骑自行车人与行人车祸伤害的流行病学特征

目的 :为控制和预防骑自行车人与行人的车祸伤害提供依据。方法 :采用描述流行病学方法 ,对 1996年郑州市机动车与骑自行车人和行人相撞的车祸资料进行分析。结果 :骑自行车人与行人的车祸伤害人数占该年总车祸伤害人数的 37.1% ,死亡人数占总死亡人数的 46 .6 % ,伤亡人员多为青壮年。骑自行车人与行人的车祸伤害主要发生在城市主干道、混合式道路、无交通控制方式的交通环境中 ;引起这类伤害的主要原因是驾驶员疏忽大意 ,骑自行车人抢道行驶和突然猛拐 ,行人违章穿行车行道。结论 :骑自行车人与行人车祸伤害是车祸伤害的重要组成部分。致伤原因是人们的交通安全意识差 ,没有按照交通规章行驶。因此 ,应加强交通法规的宣传和教育 ,提高人们的交通安全意识     

Increasing child pedestrian and cyclist visibility: cluster randomised controlled trial

STUDY OBJECTIVE: Visibility aids have the potential to reduce child pedestrian and cyclist injury but scarce data exist relating to their use or to interventions for increasing visibility aid use among children. This cluster randomised controlled trial was designed to assess the use of free visibility aids one and eight weeks after their provision among primary school children in Nottingham, UK. DESIGN: One class from each of 20 schools representing 377 children aged 7, 8, and 9 years old participated in the trial and were randomly assigned to treatment and control arms. Children in the intervention arm received two visibility aids, namely, a reflective and fluorescent slap wrap (an item that can be worn around an arm or trouser leg and is readily removed), and a reflective durable sticker in addition to educational material on the importance of being seen in the dark. Observers visited schools to observe use of reflective and fluorescent slap wraps, stickers, piping and patches on coats, and bags at baseline and at one and eight weeks after distribution of the visibility aids. The study used random effects logistic regression to calculate odds ratios (OR) and confidence intervals (CI). MAIN RESULT: The results showed that children provided with free visibility aids were significantly more likely to use any visibility aid at one week (adjusted OR 59.5, 95% CI 18.5 to 191.0) and eight weeks (adjusted OR 5.9, 95% CI 3.4 to 10.4) after distribution than children in the control arm. CONCLUSIONS: Providing free visibility aids and an educational booklet on road safety significantly increases use of visibility aids for up to eight weeks during the winter among primary school children. On the basis of an eight week follow up trial in Nottingham of 20 classes of children aged 7 to 9 years old, these results suggest that campaigns providing free visibility aids to primary school children should be encouraged.     

Motor vehicle trauma: analysis of injury profiles by road-user category

Background

Vehicle accidents in Greece are among the leading causes of death and the primary one in young people. The mechanism of injury influences the patterns of injury in victims of vehicle accidents.

Objective

Identification and analysis of injury profiles of motor‐vehicle trauma patients in a Greek level I trauma centre, by road‐user category.

Patients and methods

The trauma registry data of Herakleion University Hospital of adult trauma patients admitted to the hospital after a vehicle accident between 1997 and 2000 were retrospectively examined. Patients were grouped based on the mechanism of injury into three road‐user categories: car occupants, motorcyclists, and pedestrians.

Results

Of 730 consecutive patients, 444 were motorcyclists (60.8%), 209 were car occupants (28.7%), and 77 were pedestrians (10.5%). Young men constituted the majority of injured motorcyclists whereas older patients (p = 0.0001) and women (p = 0.0001) represented a substantial proportion of the injured pedestrians. With regard to the spectrum of injuries in the groups, craniocerebral injuries were significantly more frequent in motorcyclists and pedestrians (p = 0.0001); abdominal (p = 0.009) and spinal cord trauma (p = 0.007) in car occupants; and pelvic injuries (p = 0.0001) in pedestrians. Although the car occupants had the highest Injury Severity Score (ISS) (p = 0.04), the pedestrians had the poorest outcome with substantially higher mortality (p = 0.007) than the other two groups.

