Road Traffic Casualties Research Articles

SPATIAL AND TEMPORAL PATTERN OF ROAD ACCIDENTS AND CASUALTIES IN PENINSULAR MALAYSIA

Road traffic accidents are often found to follow some spatial and temporal patterns as the factors that influence road accident changes with space and time. Knowledge on spatial and temporal variability of accident can be helpful for optimizing resources in order to improve traffic security management. The objective of the present study is to assess the spatial and temporal variation in the incidence of road traffic accidents and casualties across the states of peninsular Malaysia. Recent trends in number of accidents, casualties and fatalities are also accessed using non-parametric statistical method. The results show more accidents but lower fatalities in more urbanized and developed states, and lower accident levels but more serious fatalities in less urbanized or developed states of Peninsular Malaysia. Trend analysis reveals increasing number of accidents, but decreasing number casualties in recent years in most of the states of Peninsular Malaysia. The temporal analysis shows clear seasonal pattern in accident in some states of Malaysia. Most of the accidents are found to occur in festive month of Hari Raya Puasa festival followed by the month of mid-year school holiday. It is expected that the finding of the study will help in making recommendations in order to improve road safety and reduce road traffic accident in Malaysia.

What is the effect of reduced street lighting on crime and road traffic injuries at night? A mixed-methods study

BackgroundSome local authorities have reduced street lighting at night to save energy, but little is known about impacts on public health or about public concerns about impacts on well-being.AimTo evaluate the effect of reduced street lighting on crime and road traffic injuries.DesignA mixed-methods study comprising a rapid appraisal, a controlled interrupted time series analysis and a cost–benefit analysis (CBA).SettingEngland and Wales.Target populationResidents and workers in eight case study areas; road traffic casualties and victims of crime.Interventions evaluatedSwitch-off (i.e. lights permanently turned off), part-night lighting (e.g. lights switched off between 12 a.m. and 6 a.m.), dimming lights and white lights/light-emitting diodes (LEDs).OutcomesPublic views about implications on well-being; road traffic injury data (STATS19:http://data.gov.uk/dataset/road-accidents-safety-data) obtained for the period 2000–13; crime data (Police.uk:data.police.uk) obtained for the period December 2010–December 2013. Detailed crime data were obtained from one police force for a methodological study of the spatial level at which Police.uk data are valid for analysis.Statistical methodsRoad traffic collisions were analysed at street segment level. Regression models were used to estimate changes in daytime and night-time collision rates associated with lighting interventions. The ratio of night-time and daytime changes was considered the best estimate of change in night-time collisions following each lighting intervention. Police.uk crime data were found to be reliable when analysed at middle super output area (MSOA) level. For crime, the analysis used the proportion of total km of road in each MSOA with each lighting intervention. Regression models controlled for yearly and monthly trends and were fitted in each geographical region and police force. Effect estimates were pooled in random-effects meta-analyses.ResultsPublic concerns centred on personal security, road safety, crime, fear of crime, sleep quality and being able to see the night sky. Street lighting reductions went largely unnoticed or had only marginal impacts on well-being, but for a minority of people switch-off and part-night lighting elicited concerns about fear of the dark, modernity and local governance. Street lighting data were obtained from 62 local authorities. There was no evidence that reduced street lighting was associated with road traffic collisions at night. There was significant heterogeneity in the estimated effects on crime at police force level. Overall, there was no evidence that reduced street lighting was associated with crime. There was weak evidence for a reduction in crime associated with dimming [rate ratio (RR) 0.84, 95% confidence interval (CI) 0.70 to 1.02] and white light (RR 0.89, 95% CI 0.77 to 1.03). The CBA suggests that part-night lighting may represent a net benefit to local authorities.LimitationsThe study did not account for the impacts of other safety/crime prevention initiatives (e.g. improved road markings; closed-circuit television), and so associations may be partly attributable to these initiatives. The CBA was unable to include potentially important impacts such as fear of crime and reduced mobility.ConclusionThis study found little evidence of harmful effects of switch-off, part-night lighting, dimming or changes to white light/LEDs on levels of road traffic collisions or crime in England and Wales. However, the public were also concerned about other health outcomes. Research is needed to understand how lighting affects opportunities for crime prevention and how these vary by context. Research is needed also on other public health impacts of light at night.FundingThe National Institute for Health Research Public Health Research programme.

