Motorcycle curve assist: A novel approach based on active speed control for crash injury reduction

OBJECTIVE

Safely negotiating curves with a powered-two-wheeler (PTW) requires a high level of skill, and a significant proportion of PTW crashes have a curve involvement. This study aimed to estimate the applicability, potential benefits and feasibility of novel Motorcycle Curve Assist (MCA). The system is designed to operate an emergency control of the speed of a motorcycle approaching a bend at an inappropriate speed.

METHODS

First, the MCA system intervention was defined. Second, the applicability of the system and an estimate of its potential benefits was performed based on a PTW crash database. Motorcyclists' injury risk estimates, MCA working parameters and timing of intervention were employed to estimate the potential injury reduction of applicable crash types. Third, a field test campaign involving 29 common riders as participants was conducted to investigate the real-world applicability and acceptability among end-users of the system deployment in one relevant riding condition adopting a range of parameters of intervention.

RESULTS

In the crash database, 23% of cases had curve involvement and after detailed analysis, 14% resulted to be suitable for MCA (60% of cases with curve involvement). The potential relative injury risk reduction considering only the benefits due to crash speed reduction ranged from 3-9% for MAIS2+ to 9-27% for MAIS3+ injuries. Field tests were performed in corners approached at an average speed of 28.7 km/h and an average lean angle of 20°. The system provided a mean deceleration of 0.33 g reached with a fade-in jerk of 1.73 g/s, for an average total duration of 0.59 s. For the field test component, participants reported good controllability of the system, with no incipient loss of control recorded nor reported by participants.

CONCLUSIONS

The proposed approach for MCA implementation showed considerable potential benefits in terms of injury reduction. The intervention with the defined working parameters was considered feasible by a sample of end-users. When integrated with an intervention logic capable of predicting emergency situations while approaching curves, MCA will be a technology capable of assisting PTW riders in conditions where other available active safety systems do not.

Over 30-year retrospective analyses of moped-motorcycle fatal road accidents in the northern area of the Italian region of Emilia Romagna and review of the literature: Aiming for further preventive measures in the future

Road traffic injuries are a major cause of morbidity and mortality worldwide, with pedestrians and riders of two-wheeled motor vehicles being the most vulnerable. The present study aims to determine the epidemiological characteristics of fatal motorcycle crashes in a portion of the Italian region of Emilia Romagna, and to compare them with the data available in literature. Data were retrieved from autopsy reports on 350 subjects who died following road accidents involving moped or motorcycle in the cities of Parma, Piacenza, and Reggio Emilia. Two types of data were extrapolated: circumstantial and traumatological. The population was divided into subgroups according to gender, crash time, alcohol positivity, presence or absence of the helmet, and the period elapsed between the accident and death. Most of the considered road accidents occurred during the day and on weekends. 25.5 % of the victims tested positive for alcohol. As far as traumas are concerned, the limbs resulted to be the most affected body segment, followed by the head (87.4 %), the thorax (85.7 %), the abdomen (65.7 %), and lastly the neck (50.3 %). According to similar studies, the sample victim of a moped/ motorcycle accident is a young male subject. The results obtained allow us to demonstrate that the mandatory use of the helmet has reduced skull and brain injury over the years. At present, no law regulates the use of protections for other body parts. Regulatory interventions in this sense would be desirable given the ever more rapid technical evolutions in the field of motorcycles.

10 city analysis of child passenger helmet use

INTRODUCTION

Road traffic injuries are the leading cause of death in children over age five. Most of these deaths occur in low- and middle-income countries. Vulnerable road users, such as motorcyclists and their passengers, are at higher risk. Helmets have significantly decreased morbidity and mortality for motorcyclists; however, they are often unused. The second phase of the Bloomberg Philanthropies Initiative for Global Road Safety was launched in 2015 to improve road safety in 10 cities. This study focuses on child passenger helmet use data from that study to understand the prevalence of helmet use and factors that are associated with helmet use.

METHODS

The 10 cities selected were Accra, Addis Ababa, Bandung, Bangkok, Bogota, Fortaleza, Ho Chi Minh City, Mumbai, Sao Paulo, and Shanghai. Eight rounds of roadside observational data were collected from February 2015 to April 2019. Observers noted correct child motorcycle passenger helmet use and other site observations including weather patterns, traffic volume, and road surface conditions. A multivariable Poisson regression model was used to examine correct helmet use trends over time. A multivariable logistic regression model was fitted for correct child passenger helmet use in all cities controlling for weather, observation time, number of passengers, and driver's correct helmet use.

