Fatal Motor Vehicle Collisions Research Articles

Leveraging computer vision for predicting collision risks: a cross-sectional analysis of 2019–2021 fatal collisions in the USA

ObjectiveThe USA has higher rates of fatal motor vehicle collisions than most high-income countries. Previous studies examining the role of the built environment were generally limited to small geographic areas...

Revisiting Older Drivers' Risks of At-fault Motor Vehicle Collisions in Japan.

In Japan, older drivers have been encouraged to surrender their driving licenses for traffic safety, despite the potential adverse social and health outcomes of driving cessation. We reconsidered such policies and social pressure by comparing the risk of at-fault motor vehicle collisions (MVCs) across the age groups of drivers. Using the national data of police-reported MVCs that occurred between 2016 and 2020, we examined the number of at-fault MVCs per licensed driver (MVC rate) and the number of fatally and non-fatally injured persons per at-fault MVC by the sex and age groups of at-fault drivers. The MVC rate of older drivers was higher than that of middle-aged drivers but lower than that of young drivers. The number of injured persons among the collided counterparts (collided car occupants, motorcyclists, bicyclists, and pedestrians) per MVC caused by older drivers was not greater than that by drivers in other age groups. In fatal MVCs caused by older drivers, drivers themselves or their passengers tend to be killed rather than their collided counterparts. Overall, the results were mostly consistent between male and female drivers. The risk of at-fault MVCs increased with the advancing age of drivers after middle age; however, this risk among older drivers did not exceed that among young drivers, without posing a high risk of injuries to their collided counterparts.

Proposal for nationwide registration of injuries or fatalities in wheelchair user motor vehicle passengers in Japan.

One consequence of population aging is an increase in the number of older wheelchair users. They often board the motor vehicle from the rear for moving. Recently, wheelchair user vehicle passengers have involved in motor vehicle collisions and died. A three-point seatbelt does not adequately fit most wheelchair user passengers because of the way that the wheelchair is constructed. Therefore, owing to the movement of the body immediately after the collision, the wheelchair user passengers attacked their body to the interior of the vehicle or suffered from the intrusion of the lap belt into the abdomen, subsequently suffered from severe head, chest or abdominal injuries. According to the review of all fatal motor vehicle collisions in Shiga Prefecture, Japan, which has a population of approximately 1.4 million, from 2017 to 2022, the rate of wheelchair users in fatal motor vehicle passenger increased from 3.6% in 2017 to 2019 to 7.8% in 2020 to 2022. Therefore, there is a risk that substantial numbers of wheelchair user passengers involved in motor vehicle collisions will die. However, in Japan, there are no official statistics on the involvement of wheelchair user passengers in motor vehicle collisions. Therefore, we propose a nationwide registration of injuries and fatalities in wheelchair user passengers. Investigating the mechanisms of injury in wheelchair user passengers would contribute to the development of safety measures, especially for restraint systems. Established preventive measure would contribute to the decrease of fatally or severely injured motor vehicle collision passengers.

Kaahaajat: Finnish Attitudes towards Speeding.

People driving in excess of the posted speed limit (referred to as speeding in English or Kaahaajat in Finnish) is a common road user behaviour. In Finland, between 2000 and 2020, speeding was identified as the key contributing factor in 41% of fatal motor vehicle collisions. This may be because disregarding speed limits on motorways and on residential roads are the most common violations performed by Finnish drivers. This study identifies factors influencing speeding while driving in Finland. In particular, 703 responses from Finnish drivers of the ESRA2 (E-Survey of Road users' Attitudes) were analysed to understand the theory of planned behaviour (TPB) factors underpinning speeding behaviours in three road environments: inside built-up areas; outside of built-up areas; and on motorways and freeways. Three binary logistic regression analyses were used to understand which elements of TPB were associated with self-reported speeding in each of these environments. Approximately two thirds of participants reported speeding in each of the three road environments. Attitudes and subjective norms were associated with speeding in built-up areas and on motorways or freeways. In addition, perceived behavioural control and age were significantly associated with speeding outside of built-up areas. The findings highlight how a systematic approach is needed to address speeding considering enforcement, engineering, legislation, and education.