The quality of the injury severity classification by the police: An important step for a reliable assessment

This study aims to assess the under-reporting and misclassification of the traffic injury severity reported by the police for the first time in Portugal. The non-fatality traffic injuries classified by the police are compared with the information recorded by the hospitals using linked data. The underreporting in the police data was found to be of 29%. Therefore, a significant number of road traffic casualties admitted in the hospitals were not known by the police. Taking advantage of the linked information on accident injuries, the misclassification in the police reports is assessed considering two criteria: the length of hospital stay (LS) and the maximum abbreviated injury scale (MAIS). The latter criterion corresponds to the common definition recently established by the European Commission, which has the advantage of representing the medical conditions of the casualty. The comparison between police classification and LS indicates that a discrepancy between the police reports and the established police definition exists. On the other hand, the police classification shows a tendency to overclassify the injury severity regarding the MAIS. A remarkable proportion of severe injuries reported by the police are, in fact, slight injuries. Additionally, using univariate and multivariate analyses, factors contributing to the misclassification of casualties by the police are identified. Finally, similarly to the fatality adjustment coefficient used in Portugal and in other countries in the past, non-fatality adjustment coefficients were computed to estimate the total casualties taking into account the under-reporting and misclassification phenomena. These adjustment factors are compared with other countries.

A90 Where, when and who: Geographic, temporal and demographic patterns in cyclist road traffic casualties in West Yorkshire

Abstract Background Research indicates that overall, the health benefits of a modal shift to cycling greatly outweigh the risks. However, the extent of these benefits appears to vary across different contexts, in terms of both geography and demography. Within the UK cycling for everyday trips remains low, but we have seen an increase in general across the country despite a decrease in London. It is therefore important to understand the balance between the risks and benefits of cycling for different groups to effectively direct cycling policy. Few studies have focused on the geographical factors that affect cycling risk at a local level. Our approach was to examine the “where, when and who” in cycling road traffic casualties, which is appropriate for developing policies at a local scale. Methods We analysed secondary data from the UK’s STATS19 dataset, which reports road accident data from 2005 to 2012. We developed an equation to measure the underlying level of exposure and examined the spatial, temporal and demographic distribution of cyclist casualties within West Yorkshire. This region was selected due to its historically low cycling rates yet ambitious plans for improvements to its cycling infrastructure. A target of a 300% increase in the rate of cycling by 2026 has been set by the West Yorkshire Integrated Transport Authority, following investment from the Department of Transport. Results West Yorkshire was found to be an unusually risky area for cyclists, with an estimated 53 deaths and 1372 serious injuries per billion kilometres cycled, based on census commuting statistics; this is roughly double the national average. This riskiness varies spatially and temporally, broadly aligning with previous literature. Cyclists were disproportionately at risk on high traffic roads, junctions and roundabouts. The proportion of traffic casualties involving cyclists has increased over time, in line with the national trend. An unexpected result was that cycling appears to be disproportionately risky for young people in West Yorkshire compared with young people nationally. Conclusions This case study progresses our understanding that risk is context-specific and geographically and demographically variable. We have shown that risk to cyclists varies within West Yorkshire, which is more risky than national average for cyclists. We conclude that the identification of local hazardous areas using the methods presented can help to prioritise investment, and inform transport policy.

The Contribution of the Israeli Trauma System to the Survival of Road Traffic Casualties

Background: According to the World Health Organization, over one million people die annually from traffic crashes, in which over half are pedestrians, bicycle riders and two-wheel motor vehicles. In Israel, during the last decade, mortality from traffic crashes has decreased from 636 in 1998 to 288 in 2011. Professionals attribute the decrease in mortality to enforcement, improved infrastructure and roads and behavioral changes among road users, while no credit is given to the trauma system. Trauma systems which care for severe and critical casualties improve the injury outcomes and reduce mortality among road casualties.Goals: 1) To evaluate the contribution of the Israeli Health System, especially the trauma system, on the reduction in mortality among traffic casualties. 2) To evaluate the chance of survival among hospitalized traffic casualties, according to age, gender, injury severity and type of road user.Methods: A retrospective study based on the National Trauma Registry, 1998–2011, including hospitalization data from eight hospitals.Outcomes: During the study period, the Trauma Registry included 262,947 hospitalized trauma patients, of which 25.3% were due to a road accident. During the study period, a 25% reduction in traffic related mortality was reported, from 3.6% in 1998 to 2.7% in 2011. Among severe and critical (ISS 16+) casualties the reduction in mortality rates was even more significant, 41%; from 18.6% in 1998 to 11.0% in 2011. Among severe and critical pedestrian injuries, a 44% decrease was reported (from 29.1% in 1998 to 16.2% in 2011) and a 65% reduction among bicycle injuries. During the study period, the risk of mortality decreased by over 50% from 1998 to 2011 (OR 0.44 95% 0.33–0.59. In addition, a simulation was conducted to determine the impact of the trauma system on mortality of hospitalized road casualties. Presuming that the mortality rate remained constant at 18.6% and without any improvement in the trauma system, in 2011 there would have been 182 in-hospital deaths compared to the actual 108 traffic related deaths. A 41% difference was noted between the actual number of deaths and the expected number.Conclusions: This study clearly shows that without any improvement in the health system, specifically the trauma system, the number of traffic deaths would be considerably greater. Although the health system has a significant contribution on reducing mortality, it does not receive the appropriate acknowledgment or resources for its proportion in the fight against traffic accidents.

