Fatal Crash Rates Research Articles

Vital Signs: Motor Vehicle Injury Prevention - United States and 19 Comparison Countries.

Each year >32,000 deaths and 2 million nonfatal injuries occur on U.S. roads. CDC analyzed 2000 and 2013 data compiled by the World Health Organization and the Organisation for Economic Co-operation and Development (OECD) to determine the number and rate of motor vehicle crash deaths in the United States and 19 other high-income OECD countries and analyzed estimated seat belt use and the percentage of deaths that involved alcohol-impaired driving or speeding, by country. In 2013, the United States motor vehicle crash death rate of 10.3 per 100,000 population had decreased 31% from the rate in 2000; among the 19 comparison countries, the rate had declined an average of 56% during this time. Among all 20 countries, the United States had the highest rate of crash deaths per 100,000 population (10.3); the highest rate of crash deaths per 10,000 registered vehicles (1.24), and the fifth highest rate of motor vehicle crash deaths per 100 million vehicle miles traveled (1.10). Among countries for which information on national seat belt use was available, the United States ranked 18th out of 20 for front seat use, and 13th out of 18 for rear seat use. Among 19 countries, the United States reported the second highest percentage of motor vehicle crash deaths involving alcohol-impaired driving (31%), and among 15, had the eighth highest percentage of crash deaths that involved speeding (29%). Motor vehicle injuries are predictable and preventable. Lower death rates in other high-income countries, as well as a high prevalence of risk factors in the United States, suggest that the United States can make more progress in reducing crash deaths. With a projected increase in U.S. crash deaths in 2015, the time is right to reassess U.S. progress and set new goals. By implementing effective strategies, including those that increase seat belt use and reduce alcohol-impaired driving and speeding, the United States can prevent thousands of motor vehicle crash-related injuries and deaths and hundreds of millions of dollars in direct medical costs every year.

Economic development and road traffic fatalities in two neighbouring African nations

IntroductionThe rapid growth of Botswana’s economy since independence in 1966 has brought more tarred roads and vehicles, accompanied by an escalating road crash fatality rate. We tested the hypothesis that motor vehicle crash fatality increases resulted from, rather than just corresponded with, annual gross domestic product (GDP) increases. Data from Zambia, adjacent to Botswana, were used for comparison.MethodsAnnual social and economic indicators and motor vehicle crash fatality rates in Botswana and Zambia were accessed from 1960 to 2012 and analysed using vector autoregressive analysis and Granger causality tests.ResultsIn Botswana, annual changes in per capita GDP predicted annual changes in motor vehicle crash fatality rates (p = 0.042). The opposite was not observed; annual changes in motor vehicle crash fatality rates did not predict annual GDP changes. These findings suggest that GDP growth in a given year caused additional road traffic fatalities in Botswana and that, on average, every billion dollar increase in GDP produced an increase in the rate of road traffic fatalities. In Zambia, annual GDP changes predicted annual fatality rate changes three years later (p = 0.029), but annual changes in road crash fatality rates also predicted annual increases in per capita GDP (p = 0.026) three years later, suggesting a correlation between trends, but not a causal effect of GDP.ConclusionRoad crash fatalities increased in recent decades in both Zambia and Botswana. But the rapid economic development in Botswana over this time period appears to have driven proportionate road traffic fatality increases. There are opportunities for newly emerging economies such as Zambia, Angola, and others to learn from the Botswana experience. Evidence-based investments in road safety interventions should be concomitant with economic development.

Fatality rate of pedestrians and fatal crash involvement rate of drivers in pedestrian crashes: a case study of Iran

The aim of this study was to uncover patterns of pedestrian crashes. In the first stage, 34,178 pedestrian-involved crashes occurred in Iran during a four-year period were grouped into homogeneous clusters using a clustering analysis. Next, some in-cluster and inter-cluster crash patterns were analysed. The clustering analysis yielded six pedestrian crash groups. Car/van/pickup crashes on rural roads as well as heavy vehicle crashes were found to be less frequent but more likely to be fatal compared to other crash clusters. In addition, after controlling for crash frequency in each cluster, it was found that the fatality rate of each pedestrian age group as well as the fatal crash involvement rate of each driver age group varies across the six clusters. Results of present study has some policy implications including, promoting pedestrian safety training sessions for heavy vehicle drivers, imposing limitations over elderly heavy vehicle drivers, reinforcing penalties toward under 19 drivers and motorcyclists. In addition, road safety campaigns in rural areas may be promoted to inform people about the higher fatality rate of pedestrians on rural roads. The crash patterns uncovered in this study might also be useful for prioritizing future pedestrian safety research areas.