RESULTS

This dataset contained 99,846 motorcycle child passenger observations across the 10 cities. The highest prevalence of correct child passenger helmet use was in Sao Paulo at 97.33%. Six cities had under 25% correct helmet use for child passengers. Examining helmet use over time, only five cities had a significant increase, four cities had no change, and Ho Chi Minh City demonstrated a decrease. In the multivariable regression model, child passengers had higher odds of wearing helmets in adverse weather conditions, early mornings, if the driver wore a helmet, and if there were fewer passengers.

CONCLUSIONS

The prevalence of correct child passenger helmet utilization shows large variation globally and is concerningly low overall. Enhanced enforcement in combination with media campaigns may have contributed to increasing helmet use prevalence over time. Further research is needed to understand reasons for low child passenger helmet use in most cities.

Reduction of motorcycle-related deaths over 15 years in a developing country

BACKGROUND

There have been major improvements in the trauma system and injury prevention in Al-Ain City. We aimed to study the impact of these changes on the incidence, pattern, injury severity, and outcome of hospitalized motorcycle-related injured patients in Al-Ain City, United Arab Emirates.

METHODS

This is a retrospective analysis of two separate periods of prospectively collected data which were retrieved from Al-Ain Hospital Trauma Registry (March 2003 to March 2006 compared with January 2014 to December 2017). All motorcycle-injured patients who were admitted to Al-Ain Hospital for more than 24 h or died in the Emergency Department or after hospitalization were studied.

RESULTS

The incidence of motorcycle injuries dropped by 37.1% over the studied period. The location of injury was significantly different between the two periods (p = 0.02, Fisher's exact test), with fewer injuries occurring at streets/highways in the second period (69.1% compared with 85.3%). The anatomical injury severity of the head significantly increased over time (p = 0.03), while GCS on arrival significantly improved (p < 0.0001), indicating improvements in both prehospital and in-hospital trauma care. The mortality of the patients significantly decreased (0% compared with 6%, p = 0.002, Fisher's exact test).

CONCLUSIONS

The incidence of motorcycle injuries in our city dropped by almost 40% over the last 15 years. There was a significant reduction in the mortality of hospitalized motorcycle-injured patients despite increased anatomical severity of the head injuries. This is attributed to improvements in the trauma care system, including injury prevention, and both prehospital and in-hospital trauma care.

Do motorcycle helmets reduce road traffic injuries, hospitalizations and mortalities in low and lower-middle income countries in Africa? A systematic review and meta-analysis

Background

Studies in Africa have examined the association between helmet use and injury prevention, however, there has been no systematic review to synthesize the literature within an African context nor has there been any meta-analysis examining the effect of helmet use on injury prevention.

Methods

The review was performed in accordance with the Joanna Briggs Institute for Systematic Reviews. Articles were searched using several databases (e.g. CINAHL, OVID Medline) and select gray literature (e.g. TRID) sources. Articles were included if they were quantitative studies published in English between 2000 and 2019 and examined the association between motorcycle helmet use with head injuries, hospitalizations, and deaths in low- and lower-middle income countries in Africa with comprehensive motorcycle helmet laws. A meta-analysis was performed using pooled effect sizes assessing the impact of helmet use on reducing head injuries.

Results

After screening 491 articles, eight studies met the inclusion criteria. Helmet use ranged from 0 to 43%. The mean age of being involved in a crash was 30 years with males being two times more likely to be involved in motorcycle crashes than females. Drivers (riders) were more likely to be involved in a crash, followed by passengers and then pedestrians. Helmet use reduced injury severity and provided an 88% reduction in serious head injuries (OR 0.118, 95% CI: 0.014–0.968, p = 0.049).

Conclusions

In our study, helmet usage significantly reduced the likelihood of fatal head injuries. African countries with no helmet laws should consider adopting helmet use policies to reduce severe head related injuries from motorcycle crashes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13138-4.

Estimates of road traffic deaths in Tanzania

INTRODUCTION

There is considerable uncertainty in estimates of traffic deaths in many sub-Saharan African countries, with the Global Burden of Disease (GBD) and the Global Status Report on Road Safety (GSRRS) reporting widely differing estimates. As a case study, we reviewed and compared estimates for Tanzania.

METHODS

We estimated the incidence of traffic deaths and vehicle ownership in Tanzania from nationally representative surveys. We compared findings with GBD and GSRRS estimates.

RESULTS

Traffic death estimates based on the 2012 census (9382 deaths; 95% CI: 7565 to 11 199) and the 2011-2014 Sample Vital Registration with Verbal Autopsy (8778; 95% CI: 7631 to 9925) were consistent with each other and were about halfway between GBD (5 608; 95% UI: 4506 to 7014) and WHO (16 252; 95% CI: 13 130 to 19 374) estimates and more than twice official statistics (3885 deaths in 2013). Surveys and vehicle registrations data show that motorcycles have increased rapidly since 2007 and now comprise 66% of vehicles. However, these trends are not reflected in GBD estimates of motorcycles in the country, likely resulting in an underestimation of motorcyclist deaths.

