Transportation Injuries Research Articles

Ascertainment and description of pedestrian and bicycling injuries and fatalities in Ontario from administrative health records 2003–2017: contributions of non-collision falls and crashes

IntroductionPedestrian and bicycling injuries may be less likely to be captured by traffic injury surveillance relying on police reports. Non-collision injuries, including pedestrian falls and single bicycle crashes, may be...

Advancing youth transportation safety in North Carolina through addressing alcohol-related motor vehicle collisions

The aim of this work is to analyze trends in youth transportation fatalities and injuries in North Carolina (NC), assess the implementation of ignition interlock devices (IIDs) in the United States and abroad, discuss policy implications for IIDs, and highlight health equity considerations related to motor vehicle collisions (MVCs). MVCs cause the highest number of unintentional injury-related deaths for children and teenagers in NC, and policymakers should pay special attention to MVCs related to alcohol consumption. IIDs are effective in reducing collision rates and recidivism for driving under the influence of alcohol (DUI). Ignition interlock device requirements have been increasingly implemented globally over the past three decades. However, the adoption of stricter IID policies after first-time DUI offenses in NC and across the U.S. is a prudent public health measure to enhance transportation safety for both adults and children. Evidence-based interventions such as IIDs must also strive to address inequities in transportation safety, and the framing of proposed policies should reflect the tenets of cultural humility.

Mortality of older construction and craft workers employed at Department of Energy (DOE) nuclear sites: Follow-up through 2021.

To determine if construction and trades workers formerly employed at US Department of Energy (DOE) nuclear weapons sites are at significant risk for occupational diseases, we studied the mortality experience of participants in the Building Trades National Medical Screening Program (BTMed). The cohort included 26,922 participants enrolled between 1998 and 2021 and 8367 deaths. Standardized mortality ratios were calculated based on US death rates. Cox models compared construction workers (n = 22,747; 7487 deaths) to two nonconstruction subpopulations: administrative, scientific and security workers (n = 1894; 330 deaths), and all other nonconstruction workers (n = 2218; 550 deaths). Mortality was elevated for all causes, all cancers, cancers of the trachea, bronchus, lung, kidneys, and lymphatic and hematopoietic system, mesothelioma, chronic obstructive pulmonary disease (COPD), asbestosis, transportation injuries, and other injuries, particularly accidental poisonings. There were 167 deaths from coronavirus disease 2019 (COVID-19), which was lower than expected using US death rates. Overall cause-specific mortality was significantly higher among construction workers than for internal comparison groups. Construction workers employed at DOE sites have a significantly increased risk for occupational illnesses. Apart from COVID-19 deaths, this update: (1) found that mortality among construction workers is significantly elevated compared to the US population and significantly higher than in the internal comparison populations, and (2) confirmed excess risk for these workers for first employment after 1990. Cancer mortality risks are similar to the cancers identified for DOE compensation from radiation exposures. The high lung cancer risk supports the value of early lung cancer detection. Continued medical surveillance is important.

Impact of Transportation Methods and Injury Severity in Trauma Victims: Insights from Federal Tertiary Hospitals in Nigeria.

Introduction: Trauma remains a leading cause of morbidity and mortality among young populations globally, with Nigeria being no exception. This study examines the relationship between transportation methods and injury severity among trauma victims. Materials and Methods: This study was carried out using the data obtained from 24 Federal Tertiary Hospitals across three geopolitical zones in Nigeria. Results: Among the 4,851 trauma cases analyzed, public taxis and private cars emerged as the most common means of transportation to healthcare facilities. However, the data revealed a concerning trend: patients transported by ambulance were associated with more severe injury outcomes. Logistic regression analysis further confirmed that those conveyed by ambulance had significantly higher odds of experiencing severe injuries. This counterintuitive finding underscores the urgent need to rethink and improve pre-hospital care in Nigeria. Conclusion: The study advocates for the development of a robust and well-coordinated Emergency Medical Services (EMS) infrastructure that can better serve trauma victims and potentially alter these severe outcomes. By shedding light on these critical issues, the findings aim to inform policy development and strengthen trauma care systems, particularly in low- and middle-income countries (LMICs) where such improvements are most needed.

