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As the elderly population grows, there is a greater concern for their safety on the roads. This is particularly important for elderly pedestrians who are more vulnerable to accidents. In Spain, one of the most aged countries in the world, the elderly accounted for 70% of all pedestrian deaths in 2019. In this study, the focus was on analysing the occurrence of elderly pedestrian-vehicle collisions in Spanish municipalities and how it is related to the built environment. The study used the hurdle negative binomial model to analyse the number of elderly and non-elderly pedestrian accidents per municipality in 2016-2019. The exploratory analysis showed that cities above 50,000 inhabitants were safer for the elderly, and larger provincial capitals had lower elderly pedestrian traffic accident rates. The occurrence of all pedestrian traffic accidents was linked to the socio-demographic features. For elderly pedestrians, land use was found to be influential, with a lower proportion of land covered by manufacturing and service activities linked to a smaller number of accidents. Results showed that improving road safety for older pedestrians may not necessarily compromise the situation for the rest of population. Hence, policymakers should focus on infrastructure improvements adapted to the needs of elderly pedestrians. [ABSTRACT FROM AUTHOR]

Introduction: There remains a significant morbidity and mortality in young pedestrians hit by motor vehicles, even in the era of pedestrian crossings and speed limits. The aim of this study was to compare the incidence and injury severity of motor vehicle-related pedestrian trauma according to time of day and season in a young population, based on the supposition that injuries would be more prevalent during dusk and dawn and during autumn and winter. Methods: Data were retrieved from the National Trauma Audit and Research Network (TARN) database for patients between 10 and 25 years old who had been involved as pedestrians in road traffic collisions between 2013 and 2020. The incidence of injuries, their severity (using the injury severity score (ISS)) and mortality were analysed according to the hours of daylight, darkness and season. Results: The study identified a seasonal pattern, highlighting that injuries were most prevalent during autumn (34.9% of injuries). Prevalence decreased throughout the year from winter (25.4%) to spring (21.4%), to summer (18.3%). The greatest incident rate (number of incidents/hour) occurred between 1500-1630 h, correlating to school pick up times, but overall there was no significant difference in injury prevalence between hours of darkness (47.3%) and daylight (52.7%). However, a significant relationship between ISS and daylight hours was demonstrated (p-value = 0.0124), whereby moderate injuries (ISS score: 9-15) were more likely during the day (72.7%), while severe injuries (ISS score > 15) were more likely at night (55.8%). Conclusion:We identified a relationship between the time of day and the frequency and severity of pedestrian trauma in young people. In addition, particular time groupings correspond to the greatest incidents rate, suggesting that reduced visibility coupled with school pick up times play a significant role. We recommend targeted public health measures to improve road safety that focus on these high-risk times of the day. [ABSTRACT FROM AUTHOR]

Abstract Motorway incidents are frequent & varied in nature. Incident management on motorways is critical for both driver safety & road network operation. The expected duration of an incident is a key parameter in the decision-making process for control room operators, however, the actual duration for which an incident will impact the network is never known with true certainty. This paper presents a study which compares the ability of different machine learning algorithms to estimate the duration of motorway incidents on Ireland’s M50 motorway, using an extensive historical incident database. Results show that the support vector machine has the best performance in most cases, but a different method may need to be used to improve accuracy in some situations. Results highlight the main challenges in accurately forecasting incident durations in real time & recommendations are made for improving prediction accuracy through systematic recording of various additional incident details.

The media plays a key role in shaping the public's perception of road safety. This study analyzes the newspaper coverage and framing of motor vehicle crashes (MVCs) and road safety in Argentina, South America. The content of 304 articles published by 15 newspapers in November 2020 was reviewed. The results show that episodically framed news stories (focused on a single event or incident) prevail over thematically framed articles. MVCs are presented primarily as 'police' events and tend to receive more coverage when fatalities are involved. There is limited information provided on contextual and risk factors, and road safety advice is rarely included. Speeding, infrastructure, alcohol and other human-related variables are the most cited risk factors. Very few articles mention the use of protective devices (seat-belt, helmet and child restraint system). Although motorcyclists represent 40% of RTC deaths in Argentina, only 20% of the news coverage was about them. News coverage was quite similar in national and regional newspapers. There is an opportunity for the media to help build a better road safety culture, but significant changes in news framing are required. Practical recommendations for editors, journalists and road safety practitioners are provided. [ABSTRACT FROM AUTHOR]

Introduction: Motorcyclists are over-represented in collision statistics in Ireland. There is a lack of descriptive studies assessing the impact and injury pattern of this trauma cohort. This study examines this trauma subset using data collected by the Major Trauma Audit (MTA) by the National Office of Clinical Audit (NOCA) to identify patient demographics, injury mechanism and type, treatments received, and outcomes. Methods: All motorcycle-related trauma cases recorded on the MTA, NOCA in Ireland for the period 2014 to 2019 were gathered and analysed. Results: There were 704 cases identified; 94% of cases were male. The median (interquartile range (IQR)) age was 38.2 (26.7–49.7). There were 6.4% (n = 45) aged 0–18 years, 88.2% (n = 621) aged 18–64 and 5.4% (n = 38) greater than 65 years. The median injury severity score (ISS) overall of this trauma cohort was 13 (IQR 9–24) but 306 patients (43.5%) had an ISS > 15. The most severe injury body region with 35.4% (n = 249) was the limbs. Most patients arrived during the summer months with Sunday the highest day of attendance (n = 181, 25.7%). May to August were the months with the most attendance (n = 366, 52%). Most patients were discharged home (n = 372, 52.8%) and 43.8% (n = 308) required transfer to at least one other hospital for definitive care. There were 19 patients (2.7%) who died after arrival to hospital. Conclusion: Motorcycle trauma predominantly affects a young male population with moderate severity injury characteristics. A significant proportion of patients present at weekends during the summer months, likely the result of recreational riding. A large cohort of patients requires transfer for definitive care, which has significant implications for trauma care pathways. National policies to enforce safety measures and public awareness for recreational motorcycle use may improve traffic safety and ultimately population health. [ABSTRACT FROM AUTHOR]

Background: Close to 500 people die annually from Road Traffic Collisions in Botswana. The country's Emergency Medical Service is limited in capacity and coverage and greatest in the region of the capital city, Gaborone. Botswana Police Service officers are often first responders to the incidents and provide first aid, however the extent of their interventions and their experiences has not been studied. Methods: A questionnaire based cross-sectional survey was conducted in January 2016 on a sample of 99 officers on past pre-hospital care training, attitudes towards providing pre-hospital care for accident victims, the number of road traffic collision related deaths and injuries encountered in the last 6 months, their interventions to the victims and limitations encountered in providing care. Results: The officers self-reported attending to a median of 10 injured victims (IQR = 5 – 20) and a median of 2 deaths (IQR = 0 – 4) in the preceding 6 months. The officers generally acknowledged their role and responsibility to provide pre-hospital care to the victims. Officers frequently secured accident scenes and transported injured victims to health facilities. They rarely performed haemorrhage control on victims, performed any airway manoeuvres or splint injured limbs. The major limitations to providing care were lack of first aid supplies and personal protective equipment, lack of knowledge and skills to provide care and interference from onlookers at accident scenes. Conclusion: Botswana Police officers in the greater Gaborone area attend to a considerable number of traffic related injuries and fatalities. These results support many opportunities for educational interventions to add value to pre-hospital care.