CONCLUSION

Reducing discrepancies between GBD and GSRRS estimates and demonstrating consistency with local epidemiological data will increase the legitimacy of such estimates among national stakeholders. GBD, which is the only project that models the road-user distribution of traffic deaths in all countries, likely severely underestimates motorcycle deaths in countries where there has been a recent increase in motorcycles. Addressing police under-reporting and strengthening surveillance capacity in Tanzania will allow a better understanding of the road safety problem and better targeting of interventions.

Factors associated with motorcycle-related road traffic crashes in Africa, a Scoping review from 2016 to 2022

Background

The toll associated with road traffic crashes (RTC) is high, and the burden of injury is disproportionately borne by pedestrians and motor riders, particularly in developing countries. This study synthesized the factors associated with motorcycle-related RTC in Africa.

Methods

The PICO framework and the PRISMA guidelines for conducting reviews were incorporated in searching, screening, and reporting the findings. Advanced search in five electronic databases (Google Scholar, PubMed Central, Scopus, CINAHL, and Embase) yielded 2552 titles and 22 from manual search, filtered for 2016 to 2022 (to generate 1699) and then further for primary studies (854). Through the title, abstract and full-text screening, 22 were appropriate for this review. Data extraction was done by the two researchers independently, and the results were compared. Convergent synthesis was adopted to integrate results, transformed into a narrative, and analyzed using thematic synthesis.

Results

The four main themes identified were the rider-related, non-rider-related factors, prevalence and severity of injuries from RTC, and the measures to reduce RTC. The behavioral factors associated with RTC were alcohol use, smoking, use of illicit drugs, tiredness of rider, poor knowledge on traffic regulations, more than one pillow rider, lack of rider license, non-observance of traffic regulations, and non-use of personal protective equipment. Road traffic crashes were common among younger age and male gender. Other factors identified included poor road network, unplanned stoppage by police, unlawful vehicular packing, increased urbanization, and slippery floors.

Conclusion

There is the need to institute multi-sectoral measures that target riders’ behavior change. Coordinated efforts should target governments, enforcement authorities, and regulatory bodies to enforce enactment that ensures safe use of roads.

Particulate matter in a motorcycle-dominated urban area: Source apportionment and cancer risk of lung deposited surface area (LDSA) concentrations

Source-apportioned particle concentrations are necessary to properly evaluate the health impacts of air pollution. In this study, a measurement station was established at an urban roadside in northern Taiwan to the investigate lung deposited surface area (LDSA) concentration, a relevant metric for the adverse health effects of aerosol exposure, along with PM₁ and equivalent black carbon (eBC) concentrations, particle number concentration (PNC), and particle size distribution (PSD). Through positive matrix factorization and multi-linear regression analysis, we attributed 57% of LDSA to traffic emissions over the entire study. During rush hour, the motorcycle fraction increased to 0.83 and LDSA (77.6 ± 9.9 µm²/cm³) and PNC (14,000 ± 2400 particles/cm³) values peaked, while 74% of LDSA was attributed to traffic. The LDSA ratio, defined as the ratio of measured LDSA to that estimated from the particle size distribution with a spherical assumption, also increased, highlighting the greater degree of fractal morphology during rush hour. The relationship between LDSA emitted by traffic and PNC yielded a higher r² (0.92) than the r² between traffic LDSA and eBC (0.82). Finally, the excess lifetime cancer risk linked with traffic emission was 1.56 × 10^-4 (i.e. 15.6 excess cancer cases for a population of 100,000 people) based on the LDSA apportionment results.

Factors affecting motorcycle crash casualty severity at signalized and non-signalized intersections in Ghana: Insights from a data mining and binary logit regression approach

Despite the countless benefits derived from motorcycle usage, it has become a significant public health concern, particularly in developing countries, due to the plateauing number of fatal/serious injuries associated with them. Although it has been well documented that the frequency and fatality rates of intersection-related motorcycle crashes are high, little research efforts have been made to explore the contributory factors influencing motorcycle-involved crashes at these locations. Interestingly, no study has investigated the latent patterns and chains of factors that simultaneously contribute to the injury severity sustained by motorcycle crash casualties at intersections under different traffic control conditions in developing countries. Since motorcycles are mostly used as taxis in developing countries, it is imperative to consider the injury severity sustained by all crash casualties in the motorcycle safety analysis. This study bridges the research gap by employing a plausible data mining tool to explore hidden rules associated with motorcycle crash casualty injury severity outcomes at both signalized and non-signalized intersections in Ghana's most densely populated region, Accra, using three-year crash data spanning 2016-2018. Besides, a binary logit regression model was also employed to explore the impact of crash factors on casualty severity outcomes using the same dataset. The results from both analysis techniques were consistent; however, the data mining technique provided chains of factors which provided additional insights into the groups of factors that collectively influence the casualty injury severity outcomes. From the rule discovery results, while full license status, daytime/daylight, and shoulder presence increased the risk of fatal injuries at signalized intersections, factors such as inattentiveness, good road surface, nighttime, shoulder absence, and young rider were highly likely to increase casualty fatalities at non-signalized intersections. By controlling all or some of these risk factors, the level of injury severity on the roadways could be reduced. Based on the findings, we provide enforcement, education, and engineering-based recommendations to help improve motorcycle safety.