Unintentional injuries in children in the south of Iran, 2004–2019: a trend analysis of mortality rates

IntroductionInjury is one of the main causes of death and disability in the world. This study was designed to determine the trend of mortality rate and years of life lost...

Circumstances and outcome of active transportation injuries: protocol of a British Columbian inception cohort study

IntroductionActive transport (AT) is promoted by urban planners and health officials for its environmental, economic and societal benefits and its uptake is increasing. Unfortunately, AT users can be injured or...

Occupational Injuries and Illnesses among Paramedicine Clinicians: Analyses of US Department of Labor Data (2010 - 2020).

Paramedicine clinicians (PCs) in the United States (US) respond to 40 million calls for assistance every year. Their fatality rates are high and their rates of nonfatal injuries are higher than other emergency services personnel, and much higher than the average rate for all US workers. The objectives of this paper are to: describe current occupational injuries among PCs; determine changes in risks over time; and calculate differences in risks compared to other occupational groups. This retrospective open cohort study of nonfatal injuries among PCs used 2010 through 2020 data from the US Department of Labor (DOL), Bureau of Labor Statistics; some data were unavailable for some years. The rates and relative risks (RRs) of injuries were calculated and compared against those of registered nurses (RNs), fire fighters (FFs), and all US workers. The annual average number of injuries was: 4,234 over-exertion and bodily reaction (eg, motion-related injuries); 3,935 sprains, strains, and tears; 2,000 back injuries; 580 transportation-related injuries; and over 400 violence-related injuries. In this cohort, women had an injury rate that was 50% higher than for men. In 2020, the overall rate of injuries among PCs was more than four-times higher, and the rate of back injuries more than seven-times higher than the national average for all US workers. The rate of violence-related injury was approximately six-times higher for PCs compared to all US workers, seven-times higher than the rate for FFs, and 60% higher than for RNs. The clinicians had a rate of transportation injuries that was 3.6-times higher than the national average for all workers and 2.3-times higher than for FFs. Their overall rate of cases varied between 290 per 10,000 workers in 2018 and 546 per 10,000 workers in 2022. Paramedicine clinicians are a critical component of the health, disaster, emergency services, and public health infrastructures, but they have risks that are different than other professionals.This analysis provides greater insight into the injuries and risks for these clinicians. The findings reveal the critical need for support for Emergency Medical Services (EMS)-specific research to develop evidence-based risk-reduction interventions. These risk-reduction efforts will require an enhanced data system that accurately and reliably tracks and identifies injuries and illnesses among PCs.

Kids gone wild - Alcohol use and patient characteristics in pediatric trauma during the coronavirus disease 2019 pandemic.

Reported coronavirus disease 2019 (COVID-19) pandemic effects on pediatric trauma have been variable. We investigated the characteristics of pediatric trauma including alcohol use during the pandemic at our urban trauma center. The trauma database of our adult level 1 trauma center was queried for all pediatric (age ≤ 18 years) patients presenting between March 1, 2020, and October 30, 2020. Data from 2017 to 2019 served as a control. Variables analyzed included demographics, mechanisms, injury severity, hospitalization characteristics, and positive blood alcohol. Pandemic pediatric trauma volumes increased by 67.5% (330/year vs. 197/year). Pandemic patients were younger (median age 13 vs. 14 years, P = 0.011), but similar in gender, ethnicity, severity, hospital length of stay, mortality, and rates of penetrating injury. Falls doubled (79/year vs. 34/year) and shifted away from high falls >6 meters (0% vs. 7.9%) to moderate falls 1-6 meters (58.2% vs. 51.5%) (P = 0.028). Transportation injury rates were similar however mechanisms shifted from motor vehicle crashes (-13.5%) towards recreational vehicles including motorcycles (+2.1%), all-terrain vehicles (+8.6%), and bicycles (+3.8%) (P = 0.018). Pediatric-positive blood alcohol was significantly higher (11.2% vs. 5.1%, P < 0.001), especially for ages 14-18 years (21.7% vs. 9.5%, P < 0.001). Pediatric trauma volumes during the COVID-19 pandemic increased. Pandemic patients had more recreational vehicle injuries and higher rates of positive blood alcohol. This suggests an increased need for alcohol assessment and targeted interventions in the pediatric population during pandemics or periods of school closures.