U.S. Vision Zero Cities: modal fatality trends and strategy effectiveness

ABSTRACT At least 68 cities in the United States have taken a Vision Zero pledge to eliminate traffic fatalities. Which cities have improved their traffic safety outcomes and which strategies have proven effective? We examined changes in counts and per capita rates of all, pedestrian, and bicyclist fatal motor vehicle collisions between 2007 and 2019 for 18 U.S. cities that took early Vision Zero pledges. Only 2 of the 18 cities have experienced statistically significant decreases in total fatalities since taking a Vision Zero pledge and only one city experienced a statistically significant decrease in pedestrian fatalities. Cities with high walking, biking, and transit mode share and those that focused on walking and biking in their Vision Zero action plans experienced the best outcomes. Cities with high population densities and those that focused on technology in their action plans were also found to have safety performance improvements.

Road traffic fatalities in rural and remote Australia from 2006 to 2017: The need for targeted action.

ObjectiveTo explore rural motor vehicle collision (MVC) fatalities by trends over time, mode of transport, age, state, sex, and Aboriginal and Torres Strait Islander status.DesignA retrospective total population‐based time series was conducted using the Australian Bureau of Statistics (ABS) death registration data.SettingAll statistical local area (SLA) within Australia from 2006 to 2017.ParticipantsAustralian residents whose deaths were registered with the ABS between 01 January 2006 and 31 December 2017 where the underlying cause of death was related to unintentional transport accidents.Main outcome measuresFatality rates were determined using population data collected from the 2006, 2011 and 2016 census. Trends over time by rurality were analysed by financial year. Rates of transport deaths by vehicle type were determined by rurality. Risk ratios were calculated to compare demographic groups based on sex, Aboriginal and Torres Strait Islander status and age. A 3‐year scorecard was organised by state and rurality using 99.7% confidence intervals.ResultsMotor vehicle collision fatalities increase with increasing remoteness. Females, children from 0 to 14 years, pedestrians, and Aboriginal and Torres Strait Islander peoples are at a significantly higher risk of fatal MVCs than their respective metropolitan counterparts. The 3‐year scorecard indicates that road fatality rates in the NT, WA, and all rural and remote areas required immediate attention and targeted action.ConclusionsThere is a need for investment in MVC fatality prevention in rural Australia from inner regional to remote areas in order to meet the road safety targets established by the National Road Safety Strategy.

Fatality Prediction for Motor Vehicle Collisions: Mining Big Data Using Deep Learning and Ensemble Methods

Motor vehicle crashes are one of the most common causes of fatalities on the roads. Real-time severity prediction of such crashes may contribute towards reducing the rate of fatality. In this study, the fundamental goal is to develop machine learning models that predict whether the outcome of a collision will be fatal or not. A Canadian road crash dataset containing 5.8 million records is utilized in this research. In this study, ensemble models have been developed using majority and soft voting to address the class imbalance in the dataset. The prediction accuracy of approximately 75% is achieved using Convolutional Neural Networks. Moreover, a comprehensive analysis of the attributes that are important in distinguishing between fatal vs. non-fatal motor vehicle collisions has been presented in this paper. In-depth information content analysis reveals the factors that contribute the most in the prediction model. These include roadway characteristics and weather conditions at the time of the crash, vehicle type, time when the collision happen, road user class and their position, any safety device used, and the status of traffic control. With real-time data based on weather and road conditions, an automated warning system can potentially be developed utilizing the prediction model employed in this study.

Opioids and the Risk of Motor Vehicle Collision: A Systematic Review.

Background: Opioid analgesics are among the most commonly prescribed medications, but questions remain regarding their impact on the day-to-day functioning of patients including driving. We set out to perform a systematic review on the risk of motor vehicle collision (MVC) associated with prescription opioid exposure. Method: We searched Medline, PubMed, EMBASE, Scopus, and TRID from January 1990 to August 31, 2021 for primary studies assessing prescribed opioid use and MVCs. Results: We identified 14 observational studies that met inclusion criteria. Among those, 8 studies found an increased risk of MVC among those participants who had a concomitant opioid prescription at the time of the MVC and 3 found no significant increase of culpability of fatal MVC. The 3 studies that evaluated the presence of a dose-response relationship between the dose of opioids taken and the effects on MVC risk reported the existence of a dose-response relationship. Due to the heterogeneity of the different studies, a quantitative meta-analysis to sum evidence was deemed unfeasible. Our review supports increasing evidence on the association between motor vehicle collisions and prescribed opioids. This research would guide policies regarding driving legislation worldwide. Conclusion: Our review indicates that opioid prescriptions are likely associated with an increased risk of MVCs. Further studies are warranted to strengthen this finding, and investigate additional factors such as individual opioid medications, opioid doses and dose adjustments, and opioid tolerance for their effect on MVC risk.