Motorized 2-3 wheelers death rates over a decade: a global study

BACKGROUND

Motorized 2-3-wheelers-related death is high due to the exposed body of the driver/passenger and the high speed. The United Nation (UN) Decade of Action for road safety aimed to reduce road traffic deaths by 50% by the year 2020. We aimed to study the factors affecting the death rates of motorized 2-3 wheelers injured victims and whether the reduction in the death rates has met the UN target.

METHODS

Data were retrieved from the WHO Global Status Reports on Road Safety published over 2009 to 2018 which covered the years of 2007 to 2016. Studied variables included motorized 2-3 wheelers death rates, percentage of helmet-wearing rate, helmet law enforcement, speed law enforcement, gross national income per capita, vehicles/person ratio, and motorized 2-3 wheelers/person ratio. A mixed linear model was used to define factors affecting the change of motorized 2-3 wheelers death rates over time.

RESULTS

The global mean motorized 2-3 wheelers death rates increased from 2.37/100,000 population to 3.23/100,000 population over the studied decade (a relative ratio of 1.36) which was not statistically significant. Factors that affected mortality included GNI (p = 0.025), motorized 2-3 wheelers per person ratio (p < 0.0001), percentage of helmet wearing rate (p = 0.046), and the interaction between vehicle/person ratio and motorized 2-3 wheelers/person ratio (p = 0.016). There was a significant increase in the death rates over time in the low-income countries (a relative ratio of 2.52, p = 0.019, Friedman test), and middle-income countries (a relative ratio of 1.46, p < 0.0001, Friedman test), compared with a significant decrease in the high-income countries (a relative ratio of 0.72, p < 0.0001, Friedman test).

CONCLUSIONS

Global mortality of motorized 2-3 wheelers has increased by a relative ratio of 1.36 over a recent decade. The UN target of reducing death was not met. The increase was related to the increase in motorized 2-3 wheelers per person ratio and economic inequity which has to be addressed globally. The economic global gap significantly impacts the mortality rates of motorized 2-3 wheelers.

Alcohol-impaired motorcyclists versus car drivers: A comparison of crash involvement and legal consequence from adjudication data

INTRODUCTION

Driving under the influence (DUI) increases the probability of motor-vehicle collisions, especially for motorcycles with less protections. This study aimed to identify commonalities and differences between criminally DUI offenses (i.e., with a blood alcohol concentration (BAC) of 80 mg/dL or higher) committed by motorcyclists and car drivers.

METHODS

A total of 10,457 motorcycle DUIs and 8,402 car DUIs were compared using a series of logistic regression models, using data extracted from the documents of adjudication decisions by the courts of Jiangsu, China.

RESULTS

The results revealed that offenders from the high-BAC group (i.e., 200 mg/dL or higher) accounted for more than 20% of the total DUI offenses, and were more likely to be involved in a crash and punished with a longer detention. Motorcyclists had a higher likelihood of crash involvement, and were also more likely to be responsible for single-vehicle crashes associated with higher odds of injury sustained, compared to alcohol-impaired car drivers. In the verdict, motorcycle offenders were more likely to receive a less severe penalty.

CONCLUSIONS

Interventions are clearly required to focus on reducing in the high-BAC group of offenders. For alcohol-impaired motorcyclists, their risks of crash and injury against BAC climb more steeply than the risks for car drivers. The factors including frequent occurrences, uncertainty of detection, and short-term sentences may weaken the deterrence effect of the criminalization of motorcycle DUI. Practical Applications: The traffic-related adjudication data support traffic safety analysis. Strategies such as combating motorcycle violations (e.g., unlicensed operators or driving unsafe vehicles), undertaking education and awareness campaigns, are expected for DUI prevention.