Epidemiology and Prevention of Child Pedestrian Injury.

This report supports policy recommendations in the accompanying policy statement "Child Pedestrian Safety" (www.pediatrics.org/cgi/doi/10.1542/peds.2023-62506). It reviews trends in public health and urban design relevant to pedestrian safety and provides information to assist practicing pediatricians discussing the benefits of active transportation and the specific risks and safety precautions to consider for child pedestrians at different ages. The report offers the evidence base for which programs and policies that, if implemented, could foster independent mobility for children while increasing pediatric pedestrian safety. Since the previous policy statement was published in 2009, the field of pedestrian safety has advanced with new evidence related to pediatric pedestrian education, the risks of distracted walking, the benefits of design and programming in safe routes to school, and the emergence of the "Vision Zero" public health and safety initiatives to prevent all serious and fatal transportation injuries.

The prophylactic effects of naringin on steroid-induced early-stage osteonecrosis in rats: a preliminary study.

The excessive steroid may cause dyslipidaemia and oxidative insult during femoral head osteonecrosis, inducing bone loss and impairment of the intraosseous blood system. In contrast, bio-flavanone naringin has shown antioxidant, antiresorptive and lipid-lowering bioactivities. The present research is an effort to explore the anti-ON potential of naringin in vivo and in vitro. After a 6-week treatment, the femora were dissected for histological examination following bone mineral density assay by X-ray absorptiometry. Blood samples were examined for coagulation, oxidative stress, lipid transportation and endothelial injury. Marrow samples were cultured and assayed for adipogenic and osteogenic alterations by ALP activity, mineralization, RT-qPCR and western blot analysis. The results showed that naringin exerted a dose-dependent effect on reducing ON incidence, with inhibition of osteoporosis, oxidative stress and dyslipidaemia. The mechanism included the suppression of PPARγ2 for adipogenesis of bone marrow stem cells (BMSCs) and the prevention of oxidative stress in endothelium injury. Naringin may restore steroid-impaired osteogenesis by enhancing the mRNA and protein expression of osteogenic markers in a dose-ascending manner and new bone formation can be found in naringin groups. Taken together, our findings showed that naringin may serve as a prophylactic agent and selective PPARγ modulator for the early-stage ON.

Trends in alcohol-impaired crashes in California, 2016 to 2021: A time series analysis for alcohol involvement and crash distribution among demographic subgroups.

In 2020, the COVID-19 pandemic and control measures changed alcohol consumption in the United States (US) and globally. Before the pandemic, alcohol-impaired crashes contributed to approximately one-third of all road traffic crash injuries and fatalities nationally. We examined the impact of the COVID-19 pandemic on crashes and examined differences in alcohol-involved crashes across various subgroups. The University of California Berkeley Transportation Injury Mapping Systems provided information on all crashes reported to the California Highway Patrol from January 1, 2016 through December 31, 2021. Using autoregressive integrated moving average (ARIMA) models applied to weekly time series data, we estimated the effect of California's first mandatory statewide shelter-in-place order (March 19, 2020) on crashes per 100,000 population. We also examined crash subgroups according to crash severity, sex, race/ethnicity, age, and alcohol involvement. In California, the mean crash rate per week before the pandemic (January 1, 2016-March 18, 2020) was 9.5 crashes per 100,000 population, and 10.3% of those were alcohol-involved. After the initiation of the COVID-19 stay-at-home order, the percentage of crashes that were alcohol-involved rose to 12.7%. Overall, the crash rate across California decreased significantly (-4.6 crashes per 100,000; 95% CI: -5.3, -3.9), including across all examined subgroups, with the greatest decrease among the least severe crashes. However, there was a 2.3% absolute increase in the proportion of crashes that were alcohol-involved (0.02 crashes per 100,000; 95% CI: 0.02, 0.03). The initiation of a COVID-19 stay-at-home ordinance in California was associated with a substantial decrease in overall crash rates. While crashes have returned to pre-pandemic levels, alcohol-involved crashes remain elevated. The initiation of the stay-at-home order significantly increased alcohol-impaired driving, which has remained elevated.