Epidemiology of traffic crash mortality in west of Iran in a 9 year period

PurposeIn Iran, the most common cause of injuries and the second leading cause of deaths are traffic accidents, and those problems impose a substantial financial burden on the society. This study aims to determine traffic accident mortality trends and their epidemiologic characteristics in the Kermanshah province, west of Iran. MethodsIn a cross sectional study, road traffic fatality data from 2004 to 2013 were analyzed to determine the epidemiological pattern of traffic accident mortality. Trend assessment was performed to ascertain the decreasing or increasing status. Chi-square and one-way analysis of variance (ANOVA) tests, as well as Poisson regression were used to determine the significance of the data in time. Data were analyzed using Excel and statistical package of SPSS version 19. ResultsOut of 5110 people that died in traffic accidents, 4024 (78.7%) were males. The state of accidents indicated that 404 (43.8%) female pedestrians died as a result of car crashes, and 1330 (41.4%) males died because of car collisions. 1554 (31.9%) deaths happened to pedestrians and 1556 (32.1%) to vehicle drivers, and the rest belonged to vehicle passengers. Head trauma was the cause of death for as much as 3400 (69.9%) cases. Fatal crashes in which pedestrians were involved mostly occurred between the hours 13:00 to 15:00, while the time for vehicle drivers was between 16:00 to 18:00. 2882 people (59.1%) died before reaching to health care facilities. Traffic crash mortality trend for pedestrians follows a linear pattern with a gentle downward slope, but the trend shows various swings when it comes to vehicle drivers. ConclusionThe number of traffic crash deaths from 2004 to 2013 indicates a decreasing trend in two groups of road users: vehicle drivers and car occupants. This can be due to some interventions such as modification of traffic rules and enhancement of police control which has been implemented in recent years. Moreover, more attention should be paid to promote the optimal health care services to save the lives of the injured from traffic accidents.

Motor Vehicle Crash Fatalities in States With Primary Versus Secondary Seat Belt Laws: A Time-Series Analysis.

Motor vehicle crashes (MVCs) remain a leading cause of injury-related deaths in the United States. Primary seat belt laws allow vehicle occupants to be ticketed solely for not wearing seat belts, and secondary laws allow ticketing only for failure to wear seat belts in the setting of other violations. To determine the association between MVC fatality rates and primary versus secondary seat belt laws. Retrospective time-series analysis. United States, 2001 to 2010. MVC fatalities in occupants aged 10 years or older identified in the Fatality Analysis Reporting System. Population-based rates of fatal crashes. There were 283 183 MVC fatalities in occupants aged 10 years or older from 2001 to 2010 (overall rate, 13.0 per 100 000 persons). In 2001, the mean fatality rate was 14.6 per 100 000 persons, 16 states had primary seat belt laws, and 33 states had secondary laws. In 2010, the mean fatality rate was 9.7 per 100 000 persons, 30 states had primary seat belt laws, and 19 states had secondary laws. In the multivariate regression model, states with primary seat belt laws had lower MVC fatality rates than states with secondary laws (adjusted incidence rate ratio, 0.83 [95% CI, 0.78 to 0.90]). Only fatalities were analyzed from the database, and the degree of law enforcement could not be ascertained. States with primary seat belt laws had lower rates of MVC fatalities than those with secondary laws. Adoption of primary seat belt laws may offer optimal occupant protection. None.

Fatality rates for crashes involving heavy vehicles on highways: A random parameter tobit regression approach

ABSTRACTFew studies have analyzed the impacts of freight movements (large truck) on crash fatality rates. This study explores a novel application of a method, namely the random parameters tobit regression model to large truck fatality rates by using the nationwide Fatality Analysis Reporting System. By utilizing random parameter tobit regression the authors examined crash rates (instead of frequencies) in per million truck-miles traveled and ton-miles of freight in the United States as continuous censored variables. The empirical and statistical results illustrate that the random-parameters tobit regression model provides a better understanding of the fatality rates per million truck-miles traveled and ton-miles of freight over the fixed parameter tobit model. Factors related to the crash mechanism, temporal and spatial characteristics, road and environmental attributes, vehicle configuration, drivers and passenger attributes were found to be statistically significant. Some exposure to injury severity related factors also were found to be significant with random parameters that vary across the observations.