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.

Severe road traffic injuries in Kenya, quality of care and access.

Road traffic injuries (RTI) are on increase in developing countries. Health care facilities are poorly equipped to provide the needed services. Determine access and quality of care for RTI casualties in Kenya. Cross-sectional survey 53 large and medium size private, faith-based and public hospitals. In-patient road traffic crash casualties and health personnel in the selected hospitals were interviewed on availability of emergency care and resources. Onsite verification of status was undertaken. Out of 310 RTI casualties interviewed, 72.3%, 15.6% and 12.2% were in public, faith-based and private hospitals, respectively. Peak age of the injured was 15-49 years. First aid was availed to 16.0% of casualties. Unknown persons transported 76.5% of the injured. Police and ambulance vehicles transported 6.1% and 1.4%, respectively. 51.9% reached health facilities within 30 minutes of crash and medical care provided to 66.2% within one hour. 40.8% of recipient facilities were adequately prepared for RTI emergencies. Most RTI casualties were young and from poor backgrounds. Training of motorists and general public in first aid should be considered in RTI control initiatives. Availability of basic trauma care medical supplies in public health facilities was highly deficient.

Down but not out: incidence and estimated costs to society of road casualties in Strathclyde, Scotland

ObjectivesTo investigate the recent epidemiological patterns and costs of road traffic casualties (RTCs) in Strathclyde, Scotland. Study designRetrospective record-linkage epidemiological study using routine data sources. MethodsA linked police-hospital database was analysed to describe the epidemiology of RTCs from 2004 to 2009. Using UK government methodology, the costs of road casualties to the National Health Service (NHS) and society were assessed. ResultsRTC rates declined over the study period. Males were at higher risk than females as were those residing in more socially deprived addresses. The estimated costs of RTCs in Strathclyde amounted to £400 million annually. Of this, around one twentieth (£20 million per year), was attributable to direct NHS costs. ConclusionsRoad casualties remain a major public health threat in Strathclyde, and contribute to health inequalities. RTC costs to society amount to almost a tenth of NHS revenue expenditure. Cost-effective road safety measures should be deployed more widely.

Contribution of the physical environment to socioeconomic gradients in walking in the Whitehall II study

Socioeconomic gradients in walking are well documented but the underlying reasons remain unclear. We examined the contribution of objective measures of the physical environment at residence to socioeconomic gradients in walking in 3363 participants (50–74years) from the Whitehall II study (2002–2004). Individual-level socioeconomic position was measured as most recent employment grade. The contribution of multiple measures of the physical environment to socioeconomic position gradients in self-reported log transformed minutes walking/week was examined by linear regression. Objective measures of the physical environment contributed only to a small extent to socioeconomic gradients in walking in middle-aged and older adults living in Greater London, UK. Of these, only the number of killed and seriously injured road traffic casualties per km of road was predictive of walking. More walking in areas with high rates of road traffic casualties per km of road may signal an effect not of injury risk but of more central locations with multiple destinations within short distances (‘compact neighbourhoods’). This has potential implications for urban planning to promote physical activity.

The effects of congestion charging on road traffic casualties: A causal analysis using difference-in-difference estimation

This paper aims to identify the impacts of the London congestion charge on road casualties within the central London charging zone. It develops a full difference-in-difference (DID) model that is integrated with generalized linear models, such as Poisson and Negative Binomial regression models. Covariates are included in the model to adjust for factors that violate the parallel trend assumption, which is critical in the DID model. The lower Bayesian Information Criterion value suggests that the full difference-in-difference model performs well in evaluating the relationship between road accidents and the London congestion charge as well as other socio-economic factors. After adjusting for a time trend and regional effects, the results show that the introduction of the London congestion charge has a significant influence on the incidence of road casualties. The congestion charge reduces the total number of car accidents, but is associated with an increase in two wheeled vehicle accidents.