Utilizing Haddon matrix to assess nonfatal commercial fishing injury factors in Oregon and Washington

BackgroundCommercial fishing is a precarious industry with high fatal and nonfatal injury rates. The Risk Information System of Commercial [RISC] Fishing project at Oregon State University has been tracking both fatal and nonfatal injuries among Oregon and Washington commercial fishermen. We examined the utility of the RISC dataset variables in highlighting injury factors and prevention opportunities.MethodWe identified 245 nonfatal commercial fishing injuries in Oregon and Washington (2000–2018) and assessed the top three injury events (contact with objects or equipment, transportation incidents, and slips/trips/falls) using a cross-sectional design. We generated a Haddon matrix for each event type and populated the matrices with injury-associated factors following our a-priori matrix.ResultsWe observed 108 nonfatal injuries due to contact with objects. Contact injuries occurred during fishing (40%) with fishing gears (40%), often while hauling the fishing gear (22%). Common injury mechanisms included getting caught in running equipment or machinery (19%) or compressed by shifting objects or equipment (18%). Of the 58 transportation injuries most occurred in catchers (93%) and smaller vessels (1 to 3 crew) (55%). Vessel casualties were common as several vessels struck rocks/bottom (29%) or experienced fire and explosion (19%). The crew was abandoned to water (38%), often due to no raft or raft malfunctions (19%). Slip/trip/fall injuries (n = 43) typically happened during onboard traffic (49%). Such events were largely experienced by the catcher-processors (44%) including large vessels with > 100 crew (28%).ConclusionThe Haddon matrix demonstrated the injury-event timeline and helped to identify potential injury-associated factors. Our injury-specific risk matrices will let commercial fishing stakeholders determine priorities and work with the experts on prevention efforts.

Risk Factors and Inequities in Transportation Injury and Mortality in the Canadian Census Health and Environment Cohorts (CanCHECs).

Road traffic injury contributes substantially to morbidity and mortality. Canada stands out among developed countries in not conducting a national household travel survey, leading to a dearth of national transportation mode data and risk calculations that have appropriate denominators. Since traffic injuries are specific to the mode of travel used, these risk calculations should consider travel mode. Census data on mode of commute is one of the few sources of these data for persons aged 15 and over. This study leveraged a national data linkage cohort, the Canadian Census Health and Environment Cohorts, that connects census sociodemographic and commute mode data with records of deaths and hospitalizations, enabling assessment of road traffic injury associations by indicators of mode of travel (commuter mode). We examined longitudinal (1996-2019) bicyclist, pedestrian, and motor vehicle occupant injury and fatality risk in the Canadian Census Health and Environment Cohorts by commuter mode and sociodemographic characteristics using Cox proportional hazards models within the working adult population. We estimated positive associations between commute mode and same mode injury and fatality, particularly for bicycle commuters (hazard ratios for bicycling injury was 9.1 and for bicycling fatality was 11). Low-income populations and Indigenous people had increased injury risk across all modes. This study shows inequities in transportation injury risk in Canada and underscores the importance of adjusting for mode of travel when examining differences between population groups.

Causes and Effects of the November 2021 Pacific Northwestern Floods in British Columbia

Global warming can result in high frequency in precipitation in some areas, and as a result of high precipitation, floods may occur more frequently and may cause more damage to urban areas. The Pacific Northwestern Flooding event that happened between November 14, 2021, to December 17, 2021, is a series of recent flooding events, and it can reasonably be the most expensive flooding event in British Columbia history. This study used QGIS tools to analyze the topographical characteristics of Vancouver in contribution to the severity of the floods. This study also organized reports on the infrastructure, population, and economic impacts of the floods in British Columbia, where Vancouver settled. Results show that Vancouver is generally low in altitude, with some areas in pot shape, making it easy for floods to invade. There was also an increase in rainfall frequency in Vancouver in the past 50 years, which aided the severity of floods. The flooding event in British Columbia has led to transportation damages, fatalities and injuries, and economic losses. Some suggestions for urban planning and administration in conscious of the presence of more severe flooding events are proposed such as comprehensive emergency management program.