The Effects of Vehicle Redesign on the Risk of Driver Death

Objectives: This study updates a 2006 report that estimated the historical effects of vehicle design changes on driver fatality rates in the United States, separate from the effects of environmental and driver behavior changes during the same period. In addition to extending the period covered by 8 years, this study estimated the effect of design changes by model year and vehicle type.Methods: Driver death rates for consecutive model years of vehicle models without design changes were used to estimate the vehicle aging effect and the death rates that would have been expected if the entire fleet had remained unchanged from the 1985 calendar year. These calendar year estimates are taken to be the combined effect of road environment and motorist behavioral changes, with the difference between them and the actual calendar year driver fatality rates reflecting the effect of changes in vehicle design and distribution of vehicle types. The effects of vehicle design changes by model year were estimated for cars, SUVs, and pickups by computing driver death rates for model years 1984–2009 during each of their first 3 full calendar years of exposure and comparing with the expected rates if there had been no design changes.Results: As reported in the 2006 study, had there been no changes in the vehicle fleet, driver death risk would have declined during calendar years 1985–1993 and then slowly increased from 1993 to 2004. The updated results indicate that the gradual increase would have continued through 2006, after which driver fatality rates again would have declined through 2012. Overall, it is estimated that there were 7,700 fewer driver deaths in 2012 than there would have been had vehicle designs not changed. Cars were the first vehicle type whose design safety generally exceeded that of the 1984 model year (starting in model year 1996), followed by SUVs (1998 models) and pickups (2002 models). By the 2009 model year, car driver fatality risk had declined 51% from its high in 1994, pickup driver fatality risk had declined 61% from its high in 1988, and SUV risk had declined 79% from its high in 1988. The risk of driver death in 2009 model passenger vehicles was 8% lower than that in 2008 models and about half that in 1984 models.Conclusions: Changes in vehicles, whether from government regulations and consumer testing that led to advanced safety designs or from other factors such as consumer demand for different sizes and types of vehicles, have been key contributors to the decline in U.S. motor vehicle occupant crash death rates since the mid-1990s. Since the early 1990s, environmental and behavioral risk factors have not shown similar improvement, until the recession of 2007, even though there are many empirically proven countermeasures that have been inadequately applied.

Impact of Georgia's teenage and adult driver responsibility act: 15-year follow-up

ABSTRACTObjective: This study was designed to investigate the 15-year impact of Georgia's graduated drivers' licensing (GDL) law, the “Teenage and Adult Driver Responsibility Act” (TADRA), on fatality crashes among young drivers.Methods: Fatality Analysis Reporting System (FARS) data for Georgia and Census denominators were used to determine fatal crash rates (FCRs) of drivers ages 16 through 19 who passed through the Georgia GDL system during the 5.5 years prior to through 15.5 years after TADRA's implementation. FCRs of younger drivers were compared to those of drivers ages 20–54 and 55–75 and compared by gender. Attention was given to speeding- and alcohol-related crashes, 2 foci of TADRA.Results: The decline in FCRs has been maintained and even increased through 15.5 years after passage of the law. Extending the curfew and further limiting passengers (passed in 2001) and driver's education and supervised driving requirements (added in 2007) may have contributed. The greatest declines were among 16- and 17-year-olds; most of the gains were among male drivers. The changes were greatest for alcohol- and speeding-related crashes. Those 18 and 19 years old did not demonstrate an increase in FCR over the period studied.Conclusion: Georgia's graduated licensing law, TADRA, has maintained and in some instances increased in effectiveness over the 15.5 years since its inception. Though national research suggests that GDL laws are associated with increased crash rates among 18- to 19-year-old drivers, this has not occurred in Georgia; 18- and 19-year-olds demonstrated no change or reductions in FCR over the 20.5-year period evaluated. Declines were greatest for those driving behaviors targeted by the law.