The effects of road safety education on the occurrence of motorcycle violations and accidents for novice riders: An analysis of population-based data

The prevalence of motorcycle riding among novice riders in most Southeast Asia countries presents an alarming rate of traffic violations and fatal accidents. Since 2013, Taiwan's government has gradually required a road safety class (RSC) for the rider's licensing process. The RSC consisted of watching videotapes of motorcycle-involved crashes followed by lectures on safety measures. Our study tried to see whether a compulsory RSC could lower the likelihood and frequency of road accidents and traffic violations among novice riders. To avoid self-selection bias, we selected 480,114 novice riders aged 18-20 years, licensed one year before starting the trial period and one year after full implementation of RSC. Using the 2012-2018 data from the Taiwan Ministry of Transportation and Communication (MOTC), we applied the logistic model to evaluate RSC effects on the risk of violations and accidents. Then, we used the negative binomial regression to model their frequency in response to RSC exposure. Following the novice drivers 1-3 years after licensing, our results showed that the RSC has a short-term effect in lowering their traffic violations' likelihood by 12%∼17% and their frequency by 11%; however, the RSC effects only last two years in reducing the counts of motorcycle-involved offenses and accidents. The RSC reduction effect was lower for the tendency of accidents than the violations, probably because committing traffic violations was self-determined; in contrast, the collision occurrence was more or less related to the riders' own or other road users' carelessness. The RSC could be more effective if a certification test for road safety education were required or if a penalty is imposed on distracted learners during the training.

Comparison of physical and psychological health outcomes for motorcyclists and other road users after land transport crashes: an inception cohort study

BACKGROUND

Serious injuries and fatalities among vulnerable road users on two wheeled motorised vehicles have increased across Australia and internationally in the past decade yet fallen for motor vehicle occupants. Almost half of all reported motorcycle injury crashes cause serious injury or death, nearly double that of motor vehicle police-reported crashes. This study explores associations with sociodemographic and pre-injury health characteristics and health outcomes after a road traffic injury; aiming to compare motorcyclists with other road users and inform recovery care.

METHODS

An inception cohort study recruited 1854 individuals aged > 17 years, injured following land-transport crashes in New South Wales, Australia (July 2013-November 2016). Interviews conducted at baseline, 6-and 12-months post-injury elicited demographic, socioeconomic, and self-reported health conditions.

RESULTS

Primary analysis involved 1854 participants who were recruited at baseline as three distinct road user groups; 628 (33.9%) motorcyclists, 927 (50%) vehicle occupants and 299 (16.1%) bicyclists. At baseline, injury patterns differed significantly between road user groups; motorcyclists were more than twice as likely to sustain lower extremity injury (p < 0.001); to have more severe injury severity scores (p < 0.001) and longer hospital stays versus vs vehicle occupants and bicyclists (< 0.001) across these measures. Injured motorcyclists were predominantly male (88.1%, p < 0.001), were younger on average (38 years) than bicyclists (41.5 years), had lower income and education levels, and poorer pre-injury physical health than other road user groups. Despite these differences, at 12 months post-injury motorcyclists had better physical health (SF12-PCS 2.07 (0.77, 3.36), p = 0.002) and reported lower pain scores (- 0.51 (- 0.83, - 0.2), p < 0.001) than vehicle occupants. Motorcyclists displayed less evidence of psychological distress than vehicle occupants, but more than bicyclists across several measures used.

CONCLUSIONS

Road user types differ in important characteristics, including pre-injury health status and recovery after injury. As vulnerable road users experiencing transport crash and considering their higher initial injury severity, the degree of recovery among motorcyclists compared with other user types is remarkable and unexplained. Health and recovery outcomes after land-transport crashes is least favourable among vehicle occupants despite their higher levels of protection in a crash. This information is valuable for targeting early intervention strategies by road user type during the post-crash care phase, to improve long-term recovery.

Quality of Life after Motorcycle Traffic Injuries: A Cohort Study in Northwest of Iran

Objective:

To investigate the quality of life (QOL) of injured motorcyclists and associated factors in a period of three months after the accident.

Methods:

In the present study, we were included 190 injured motorcyclists who admitted to two referral specialized hospitals (Emam Reza and Shohada) in Tabriz, between June 2018 and January 2019. All injured motorcyclists were contacted through the telephone one and 171 of them (90%) three months after their accident to complete an EQ-5D-3L questionnaire. The baseline measurements were gathered by using face to face interviews in the hospitals. The QOL score could vary between 1 and 3. The higher score showed a lower QOL.