Opioids and the Risk of Motor Vehicle Collision: A Systematic Review

Aim and Background: Opioid analgesics are amongst the most commonly prescribed medications, but questions remain regarding their impact on the day-to-day functioning of patients including driving. Previous studies of the effects of opioids on the risk of motor vehicle collisions (MVCs) have shown inconsistent findings. We set out to perform a systematic review on the risk of MVC associated with prescription opioid exposure. Methods: We searched Medline, PubMed, EMBASE, Scopus and TRID from January 1990 to January 31, 2020 for primary studies assessing prescribed opioid use and MVCs. Studies that used surrogate driving capability tests were excluded. The Newcastle-Ottawa scale was used to assess quality of included studies. Findings: We identified 12 observational studies that met inclusion criteria. Among those, 7 studies found an increased risk of MVC among those participants who had a concomitant opioid prescription at the time of the MVC and 2 found no significant increase of culpability of fatal MVC. The three studies that evaluated the presence of a dose-response relationship between the dose of opioids taken and the effects on MVC risk reported the existence of a dose-response relationship. Due to the heterogeneity of the different studies, a quantitative meta-analysis to sum evidence was deemed unfeasible. Interpretation: Our review indicates that opioid prescriptions are likely associated with an increased risk of MVCs. Further studies are warranted to strengthen this finding, and investigate additional factors such as individual opioid medications, opioid doses and dose adjustments, and opioid tolerance for their effect on MVC risk. Funding: This project was supported by the Rady Faculty of Health Sciences, University of Manitoba and the Chronic Disease Innovation Centre, Seven Oaks Hospital. Declaration of Interest: None to declare.

Prediction model for autopsy diagnosis of driver and front passenger in fatal road traffic collisions

Road traffic collisions (RTC) analysis is almost a daily activity in many autopsy room. Especially when analyzing an RTC with multiple occupants in the car, it can be necessary to distinguish driver from front seat passenger in order to provide the judicial authority with elements useful to understand and to prove who was driving, considering the criminal and civil responsabilities that may derive from it. Despite this, it is beyond doubt that there is enormous difficulty in providing such information. The aim of this paper is then to evaluate whether it is possible to differentiate driver and front seat passenger in case of fatal collisions using a mathematical model based on injury pattern alone. Autopsy reports concerning 90 drivers and 60 front-seat passengers were analyzed. Statistical analysis was used to detect injuries capable of discriminating between driver and passenger, considering skin, skeletal and visceral injuries. Results show that certain skin injuries, fractures and internal organ lesions are possibly associated with drivers and front seat passenger status and the overall injury pattern seems to be able to provide useful information. A mathematical model is presented. The process to distinguishing driver from front seat passenger following fatal motor vehicle collision may use multiple sources of information, including autopsy injury pattern analysis.

Motor Vehicle Collisions during Adolescence: The Role of Alexithymic Traits and Defense Strategies.

International literature has shown that adolescents represent the population most at risk of fatal and nonfatal motor vehicle collisions (MVCs). Adolescents’ alexithymic traits and significant use of immature defense strategies have been seen to play a key role. This study aimed to investigate the possible mediation role played by defense strategies use in the relationship between alexithymia and MVCs. Our sample consisted of 297 adolescents divided into four subgroups, based on the number of visits to the emergency department due to an MVC. We assessed adolescents’ alexithymic traits and defense strategies use through self-report instruments. Results showed that males reported a higher rate of MVCs than females. Higher rates of MVCs are associated with more alexithymic traits and maladaptive defense strategies use. Adolescents’ Acting Out and Omnipotence use significantly mediated the relationship between alexithymia and MVCs. Our findings suggest the recidivism of MVCs as an attempt to cope with emotional difficulties, with important clinical implications.