Close to 500 people die annually from Road Traffic Collisions in Botswana. The country's Emergency Medical Service is limited in capacity and coverage and greatest in the region of the capital city, Gaborone. Botswana Police Service officers are often first responders to the incidents and provide first aid, however the extent of their interventions and their experiences has not been studied. A questionnaire based cross-sectional survey was conducted in January 2016 on a sample of 99 officers on past pre-hospital care training, attitudes towards providing pre-hospital care for accident victims, the number of road traffic collision related deaths and injuries encountered in the last 6 months, their interventions to the victims and limitations encountered in providing care. The officers self-reported attending to a median of 10 injured victims (IQR = 5 – 20) and a median of 2 deaths (IQR = 0 – 4) in the preceding 6 months. The officers generally acknowledged their role and responsibility to provide pre-hospital care to the victims. Officers frequently secured accident scenes and transported injured victims to health facilities. They rarely performed haemorrhage control on victims, performed any airway manoeuvres or splint injured limbs. The major limitations to providing care were lack of first aid supplies and personal protective equipment, lack of knowledge and skills to provide care and interference from onlookers at accident scenes. Botswana Police officers in the greater Gaborone area attend to a considerable number of traffic related injuries and fatalities. These results support many opportunities for educational interventions to add value to pre-hospital care. • Road traffic accidents disproportionately affect LMICs, with sub-Saharan Africa having the world's highest fatality rate [1]. The majority of Africans have no access to EMS systems, and lay responders play a crucial role in pre hospital care [2]. • This study provides insight into how lay responders such the Botswana Police Service currently work in this role in Botswana. • The data supports many opportunities for simple educational interventions that could assist pre-hospital care. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to characterise cycling related injuries presenting to a major trauma centre located within a region with the highest rates of cycling in the UK.Methods: A retrospective analysis of cycling related trauma admissions occurring between January 2012 and June 2020 was performed. Our institution's electronic patient record system was used to collect relevant data for analysis including age, gender, mechanism of injury, Glasgow coma scale (GCS) on arrival, incident date and time, injured body regions, 30-day mortality, helmet use and intubation rate. Comparison was made between groups of patients based on mechanism of injury.Results: A total of 605 cycling related trauma cases were identified, with 52 being excluded due to incomplete data. The most common mechanism was 'fall from cycle' (53.5%). The 'cyclist v vehicle' group was associated with a significantly higher Injury Severity score (ISS), lower GCS and higher intubation rate. Helmet wearers were significantly older than non-wearers and helmet use was associated with a significantly reduced risk of head injury, lower ISS and intubation rate and a higher GCS.Discussion: With a likely increase in future cycling uptake, it is crucial that effective interventions are implemented to improve the safety of cyclists. The findings of this study may be used to guide any such intervention. A multi-faceted strategy involving driver and cyclist education, effective road infrastructure changes and helmet promotion campaigns specifically targeting the younger generation could be employed. [ABSTRACT FROM AUTHOR]

Abstract Background With increasing urbanization in developing countries, sanitation workers are frequently involved in road traffic collisions. Our purpose was to study specific collisions involving sanitation workers and provide decision-making suggestions and reference measures for the sanitation industry and urban managers to reduce the occurrence of collisions. Methods We obtained online news data about sanitation worker road traffic collisions in China between 2013 and 2017 and analyzed occurrence time and location, victim characteristics, and causes of collisions. Results In China, between 2013 and 2017, 511 road traffic collisions were reported, with the fewest in February and July. Most occurred around 5:00 a.m. in Eastern regions and in urban areas. Victims were mainly over 50 years old, with more females than males. Collisions usually resulted in death at the scene. The ambiguity of laws, the exploitation of workers through industry outsourcing, and the difficulty of processing claims may be the main factors preventing victims from obtaining legal compensation. Conclusions The most common cause of collisions was drivers’ speeding, but workers also regularly risk death by crossing the road in pursuit of their duties. The absence of legal controls for environmental protection, the excessive pursuit of efficiency in urban governance, and the lack of basic education of sanitation workers are underlying causes of collisions. Raising awareness about sanitation worker road traffic collisions will help protect the work safety rights of this vulnerable group.

• The impact of different features in the severity of vehicle–pedestrian collisions is examined. • The mixed effect of traffic enforcement cameras in the severity of such collisions is analyzed. • A Linear Discriminant Analysis model outperforms other ML models for predicting such collisions in Medellín. • Age of the victim, heavy vehicles and illumination are associated to pedestrian deaths. • Motorcycles, densely populated locations, and quality of vertical signals are associated to pedestrian injuries. Purpose : One of the leading causes of violent fatalities around the world is road traffic collisions, and pedestrians are among the most vulnerable road users with respect to such incidents. Since walking is highly promoted in urban areas to alleviate motor-vehicle externalities, it is paramount to understand the causes associated with vehicle–pedestrian collisions and their severity to provide safe environments. Although traffic enforcement cameras can address vehicle-vehicle collisions, little is known about their effectiveness with respect to vehicle–pedestrian incidents. Methodology: In this study, we trained a set of machine learning models to forecast if a vehicle–pedestrian collision will turn into an injury or fatality, and the most suitable model was used to investigate the contributing features associated with such events with emphasis on the impact of traffic enforcement cameras. In addition to traffic enforcement camera proximity, features associated with the collision, weather, vehicle, victim, and infrastructure are included in the model to reduce unobserved heterogeneity. Results: Results show that a Linear Discriminant Analysis model surpasses other machine learning models considering the evaluation metrics. Results reveal that the age and gender of the victim, the involvement of larger vehicles in the collision, and the quality of the illumination are the causes associated with pedestrian fatalities. On the other hand, involvement of motorcycles and collisions that occurred in densely populated locations are the causes associated with pedestrian injuries. Conclusions: This investigation demonstrates how to articulate machine learning into a vehicle–pedestrian crash analysis to understand the direction and magnitude of covariates in the corresponding severity outcome. Furthermore, it highlights the remarkable effect that traffic enforcement cameras and other features have on vehicle–pedestrian crash severity. These results provide actionable guidance for educational campaigns, enhanced traffic engineering, and infrastructure improvements that could be implemented in the analyzed region to provide safer transportation. [ABSTRACT FROM AUTHOR]

Background: With increasing urbanization in developing countries, sanitation workers are frequently involved in road traffic collisions. Our purpose was to study specific collisions involving sanitation workers and provide decision-making suggestions and reference measures for the sanitation industry and urban managers to reduce the occurrence of collisions.Methods: We obtained online news data about sanitation worker road traffic collisions in China between 2013 and 2017 and analyzed occurrence time and location, victim characteristics, and causes of collisions.Results: In China, between 2013 and 2017, 511 road traffic collisions were reported, with the fewest in February and July. Most occurred around 5:00 a.m. in Eastern regions and in urban areas. Victims were mainly over 50 years old, with more females than males. Collisions usually resulted in death at the scene. The ambiguity of laws, the exploitation of workers through industry outsourcing, and the difficulty of processing claims may be the main factors preventing victims from obtaining legal compensation.Conclusions: The most common cause of collisions was drivers' speeding, but workers also regularly risk death by crossing the road in pursuit of their duties. The absence of legal controls for environmental protection, the excessive pursuit of efficiency in urban governance, and the lack of basic education of sanitation workers are underlying causes of collisions. Raising awareness about sanitation worker road traffic collisions will help protect the work safety rights of this vulnerable group. [ABSTRACT FROM AUTHOR]