Results:

The injured motorcyclist’s QOL score was relatively better in three months after the accident (mean±Standard Deviation (SD): 1.78±0.51) in comparison with their status a month after the accident (2.15±0.65) (p<0.001). The multivariable model showed that individuals with pelvis injuries (Coef: 0.29, (95% CI: 0.16, 0.42), p=0.001) and knee injuries (Coef: 0.26, (95% CI: 0.10, 0.42), p=0.001), experienced a higher QOL score. Also, those whose accident had happened in rainy weather experienced higher QOL score (Coef: 0.33, (95% CI: 0.12, 0.53), p=0.001). The patients who were in an accident with a vehicle were experienced a better QOL than others (Coef: -0.26, (95% CI: -0.43, -0.09), p=0.002).

Conclusion:

The assessment of three-months post-accident showed that the QOL score of the motorcyclists was reduced. It is recommended that the QOL of patients should be improved in hospital discharge victims.

Patterns and clinical outcomes of injuries related to two-wheeled vehicles (bicycle and motorcycle) in the geriatric population: a nationwide analysis in South Korea (2016-2018)

Background

South Korea has a rapidly ageing population. This study aimed to provide epidemiologic data and to identify the characteristics of the patterns and clinical outcomes of two-wheeled vehicle-related injuries (bicycle and motorcycle) in elderly riders.

Methods

This study retrospectively analyzed data from the National Emergency Department Information System from 2016 to 2018. Adult patients (≥ 20 years old) who were injured while using two-wheeled vehicles were included. Elderly patients were defined as being 65 years and older. The analysis was performed for 65,648 bicycle-related injuries (15,272 elderly patients) and 87,855 motorcycles-related injuries (17,292 elderly patients).

Results

In emergency departments (EDs), the average injury severity score (ISS) for motorcycle-related accidents was 9.8 ± 11.2 in the younger group and 14.1 ± 14.7 in the elderly group (p = 0.001). In addition, the average ISS of bicycle-related accidents was 7.1 ± 8.9 in the younger group and 10.5 ± 12.3 in the elderly group (p = 0.001). Two-wheeled vehicle accident mortality rates of elderly riders (0.9% for bicycle and 1.8% for motorcycle in the ED; 4.1% for bicycle and 3.8% for motorcycle in the hospital) were more than twice those of younger riders.

The elderly stayed in the hospital longer than younger patients (485.2 ± 543.0 h vs 336.8 ± 385.5 h, p = 0.001) for bicycle-related injuries. They also stayed longer for motorcycle-related injuries (529 ± 598.6 h vs 452.0 ± 543.55 h, p = 0.001).

The logistic regression analysis showed that age ≥ 65 years was an independent factor associated with severe trauma (ISS ≥ 16) for both bicycle-related injuries (adjusted odds ratio [OR] 2.185 [95% Confidence Interval (CI) 2.072–2.303]) and motorcycle-related injuries (adjusted OR 1.220 [95% CI 1.137–1.287]).

Conclusion

Two-wheeled vehicle-related injuries in the elderly were associated with higher ISS, length of hospital stay, and mortality than in younger riders. Analysing the characteristics of two-wheeled vehicle-related injuries in the elderly can be the basis for planning to reduce and prevent injuries in elderly riders.

[Differences in injury patterns in motorcycle accidents involving children and adolescents]

Hintergrund

Verkehrsunfälle und ihre Verletzungsfolgen stellen eine häufige traumatische Ursache für das Versterben und für das Auftreten von irreversiblen Schäden bei Kindern und Jugendlichen dar. Bei Motorradunfällen unterscheiden sich dabei Verletzungsmuster abhängig vom Patientenalter.

Ziel der Arbeit

Ziel dieser Studie ist es, die typischen Verletzungsmuster nach Motorradunfällen im Kindes- und Jugendalter vergleichend zu beschreiben, da diese einen ausschlaggebenden Einfluss auf die Prävention sowie die adäquate Behandlung der jeweiligen Patientengruppen bieten können.

Material und Methoden

In die Studie wurden innerhalb der Jahre 2002–2018 22.923 Patienten aus dem TraumaRegister der Deutschen Gesellschaft für Unfallchirurgie (DGU®) eingeschlossen. Die Auswertung erfolgte in 4 Altersgruppen: Gruppe 1 (4 bis 15 Jahre), Gruppe 2 (16 bis 17 Jahre), Gruppe 3 (18 bis 20 Jahre) sowie Gruppe 4 (21 bis 50 Jahre) als Kontrolle.

Ergebnisse

In Gruppe 2 stellten Extremitätenverletzungen das häufigste Verletzungsmuster dar und traten überwiegend im Bereich der unteren Extremität auf. Zudem ergab die Analyse, dass Gruppe 1 häufiger ein schweres Schädel-Hirn-Trauma erleidet, trotz initial schlechtem Zustand aber ein besseres Outcome aufweist. Thorakale, abdominelle sowie Wirbelsäulen- und Beckenverletzungen kommen bei den jüngeren Altersgruppen seltener vor. Insbesondere stellen Rippenfrakturen eine Rarität bei Kindern dar. In der Diagnostik werden Kinder im Vergleich zu Erwachsenen seltener einer Ganzkörper-CT-Diagnostik zugeführt.