Autopsy findings in drivers and passengers from fatal motor vehicle collisions: limited differences in injury patterns and toxicological test results

We performed a retrospective study of the injuries and characteristics of occupant fatalities in motor vehicle collisions in southeast Norway. The goal was to provide updated knowledge of injuries sustained in modern vehicles and detect possible differences in injury pattern between drivers and passengers. Forensic autopsy reports, police, and collision investigation reports from 2000 to 2014 were studied, data extracted and analyzed.A total of 284 drivers, 80 front-seat passengers, and 37 rear-seat passengers were included, of which 67.3% died in front collisions, 13.7% in near-side impacts, 13.5% in rollovers and 5.5% in other/combined collisions. Overall, 80.5% died within one hour after the crash. The presence of fatal injuries to the head, neck, thorax and abdomen were observed in 63.6%, 10.7%, 61.6% and 27.4% respectively. All occupants with severe injuries to the head or neck had signs of direct impact with contact point injuries to the skin or skull. Injuries to the heart and spleen were less common in front-seat passengers compared to drivers. Seat belt abrasions were more common and lower extremity fractures less common in both front-seat and rear-seat passengers compared to drivers. Blood alcohol and/or drug concentrations suggestive of impairment were present in 30% of all occupants, with alcohol more often detected among front-seat passengers compared to drivers.Few driver-specific and passenger-specific patterns of injury could be identified. When attempting to assess an occupant’s seating position within a vehicle, autopsy findings should be interpreted with caution and only in conjunction with documentation from the crash scene.

Young and under the influence: A systematic literature review of the impact of cannabis on the driving performance of youth

BackgroundYoung drivers ages 15–24 continue to constitute a high-risk population for fatal motor vehicle collisions (MVCs) compared to all other age groups. Driving under the influence of cannabis is an important contributor to the high rates of MVCs among youth. Understanding the specific impact of cannabis on the driving performance outcomes of young drivers can inform injury prevention, education, and intervention strategies. ObjectivesThis systematic literature review (SLR) aims to determine the Class (I- highest to IV-lowest) of evidence and level of confidence (A-high to U-insufficient) in the effects of cannabis on the driving performance of young drivers. MethodsRegistered in PROSPERO (#CRD42020180541), this SLR searched seven data bases and appraised the quality and confidence in the evidence using an established research methodology. ResultsClass II evidence suggests that THC is likely to reduce mean speed and increase headway distance; and increase reaction time, lane, and steering wheel position variability among young drivers (Level B, moderate confidence). ConclusionsThis study shows that there is a moderate to low level of confidence on the impact of cannabis on the specific driving performance outcomes of young drivers. A need remains for Class I and II studies that focus on the specific effects on young drivers, distinguish between the biological and socially constructed variables of sex and gender, and includes larger and more representative samples.

Association between legalization of recreational cannabis and fatal motor vehicle collisions in the United States: an ecologic study.

Background:With the recent legalization of recreational cannabis in Canada, cannabis-impaired driving is an important public safety concern. Our aim was to examine the association between recreational cannabis legalization and fatal motor vehicle collisions using data from the United States, which present a timely natural experiment of cannabis legalization.Methods:We conducted an ecologic study using the number of fatal motor vehicle collisions and the associated number of deaths for US jurisdictions with legalized recreational cannabis (2007–2018) retrieved from the US Fatality Analysis Reporting System. We examined jurisdiction-specific rates of fatal motor vehicle collisions and associated deaths before and after recreational cannabis legalization using Poisson regression and meta-analyzed estimates across jurisdictions using DerSimonian and Laird random-effects models.Results:After adjustment for calendar year, legalization was associated with increases in rates of fatal motor vehicle collisions (incidence rate ratio [IRR] 1.15, 95% confidence interval [CI] 1.06–1.26) and associated deaths (IRR 1.16, 95% CI 1.06–1.27). Differences between the first 12 months after legalization relative to subsequent months were inconclusive for rates of fatal motor vehicle collisions (IRR 0.92, 95% CI 0.84–1.02) and associated deaths (IRR 0.92, 95% CI 0.84–1.01).Interpretation:Recreational cannabis legalization in the US was associated with a relative increased risk of fatal motor vehicle collisions of 15% and a relative increase in associated deaths of 16%, with no conclusive difference between the first and subsequent years after legalization. These findings raise concern that there could be a similar increase in fatal motor vehicle collisions and associated deaths in Canada following recreational cannabis legalization.