A comparative study of collision types between automated and conventional vehicles using Bayesian probabilistic inferences

Introduction: Automated vehicle (AV) technology is a promising technology for improving the efficiency of traffic operations and reducing emissions. This technology has the potential to eliminate human error and significantly improve highway safety. However, little is known about AV safety issues due to limited crash data and relatively fewer AVs on the roadways. This study provides a comparative analysis between AVs and conventional vehicles on the factors leading to different types of collisions. Method: A Bayesian Network (BN) fitted using the Markov Chain Monte Carlo (MCMC) was used to achieve the study objective. Four years (2017–2020) of AV and conventional vehicle crash data on California roads were used. The AV crash dataset was acquired from the California Department of Motor Vehicles, while conventional vehicle crashes were obtained from the Transportation Injury Mapping System database. A buffer of 50 feet was used to associate each AV crash and conventional vehicle crash; a total of 127 AV crashes and 865 conventional vehicle crashes were used for analysis. Results: Our comparative analysis of the associated features suggests that AVs are 43% more likely to be involved in rear-end crashes. Further, AVs are 16% and 27% less likely to be involved in sideswipe/broadside and other types of collisions (head-on, hitting an object, etc.), respectively, when compared to conventional vehicles. The variables associated with the increased likelihood of rear-end collisions for AVs include signalized intersections and lanes with less than 45 mph speed limit. Conclusions: Although AVs are found to improve safety on the road in most types of collisions by limiting human error leading to vehicle crashes, the current state of the technology shows that safety aspects still need improvement.

What is counted counts: An innovative linkage of police, hospital, and spatial data for transportation injury prevention

Introduction: Growing research indicates transportation injury surveillance using police collision reporting alone underrepresents injury to vulnerable groups, including pedestrians, cyclists, and people of color. This reflects differing reporting patterns and non-clinicians’ challenge in accurately evaluating injury severity. To our knowledge, San Francisco is the first U.S. city to link and map hospital and police injury data. Analysis of linked data injury patterns informs interventions supporting traffic fatality and injury prevention goals. Methods: Injury and fatality records 2013–2015 were collected from San Francisco Police, Emergency Medical Services (EMS), Medical Examiner, and Zuckerberg San Francisco General Hospital (ZSFG). Probabilistic linkage was conducted using LinkSolv9.0 on match variables collision/admission time, name, birthdate, sex, travel mode, and geographic collision location. Results: From 2013-2015, this study identified 17,000+ transportation-related injuries on public roadways in San Francisco. Twenty-six percent (n = 4,415) appeared in both police and ZSFG sources. Linked injury records represent 39% of police records (N = 11,403) and 43% of hospital records (N = 10,223). Among hospital records, 34% of cyclist, 38% of motor vehicle occupant, 61% of pedestrian, and 54% of motorcyclist records linked with a police record. Linkage rate varied by travel mode even after controlling for injury severity. Transportation-injured ZSFG-treated patients lacking police reports were more often cyclists, male, Hispanic or Black, and less often occupants of motor vehicles compared to those with injuries captured only in police reports. Conclusions: Incorporating hospital and EMS spatial data into injury surveillance systems historically reliant on police reports offers trifold benefits. First, linkage captures injuries absent in police data, adding data on populations empirically vulnerable to injury. Second, it improves injury severity assessment. Finally, linked data better informs and targets interventions serving injury-burdened populations and road users, advancing transportation injury prevention. Practical applications: Linkage closes data gaps, improving ability to quantify injury and develop evidence-based interventions for vulnerable groups.