Investigation of fatal crash trends in the Arab world compared with Eu

Over three decades, vehicular and fatality related data are analysed and modelled for the Arab world and compared with 27 EU countries. The data comparison and modelling include vehicle development, death frequencies and death rates per inhabitants and vehicles. The modelling is based on least-squares regression fit considering around two-third of a million gathered data points for 45 considered countries. The gathered Arab countries’ data, as a whole, are thought to be presented for the first time; since no such data are yet observed in the literature. It is expected that an extra 117 million vehicles will be pumped into the global road network in a decade time from the earlier two regions. This sums to around 15% of the current global vehicle population. While such an increase looks very encouraging for the vehicles’ manufacturers, its environmental consequences and power consumption needs are surely not. While crash deaths in EU countries dropped from 74,876 during 1980 to 30,170 during 2011, that in the Arab countries increased from 22,145 victims to 37,736. The death record in the Arab countries is expected to further escalate to 54 thousand by the year 2022 based on mathematical models developed here. This represents around 45% increase since 2011. That for 27 EU countries is expected to be within 10 and 20 thousand deaths, which is less than half of the 2011 record. The crash death rates in the EU countries decreased continuously during the past three decades and will continue doing so during the coming decade. That in the Arab world will also continue dropping gently during the coming decade. Currently, the overall rates for the EU countries is half that of the average Arab countries. The gap between the two will increase with the time if no proper counter action is considered. The rates in the Arab countries is quite misleading because of the clear difference in the vehicle ownership rate and average vehicle-miles travelled between Arab and EU countries. While the deaths rates per population in the 15 EU countries are heading towards zero in a decade time; the rate in the Arab countries are expected to increase by 16%. Many factors contribute to such high rates of traffic deaths in the Arab countries, as lack of measurable long-term safety plans, inconsistent handling of traffic safety strategies, poor research involvement and limited post-accident rehabilitation centres.

The impact of policy, environmental, and educational interventions: a synthesis of the evidence from two public health success stories.

Motor vehicle safety and tobacco control are among the greatest public health achievements of the 20th century, according to the Centers for Disease Control and Prevention. As the number of miles traveled in the United States multiplied 10 times from the 1920s to the 1990s, the annual motor vehicle crash death rate per vehicle mile traveled decreased by 90%. Similarly, tobacco-related deaths from heart disease, stroke, and cancer were rapidly mounting over the first two thirds of the 20th century. Then, in the last third of the century, tobacco consumption decreased by more than 50%, and rates of heart disease and stroke deaths, and later cancer deaths, declined similarly. This analysis addresses the central question of what lessons can be learned from these success stories that will help public health professionals successfully tackle new and emerging health behavior problems of today and tomorrow? Surveillance, research, multilevel interventions, environmental modifications, and strong policies were key to reducing motor vehicle- and tobacco-related health problems. Generating public support and advocacy, and changing social norms also played critical roles in promoting the safer and smoke-free behaviors. Lessons learned include the need for evidence-based practices and interventions that are ecologically comprehensive with an emphasis on changing environmental determinants and capitalizing on the concept of reciprocal determinism. The analysis concludes with a description of how the PRECEDE-PROCEED planning framework can be used to apply the lessons from motor vehicle safety and tobacco control to other public health threats.

Mature Driver Laws and State Predictors of Motor Vehicle Crash Fatality Rates Among the Elderly: A Cross-sectional Ecological Study

Objective: State-level data have indicated that motor vehicle crash (MVC) fatality rates among the elderly vary widely across states. To date, the majority of states have implemented mature driver laws, which often require more frequent license renewals, in-person renewal, and vision testing for drivers above a certain age. We sought to evaluate the impact of mature driver laws on states’ MVC fatality rates among the elderly while examining other state-level determinants of MVC-related deaths.Methods: We performed a cross-sectional ecological study and modeled state MVC fatality rates for the population over age 65 as a function of state transportation policies and demographic, health system, population health, travel, and climate characteristics using a general linear model. Principal component analysis was used to reduce dimensionality of the data and overcome multicollinearity of state predictor variables.Results: Higher average temperature, higher gas prices, and a greater number of emergency medicine physicians to population size were significantly associated with lower MVC fatality rates. Positive predictors of MVC fatality rates were percentage of population overweight or obese and percentage with college degree over the age of 65. Having any restriction on elderly drivers was associated with a higher MVC fatality rate and no individual component of mature driver laws (shortened renewal cycle, in-person renewal, and vision testing) was significantly associated with lower fatality MVC rates for adults over 65.Conclusions: Mature driver laws are not associated with lower state MVC fatality rates among the elderly.