Assessing the Trends in Road Traffic Accident Casualties on Nigerian Roads

The paper assesses the trend of road traffic accident casualties on Nigerian roads. In spite of efforts by law enforcement agencies to curb the carnage on Nigerian roads, traffic safety still remains a crucial issue in the country. The study used data on number of casualties from road traffic accidents in Nigeria for the period 1975 - 2009. These were obtained from records of the Nigerian Police, Federal Road Safety Commission and Na tional Bureau of Statistics. The data were analysed using the Statistical Package for the Social Sciences ( SPSS) and Regression models were developed for predicting death and injuries on Nigerian roads. The study showed that the establishment of the Federal Road Safety Commission in the country has had positive impact on the ra te of casualties from road traffic accidents in the country. In order to reduce deaths and injuries from r oad traffic accidents in Nigeria, the study recommends that law enforcement, education and research funding shou ld be the focus of government in the country.

Prehospital Trauma System Reduces Mortality in Severe Trauma: A Controlled Study of Road Traffic Casualties in Iraq

In low-resource communities with long prehospital transport times, most trauma deaths occur outside the hospital. Previous studies from Iraq demonstrate that a two-tier network of rural paramedics with village-based first helpers reduces mortality in land mine and war-injured from 40% to 10%. However, these studies of prehospital trauma care in low-income countries have been conducted with historical controls, thus the results may be unreliable due to differences in study contexts. The aim of this study was to use a controlled study design to examine the effect of a two-tier prehospital rural trauma system on road traffic accident trauma mortality. A single referral surgical hospital was the endpoint in a single-blinded, non-randomized cohort study. The catchment areas consisted of some districts with no formal Emergency Medical Services (EMS) system, and other districts where 95 health center paramedics had been trained and equipped to provide advanced life support, and 5,000 laypersons had been trained to give on-site first aid. The hospital staff registered trauma mortality and on-admission physiological severity blindly. Assuming that prehospital care would have no significant impact on mortality in moderate injuries, only road traffic accident (RTA) casualties with an Injury Severity Score (ISS)≥9 were selected for study. During a three-month study period, 205 patients were selected for study (128 in the treatment group and 77 in the control group). The mean prehospital transit time was approximately two hours. The two groups were comparable with regards to demographic characteristics, distribution of wounds and injuries, and mean anatomical severity. The mortality rate was eight percent in the treatment group, compared to 44% in the control group (95% CI, 25%-48%). Adjusted for severity differences between the treatment and control groups, prehospital care was a significant contributor to survival. Where prehospital transport time is long, a two-tier prehospital system of trained paramedics and layperson first responders reduces trauma mortality in severe RTA injuries. The findings may be valid for civilian Emergency Medical Services interventions in other low-resource countries.

Population ageing, gender and the transportation system

Across the globe population structures are ageing and how older men and women interact with the transport system is increasingly important in maintaining a good quality of life and inclusion in society. The paper reviews three issues: the nature of older people’s interaction with the transport system by gender; older people’s attitude to travel; and the involvement of older people as road traffic casualties. Patterns of travel in the UK show that older people are heavily dependent on car use, but in the form of more frequent but shorter journeys than younger people. This is especially so for women over 70 years old who, as passengers, are very reliant on males to drive them. Attitudes suggest that there are few obstacles to public transport use, and most agree that bus travel is good, but convenience means many prefer cars. Involvement of older men and women in serious road traffic accidents show that they have lower killed and seriously injured (KSI) rates than 17–24 year old drivers. However, those aged over 70 years exhibit a trend of increasing KSI rates. Analysis of casualty rates of drivers by type of junction, manoeuvre and environmental conditions found that some gender-age groups are overrepresented in certain accident types, including higher serious accidents rates for men, and over representation of older women when driving in poor conditions and turning right and negotiating roundabouts, crossroads and T, Y and staggered junctions. Improvement in engineering design and driver training are suggested together with the need for a greater understanding of the transportation system needs of old and very old people.