Conclusions

The results reveal a clear association between different road‐user categories and age and sex incidence patterns, as well as outcomes and injury profiles. Recognition of these features would be useful in designing effective prevention strategies and in comprehensive prehospital and inhospital treatment of motor‐vehicle trauma patients.     

Craniocerebral injuries in traffic accidents with fatal outcomes

Research into crainiocerebral injury (CCI) characteristics of traffic accidents with fatal outcomes, as well as certain types of CCIs and defined categories of traffic participants, has been conducted. The research data were obtained from autopsy protocols at the Institute of Forensic Medicine in Serbia. Out of the 202 cases of individuals who had been fatally injured in traffic accidents, CCIs were diagnosed in 82.7% of them. The highest percentage of CCIs was established for front-seat passengers (95%), while for drivers it was 86.2%, pedestrians 78%, and 76% for rear-seat passengers. The domination of males among the deceased was also found, mostly as drivers (92%). The majority of individuals who experienced a CCI were in the age group of 21 to 30 years old, while pedestrians were commonly older than 60. In these cases, a high frequency of skull fractures was usually localized in different cranial regions (67.7%). In the majority of cases with CCIs (81.4%), these injuries contributed to an ultimate fatal outcome, mainly in pedestrians (93%). Fatal and non-fatal CCIs resulting from traffic accidents can result in significant socio-economic consequences for the individual and society as a whole that include specifically the ongoing costs and outcomes in cases from non-fatal injuries.     

Child traffic accident injuries in Japan

This study analyzes the characteristics of traffic accidents involving children. It discusses why children with certain attributes and in specific situations are exposed to a higher traffic accident risk, in light of their ability to deal with traffic and their body characteristics. Finally, based on these results, it offers some conclusions and recommendations on ways of improving child safety in road traffic.     

RESOURCE UTILIZATION BY INJURED AUTOMOBILE OCCUPANTS AND PEDESTRIANS

Background : This study was designed to test the hypothesis that the hospital resources utilized in treating pedestrian trauma would be significantly greater than that for automobile occupants. This was based on previous studies that showed that the demographic features and patterns of injury sustained by the pedestrian population were significantly different from that of automobile occupants. Methods : A hospital-based study was designed utilizing retrospective analysis of a prospective trauma database. All primary retrievals of pedestrians (n= 547) and automobile occupants (n= 597) involved in accidents in Central Sydney from mid-1990 to mid-1995 were included. The length of hospital stay, use of the intensive care unit (ICU) and visits to the operating theatre (Standard Resource Cost) were compared. Results : The age and injury severity scores were significantly higher for the pedestrian group. The length of stay (days) for the pedestrians (mean, 12 SD 14; median, 7 interquartile range (IQR) 13), was significantly higher (P < 0.0001) than that for the automobile occupants (mean, 7 SD 11; median, 2 IQR 6). The ICU utilization (days) for the pedestrians (mean, 1.3 SD 4.0; median, 0) was significantly higher (P < 0.0001) than that of the automobile occupants (mean, 0.6 SD 2.9; median, 0). The average operating theatre utilization per pedestrian (0.65 visits) exceeded that of automobile occupants (0.43) by 50% (P < 0.0001). Conclusions : The study confirms that the acute care of pedestrian injury utilizes more hospital resources than that of automobile occupants. Resources should be allocated to meet this need both in terms of hospital reimbursement and overall directives in public health policy.     