Background/aim: Permanent daylight saving time has been implemented in Turkey since 2016. The present study determines the characteristics of road traffic collisions in the short‐term, trauma severity, and whether permanent daylight saving time has an impact on these parameters. Materials and methods: Drivers admitted because of road traffic collisions to a tertiary care university hospital emergency service two weeks before and after the transition to wintertime in 2014 and 2015 and summertime in 2015 and 2016 as well as those admitted two weeks before and after the same period with permanent daylight saving time in 2016 and 2017 wintertime and 2017 and 2018 summertime were included in the study. Trauma severity was measured using the Injury Severity Score. Results: The study analysed the data of 710 patients. There was no statistically significant difference was found between admissions in the summertime and permanent daylight saving time periods in terms of gender, time of admission, week of admission, Injury Severity Score and outcome (P >.05 for all values). Conclusions: In this study, we examined the short‐term effects of daylight saving time on road traffic collisions, and demonstrated that it had no impact on the number or time of admission, trauma severity and patient outcomes. More comprehensive studies covering longer periods can be performed across the country. [ABSTRACT FROM AUTHOR]

Background: Unlike some neighboring countries like Nigeria, few studies on actual causes, impact and the prevention of road traffic collisions have been carried out in Ghana. There is the need for further research and this study sought to link injuries that caused the death of drivers involved in vehicular collisions to the latent possible contributing diseases and medical conditions in these drivers and how these conditions predispose them to the collisions. Methods: This is a retrospective study that used the forensic autopsy records of driver fatalities and various injuries and medical conditions of drivers involved in road traffic collisions. Information on all drivers was retrieved from archives at the Komfo Anokye Teaching Hospital' Pathology Unit. Demographics and cause of death were used in selecting the cases, including all driver-related road traffic collisions from 2009 to 2014. Results: A total of 1842 road traffic collisions were recorded with 127 of them being driver related. There were 31 cases (24.4%) in 2014; the highest cases recorded for this study, with the least recorded in 2009 with only 12 cases (9.4%). There were 121 (95.3%) male drivers and 6 female drivers (4.7%). Most of the male drivers were between the ages of 30 and 39 with 39 cases, while that of females was between 40 and 49 years with 6 cases. There was no significant statistical correlation between age and sex (P =.124). No statistical correlation also existed between sex and year (P =.331). Pathologies of all body systems were established. Cardiovascular diseases were the most prevalent systemic medical condition seen in the drivers with 44.1%. Conclusion: The study established that the drivers had various latent medical conditions and all these could lead to possible incapacitation, affecting driver judgment, leading to collisions on the road. The National Road Safety Commission (NRSC) should request medical screening before issuing driver licenses. [ABSTRACT FROM AUTHOR]

Investigating the cost-implications of road traffic collision factors is an important endeavour that has a direct impact on the economy, transport policies, cities and nations around the world. A Bayesian network framework model was developed using real-life road traffic collision data and expert knowledge to assess the cost of road traffic collisions. Findings of this study suggest that the framework is a promising approach for assessing the cost-implications associated with road traffic collisions. Moreover, adopting this framework with other computational intelligence approaches would have a positive impact towards achieving the Sustainable Development Goals in terms of road safety. [ABSTRACT FROM AUTHOR]

Rapid urbanisation, a steady increase in the number of vehicles, speeding, negligence in road safety, and other factors have led to the inevitable worldwide growth of road traffic accidents involving pedestrians. According to the 'Global Status Report on Road Safety' released by the World Health Organization, road traffic collisions are one of the leading causes of death for people of all ages, with approximately 1.35 million road fatality deaths occurring globally each year. Figures from the report also highlight that a large part of road deaths involves pedestrians as the most vulnerable road users. Therefore, forensic examination of vehicle–pedestrian collisions has become increasingly important in the detection, investigation and reduction of road casualties and permanent development of this discipline is urgently needed. Thus, this article aims to review the capability and effectiveness of forensic examination in tackling road fatalities and explores the most important aspects of this discipline, such as nature of a vehicle–pedestrian collision, common issues resolved by this type of examination and typical physical evidence used in the reconstruction of vehicle–pedestrian collisions. Moreover, the paper outlines the latest advances and approaches in the field. [ABSTRACT FROM AUTHOR]

In Malawi, pre-hospital care assistance is mainly provided by laypersons who witnessed the event. The aim of our study was to determine the knowledge and skills of such persons who bring victims of road traffic crashes to hospital. The study was conducted at Adult Emergency and Trauma Centre at Queen Elizabeth Central Hospital in Blantyre, Malawi. A total of 392 participants were interviewed. Most were merchants (22%) and unskilled labourers (14.5%). Three quarters (75.8%) provided assistance on the scene. The most common assistance provided was transporting victim to the hospital (68.7%), assisting with safe lifting (57.9%) and calling for help (39.7%). Airway protection was provided by only 1% of participants. Therefore, it is recommended to establish some formal pre-hospital assistance to reduce morbidity and mortality from road traffic crashes. Laypersons, especially merchants, students and drivers are potential strong first responders, and training them may help improve pre-hospital care outcome. [ABSTRACT FROM AUTHOR]

Abstract Background Africa accounts for one sixth of global road traffic deaths—most in the pre-hospital setting. Ambulance transport is expensive relative to other modes of pre-hospital transport, but has advantages in time-sensitive, high-acuity scenarios. Many countries, including Ethiopia, are expanding ambulance fleets, but clinical characteristics of patients using ambulances remain ill-defined. Methods This is a cross-sectional study of 662 road traffic collisions (RTC) patients arriving to a single trauma referral center in Addis Ababa, Ethiopia, over 7 months. Emergency Department triage records were used to abstract clinical and arrival characteristics, including acuity. The outcome of interest was ambulance arrival. Secondary outcomes of interest were inter-facility referral and referral communication. Descriptive and multivariable statistics were computed to identify factors independently associated with outcomes. Results Over half of patients arrived with either high (13.1%) or moderate (42.2%) acuity. Over half (59.0%) arrived by ambulance, and nearly two thirds (65.9%) were referred. Among referred patients, inter-facility communication was poor (57.7%). Patients with high acuity were most likely to be referred (aOR 2.20, 95%CI 1.16–4.17), but were not more likely to receive ambulance transport (aOR 1.56, 95%CI 0.86–2.84) or inter-facility referral communication (aOR 0.98, 95%CI 0.49–1.94) than those with low acuity. Nearly half (40.2%) of all patients were referred by ambulance despite having low acuity. Conclusions Despite ambulance expansion in Addis Ababa, ambulance use among RTC patients remains heavily concentrated among those with low-acuity. Inter-facility referral appears a primary contributor to low-acuity ambulance use. In other contexts, similar routine ambulance monitoring may help identify low-value utilization. Regional guidelines may help direct ambulance use where most valuable, and warrant further evaluation.