Rear-facing child car seats: are laws requiring them effective?

INTRODUCTION: Motor vehicle crashes are a leading cause of death in children aged ≤ 2 years in the U.S. The American Academy of Pediatrics advised that children should remain in rear-facing child car seats to mitigate injury from the most common type of severe collision (frontal). Several states have passed laws following these recommendations. Methods: In 2013 publicly available statutes and comprehensive motor vehicle fatality data from the National Highway Traffic Safety Administration's Fatality Analysis Reporting System database were used to investigate whether there is a relationship between motor vehicle crash fatality rates for children under 1 year of age and state laws regulating the direction of car seat placement. States with known rear-facing car seat laws in place were analyzed in a two-step approach in 2014. Simple fatality rates per 100 million vehicle miles were calculated with 95% Poisson CIs. A negative binomial count model for infant deaths was calculated, with state fixed effects, adjusted for the exposure of vehicle miles in each state by year. Results: Unadjusted models showed a protective mortality effect for rear-facing car seat laws, while adjusted models demonstrated no beneficial effect. Implications: This preliminary study suggests that state rear-facing child restraint laws may be having an impact on infant motor vehicle mortality; however the current model is unable to determine their relative contribution given the overall decline in traffic mortality. Language: en

Age, Poverty, Homicide, and Gun Homicide

Traditional theories of “adolescent risk taking” have not been validated against recent research indicating that youthful traffic crash, violent crime, felony crime, and firearms mortality rates reflect young people’s low-socio-economic status (SES) compared with older adults’, not young age. Aside from a small number of recent, conflicting studies, the literature gap on this key issue remains. The present study examines the 54,094 homicide deaths, including 41,123 gun homicides, victimizing California residents ages 15 to 69 during 1991 to 2012 by poverty status. Without controlling for poverty, homicide rates display the traditional age-curve peaking at 19, then declining. When poverty is controlled, the traditional age-curve persists only for high-poverty populations, in which young people are vastly over-represented, and homicide rates are elevated for all ages. This finding reiterates that “adolescent risk taking” may be an artifact of failing to control for age-divergent SES.

Tracking progress in teenage driver crash risk in the United States since the advent of graduated driver licensing programs

IntroductionThis study examined U.S. teenagers' crash rates since 1996, when the first graduated driver licensing (GDL) program in the United State was implemented. MethodsPassenger vehicle driver crash involvement rates for 16–19 and 30–59 (middle-aged) year-olds were examined, using data from the Fatality Analysis Reporting System, National Automotive Sampling System General Estimates System, Census Bureau, and National Household Travel Surveys. ResultsPer capita fatal and police-reported crash rates in 2012 were lower for 16year-olds than for middle-aged drivers but older teenagers' rates were higher. Mileage-based fatal and police-reported crash rates in 2008 were higher for teenagers than for middle-aged drivers and higher for 16–17year-olds than for older teenagers. In 1996–2012, teenagers' per capita fatal and police-reported crash rates declined sharply, especially for 16–17year-olds, and more so than for middle-aged drivers. Substantial declines also occurred in teenagers' mileage-based fatal and police-reported crash rates from 1995–96 to 2008, generally more so than for middle-aged drivers. Regarding factors in fatal crashes in 1996 and 2012, proportions of young teenagers' crashes occurring at night and with multiple teenage passengers declined, more so than among older teenagers and middle-aged drivers. The proportion of fatally injured drivers who had been drinking declined for teenagers but changed little for middle-aged drivers. Improvements were not apparent in rates of driver errors or speeding among teenage drivers in fatal crashes. ConclusionsTeenage drivers' crash risk dropped during the period of implementation of GDL laws, especially fatal crash types targeted by GDL. However, teenagers' crash risk remains high, and important crash factors remain unaddressed by GDL. Practical applicationsAlthough this study was not designed to examine the role of GDL, the results are consistent with the increased presence of such laws. More gains are achievable if states strengthen their laws.