Adult pedestrian and cyclist injuries in Lilongwe,Malawi: a cross-sectional study

BackgroundPedestrian and cyclist injuries are a major concern globally, but especially in low-income countries. Locally conducted research is needed to measure the size of the problem and advise policy on road safety interventions. We wanted to investigate the precise circumstances of these injuries in Lilongwe, Malawi and to identify risk factors for severe injuries.MethodsCross-sectional study of all adult pedestrian and cyclist injuries presenting to a large central hospital. This was a sub-study of a larger study with all types of road users included. All patients provided detailed information about the incidents leading to injury and were tested for alcohol.ResultsThere were 222 pedestrians, 183 bicycle riders and 42 bicycle passengers among the 1259 adult road traffic injury victims that were treated at Kamuzu Central Hospital during a 90-day period in 2019. Of these injuries, 60.2% occurred while the victim was walking/cycling along the road and 22.3% when the victim was trying to cross the road. The majority of the victims were men (89.1%). Helmet use for bicyclists was almost non-existent. Only 1 patient had used reflective devices when injured in the dark, despite 44.7% of these injuries occurring in reduced light conditions. There was an increased risk for serious and fatal injuries for pedestrians compared with bicyclists, and also compared with all types of road users. Patients injured in rural areas and those hit by lorries were more severely injured. Consuming alcohol before being injured was associated with more severe injuries in bicyclists. Being injured while crossing the road at painted zebra crossings was associated with an increased risk of serious and potentially fatal injuries.ConclusionThis study identified important risk factors for severe injuries in pedestrians and cyclists. Implications for preventive measures are presented in a Haddon Matrix.     

From the Cover: Pedestrian dynamics at the running of the bulls evidence an inaccessible region in the fundamental diagram

We characterize the dynamics of runners in the famous “Running of the Bulls” Festival by computing the individual and global velocities and densities, as well as the crowd pressure. In contrast with all previously studied pedestrian systems, we unveil a unique regime in which speed increases with density that can be understood in terms of a time-dependent desired velocity of the runners. Also, we discover the existence of an inaccessible region in the speed–density state diagram that is explained by falls of runners. With all these ingredients, we propose a generalization of the pedestrian fundamental diagram for a scenario in which people with different desired speeds coexist.

The world-famous Running of the Bulls (San Fermín) Festival constitutes a unique system of pedestrians running away from bulls in the streets of Pamplona (Spain). Curiously, despite that this race has been repeatedly used as an illustration of competitive pedestrian dynamics, it has not been studied in detail until now. Runners, first waiting for and then escaping from bulls, constitute a fascinating annual scenario of real fleeing pedestrians, becoming an invaluable opportunity for studying and understanding extreme pedestrian dynamics.One of the main macroscopic observables for characterizing pedestrian systems is the fundamental diagram derived from the speed–density relation for a group of moving pedestrians (1–16). This relation, which is used as a benchmark in design and planning (17–20), accounts for the accepted fact that the speed of the group decreases monotonically as the density increases. Under ordinary conditions, this behavior can be explained because people try to avoid physical contact and slow down when the available space reduces. A key feature of this plot is the speed at near-zero density, which indicates the velocity at which pedestrians would move if they were alone. This speed is known as the desired speed or the free speed (v₀).Given their importance, speed–density relations are widely studied in the literature; however, most of the existing investigations assume implicitly two essential facts:

• •All pedestrians have constant desired speed normally distributed with small variance (an exception to this is the time-dependent desired speed implemented in ref. 21).
• •The speed–density relations correspond to stationary (or quasi-stationary) pedestrian systems.

Importantly, these premises hold even for the fundamental diagrams obtained in extreme conditions. As examples, we highlight the fundamental diagram for running pedestrians at medium speed (16), the empirical results collected in a real event (8), and the outcomes obtained in highly competitive evacuation drills in which pedestrians were allowed to push each other (22). In these last two cases, very high densities were present (which dominate the dynamics) and the free velocities were below 1.5 m/s. Remarkably, the assumptions used for traditional fundamental diagrams are not valid in the Running of the Bulls Festival. Here, a moving threat (the bulls) induces time-dependent desired velocities along with a broad distribution among individuals. To understand the complicated dynamics observed, we characterize this system by studying—among other variables—the speed, density, and falling probability of the pedestrians.