Introduction: Colombia is the fourth largest country in South America. It is an upper middle-income country with an estimated population of 49.2 million people, and road traffic collisions (RTCs) are the second most common cause of traumatic death. The United Nations (UN) proclaimed 2011 to 2020 as the "Decade of Action for Road Safety." In this context, the government of Colombia established the National Road Safety Plan (PNSV) for the period 2011-2021, aiming to reduce RTC-related deaths by 26%. Some road safety laws (RSLs) were implemented before the PNSV, but their impact on deaths and injuries is still not known.Study Objective: The aim of this study was to evaluate whether these RSLs have had a long-term effect on road safety in the country.Methods: Data on RTC casualties, deaths, and injuries from January 1, 2001 through December 31, 2017 were collated from official Colombian governmental publications. Three different periods were considered for analysis: 2001-2010 to evaluate the Transit Code; 2011-2017 to evaluate the PNSV; and 2001-2017 to evaluate a composite of the full study period. Analyses of trends in deaths and injuries were related to dates of new RSLs.Results: A total of 102,723 deaths (12.7%) and 707,778 injuries (87.3%) were reported from 2001 through 2017. The Transit Code period (2001-2010) showed a 10.1% decline in deaths, 16.6% decline in injuries, and rates per 100,000 inhabitants and per 10,000 registered vehicles also declined. During the period of the PNSV (2011-2017), there was an increase in the number of deaths by 16.6%, injuries decreased by 1.7%, and death rates per 100,000 inhabitants also increased. During the total study period, a 12.4% reduction in the total number of casualties was achieved, and death and injury rates per 100,000 inhabitants decreased by 12.4% and 27.5%, respectively.Discussion: Despite the introduction of the PNSV, RTCs remain the second most common cause of preventable death in Colombia. Overall, while the absolute number of RTCs and deaths has been increasing, the rate of RTCs per 10,000 registered vehicles has been decreasing. This suggests that although the goals of the PNSV may not be realized, some of the laws emanating from it may be having a beneficial effect. Further study is required over a protracted period to determine the longer-term impact of these initiatives. [ABSTRACT FROM AUTHOR]

Introduction: Cycling as a means of transport or recreational activity is increasing in popularity in Ireland. However, increasing numbers of cyclists may lead to an increased number of bicycle collisions and fatalities. The Road Safety Authority is the statutory body for road safety in Ireland but uses police data alone to collate cycling collision statistics. This may lead to an underestimation of cycling injuries in Ireland. Using hospital statistics may provide a greater understanding of cycling trauma in Ireland.Objective: The present study examines cycling related trauma in Ireland using the Major Trauma Audit (MTA) data collected via the Trauma and Research Network (TARN) from hospitals in Ireland for the period 2014 to 2016. The database was interrogated for demographics, mechanism of injury, injury characteristics and patient outcomes.Results: There were 410 cycling collisions recorded in the TARN database which represented 4.4% of trauma captured by TARN for the study period. Of this cohort 79% were male compared with 58% in the overall (TARN) trauma cohort (p < 0.001) and the median (IQR) age was 43.8 years (31.0, 55.7) which is younger than the median (IQR) of 58.9 (36.2, 76.0) years for the overall trauma cohort (p < 0.001). Cycling collisions had a median (IQR) injury severity score (ISS) of 10 (9, 20) which was higher than the overall trauma cohort ISS of 9 (9, 17). Of the mechanisms observed for cycling trauma, 31.7% (n = 130) had a collision with a motor vehicle. Of those who did not wear a helmet, 52.2% (n = 47) sustained a head injury compared with 27.5% (n = 44) in the group who were wearing a helmet (p < 0.001).Conclusion: The TARN data presented in this paper builds a more complete overview of the burden of cycling collisions in Ireland. Particular points of focus are that serious cycling injuries occur in a predominantly male population, and that only around 30% of cases are recorded as involving a motor vehicle, with the majority having an unknown mechanism of injury. There was an association between helmets and head injuries in this study, but there are likely other contributing factors such as mechanism of injury, velocity or cycling infrastructure. Using hospital data such as the MTA provides valuable information on the injuries sustained by cyclists, but more prospective studies to capture injury mechanism and contributing factors are needed. [ABSTRACT FROM AUTHOR]

South Korea is ranked as 4th among 34 nations of the Organization for Economic Cooperation and Development with 102 deaths in road accidents per one million population. This paper aims to investigate the factors associated with road accidents in South Korea. The rainfall data of the Korea Meteorological Administration and road accidents data of Traffic Accident Analysis System of Korea Road Traffic Authority is analyzed for this purpose. In this connection, multivariate regression analysis and ratio analysis with the descriptive analysis are performed to uncover the catastrophic factors involved. In turn, the results reveal that traffic volume is the leading factor in road accidents. The limited road extension of 1.47% compared to the 4.14% per annum growth of the vehicles is resulting in road accidents at such a large scale. The increasing proportion of passenger cars accelerate road accidents as well. 56% of accidents occur by the infringement of safety driving violations. The drivers with higher driving experience tend to have a higher accident ratio. The collected data is analyzed in terms of gender, driver experience, type of violations and accidents as well as the associated time of the accidents when they happen. The results indicate that 36.29% and 53.01% of accidents happen by male drivers in the day and night time, respectively. 29.15% of crashes happen due to safety infringement and violations of 41 to 60 years old drivers. The results demonstrate that population density is associated with the accidents frequency and lower density results in an increased number of accidents. The necessity of the state-of-the-art regulations to govern the urban road traffic is beyond dispute, and it becomes even more crucial for citizens’ relief since in our daily lives road accidents are getting more diverse. [ABSTRACT FROM AUTHOR]

Background: Road Traffic Accidents have become an enormous global public health problem killing approximately 1.25 million people and injuring 20 to 50 million others yearly. It is the 10th leading cause of death universally and the number one cause of mortality of the young population between the ages of 5 and 29. Only few studies have been conducted on the severity of road traffic injuries in Ethiopia hence the need for the study. Objective: To assess injury severity level and associated factors among road traffic accident victims. Methods: A cross-sectional study of patients involved in road traffic accident and attended Tirunesh Beijing hospital, Addis Ababa, Ethiopia. Victims were consecutively recruited until sample size (164) attained during the study period. Data collectors administered a structured questionnaire. The collected data was then entered and cleaned using Epi info and exported to IBM SPSS for statistical analysis. Independent factors associated with injury severity were assessed using bivariate and multivariate logistic regression. Results: A total of 164 road traffic injury victims were included to the study. Prevalence of severe injury accounted for 36.6% of cases. “can read and write” educational status OR 35.194(95% CI; 3.325–372.539), sustaining multiple injury OR 18.400(95% CI; 5.402–62.671), sustaining multiple injury type OR 6.955(95% CI; 1.716–28.185) and being transported by ambulance from the scene of accident OR 13.800(95% CI; 1.481–128.635) were the explanatory variables found to have a statistically significant association with severe injury. Conclusion: This study showed road traffic accident is predominantly affecting the economically active, male young population. Not a single victim received pre-hospital care, majority were extracted by bystanders and most used commercial vehicle to be transported to a health institution reflecting the need for improvements in pre-hospital emergency services and socio-economic related infrastructures. [ABSTRACT FROM AUTHOR]