Diskussion

Die Studie deckt altersabhängige Unterschiede in den Verletzungsmustern von Patienten auf, die als Beifahrer oder Fahrer eines Motorrades in einen Unfall involviert waren. Zudem konnten ebenso Unterschiede in der prä- und innerklinischen Versorgung herausgearbeitet werden.

The rider behavior questionnaire to explore associations of motorcycle taxi crashes in Cartagena (Colombia)

OBJECTIVE

This study aimed to identify the association between behavioral factors and crashes of motorcycle taxi riders using the Motorcycle Rider Behavior Questionnaire (MRBQ).

METHODS

This study was a cross-sectional survey of motorcycle taxi riders in Cartagena. The MRBQ was adapted to the socio-cultural context and contained 45 items. The survey was conducted between February 2019 and May 2019. The items of the MRBQ were processed using factor analysis. Four logistic regression models were used to analyze the association between behavioral factors and aspects of demographics, operating conditions, and experiencing near-crashes, crashes, traffic tickets, and at-fault crashes.

RESULTS

Four hundred and thirty-eight motorcyclists participated. The exploratory factor analysis extracted five elements: stunts, speed violations, traffic errors, control errors, and safety, explaining 42% of the variance. The increase in riding per week showed significant differences with stunts, speed violations, and traffic errors. Riding experiences, traffic errors, control errors, and safety were significantly associated with crashes and near-crashes. Stunts were the strongest factors related to traffic tickets. Speed violations were the strongest factors associated with at-fault accidents.

CONCLUSIONS

The study showed recent results considering behavioral, exposure, and operational conditions in a group of motorcycle taxi riders. The study recommends some practical implications for the well-being of motorcyclists and road safety.

Association between alcohol consumption, marijuana use and road traffic injuries among commercial motorcycle riders: A population-based, case-control study in Dares Salaam, Tanzania

BACKGROUND

Alcohol consumption and psychoactive drug use are well-recognised risk factors for road traffic injuries (RTIs). Both types of use may impair and affect drivers' performance. Yet, there is limited literature on their contribution to RTIs among commercial motorcycle riders, particularly in low- and middle-income settings. This study aimed to determine the association between alcohol consumption, marijuana use and RTIs among commercial motorcycle riders in the city of Dar es Salaam, Tanzania.

METHODS

We conducted a case-control study between July 2018 and March 2019. Cases (n = 164) were commercial motorcycle riders who had sustained an RTIs and attended at a hospital. Controls (n = 400) were commercial motorcycle riders who had not experienced an RTIs that led to hospital attendance during the past six months. Alcohol consumption was assessed using the Alcohol Use Disorder Identification (AUDIT) score, which classified participants as a non-drinker, normal drinker(1-7 scores) and risky drinker (scores ≥ 8). Marijuana use was assessed through self-reported use in the past year. We estimated odds ratios (ORs) using logistic regression adjusted for sociodemographic, driver-, and work-related factors.

RESULTS

Risky drinking was associated with close to six times the odds of RTIs compared to non-drinkers (OR = 5.98, 95% CI: 3.25 - 11.0). The association remained significant even after adjusting for sociodemographic, driving and work-related factors (OR = 2.41, 95% CI: 1.01 - 5.76). The crude odds ratios of RTIs were significantly higher among users of marijuana than non-users (OR = 2.33, 95% CI: 1.38 - 3.95). However, the association did not remain statistically significant after adjusting for confounders (OR = 1.11, 95% CI = 0.49-2.48).

CONCLUSION

Our findings confirm increased odds of RTIs among commercial motorcycle riders with risky drinking behaviour even after taking sociodemographic, driving and work-related factors into account. Unlike alcohol consumption the relationship between marijuana use and RTIs among commercial motorcycle riders was unclear. Since motorcycle riders are more susceptible to the effect of alcohol due to higher demands of balance and coordination and because commercial motorcyclist riders, in particular, they spend a considerable amount of time on the road, our results underscore the importance of addressing hazardous alcohol consumption and marijuana use in future prevention strategies to enhance road safety.

Investigation of speed and trajectory of motorcycle riders at curved road sections of two-lane rural roads under diverse lighting conditions

INTRODUCTION

Vehicular accidents at horizontal curves are over-represented compared to accidents that occur at tangent sections. Investigations have been conducted aimed at identifying the major causes that result in higher accident risk, both in terms of severity and rate, at curved road sections. Excessive or abrupt changes in speeding and improper vertical position are cited as major factors of lane departure, whereas other factors (either human or environmental) have also been documented. However, most research involves 4-wheel vehicles rather than other modes of transport that behave differently. More specifically, while motorcyclist fatalities occur more frequently than passenger vehicles, when accounting for vehicle distance traveled only a limited number of research studies address their behavior at curved road sections.

