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Abstract: Motorway operators deploy dynamic lane management operations to reduce recurrent congestions. The aim of this paper is to contribute to the safety assessment of such an operation which has been introduced on a French urban motorway weaving section. It consists in the opening of an auxiliary lane partly taken on the hard shoulder. The assessment is based on the observational before-after method in road safety, which compares the empirical number of accidents with a prediction of the number of those which would have occurred, had no change happened. A comparison site is used to identify the trend on the number of accidents between the before and after periods, independently of the effect of the operation. A variant of this method, which takes into account the traffic regimes, is developed here. This variant removes some bias, which may exist when the traffic patterns on the comparison site and on the assessed site are different. We highlight here how critical is the choice of the comparison site; how significant is the correlation between the risks of accidents by type and the traffic regimes, because that correlation, if changing over time, induces a bias; how meaningful is the provided analytic expression of the bias. Although inconclusive – due to the small number of recorded accidents – concerning the final safety impact of the operation, the main questions are discussed - reduction in traffic density leading to a reduction in the number of accidents, migration of traffic towards the opening hours, migration of density and accidents downstream. This contributes to a better understanding of the evolution of traffic safety and of the safety impact of the lane management operation. [Copyright &y& Elsevier]

Abstract: This article examines the consequences, for Paris, of the increase in two-wheel motor vehicle (2WMV) traffic (measured in vehicle/km). Our study reveals that, between 2000 and 2007, the subway''s (Métro) share in total inner-Paris travel increased by 13.6%, the RER''s share by 10.3% and the SNCF''s share by 20.5%. These three means of transport account for 58% of daily travel. On the other hand, the bus share has decreased by 16% and that of cars by 23.7%. Private motor vehicles represent 37.3% of total travel. Looking at road traffic, where public transport (buses) and private motor transport compete for the use of limited road space, private motor vehicles account for 91.5% and public transport 8.5% of total travel. The 2WMV share in Paris traffic increased by 36% between 2000 and 2007, with 2WMVs now accounting for a share twice as large as that of buses. A survey has shown that 100 million additional passenger kilometres were made by 2WMV in 2007 compared to 2000. 53% of this increase comes from people shifting to 2WMV from public transport and 26.5% from private cars. The remaining 20% is attributable to the increased use of 2WMVs by those already owning such vehicles in 2000. Is the growth in the share of 2WMV traffic in Paris beneficial to the community? This shift in the means of transport generates time savings of €293 million and increases owners'' vehicle usage costs by €49 million. The cost of accidents is increased by €49 million and the negative consequences in terms of pollution are estimated at €22.6 million. The welfare impact of the government revenue change is negative and equal to €4.7 million. In total, the gain for the community is therefore around €168 million. Accident costs are the key issue. The fact that there are on average 21 2WMV fatalities in Paris (average 2006–2007) for a means of transport accounting for 16% of passenger/km made every day in Paris offers a striking contrast to the 6 (average 2006–2007) fatalities concerning cyclists which account for a mere 0.1% of trips. The massive shift to 2WMV has taken place without any public policy support. Public policy could easily further improve the 2WMV cost-benefit balance by taking measures that would decrease the number of accidents. [Copyright &y& Elsevier]

Summary: Objective: It is essential to know about the long-term consequences of road crashes involving corporal injury in order to adopt relevant public health measures. Methods: 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 ≥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. Results: 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. Conclusion: 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. [Copyright &y& Elsevier]

Background: The specific features of crashes involving an alcohol-intoxicated driver have been extensively characterized, but no such data are available for crashes involving a driver who has used a prescription medicine, which could help to plan and target prevention and control initiatives. This study aimed to describe the characteristics of crashes involving drivers under the influence of prescription medicines.Methods: We took advantage of CESIR, a French record linkage study for which data were extracted and matched from three French national databases: police reports, the national police database of injurious crashes and the national health care insurance database (HCI database). The drivers included in the study were those involved in an injurious road crash in France from July 1, 2005 to December 31, 2015, whose national identity number, date of birth and sex allowed matching. Prescription medicines considered were those with the two highest levels of warning.Results: Similar crash profiles were found when drivers used alcohol or medicines, particularly with respect to injury severity, type of vehicle, type of collision, type of road and cross-track profile. Alcohol-related crashes were over-represented during weekends and in low-density areas and medicine-related crashes were over-represented during weekdays and in cities of fewer than 300 000 inhabitants. While a much higher strength of association with responsibility was found for alcohol than for medicines, the proportion of crashes with drivers using medicines was twice as high as crashes with drivers using alcohol.Conclusion: The lower risk carried by medicines is therefore in part compensated by a higher prevalence of use, making medicines one of the hidden factors of road risk. Characterizing these crashes will therefore be useful to better focus road safety intervention on the prevention of driving under the influence of psychotropic medicines. [ABSTRACT FROM AUTHOR]