This paper quantifies the effect of speed cameras on road traffic collisions using an approximate Bayesian doubly-robust (DR) causal inference estimation method. Previous empirical work on this topic, which shows a diverse range of estimated effects, is based largely on outcome regression (OR) models using the Empirical Bayes approach or on simple before and after comparisons. Issues of causality and confounding have received little formal attention. A causal DR approach combines propensity score (PS) and OR models to give an average treatment effect (ATE) estimator that is consistent and asymptotically normal under correct specification of either of the two component models. We develop this approach within a novel approximate Bayesian framework to derive posterior predictive distributions for the ATE of speed cameras on road traffic collisions. Our results for England indicate significant reductions in the number of collisions at speed cameras sites (mean ATE = -15%). Our proposed method offers a promising approach for evaluation of transport safety interventions. [ABSTRACT FROM AUTHOR]

In this paper, from the practical point of view, we focus on modeling traumatic brain injury data considering different stages of hospitalization, related to patients’ survival rates following traumatic brain injury caused by traffic accidents. From the statistical point of view, the primary objective is related to overcoming the limited number of traumatic brain injury patients available for studying by considering different estimation methods to obtain improved estimators of the model parameters, which can be recommended to be used in the presence of small samples. To have a general methodology, at least in principle, we consider the very flexible Generalized Gamma distribution. We compare various estimation methods using extensive numerical simulations. The results reveal that the penalized maximum likelihood estimators have the smallest mean square errors and biases, proving to be the most efficient method among the investigated ones, mainly to be used in the presence of small samples. The Simulated Annealing technique is used to avoid numerical problems during the optimization process, as well as the need for good initial values. Overall, we considered an amount of three real data sets related to traumatic brain injury caused by traffic accidents to demonstrate that the Generalized Gamma distribution is a simple alternative to be used in this type of applications for different occurrence rates and risks, and in the presence of small samples. [ABSTRACT FROM AUTHOR]

Introduction: The fixation of unstable zygomaticomaxillary complex (ZMC) fractures can be achieved by open reduction with rigid internal fixation (ORIF) and/or by closed reduction with percutaneous transfacial Kirschner wire fixation (CRWF). The aim of this study was to tomographically assess the symmetry and the protrusion of the cheekbone with unstable ZMC fractures that had been treated by ORIF vs. CRWF. Materials and methods: Sixty patients exhibiting a surgically unstable tetrapodal ZMC fracture were included in this multicenter retrospective study. The coordinates of 5 landmarks representing the zygomatic protrusion were comparatively studied on the healthy and on the broken side using preoperative and postoperative tridimensional computed tomography (CT) scans or cone beam CT. Results: No significant difference was found in the zygomatic protrusion irrespective of the surgical technique that was used. The zygomatico-maxillary ansa was found to be the most complicated area to reduce, particularly in the frontal plane with both the CRWF and the ORIF technique (p1 = 0.001 and p2 = 0.0009, respectively). There was no difference in terms of the level of complications, while the mean duration of the surgery was significantly less for the CRWF group. Conclusion: With good postoperative radiographic outcomes, the CRWF can be proposed as an alternative or in association with the ORIF technique for fixation of tetrapodal fractures of the ZMC. [ABSTRACT FROM AUTHOR]

We introduce a rapid deterministic algorithm for identification of the most critical links which are capable of causing network disruptions. The algorithm is based on searching for the shortest cycles in the network and provides a significant time improvement compared with a common brute-force algorithm which scans the entire network. We used a simple measure, based on standard deviation, as a vulnerability measure. It takes into account the importance of nodes in particular network components. We demonstrate this approach on a real network with 734 nodes and 990 links. We found the worst scenarios for the cases with and without people living in the nodes. The evaluation of all network breakups can provide transportation planners and administrators with plenty of data for further statistical analyses. The presented approach provides an alternative approach to the recent research assessing the impacts of simultaneous interruptions of multiple links. [ABSTRACT FROM AUTHOR]

Long working hours and a lack of sleep have been suggested to negatively affect the safety of workers. Here, we examined the association between long working hours/sleep-related problems and near-misses/injuries in industrial settings using a nationally representative sample of workers in Japan. Based on the composition ratio of workers by industry, sex, and age in Japan, data from a web-based cross-sectional survey for 18,682 participant full-time workers (7,098 female and 11,584 male; mean age, 43.7 [standard deviation 11.1] years) were analyzed. Nearly 30% and 5% of participants reported any types of near-misses during the past six months and injuries during the past year, respectively. For all types of near-misses and some types of injuries, a significant difference in frequency distribution was observed by industry. After adjustment for demographic, job-, and life-related variables, participants who worked long hours (i.e., more than 51 hours per week) were more likely to report job-related near-misses/injuries than those who worked 35–40 hours per week. The presence of sleep-related problems was also significantly related to near-misses and injuries. However, while sleep-related problems were significantly associated with near-misses/injuries in all industries, the association between long working hours and near-misses/injuries differed by industry. Odds ratios for near-misses/injuries were strongly significant in the “transport/postal services” industry for those who worked more than 51 hours per week compared to those who worked 35–40 hours per week. Comprehensive protective measures for workers, including (1) reducing total hours of service/job-related fatigue, (2) maintaining sufficient sleep hours/good sleep, and (3) increasing awareness about the impact of overwork/long working hours and sleep-related problems on workers’ safety among employers, workers, clients/customers, and the general public might be effective for preventing near-misses and injuries in industrial settings among workers, especially those who work long hours in the “transport/postal services” industry. [ABSTRACT FROM AUTHOR]

Objective: To analyze trends in external mortality in Hungary between 1995 and 2014 by sex. Methods: Data on the numbers of deaths due to external causes were obtained from the published nationwide population register. Negative binomial regression was applied to investigate the yearly trends in external-cause mortality rates. Cyclic trends were investigated using the Walter-Elwood method. Results: Suicide and accidents accounted for approximately 84% of the all-external-cause of deaths in Hungary. Annual suicide, unintentional falls and traffic accidents mortality declined significantly (p-value for annual trend: p < 0.001) from 30.5 (95% CI: 29.5–31.5) to 15.8 (15.1–16.5), from 31.2 (30.2–32.2) to 12.2 (11.7–12.8) and from 17.2 (16.4–18) to 5.4 (5–5.8) per 100 000 persons per year, respectively, during the study period. A significant declining trend in annual mortality was also found for assault, cold/heating-related accidents and accidents caused by electric current. However, the declining trend for drowning-related accidents was significant only for males. Significant winter-peak seasonality was found in the mortality rates from accidental falls, cold/heat-related accidents, other accidents caused by submersion/obstruction and other causes. Seasonal trends with a peak from June to July were observed in death rates from suicide/self-harm, accidental drowning/submersion and accidents caused by electric current. A significant seasonal variation with a peak in September was revealed in the mortality due to traffic accidents. Conclusions: This Hungarian study suggests that there was a significant seasonal effect on almost all kinds of deaths from external causes between 1995 and 2014. Environmental effects are involved in the aetiology of suicide and accidents. [ABSTRACT FROM AUTHOR]

