Transport Accident Commission Research Articles

DIFFERENTIATING PATTERNS OF HEALTH SERVICE USE FOLLOWING SEVERE TRAUMATIC BRAIN INJURY: AN IDIOGRAPHIC ANALYSIS

BackgroundTraumatic Brain Injury (TBI) can result in lifelong physical and behavioural impairments that necessitate long-term access to healthcare services. Provision of health services to those with severe TBI is a...

Older Drivers, Crashes and Injuries

Objective: This article aimed to identify the main features of older driver casualty crashes, including detailed descriptions of injury outcomes. Methods: Data were obtained from the Transport Accident Commission insurance claims database for 2 groups of drivers: aged 41 to 55 years (middle-aged drivers) and aged 65 years and older (older drivers). Results: In terms of crash circumstances, the majority of crashes involved a collision with another vehicle (70.0% of middle-aged drivers and 68.7% of older drivers). The 2 main maneuvers at the time of crash were driving straight ahead (44.6% of middle-aged drivers and 42.8% of older drivers) and turning right (equivalent of left turn in North America; 15.2% of middle-aged drivers and 17.6% of older drivers). In terms of injury outcomes, older drivers sustained a significantly higher proportion of injuries to the thorax (30.9% compared to 18.5% of middle-aged drivers). Conversely, a significantly higher proportion of middle-aged drivers sustained some form of injury to the neck (30.6% compared to 12.1% of older drivers). Conclusion: These findings highlight the situations that are particularly risky for older drivers and provide important insights for developing solutions to reduce older driver crash and injury risk.

The feasibility of using auto-titrating continuous positive airway pressure to treat obstructive sleep apnoea after acute tetraplegia

A prospective cohort with acute tetraplegia. Obstructive sleep apnoea (OSA) is common within weeks of tetraplegia. This study aimed at determining the feasibility of auto-titrating continuous positive airway pressure (CPAP) to treat OSA after acute tetraplegia. The Victorian Spinal Cord Service, Melbourne, Australia. Participants underwent full, portable polysomnography. Those with an apnoea hypopnoea index of more than 10 events per hour were defined as having OSA and were offered treatment with CPAP. Treatment adherence was objectively monitored, and measures of quality of life, sleepiness and functional outcomes were determined at enrollment and 3 months later at study conclusion. A total of 44 patients were admitted to our Spinal Cord Service over 9 months, and 19 participated. Fourteen of them had OSA and seven were adherent with therapy for 3 months. Compared with those who did not have OSA, and with those with OSA who were not adherent with CPAP, those who adhered to CPAP were older (mean (s.d.) age 54 years (13) versus non-adherent 28 years (15) and no OSA 29 years (10)) and heavier (body mass index (BMI) 32.5 (11.7), 24.1 (3.7) and 20.6 (3.1), respectively). CPAP-adherant patients and those without OSA showed a 50% or greater improvement in their state sleepiness over the 3 months. Patients with OSA who did not tolerate CPAP had no improvement in sleepiness. Auto-titrating CPAP is a feasible treatment for OSA in acute tetraplegia. Intensive clinical support was required initially, and a tolerance of therapy for at least 4 h for one of the first 3 days was predictive of good CPAP usage. Transport Accident Commission.

The cost of severe spinal cord injuries and traumatic brain injuries in Victoria

The Transport Accident Commission (TAC) is a Victorian Government owned organisation established to manage Victoria's transport accident scheme. Our mission is to work with the Victorian community to reduce road trauma and support those it affects.

Vukovic v Transport Accident Commission

Vukovic v Transport Accident Commission

Supporting Individuals to Make Informed Personal Mobility Choices

Individuals want to make informed choices about mobility transitions to retain dignity and independence as they age. The Transport Accident Commission initiated the development, trial, and evaluation of a health promotion education program to meet this need. A participative model was applied and program instruction goals focused on community and driver safety, how health and aging influence transportation independence, mobility options, and resources. Data collected from 94 individuals yielded positive outcomes: the target group was reached (90% were 60 years or older), community mobility information was retained, and participants were satisfied with program content and resources.