Safety Effectiveness of Autonomous Vehicles and Connected Autonomous Vehicles in Reducing Pedestrian Crashes

This research aims to study the safety effectiveness of autonomous vehicles (AVs) and connected autonomous vehicles (CAVs) in reducing pedestrian crashes in various scenarios. The proposed methodology involves (1) identifying factors that contribute to pedestrian crashes, (2) developing crash-frequency models to predict the pedestrian crash and identifying the model that performs the best, (3) identifying the AV and CAV technologies that can minimize and remove those identified factors, and (4) assessing the effectiveness of AV and CAV technologies in reducing pedestrian crashes for various road classifications. Using crash data obtained from San Francisco Transportation Injury Mapping System (TIMS) for 2016 to 2020, a two-level Bayesian Poisson lognormal (TLBPL) model is developed to assess the effectiveness of AVs and CAVs in reducing pedestrian crashes. The outcomes of the TLBPL model suggest that weather, lighting, and road classifications tend to influence more vehicle–pedestrian crashes in all road classifications. The results of TLBPL indicate that driver faults related to prediction ability contribute more to pedestrian crashes for all road classifications, while driver fault related to sensing (perception) on urban arterials is the factor contributing most to pedestrian crashes. This paper provides a framework for researchers and engineers to evaluate AVs’ and CAVs’ safety effectiveness by considering crash contributing factors and road classifications.

Validity of Global Fog‐Day Trends Indicated by the Global Surface Summary of the Day (GSOD) Data Set

AbstractIt has long been understood that fog plays an important role in the atmospheric radiation budget and contributes to many transportation related fatalities and injuries. This study utilizes &gt;8,000 Global Surface Summary of the Day (GSOD) ground stations to investigate trends observed in fog‐days over the past 44‐years, and to examine the validity of these trends under varying observational techniques. Results show strong large‐scale regional trends in the GSOD fog‐day data, with the United States (USA) and much of Europe observing ∼20–25% and ∼3–5% decreases respectively in fog‐day occurrence. However, when comparing fog‐day counts to simultaneous visibility, it is evident that several different fog‐day data collection techniques were used throughout the timeseries in many regions. For example, many stations in the USA made data collection changes in the mid 1990s, and again in the mid 2000s. To identify the artifacts from different data collection techniques, a simple method is developed to determine which stations indeed encountered at least one false deviation to the timeseries. After applying the methodology to all GSOD stations, 1,696 stations are identified as being potentially quality long‐term fog‐day stations. Utilizing these stations, more reliable regional trends can be derived over some specific regions. Spain, Australia, and China show statistically significant decreases in fog‐day occurrence. India and Japan show increases in fog day occurrence. Further analysis shows that the driving factors of fog such as temperature and moisture have changed regionally during the last four decades and could be linked to the long‐term regional fog‐day trends.

All causes of death among veterinarians in the United States during 1979 through 2015

To assess proportionate mortality from all causes for male and female US veterinarians during 1979 through 2015. Death records for 11,620 veterinarians. For this proportionate mortality ratio (PMR) study, information for veterinarians who died during 1979 through 2015 was obtained from AVMA obituary and life insurance databases and submitted to a centralized database of US death records to obtain underlying causes of death. Decedent data that met records-matching criteria were imported into a software program for calculation of PMRs for all causes stratified by sex and indirectly standardized for age, race, and 5-year calendar period with 95% CIs. 11,620 decedents consisted of 11,049 (95%) males and 571 (5%) females with a median age at death of 77 years. Proportionate mortality for all veterinarian decedents was higher than expected for melanoma (PMRs, 2.1 and 2.2 for males and females, respectively), suicide (PMRs, 2.1 and 3.5 for males and females, respectively), and transportation injuries (PMRs, 1.7 and 1.6 for males and females, respectively). Proportionate mortality for all decedents was lower than expected for respiratory cancers (PMRs, 0.6 and 0.5 for males and females, respectively), diabetes mellitus (PMRs, 0.7 and 0.4 for males and females, respectively), heart disease (PMRs, 0.9 and 0.6 for males and females, respectively), and respiratory disorders (PMRs, 0.7 and 0.6 for males and females, respectively). Results indicated proportionate mortality from malignant melanoma, transportation injuries, and suicide for male and female veterinarians was higher than the general population. These data may help stakeholders improve veterinarian workplace safety and health guidelines.

Longitudinal cohort study of injury type, settings, treatment and costs in British Columbia youth, 2003–2013

BackgroundIn 2010 in British Columbia (BC), Canada, total injury costs per capita were higher among youth aged 15–24 years than in any other age group. Injury prevention efforts have targeted...