Estimating and selecting risk factors with extremely low prevalences of exposure for a binary outcome is a challenge because classical standard techniques, markedly logistic regression, often fail to provide meaningful results in such settings. While penalized regression methods are widely used in high-dimensional settings, we were able to show their usefulness in low-dimensional settings as well. Specifically, we demonstrate that Firth correction, ridge, the lasso and boosting all improve the estimation for low-prevalence risk factors. While the methods themselves are well-established, comparison studies are needed to assess their potential benefits in this context. This is done here using the dataset of a large unmatched case-control study from France (2005-2008) about the relationship between prescription medicines and road traffic accidents and an accompanying simulation study. Results show that the estimation of risk factors with prevalences below 0.1% can be drastically improved by using Firth correction and boosting in particular, especially for ultra-low prevalences. When a moderate number of low prevalence exposures is available, we recommend the use of penalized techniques. [ABSTRACT FROM AUTHOR]

Objectives: Every day, an average of 3,400 deaths and tens of millions of injuries occur as a result of traffic accidents. This study aims to model and validate road traffic injury (RTI) times series, specifically considering gender. Study design: Time trend studies of monthly road traffic injuries (RTI) in Iran from March 2005 to February 2016, as well as those of males and females from March 2009 to February 2016 were performed. Methods: The seasonal auto-regressive integrated moving average method (SARIMA) was employed to predict RTI time series. The final model was selected from various SARIMA models based on the Akaike information criterion (AIC) and the Bayesian information criterion (BIC). To examine whether the residuals were white noise, the Ljung-Box (LB) test and residuals plots were used for un-correlation, and the zero mean and stationarity, respectively. Additionally, smoothing methods were utilized to validate the SARIMA models for fitting and out-of-range prediction of the time series models under study. The sample auto-correlation function (ACF) and the partial autocorrelation function (PACF) with 20 lags were employed to determine the order of models and to ascertain if the residuals of the model were uncorrelated. Results: Based on the obtained results, SARIMA (2,1,0)(0,1,1)12, SARIMA (0,1,1)(0,1,1)12, SARIMA (1,1,1)(0,0,1)12, and SARIMA (2,0,0)(1,0,0)12 were chosen for the time series including incidence rates of total road traffic injuries (IRTI), IRTI of males, females, and males-to-females, respectively. The AIC values were -87.57, 413.38, -732.91, and -85.32, respectively. The LB test for the residuals of the time series models of (0.539) IRTI, (0.3) IRTI of males, (0.23) females, and (0.237) males-to-females indicated that residuals were uncorrelated. Furthermore, prediction values for the next 24 months (2016 to 2018) showed no decline in the incidence rate of male and female traffic injuries. Results of the predictions using exponential smoothing methods indicated out-of-range prediction validity of the SARIMA models. Conclusion: This study exemplified the high efficiency of SARIMA models in predicting road traffic injuries (RTIs). Based on observations, the IRTI mean in Iran was 35.57 in 2016. The predicted values of the IRTI for 2016–2018 by the SARIMA model showed no decreasing trend. During the studied period, the observed values of IRTI for males were two to three times the female values. Thus, prediction of RTI can provide a useful tool for traffic safety policymaking by simulating interrupted time series when applying new traffic enforcement interventions and regulations in the future. Additionally, IRTI analysis of males and females showed that men had a non-increasing trend but higher incidence of traffic injuries, whereas the IRTI for women revealed an increasing trend from 2009 to 2012 with a lower incidence of injuries. This growth could be attributed to the impact of increased outdoor activities of women and the increased number of issued driving licenses in the period of 2009–2012. [ABSTRACT FROM AUTHOR]

Whiplash-associated disorder (WAD) causes substantial social and economic burden, with ≥70% patients classified as WADII (neck complaint and musculoskeletal sign(s)). Effective management in the acute stage is required to prevent development of chronicity; an issue for 60% of patients. An Active Behavioural Physiotherapy Intervention (ABPI) was developed to address both physical and psychological components of WAD. The ABPI is a novel complex intervention designed through a rigorous sequential multiphase project to prevent transition of acute WAD to chronicity. An external pilot and feasibility cluster randomised double-blind (assessor, participants) parallel two-arm clinical trial was conducted in the UK private sector. The trial compared ABPI versus standard physiotherapy to evaluate trial procedures and feasibility of the ABPI for managing acute WADII in preparation for a future definitive trial. Six private physiotherapy clinics were recruited and cluster randomised using a computer-generated randomisation sequence. Twenty-eight (20 ABPI, 8 standard physiotherapy) participants [median age 38.00 (IQR = 21.50) years] were recruited. Data were analysed descriptively with a priori establishment of success criteria. Ninety-five percent of participants in the ABPI arm fully recovered (Neck Disability Index ≤4, compared to 17% in the standard physiotherapy arm); required fewer treatment sessions; and demonstrated greater improvement in all outcome measures (pain intensity, Cervical Range of Motion, Pressure Pain Threshold, EuroQol-5 Dimensions) except for the Impact of Events Scale and Fear Avoidance Beliefs Questionnaire. The findings support the potential value of the ABPI, and that an adequately powered definitive trial to evaluate effectiveness (clinical, cost) is feasible with minor modifications to procedures. [ABSTRACT FROM AUTHOR]

China's rapid urbanization and high traffic accident frequency have received many researchers’ attention. It is important to reveal how urban infrastructures and other risk factors affects the traffic accident frequency. A growing amount of research has examined the local risk factors impact on traffic accident frequency at certain time. Some studies considered these spatial influences but overlooked the temporal correlation/heterogeneity of traffic accidents and related risk factors. This study explores risk factors’ influence on urban traffic accidents frequency while considering both the spatial and temporal correlation/heterogeneity of traffic accidents. The study area is split into 100 equally sized rectangle traffic analysis zones (TAZs), and the urban traffic accident frequency and attributes in each TAZ are extracted. The linear regression model, spatial lag model (SLM), spatial error model (SEM) and time-fixed effects error model (T-FEEM) are established and compared respectively. The proposed methodologies are illustrated using ten-month traffic accident data from the urban area of Guiyang City, China. The results reveal that the time-fixed effects error model, which considers both spatial and temporal correlation/heterogeneity of traffic accidents, is superior to other models. More traffic accidents will happen in those TAZs that have more hospitals or schools. Moreover, hospitals have a greater influence on traffic accidents than schools. Because of the location in the margin of the city, those TAZs that have passenger stations have more traffic accidents. This study provides policy makers with more detailed characterization about the impact of related risk factors on traffic accident frequencies, and it is suggested that not only the spatial correlation/heterogeneity but also the temporal correlation/heterogeneity should be taken into account in guiding traffic accident control of urban area. [ABSTRACT FROM AUTHOR]

The primary purpose of the present study was to examine the effectiveness of threat appeals in influencing impulsive decision making associated with texting while driving. The participants in the treatment group were exposed to a threatening message about the danger of texting while driving, whereas those in the control group were exposed to a non-threatening message. Following the exposure to either message, the participants completed a delay-discounting task that assessed the degree of impulsive decision making in a hypothetical texting-while-driving scenario. A comparison between the groups revealed that the threat appeals reduced the degree of impulsive decision making associated with texting while driving. In addition, the threat appeals led to greater anticipated regret from texting while driving, less favorable attitudes toward texting while driving, and decreased intentions to text while driving in the future in the treatment group. These results suggest that video-based threat appeals are promising intervention strategies for the public health challenge of texting while driving. Implications from the behavioral economic perspective are discussed. [ABSTRACT FROM AUTHOR]