Automated Extraction of Horizontal Curve Information for Low-Volume Roads

Rates of fatal and injury crashes on low-volume roads are much higher than those on higher-volume roads. A large proportion of crashes on low-volume roads are roadway departure crashes. Research has shown that roadway departure crashes are 1.5 to 4 times more likely at curves than on tangent sections. Therefore, knowledge of where horizontal curves are located and their geometric characteristics is key to addressing safety issues for low-volume roads. In the United States, although many states have a horizontal curve database for their state routes and Interstate highways, most states do not have such a database for non-state-owned roads, especially for low-volume rural roads, because of the lack of funds for additional data collection. A novel approach is presented that can extract curve data for both state and local roads in an accurate, cost-effective, and time-efficient manner without additional data collection. An ArcGIS add-in tool, CurveFinder, was developed by the authors previously to automatically identify horizontal curves from a selected roadway layer, classify curves, compute curve geometrics, and, finally, create a geographic information system for curve layers. CurveFinder was updated to incorporate compatibility with curve elements of FHWA's Model Inventory of Roadway Elements. Case studies are used to demonstrate the application of the updated CurveFinder on rural low-volume roads in different states and the lessons learned. Results show that none of the control curves were 100% missed by CurveFinder. False identification rates were also low. Both results validate CurveFinder. Causes of the few errors in the extracted curve data are identified, and potential solutions are explored.

Reduction in Fatal Longitudinal Barrier Crash Rate Due to Electronic Stability Control

Electronic stability control (ESC) is a vehicle safety system designed to keep vehicles moving in the direction commanded by the driver and thereby prevent loss-of-control crashes. Previous research has shown that ESC has been highly effective at reducing road departures related to loss of control. ESC is mandatory in all U.S. passenger vehicles manufactured from model year 2012 onward; by a 2014 estimate, ESC is in approximately one-third of passenger vehicles on the road. The proliferation of ESC may therefore alter benefit-to-cost ratios for roadside barriers. The objective of this analysis was to determine the effect of ESC on fatal crashes with roadside barriers. This objective was a first step toward determining whether ESC reduced the overall rate of crashes with roadside barriers and whether ESC had any effect on impact conditions or injury outcomes in barrier crashes. For cars, ESC reduced the odds of fatal crashes with roadside barriers by about 50% and reduced the odds of fatal rollovers that occurred in association with roadside barriers by about 45%. For light trucks and vans, ESC reduced barrier fatality odds by about 40% and barrier-associated rollover fatality odds by about 55%. By 2028, when an estimated 75% of passenger vehicles will have electronic stability control, ESC will have the potential to prevent about 410 out of an estimated 1,180 possible barrier-related fatalities per year. In the long term, once installed in every U.S. passenger vehicle, ESC could prevent about 550 of those same 1,180 possible barrier-related fatalities each year.

Preliminary Investigation of Circumstances Contributing to Fatal Crashes Involving Law Enforcement Officers

Over the past several decades, the number of fatal crashes in the United States has steadily declined. This decline is the result, at least in part, of the combined efforts of the three E's: engineering, education, and enforcement. Although these overall trends have shown promising results, there remain specific groups with alarming fatal crash rates. One of these groups, in particular, is law enforcement officers. Because police officers are a unique group with very particular job requirements, these crashes must be evaluated separately from crashes involving the general population. This study investigated 3 years of police-related fatal crash data to determine what contributing circumstances needed to be further investigated to reduce the trend in crashes. Data from the Fatality Analysis Reporting System were used to develop a logistic regression model to determine the statistically significant factors in 220 fatal crashes involving law enforcement officers from 2010 through 2012. It was found that a crash was less likely to be fatal if the officer was wearing a seat belt and if there was more than one occupant in the vehicle at the time of the crash. Conversely, the law enforcement officer was more likely to be the fatality when the crash was speed-related.

Alcohol consumption and fatal injuries in Australia before and after major traffic safety initiatives: a time series analysis.