Impact on Car Driving Performance of a Following Distance Warning System: Findings from the Australian Transport Accident Commission SafeCar Project

The Transport Accident Commission (TAC) SafeCar study evaluated the impact of three Intelligent Transport System technologies, alone and in combination, on driver performance: Following Distance Warning; Intelligent Speed Adaptation; and a Seatbelt Reminder. Each test vehicle or “SafeCar” was also equipped with Daytime Running Lights and a Reverse Collision Warning system. Twenty-three fleet car drivers each drove a SafeCar for 16,500 kilometers. This article focuses on the impact on driving performance, mental workload and driver acceptability of the Following Distance Warning system. The results revealed that the Following Distance Warning system had a positive effect on drivers' following behavior, with use of the system significantly increasing mean time gap between the SafeCars and lead vehicles in several speed zones and reducing time gap variability in one speed zone. The system was rated as acceptable by the drivers and did not increase subjective mental workload. However, most drivers did report an increase in frustration when using the system, brought about by the occasional issuing of nuisance warnings.

Sweedman V Transport Accident Commission: State Residence Discrimination and the High Court's Retreat into Characterisation

The High Court's decision in Sweedman v Transport Accident Commission is discussed. The issue dealt with at greatest length in the judgments was the suggested conflict between New South Wales and Victorian enactments and the related suggestion that constitutional principles would enliven to resolve this conflict. The comment also includes the second issue, the potential application of the s 117 prohibition on state residence discrimination.

Road traffic injuries in the elderly

Objective: Elderly victims of motor vehicle collisions are increasing with the aging population. This study aimed to investigate the injury pattern of elderly victims involved in motor vehicle collisions. Methods:...

Smith v Transport Accident Commission

Smith v Transport Accident Commission

Transport Accident Commission v Sweedman

Transport Accident Commission v Sweedman

Transport Accident Commission v Lincoln

Transport Accident Commission v Lincoln

Transport Accident Commission v Woods

Transport Accident Commission v Woods

State Trustees Ltd v Transport Accident Commission

State Trustees Ltd v Transport Accident Commission

Transport Accident Commission v Coyle

Transport Accident Commission v Coyle

Transport Accident Commission v Lanson and Another

Transport Accident Commission v Lanson and Another

Denton v Transport Accident Commission

Denton v Transport Accident Commission

Advertising wearout in the Transport Accident Commission road safety campaigns

This paper uses a varying coefficient regression model to investigate whether there is any significant advertising wearout in the Transport Accident Commission (TAC) road safety campaigns on Victorian television. The results suggest that there is some evidence that the effectiveness of the campaigns may be declining with increased exposure.

Temporomandibular pain dysfunction disorder resulting from road traffic accidents — An Australian study

The relationship between temporomandibular pain dysfunction disorder (TMPD) and trauma to the head and neck is unclear. A retrospective analysis of the records from the Transport Accident Commission (TAC) of Victoria, Australia, in the year 1987, was done to identify those subjects who received treatment for TMPD resulting from a road traffic accident (RTA). Twenty-eight subjects with TMPD were identified from a total of 20 673 subjects who claimed health care services from the TAC for RTA-related disorders. In this study, TMPD for which subjects sought treatment was uncommonly associated with either direct or indirect trauma to the temporomandibular joints: 0.4% of subjects with mandibular fractures and 0.5% of subjects with whiplash injuries presented for treatment of an associated TMPD. Females were found to present for treatment of TMPD more commonly than males at a ratio of 5:2. It was also noted that 75% of subjects complained of symptoms of TMPD immediately after the accident and approximately 96% within 2 months of the accident. Subjects were not lost to follow-up because all claims for treatment were made to the TAC, regardless of the clinician involved. In this study, 25% of subjects attended more than one dentist for management. It was concluded that TMPD for which subjects sought treatment was an uncommon result of an RTA and was infrequently associated with a mandibular fracture or whiplash injury.

The seat belt syndrome in children

Lap belts, fitted to the centre seats of Australian cars for the past 22 years, have come under criticism as being injurious to children. The weight of evidence is that lap belts provide substantial protection, though less than three-point belts. A specific injury, the seat belt syndrome (SBS), to abdominal viscera and/or lumbar spine has been particularly associated with lap belts, an association confirmed by a hospital-based study in Melbourne. Roadside observations of belt use and Transport Accident Commission claims permitted the calculation of the incidence of SBS and the relative risks of SBS by seated position. The centre rear seat (lap belt) carried about twice the risk of SBS as outboard rear seats (three-point belts), which in turn have 2.7 times the risk of the outboard front seat. The number of SBS cases in Victoria has increased with penetration of the car fleet by 1971 and later cars. Suggestions are made for improvements in the restraint system.