Road Traffic Accidents (RTA) are a major worldwide public health problem. The aim of this study was to use the growth mixture model for clustering countries on the basis of the mortality rate patterns of RTAs from 2007 to 2013. We obtained the data on RTA death rates from World Health Organization reports and Human Development Index (HDI) of United Nations Development Programme reports for the years 2007, 2010 and 2013. Simple Latent Growth Models (LGM) in 181 countries were applied to estimate overall RTA mortality rate growth trajectories and the latent growth mixture modeling utilized to cluster them. According to non-linear LGM, the overall mortality rate of RTAs showed a decrease from 2007 to 2010 followed by an increase from 2010 to 2013. The HDI covariate had a significant negative and positive effect on intercept and slope of the LGM, respectively. The extracted mixture model appeared to have seven classes with different trends in RTA mortality rates. The worldwide countries were clustered into seven classes. Further studies on each of the seven classes are suggested to provide recommendations for reducing the mortality rate of the RTAs. Additionally, increasing HDI in some countries could have a significant effect on reducing the RTA death rates. [ABSTRACT FROM AUTHOR]

Background: In many developing countries there is paucity of evidence regarding the epidemiology of road traffic accidents (RTAs). The study determines the rates of injuries and fatalities associated with RTAs in Ethiopia based on the data of a recent national survey. Methods: The study is based on the secondary data of the Ethiopian Demographic and Health Survey conducted in 2016. The survey collected information about occurrence injuries and accidents including RTAs in the past 12 months among 75,271 members of 16,650 households. Households were selected from nine regions and two city administrations of Ethiopia using stratified cluster sampling procedure. Results: Of the 75,271 household members enumerated, 123 encountered RTAs in the reference period and rate of RTA-related injury was 163 (95% confidence interval (CI): 136–195) per 100,000 population. Of the 123 causalities, 28 were fatal, making the fatality rate 37 (95% CI: 25–54) per 100,000 population. The RTA-related injuries and fatalities per 100,000 motor vehicles were estimated as 21,681 (95% CI: 18,090–25,938) and 4,922 (95% CI: 3325–7183), respectively. Next to accidental falls, RTAs were the second most common form of accidents and injuries accounting for 22.8% of all such incidents. RTAs contributed to 43.8% of all fatalities secondary to accidents and injuries. Among RTA causalities, 21.9% were drivers, 35.0% were passenger vehicle occupants and 36.0% were vulnerable road users including: motorcyclists (21.0%), pedestrians (12.1%) and cyclists (2.9%). Approximately half (47.1%) of the causalities were between 15–29 years of age and 15.3% were either minors younger than 15 years or seniors older than 64 years of age. Nearly two-thirds (65.0%) of the victims were males. Conclusion: RTA-related causalities are extremely high in Ethiopia. Male young adults and vulnerable road users are at increased risk of RTAs. There is a urgent need for bringing road safety to the country's public health agenda. [ABSTRACT FROM AUTHOR]

Introduction: In Lao People’s Democratic Republic (PDR), community-based health insurance (CBHI) is the only voluntary insurance scheme; it typically targets self-employed people, most of whom reside in rural areas and are dependent on agricultural activities for subsistence. However, until very recently, the enrollment rate has fallen short and failed to reach a large percentage of the target group. To promote the CBHI scheme and increase demand, some supporting components should be considered for inclusion together with the health infrastructure component. Objectives: This paper provides empirical evidence that the benefit package components of hypothetical CBHI schemes have causal effects on enrollment probabilities. Furthermore, we examine the distribution of willingness to pay (WTP) in response to policy changes based on a sample of 5,800 observations. Methods: A randomized conjoint experiment is conducted in rural villages in Savannakhet Province, Lao PDR, to elicit stated preference data. Each respondent ranks three options—two hypothetical alternatives and the CBHI status quo scheme. The levels of seven attributes—insurance coverage for medical consultations, hospitalizations, traffic accidents, pharmaceuticals and transportation; premiums; and prepaid discounts—are randomly and simultaneously assigned to the two alternatives. Results: The findings suggest that the average WTP is at least as large as 10.9% of the per capita income of those who live in rural areas, which is higher than the WTP for health insurance averaged across low- and middle-income countries (LMICs) in the literature. The component of round-trip transportation insurance coverage has a significant effect on WTP distribution, particularly increasing the share of the highest bin. Conclusion: Therefore, the low CBHI scheme enrollment rate in Lao PDR does not necessarily imply low demand among the targeted population, as the finding from the WTP analysis illustrates potential demand for the CBHI scheme. Specifically, if transportation is addressed, enrollment is likely to significantly increase. [ABSTRACT FROM AUTHOR]

• Road traffic collisions and fuel prices are negatively related to each other. • Monthly data from 2005 to 2018 for the 28 EU member states is used. • Use of Random Effect Negative Binomial and Generalised Estimating Equations (GEE). • Higher fuel prices are more effective in reducing fatal road traffic collisions. Road deaths globally have steadily climbed in recent years with the increase in motorisation. Yet in many economically developed countries they have actually fallen. Explanations for this reduction include the role of improved vehicle and highway design, better enforcement and the impact of the economic downturn, whilst there is also some evidence that microeconomic factors like changes in road fuel prices could be contributing to this situation. This paper investigates the effects of fuel prices on road collision frequency in countries where fuel prices are relatively high. Monthly panel data from 28 EU member states from 2005 to 2018 was analysed for both petrol and diesel prices, and for fatalities, total injury collisions and total collisions using: 1) random effect negative binomial (RENB); and 2) population-averaged negative binomial using generalised estimating equations (GEE). The findings indicate that higher fuel prices lead to lower road traffic deaths, injury collisions and overall collisions across all 28 EU member states. Thus, for every 10 percent increase in fuel prices, there will be a 2.6 percent and 2.2 percent reduction in fatalities for petrol and diesel models, respectively. Similarly, total collisions fall by 1.4 percent for petrol and 1.2 for diesel models, and total casualties fall by 1.6 percent for petrol and 1.4 percent for diesel with every 10 percent rise in fuel price. These results could be due to drivers reducing speed to achieve better fuel efficiency and to people driving less to save money – in particular younger, riskier drivers – hence reducing exposure. These findings suggest that policies replacing petrol and diesel vehicles with alternative fuel sources over the next 20 years could have negative repercussions for road safety if not adequately considered. [ABSTRACT FROM AUTHOR]

Summary of what was known• Few studies on road traffic collisions conducted in Latin American and the Caribbean region• Increasing car ownership within the region• Lack of seatbelt usage in Trinidad• Most accidents are associated with alcohol usage• High mortality among pedestriansSummary of what this study adds• Most collisions occur at night• Most collisions occur at weekends• Collisions are evenly distributed throughout the year• More males than females die in fatal collisions• The most productive age group (15–44) is affected the most• More drivers than pedestrians are affected• Reflects the pattern of developed rather than developing countries with respect to time of day for RTCs Background: The purpose of the study is to determine the epidemiology of road traffic collisions (RTCs) in Trinidad and Tobago by characterizing RTCs in terms of number of collisions, fatalities, victim profiles, and locations for the purpose of informing accident prevention programs. Previous studies of RTCs in Trinidad and Tobago were primarily concerned with patterns of drivers use of seat belts, road collisions as a cause of mortality in young men, and the economic burden of road collisions. Attempts were made to model road fatalities, but limited epidemiological data meant that it was difficult to determine trends or develop models. Methods: This study determined the epidemiology of RTCs in Trinidad and Tobago over the period 2000–2011using data collected by the Trinidad and Tobago Road Traffic Branch of the Police Service and secondary data from the Central Statistical Office. Data were analyzed using Excel, SPSS, and R statistical packages. Results: Fatalities were greater among men (80%) than among women (20%) and were highest on two major freeways in Trinidad [the Churchill–Roosevelt Highway and the Sir Solomon Hochoy Highway]. Most collisions occurred during the night among individuals between the ages of 15 and 44 years. Fatalities among drivers steadily increased over the study period and overtook fatalities among pedestrians, who were the group most affected in 2000. Most fatalities occurred at weekends. Conclusions: These patterns can inform (i) education programs and (ii) road and traffic control measures.