Developmental trends in detection threshold for looming objects

Detection and sensitivity to optical expansion is critical for collision avoidance and survival. Adult sensitivity to looming and motion in depth has been well documented under strict psychophysical conditions (e.g., Regan & Beverley, 1979). Much less is known about perceptual thresholds for looming in complex scenes, and there has been no investigation of developmental decrements in perceptual ability, which may explain in part children's overrepresentation in road traffic casualties. Looming thresholds for children (n = 111) and adults (n = 27) were measured using adaptive (best-PEST) psychophysical procedures to determine sensitivity to looming in foveal or extra-foveal vision (4.25° eccentricity). A photo-realistic image of a car was viewed monocularly against a static road scene background for 200 ms. Observers were required to determine whether the car expanded or not. The car image changed in size and virtual distance to simulate approach at different speeds, with time-to-passage fixed at 5s (sufficient time to cross the road). Images were automatically rescaled according to viewing distance so that visual angles were equivalent to those experienced at the roadside. Results show clear developmental trends in looming thresholds. Younger children (6–9 yrs) were less sensitive to optical expansion than older children (10–11 yrs) and adults when the image expanded isotropically in foveal or extra-foveal vision, and as well as when it expanded with additional lateral image translation (1° scene displacement scaled with distance) in foveal vision, but not extra-foveal vision. Conversion of looming thresholds into vehicle speeds revealed that children are unable to reliably detect cars approaching 5 s away at speeds in excess of 25 mph if they do not fixate directly on the car, or are in motion when looking down the road. Our study is the first to provide evidence that the neural mechanisms for detection of looming are not fully developed until adulthood.

Children aged 9–14 living in disadvantaged areas in England: Opportunities and barriers for cycling

The aim of this paper is to take a holistic perspective to explore levels of cycling and opportunities and barriers to increase children’s safer cycling in disadvantaged areas in England. The study was one part of a larger study which explored the factors underlying the high level of road traffic casualties especially among children in the most disadvantaged areas of England and to explore how this impacts on mobility and quality of life. The methods involved a cross sectional survey comprising school based questionnaire surveys with children aged 9–14 and focus groups with parents who had children within this age range. The surveys were conducted in 2007 and the focus groups during 2008. 4286 children completed the survey and eight focus groups were held. Bike ownership (77%) was high, use in previous week moderate (39%) but only 2% cycled to school. Ownership was significantly lower in minority ethnic groups. Despite young children’s strong preference to travel by cycle (30%) than walk or go by car, most parents felt it was too hazardous. It is unlikely that these findings would be any different from the rest of England, however the combination of environmental and social factors may elevate the risks for young cyclists in these areas. This paper concludes that a number of barriers exist to increasing levels of cycling among children living in disadvantaged areas particularly amongst ethnic groups. These barriers could be addressed by environmental modifications to reduce speeds and by reducing the levels of antisocial driving and riding in residential areas and around destinations where children travel, by providing cycle training to improve children’s skills and parent’s confidence, and by providing secure storage facilities for bikes. Until these barriers are addressed it is unlikely that cycling will increase despite the strong preferences children have to travel by bike. Such preferences to cycle provide an opportunity for local authorities to act on.

Predictive factors of chronic post-traumatic stress disorder 6 months after a road traffic accident

Background This study sets out to identify risk factors for post-traumatic stress disorder (PTSD) after a road traffic accident with a view to improving prevention. Methods The study used a prospective cohort of road traffic accident casualties. All subjects over 15 years of age were recruited in the course of an interview conducted while they were receiving care in a hospital of the Rhône area administrative département. Six months after their accident, they answered a self-administered postal questionnaire that included the Post-traumatic Check-List Scale (PCLS) in order to evaluate PTSD. Multivariate logistic regression analysis was conducted to compare those subjects with a PCLS score of 44 or over with those with a lower score, in order to identify factors that might be associated with PTSD. Results 592 subjects (out of 1168) returned the 6-month questionnaire and 541 completed the PCLS test. One hundred subjects had a PCLS score ≥44, suggesting PTSD, and 441 subjects did not. The factors associated with PTSD were initial injury severity, post-traumatic amnesia, the feeling of not being responsible for their accident and persistent pain 6 months after it. A lower odds-ratio was associated with users of two-wheel than four-wheel motor vehicles (OR = 0.4; 0.2–0.9). Conclusion Besides predictive factors for PTSD (injury severity, post-traumatic amnesia and the feeling of not being responsible for their accident), our study suggested a reduced risk of PTSD among two-wheel motor vehicle users.

