立论饮酒是伤害共同危险因素，提出防治措施。方法 分别就酒精对大脑／肝脏的短期／长期作用，对机动车驾驶员／步行和骑自行车的影响，酗酒对意外伤害／故意伤害的影响进行比较研究、原因深入研究，就血酒浓度的增高对道路交通伤害的影响进行回顾分析。结果 酒精对大脑的短期作用与伤害发生关系密切，酒后驾车及酗酒后的步行、骑自行车，发生道路交通伤害的危险性增加。急诊伤害的前3位原因构成是机械伤、跌伤、道路交通伤害，并未因经济发达程度不同、地理位置不同而改变。酗酒是道路交通伤害、跌伤等意外伤害以及机械伤等故意伤害的危险因素。结论 酗酒是伤害发生重要而共同的危险因素；应加强健康教育、增强自控能力、健全法制法规、提高管理效能。     

How comparable are road traffic crash cases in hospital admissions data and police records? An examination of data linkage rates

OBJECTIVES: An assessment of linked data was used to investigate the scope and the extent to which hospitalisations data and police crash records represent road crashes in New South Wales (NSW). METHODS: Hospital separation records for the period 1 July 2000 to 30 June 2001, inclusive, were linked to police crash casualty records for the same period using probabilistic record linkage techniques. Multivariable logistic regression techniques were used to identify factors independently associated with the probability of record linkage. RESULTS: Of 17,552 road transport-related hospital records, 45.1% matched to police crash casualty records. When the analysis was restricted to road traffic crashes, 69.2% of the 9,178 records had a matching police crash casualty record. Multivariable analysis found the most significant factors contributing to the likelihood of linkage to be road user type, payment status and principal diagnosis of injury variables. Motor vehicle controllers, cases entitled to financial compensation and cases with a principal diagnosis of injury were significantly more likely to be linked than all other cases. CONCLUSIONS: The findings indicate that researchers and policy makers should be cautious when examining traffic crashes based on a separate analysis of the hospitalisations data and police crash records. This is particularly true for crashes involving pedestrians, cyclists and motorcyclists, and those resulting in less severe injuries. IMPLICATIONS: The findings have implications for use of both police crash records and hospital records in informing the development of strategies designed to prevent road trauma in the community.     

Promoting safe walking and cycling to improve public health: lessons from The Netherlands and Germany

OBJECTIVES: We examined the public health consequences of unsafe and inconvenient walking and bicycling conditions in American cities to suggest improvements based on successful policies in The Netherlands and Germany. METHODS: Secondary data from national travel and crash surveys were used to compute fatality trends from 1975 to 2001 and fatality and injury rates for pedestrians and cyclists in The Netherlands, Germany, and the United States in 2000. RESULTS: American pedestrians and cyclists were much more likely to be killed or injured than were Dutch and German pedestrians and cyclists, both on a per-trip and on a per-kilometer basis. CONCLUSIONS: A wide range of measures are available to improve the safety of walking and cycling in American cities, both to reduce fatalities and injuries and to encourage walking and cycling.     

Road traffic accidents in a Swedish municipality

A continuous all embracing registration of acute, in-patient and out-patient visits at hospitals and primary health care centres, was conducted in Skaraborg County in western Sweden. A special focus was directed at accident cases which account for 20% of the total number of acute visits. The accidents were divided up by environment: home, work, traffic and other. Cases of road traffic accidents have been mapped out in more detail with the help of standardised and structured surveys via telephone interviews, information from hospital records, and death certificates. This study aimed at achieving an increased understanding and knowledge about the accident pattern in the traffic environment in a municipality. Road traffic accidents accounted for 6.5% of all accidents. Cyclists, car drivers, car passengers and pedestrians were the most common victims. Children showed a high frequency of bicycle accidents. There was an increased risk of injury for young car-drivers. Thirty-six per cent were single-accidents. Cars and bicycles dominated among injury-inducing vehicles. Head, arm and knee injuries were most common. Twenty-six per cent of the victims were hospitalized. Safety devices were not used in 10% of cases where they should have been used according to legislation. A comparison of our registration system for road traffic accidents with the official statistics of Sweden reveals a substantial under-reporting of road traffic accidents in the latter. Consequently, a need exists for the surveillance of injuries by the public health services as a basis of injury control.     

The risk of accidents among older drivers

The number of older persons holding a driver's license is rapidly increasing, as is the number of older persons driving a car. This paper examines driver accident risk by age group, focusing on the older driver. Two different measures of accident risk are used; involvement in personal injury traffic accidents per million kilometers driven, and involvement in traffic accidents where one or more pedestrians were injured per million kilometers driven. The latter measure is used to refute the assumption that the elderly's risk of being involved in personal injury accidents might, to some extent, be explained by the fact that older drivers generally tend to run a higher risk than younger drivers of being injured in the event of a traffic accident. Another motive is that it provides a measure of the extent to which drivers of different ages present a risk to their fellow road users. This study shows that drivers in the 75-84 age group are at four to six times greater risk than are middle-aged drivers of being involved in personal injury traffic accidents.     