Introduction: About 1.25 million people worldwide die every year because of road accidents. Risk is higher when drivers use mobile phones, whereas seat belts help to prevent crash-related injury. We aimed to evaluate the prevalence, associated factors, and temporal trend of the use of seat belts and mobile phones among drivers and passengers in Florence, Italy (2005–2015). Methods: Use of seat belts and mobile phones use was monitored via direct observation in four areas in the province of Florence. We fitted Poisson regression models with robust variance to investigate the factors associated with the use of seat belts and mobile phones use by the drivers and to explore long-term trends and seasonal patterns in the two time-series. Results: We observed a total of an overall 134,775 vehicles: seat belts were worn by 71.8% of drivers and front-seat passengers and 27.6% of back-seat passengers, while mobile phones were being used by 4.8% of drivers. Drivers were more likely to wear seat belt when transporting passengers (≥2 vs none: prevalence ratio [PR] 1.21, 95% confidence intervals [CI] 1.14–1.29) and while driving in the afternoon (PR 1.04, 95% CI 1.03–1.05), and less likely when the front-seat passenger was not wearing seat belts (PR 0.33, 95% CI 0.32–0.34). After an initial increase, seat belts use by the driver decreased over time (-0.5% each year during 2010–2015), with significant peaks and troughs in July and January, respectively. Mobile phone use by the driver was inversely associated with wearing seat belts (PR 0.67, 95% CI 0.64–0.70) and carrying passengers (≥2 vs. none PR 0.20, 95% CI 0.07–0.52). The proportion of drivers using mobile phones did not vary over time nor showed any clear seasonality. Conclusions: Drivers’ risky behaviours (not wearing a seat belt and using a mobile phone) are associated, showing a global misperception of risk among a subset of drivers. The number of passengers and their behaviour is also associated with the driver’s attitude. The effectiveness of primary enforcement laws has declined in Italy in recent years; therefore, other strategies should be devised and implemented. [ABSTRACT FROM AUTHOR]

Road traffic accidents are the major cause of mortality among people aged 15–29 years in Africa. World Health Organisation (WHO) and the World Bank launched a Decade of Action for Road Safety in 2011 with the goal of halving the number of injuries and deaths on the roads. No progress has been reported in Low and Middle Income Countries (LMICs) and the number of deaths remains very high. To reach the target set, there is a need for interventions in several areas. This scoping review proposes to produce a synthesis by identifying the kinds of interventions and outcomes which have been carried out on the African continent. Using the scoping studies method, 23 articles were selected and analysed. The study shows that interventions were developed in four fields: road safety policy, health education, safety equipment and data collection. It shows also that there were records of interventions in only twelve countries, mostly in Eastern and Southern Africa. The main conclusion of this study reveals both a lack of road safety interventions and shortcomings in the assessment of those performed and selected for our study. [ABSTRACT FROM AUTHOR]

Despite downward trends, driving under the influence (DUI) remains one of the most salient traffic safety problems. It is crucial to identify the processes behind a problem behaviour to target the most effective measures to address it. One way of exploring precursors of behaviour is measuring attitudes. All persons hold two types of attitudes, explicit and implicit. Although only one of these (explicit) lays the groundwork for current understandings of DUI, it is imperative to explore both types of attitudes. We explore the relationship between explicit and implicit attitudes towards DUI for the first time in the field. Explicit attitudes (what we say we mean) are measured by a questionnaire. Implicit attitudes (which are introspectively unidentified or inaccurately identified traces of past experience) are measured by the Go/No-go Association Task (GNAT) in a sample of young male drivers (n = 101). The results show a relationship between the two types of attitudes, but not completely in the expected way. Depending whether the amount of alcohol is over or under the legal limit, the relationship between explicit and implicit attitudes varies. We discuss the findings and provide directions for future investigations. [ABSTRACT FROM AUTHOR]

The vehicular ad hoc network (VANET) has been identified as one of the most promising technologies for managing future intelligent transportation systems. This paper proposes a distributed transmission power adjustment algorithm for communication congestion control and awareness enhancement to address communication congestion problems that can arise in VANETs. The objective of the proposed algorithm is to provide maximum awareness of surrounding vehicles’ status while maintaining a communications channel load below the allowed threshold. The proposed algorithm accomplishes this by adjusting the transmission range of each vehicle in the network progressively and gradually, while monitoring the communications channel load of each vehicle. By changing the transmission range of a vehicle little by little according to the communications channel load of its neighboring vehicles, the algorithm finds the optimal transmission range that provides maximum awareness without resulting in communications congestion. In addition, the proposed algorithm appropriately controls the channel load in a fair manner without sacrificing awareness of specific vehicles in the congested situation. This allows nearby vehicles to obtain more peripheral information to help them stay away from potential hazards and maintain safety. The proposed algorithm was implemented in a simulation environment, and its performance was validated in various traffic scenarios. The simulation results show that the proposed algorithm can deal with communication congestion by controlling the transmission power fairly to a target threshold in various traffic situations. [ABSTRACT FROM AUTHOR]

Background: Road accidents are one of the main causes of death around the world and yet, from a time-space perspective, they are a rare event. To help us prevent accidents, a metric to determine the level of concentration of road accidents in a city could aid us to determine whether most of the accidents are constrained in a small number of places (hence, the environment plays a leading role) or whether accidents are dispersed over a city as a whole (hence, the driver has the biggest influence). Methods: Here, we apply a new metric, the Rare Event Concentration Coefficient (RECC), to measure the concentration of road accidents based on a mixture model applied to the counts of road accidents over a discretised space. A test application of a tessellation of the space and mixture model is shown using two types of road accident data: an urban environment recorded in London between 2005 and 2014 and a motorway environment recorded in Mexico between 2015 and 2016. Findings: In terms of their concentration, about 5% of the road junctions are the site of 50% of the accidents while around 80% of the road junctions expect close to zero accidents. Accidents which occur in regions with a high accident rate can be considered to have a strong component related to the environment and therefore changes, such as a road intervention or a change in the speed limit, might be introduced and their impact measured by changes to the RECC metric. This new procedure helps us identify regions with a high accident rate and determine whether the observed number of road accidents at a road junction has decreased over time and hence track structural changes in the road accident settings. [ABSTRACT FROM AUTHOR]