The expected number of road traffic casualties using stratified data

Road safety policy plans often require robust calculation of the expected number of road casualties in a certain target year. The relevance of such estimations should be measured by their power to influence and support safety policy makers. Thus, techniques to evaluate the safety developments and the estimating methods must be sound, robust, and preferably accepted by both policy makers and the scientific community. In this paper, we concentrate on choosing an appropriate model used for the calculation, rather than on statistical techniques. We calculate a casualty rate from casualty data and mobility (distance travelled) data, which is extrapolated and subsequently multiplied by an expected future distance travelled. After correction for separately assessed effects of additional safety measures, the number of casualties is estimated. We investigate a method where this is done after both mobility data and casualty data are stratified into properly chosen subsets. Projecting these different trends generally leads to a result that differs from the projection of the aggregated data. Also, stratification enables incorporation in the estimation of explaining factors or additional measures related to a specific subset of the casualties. The principles of stratified projections are illustrated by three Dutch projections which were carried out between 2006 and 2008. Also, some preliminary results of further research on stratification are given. The results imply that the rates of change in casualty rate for different traffic modes or driver age, are not necessarily equal. We propose that these specific decreasing trends are a consequence of external influencing factors.

Effects of Improved Traffic Management on Sustainable Distributed Road Transportation Safety Based on Asian Experiences

Effects of Improved Traffic Management on Sustainable Distributed Road Transportation Safety Based on Asian Experiences Knowledge of the improved traffic management and its effect on road safety is an important component in the process of sustainable road network development. Having in mind that so many road traffic casualties occur, a key priority in transport policy is making highways as safe as possible. The mentioned objective is attained by means of sustainable safety. The paper focuses on sustainable road safety and his principles, based on selected Asian countries experiences. The knowledge base covers institutional responsibility of road safety, the development of a road safety action plan, raising awareness and understanding of road safety problems, road crash data systems, road safety education and training, traffic safety legislation, enforcement of traffic laws and monitoring and evaluation of the effectiveness of road safety activities. In order to improve road transportation safety an organized sustainable approach is needed via concentrated action of all of participants in the process of realizing the transport service such as: governments at all levels, those who are professionally engaged in transport and traffic engineering and road users themselves.

Safety effects of mobile speed cameras in Norfolk: No more than regression to the mean?

This letter is a comment on the paper effects of mobile speed camera introduction on road traffic crashes and casualties in a rural county of England, published in this journal (vol. 39, issue 1, pp. 101-110, 2008). The authors of the original paper (Jones, Sauerzapf and Haynes) analyze the effects of a camera enforcement program on injury crashes in the county of Norfolk. The author of the letter has found that an error was made in the calculation of the regression-to-the-mean (RTM) effect, leading to an underestimation of RTM bias. A correction of this error would partly change the conclusions of the paper. Based on the corrected results, the study does not seem to provide evidence of an overall safety benefit due to the mobile speed camera introduction at the treated sites. The original authors respond to the letter by agreeing that the error led to an underestimation of regression to the mean bias, and that the conclusion thus needs to be amended.

Functional outcome after road-crash injury: Description of the ESPARR victims cohort and 6-month follow-up results

It is essential to know about the long-term consequences of road crashes involving corporal injury in order to adopt relevant public health measures. The ESPARR cohort comprises 1168 road-crash victims, aged 16 or over, managed in hospitals in the Rhône administrative départment (France). It is based on the Registry of Road Traffic Casualties, which has been collecting exhaustive data since 1995. Two groups are monitored: mild to moderate (M-AIS 1 or 2) and severe (M-AIS > or =3). Patients were interviewed at the point of primary care, between 1 October 2004 and 31 July 2006. 6 months later, their state of health and presence of pain were compared. Multivariate analysis (logistic regression) was performed to identify factors related to residual pain. Adults of the cohort were compared to the road crash population as a whole recorded over the same period in the same area. At 6 months post-accident, only 31.9% of victims deemed their health status to have entirely returned to normal; 63.8% of mild to moderate and 89.2% of severe cases reported residual pain, but neither pain frequency nor intensity correlated with M-AIS. Residual pain was related to lower limb injuries (OR=1.6; 95% CI=1.1-2.4). After adjustment, pain was essentially related to age, seriousness of the lesions and a stay in a rehabilitation unit. The ESPARR cohort provides a unique opportunity in France to describe the trajectory of a road crash victim, in terms both of care and rehabilitation and of resumption of work and personal activity.