Reduced Road Injuries While Commuting Due to Heavy Snowfall and Ensuing Modal Shifts Among Junior High School Students in Japan

BackgroundModal shifts in transport may reduce overall road injuries. Cyclist junior high school students are at a high risk of road injuries while commuting in Japan, and injuries among junior high school students could be reduced if the cyclists switch to other transport modes.MethodsWe estimated the change in the incidence of road deaths and serious injuries while commuting in months with heavy snowfall, when cyclists are likely to switch to other transport modes. Using police data on the monthly number of road injuries while commuting among junior high school students in Japan between 2004 and 2013 and corresponding population statistics and snowfall data, we calculated the monthly injury rate (number of deaths and serious injuries divided by population) at the prefecture level. We conducted Poisson regression analysis to estimate the change in the rate in months with a snowfall of ≥100 cm, compared to months without snowfall.ResultsA total of 3,164 deaths and serious injuries occurred during 2004 to 2013. The injury rate among cyclists was almost zero in months with a snowfall of ≥100 cm. That among cyclists and pedestrians in these months was reduced by 68% (95% confidence interval, 43–82%).ConclusionIn months with heavy snowfall, road injuries while commuting were reduced due to the near-elimination of cycling injuries among junior high school students in Japan. Switching from cycling to other transport modes would reduce overall road injuries among this population, and inducing modal shifts can be an important tool for road safety.Key words: epidemiology, injuries, transportation, adolescent     

Road accidents in a city in southern Brazil]

The study was conducted in the municipality of Londrina, a medium-sized city of southern Brazil. Analysis was performed in the characteristics of road accidents that had occurred during the first semester of 1996, resulting in 3,643 victims. Car or small truck collisions were the most common type of accident. The rate of motorcycle-related injuries (per 1,000 registered vehicles) was seven times higher than that resulting from cars or small trucks. Fatality rates were higher for motorcyclists who collided with stationary objects (29.4%) and pedestrians who were injured by lorries or buses (22.2%), in comparison with a mean fatality rate of 1.8%. This information may provide a basis for the implementation of public policies aiming at reducing accidents.     

Traffic accidents in a city in Southern Brazil: an evaluation of coverage and quality of data]

The aim of this study was to analyze police coverage and the validity of data on emergency and hospitalization records as well as on death certificates for traffic casualties in Londrina, Paraná State, Brazil. Victims (3,643) of road accidents during the first semester of 1996 were investigated and followed up after 180 days to confirm whether death was due to the accident. Police data recorded only 32.5% of the casualties, the coverage being higher for car occupants (71.6%) and lower for cyclists (8.1%) and pedestrians (24.8%). Agreement was low between original information and that derived from investigation of death certificates (Kappa coefficient 0.10; 95% CI: 0.02-0.17), fair for hospitalization records (Kappa coefficient 0.33; 95% CI: 0.27-0.40), and substantial for emergency records (Kappa coefficient 0.63; 95% CI: 0.61-0.65). Results suggest that police data underestimate the number of traffic casualties and that it is necessary to improve the validity of medical records.     

A case-control study of childhood pedestrian injuries in Perth, Western Australia.

STUDY OBJECTIVES: To identify the determinants of childhood pedestrian injuries, taking the child's exposure to the road environment into account. DESIGN: This was a case-control study. SETTING AND PARTICIPANTS: The study was conducted in Perth, Western Australia between 1991 and 1993. Altogether 100 injured and 400 uninjured child pedestrians aged 1 to 14 years were studied. Aspects of the child's social and physical environments, measures of his or her behaviour, cognitive skills, and "habitual" exposure to the road environment, as well as his or her knowledge of road safety, were recorded. MAIN RESULTS: The likelihood of injury increased by 12% with each 10,000 vehicles per day increase in the volume of traffic (odds ratio (OR) 1.12, 95% confidence interval (CI) = 1.05, 1.19) on roads most frequently crossed. In addition, the presence of visual obstacles on the verge of the child's street of residence increased the likelihood of injury by more than 2.6 times (OR 2.68, 95% CI = 1.42, 5.02). In contrast, the absence of footpaths was associated with a 52% reduction in the likelihood of injury compared with the presence of footpaths on the child's street of residence (OR 0.48, 95% CI = 0.27, 0.87). CONCLUSION: The amount of exposure to the road environment and the nature of the road environment to which the child pedestrian was exposed partly influenced the likelihood of injury in children from low socioeconomic areas, male children, and children aged 13 to 14 years. Until now, the excess incidence of childhood pedestrian injuries in these subgroups of the population had not been explained because the child's exposure per se had not been examined.