An evaluation of postmortem concentrations of Δ9-tetrahydrocannabinol (THC) and 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THCCOOH)

Δ9-tetrahydrocannabinol (THC), the primary psychoactive component of cannabis, leads to impaired cognitive and psychomotor function resulting in an increased risk of fatal motor vehicle collisions and other traumas resulting in death. It is important to measure cannabinoids in postmortem cases to improve understanding of this growing public safety issue. However, postmortem concentrations of THC and its primary inactive metabolite, 11-nor-9-carboxy-tetrahydrocannabinol (THCCOOH), have not been extensively studied. We aim to further characterize postmortem concentrations of THC and THCCOOH in peripheral blood with and without preservation, central blood, and central “serum” to support improved forensic interpretation. Cannabinoids were extracted from blood and “serum” from twenty-five decedents using solid phase extraction followed by quantification using gas chromatography – mass spectrometry. We evaluated the impact of sample preservation, reported central blood-to-peripheral blood (CB:PB) ratios and blood-to-”serum” ratios, and assessed the relationship of CB:PB and postmortem interval for THC and THCCOOH. Correlations of preserved compared to unpreserved blood were strong with r2 > 0.97. The median CB:PB ratios were 1.1 and 1.3 for THC and THCCOOH, respectively. THCCOOH CB:PB was significantly higher than 1.0 (p-value < 0.001). The CB:PB ratio was only weakly correlated with PMI for both compounds. The median blood-to-”serum” ratio was 1.0 for THC and 0.8 for THCCOOH. The blood-to-”serum” ratio of THCCOOH was significantly lower than 1.0 (p-value < 0.001). Results demonstrated minimal potential for postmortem redistribution of THC and THCCOOH and that the ratio of blood-to-”serum” in postmortem samples differs from the blood-to-plasma ratio established in living humans. Based on these results, it is not recommended to apply a correction factor to THC and THCCOOH concentrations from postmortem blood samples. Our study improves the understanding of postmortem cannabinoid concentrations to support forensic interpretation in cases of fatal motor vehicle accidents.

Legalized Cannabis in Colorado Emergency Departments: A Cautionary Review of Negative Health and Safety Effects.

Cannabis legalization has led to significant health consequences, particularly to patients in emergency departments and hospitals in Colorado. The most concerning include psychosis, suicide, and other substance abuse. Deleterious effects on the brain include decrements in complex decision-making, which may not be reversible with abstinence. Increases in fatal motor vehicle collisions, adverse effects on cardiovascular and pulmonary systems, inadvertent pediatric exposures, cannabis contaminants exposing users to infectious agents, heavy metals, and pesticides, and hash-oil burn injuries in preparation of drug concentrates have been documented. Cannabis dispensary workers (“budtenders”) without medical training are giving medical advice that may be harmful to patients. Cannabis research may offer novel treatment of seizures, spasticity from multiple sclerosis, nausea and vomiting from chemotherapy, chronic pain, improvements in cardiovascular outcomes, and sleep disorders. Progress has been slow due to absent standards for chemical composition of cannabis products and limitations on research imposed by federal classification of cannabis as illegal. Given these factors and the Colorado experience, other states should carefully evaluate whether and how to decriminalize or legalize non-medical cannabis use.