The associations between population-level alcohol consumption and fatal injuries have been examined in a number of previous studies, but few have considered the external impacts of major policy interventions. This study aims to quantify the associations between per capita alcohol consumption and traffic and nontraffic injury mortality rates in Australia before and after major traffic safety initiatives (the introduction of compulsory seat belt legislation [CSBL] and random breath testing [RBT] in 1970s). Using data from 1924 to 2006, gender- and age-specific traffic and nontraffic mortality rates (15 years and above) were analyzed in relation to per capita alcohol consumption using time series analysis. The external effects of policy interventions were measured by inserting a dummy variable in the time series models. Statistically significant associations between per capita alcohol consumption and both types of fatal injuries were found for both males and females. The results suggest that an increase in per capita alcohol consumption of 1 l was accompanied by an increase in traffic mortality of 3.4 among males and 0.5 among females per 100,000 inhabitants and an increase in nontraffic mortality of 3.0 among males and 0.9 among females. The associations between alcohol consumption and fatal injury rates varied across age groups. The introduction of CSBL and RBT was associated with significant reductions in traffic crash mortality in Australia, particularly for males and young people. The magnitude and distribution of the preventive effects from the reduction in population drinking on fatal injuries vary across different gender and age groups, with the strongest preventive impacts on fatal injuries among people aged 15 to 29 and 70 years and above. The mechanisms behind these effects are unclear from this study, but are likely to be due to the strong association between per capita consumption and heavy drinking.

Road crash fatality rates in France: A comparison of road user types, taking account of travel practices

BackgroundTravel practices are changing: bicycle and motorized two-wheeler (MTW) use are rising in some of France’s large cities. These are cheaper modes of transport and therefore attractive at a time of economic crisis, but they also allow their users to avoid traffic congestion. At the same time, active transport modes such as walking and cycling are encouraged because they are beneficial to health and reduce pollution. It is therefore important to find out more about the road crash risks of the different modes of transport. To do this, we need to take account of the number of individuals who use each, and, even better, their travel levels. MethodWe estimated the exposure-based fatality rates for road traffic crashes in France, on the basis of the ratio between the number of fatalities and exposure to road accident risk. Fatality data were obtained from the French national police database of road traffic casualties in the period 2007–2008. Exposure data was estimated from the latest national household travel survey (ENTD) which was conducted from April 2007 to April 2008. Three quantities of travel were computed for each mode of transport: (1) the number of trips, (2) the distance traveled and (3) the time spent traveling. Annual fatality rates were assessed by road user type, age and sex. ResultsThe overall annual fatality rates were 6.3 per 100 million trips, 5.8 per billion kilometers traveled and 0.20 per million hours spent traveling. The fatality rates differed according to road user type, age and sex. The risk of being killed was 20 to 32 times higher for motorized two-wheeler users than for car occupants. For cyclists, the risk of being killed, both on the basis of time spent traveling and the number of trips was about 1.5 times higher than for car occupants. Risk for pedestrians compared to car occupants was similar according to time spent traveling, lower according to the number of trips and higher according to the distance traveled. People from the 17–20 and 21–29 age groups and those aged 70 and over had the highest rates. Males had higher rates than females, by a factor of between 2 and 3. ConclusionWhen exposure is taken into account, the risks for motorized two-wheeler users are extremely high compared to other types of road user. This disparity can be explained by the combination of speed and a lack of protection (except for helmets). The differential is so great that prevention measures could probably not eliminate it. The question that arises is as follows: with regard to public health, should not the use of MTW, or at least of motorcycles, be deterred? The difference between the fatality risk of cyclists and of car occupants is much smaller (1.5 times higher); besides, there is much room for improvements in cyclist safety, for instance by increasing the use of helmets and conspicuity equipment. Traffic calming could also benefit cyclists, pedestrians and perhaps moped users.

Urban sprawl as a risk factor in motor vehicle crashes

A decade ago, compactness/sprawl indices were developed for metropolitan areas and counties which have been widely used in health and other research. In this study, we first update the original county index to 2010, then develop a refined index that accounts for more relevant factors, and finally seek to test the relationship between sprawl and traffic crash rates using structural equation modelling. Controlling for covariates, we find that sprawl is associated with significantly higher direct and indirect effects on fatal crash rates. The direct effect is likely due to the higher traffic speeds in sprawling areas, and the indirect effect is due to greater vehicle miles driven in such areas. Conversely, sprawl has negative direct relationships with total crashes and non-fatal injury crashes, and these offset (and sometimes overwhelm) the positive indirect effects of sprawl on both types of crashes through the mediating effect of increased vehicle miles driven. The most likely explanation is the greater prevalence of fender benders and other minor accidents in the low speed, high conflict traffic environments of compact areas, negating the lower vehicle miles travelled per capita in such areas.