Prior Arrest, Substance Use, Mental Disorder, and Intent-Specific Firearm Injury

Substance use, mental disorders, and arrest are markers of increased firearm injury risk. It is unclear how these markers vary by intent. Examining these interrelated factors together can clarify their associations with assault-related, self-inflicted, unintentional, and legal intervention firearm injuries, informing intent-specific interventions. In 2017-2018, 2-year diagnosis and arrest histories of intent-specific firearm injury cases were compared with those of unintentionally injured motor vehicle collision passenger controls. Fatal and nonfatal firearm and motor vehicle collision injury records in Seattle (2010-2014) were linked to statewide hospitalization and arrest records. Multinomial logistic regression models compared odds of prior arrest, substance use, and mental disorder diagnoses among intent-specific firearm injury cases relative to controls, adjusting for age, race, and gender. A total of 763 cases and 335 controls were identified. Unintentional and self-inflicted cases did not differ significantly from controls in arrest history. Legal intervention cases resembled assault-related cases in their arrest history, and self-inflicted cases in their hospitalization history. The legal intervention cases were more likely than controls to have a prior felony arrest (OR=7.72, 95% CI=2.63, 20.97), and diagnoses involving alcohol (OR=4.06, 95% CI=1.04, 15.84); cannabis (OR=11.00, 95% CI=1.01, 119.36); depression/anxiety (OR=7.22, 95% CI=1.89, 27.67); psychosis (OR=6.99, 95% CI=1.35, 36.24); or conduct disorder (OR=22.01, 95% CI=1.44, 335.93). Individuals with intent-specific firearm injuries have distinct patterns of prior substance use, mental disorder, and arrest. Many injuries occur after a series of encounters with institutions meant to help individuals during crises that can fail to provide longer-term solutions.

Risk of fatal motor vehicle collisions in zolpidem users

Risk of fatal motor vehicle collisions in zolpidem users

Prescription of Zolpidem and the Risk of Fatal Motor Vehicle Collisions: A Population-Based, Case-Crossover Study from South Korea.

Zolpidem is one of the most frequently used hypnotics worldwide, but associations with serious adverse effects such as motor vehicle collisions have been reported. The objective of this study was to evaluate the association of fatal motor vehicle collisions with a prescription for zolpidem, considering the context of the motor vehicle collisions. We conducted a case-crossover study, where each case served as its own control, by linking data about fatal motor vehicle collisions from the Korean Road Traffic Authority between 2010 and 2014 with national health insurance data. The case period was defined as 1day before the fatal motor vehicle collisions, and was matched to four control periods at 90-day intervals. Conditional logistic regression was performed to calculate the odds ratio for fatal motor vehicle collisions associated with zolpidem exposure, and odds ratios were adjusted for time-varying exposure to confounding medications. A stratified analysis was performed by age group (younger than 65years or not), the Charlson Comorbidity Index, and whether patients were new zolpidem users. Among the 714 subjects, the adjusted odds ratio for a fatal motor vehicle collision associated with a prescription for zolpidem the previous day was 1.48 (95% confidence interval 1.06-2.07). After stratification, a significantly increased risk was observed in subjects with a high Charlson Comorbidity Index (odds ratio 1.81; 95% confidence interval 1.16-2.84), the younger age group (odds ratio: 1.62; 95% confidence interval 1.03-2.56), and new zolpidem users (odds ratio 2.37; 95% confidence interval 1.40-4.00). A prescription for zolpidem on the previous day was significantly related to an increased risk of fatal motor vehicle collisions in this population-based case-crossover study.

The significance of preexisting medical conditions, alcohol/drug use and suicidal behavior for drivers in fatal motor vehicle crashes: a retrospective autopsy study.

Driver fatalities in motor vehicle collisions (MVCs) encompass accidents, suicides, and natural deaths when driving. The objective of this study was to determine the significance of pathology and other autopsy findings for drivers in fatal MVCs. Forensic autopsy records of driver fatalities in southeast Norway between 2000 and 2014 were studied retrospectively. Data from individual police and collision investigation reports were also collected and analyzed. In 406 driver fatalities, the male/female ratio was 340/66; 9% died from natural causes, 9% were suicides, 65% were culpable accidental deaths, 14% were nonculpable deaths, and 3% were undetermined deaths. Head injuries and thoracic injuries were the most common causes of death. A seatbelt had been worn in 50% of the fatalities, and its prevalence did not differ between accidental deaths and suicides. Blood levels of alcohol and/or drugs that indicated impairment at the time of the collision were found in 40% (105/262) of all culpable accidental deaths but in 50% (64/127) of drivers aged up to 35years. Pathology (most often cardiovascular disease) suggestive of sudden incapacitation before the collision was present in 24% (62/264) of drivers who were culpable in the accident and in 70% (46/66) of culpable drivers older than 55years. A substantial proportion of drivers are killed in accidental collisions that may have occurred as a result of either alcohol/drug impairment or preexisting disease. Suicides and natural deaths both constitute significant proportions of MVC fatalities and may be misclassified unless a full inquest including an autopsy is performed.