METHOD

This paper presents the findings of field operational tests carried out by motorcyclists along two-lane rural roads with a wide range of horizontal curves using an instrumented motorcycle. Key objectives of the research included the conditions under which the motorcyclists differentiate their trajectory in regards to the direction of the horizontal curves, the correlation between the trajectory and the geometry of the road, and the impact of the lighting conditions on riders' behavior.

RESULTS

The research showed that motorcyclists tend to ride closer to the centerline of the road, neglect the hazards associated with dim lighting conditions, and maintain constant speed in the left hand and the right-hand horizontal curves.

Evaluating automated emergency braking performance in simulated car-to-two-wheeler crashes in China: A comparison between C-NCAP tests and in-depth crash data

Automated Emergency Braking (AEB) is an effective way to prevent crashes from happening or mitigate their severity. Because riders of two-wheelers (TWs) are among the most vulnerable road users, New Car Assessment Programs, like the China New Car Assessment Program (C-NCAP), have recently introduced test scenarios for the assessment of AEB for cars encountering TWs (TW-AEB). The main aim of this study was to determine how well two different C-NCAP test scenario datasets reflect real-world crash scenarios for the purpose of assessing TW-AEB performance. We used virtual counterfactual simulations to determine whether the hypothetical TW-AEB's performance, when applied to the two C-NCAP datasets, was similar to its performance when applied to a set of reconstructed car-to-TW crashes representing real-world crashes. The test datasets were the current C-NCAP scenario set and a proposed C-NCAP scenario set; the real-world crash dataset comprised 113 reconstructed crashes from the Shanghai United Road Traffic Safety Scientific Research Center database (SHUFO). The performances were compared with respect to crash avoidance rate and the characteristics of the remaining crashes. A substantially higher proportion of crashes was avoided in the current C-NCAP scenario set than in the other two (with the sensor field of view (FoV) set to 70° and the activation time to 1.1 s TTC). In fact, with these parameter settings, no crashes remained in the current C-NCAP scenarios, while only 37% and 46% of the crashes in the proposed C-NCAP scenario set and SHUFO crash set were avoided, respectively. Our findings show that TW-AEB systems which are optimized for the current C-NCAP test scenarios are likely to provide benefits in real-world crashes. However, including additional test scenarios which reflect real-world crash situations more accurately would likely lead to a higher correlation between C-NCAP scores and real-world TW-AEB performance. In particular, we recommend the introduction of longitudinal same-direction scenarios with the car or TW turning and perpendicular scenarios with high TW traveling speed, in future C-NCAP releases. Inclusion of these scenarios in C-NCAP might reward improvements of future TW-AEBs toward systems that can save more lives. Furthermore, our study shows that there is likely to be a substantial number of crashes with an impact speed higher than 40 km/h still remaining even after the widespread application of TW-AEB. Therefore, passive safety for TW riders on Chinese roads will be still needed.

Healthcare costs of road injuries in Saudi Arabia: A quantile regression analysis

BACKGROUND

Road traffic injuries (RTIs) are the second leading cause of death in Saudi Arabia. Their economic burden is significant but poorly quantified, as limited literature exists locally. We aim to estimate the impact of RTIs on healthcare costs.

METHODS

We included all patients from the hospital's trauma registry for the year 2017 (n = 381). Due to the availability of data, the analysis focused only on direct medical costs incurred during the hospitalization period. We computed the components of hospitalization costs and evaluated the association between patient and RTI characteristics and total hospitalization costs (the average and median) using quantile and log-linear regression techniques respectively.

RESULTS

Patients were relatively young with an average age of 31 years (SD ± 14.6). Overall, patients treated for RTIs cost the hospital around 77,657 Saudi Riyal (SAR) on average. Pedestrian injuries incurred the highest costs. Motor vehicle injuries accounted for the highest procedure-related costs (SAR 19,537). The quantile regressions results suggest that Glasgow coma scale (GCS), admission to intensive care unit (ICU), and hospital length of stay were significantly associated with an increase in hospitalization cost. Hospital home disposition was however, associated with a decrease in cost. One additional day of stay in the hospital increases total hospitalization cost by SAR 3,508. Additionally, the log-linear showed injury severity score (ISS < 16) was associated with a 20% decrease in the geometric mean of the hospitalization costs (p < 0.001).

CONCLUSIONS

This study underlines the economic burden of RTIs in addition to their impact on population health. The findings may be used to inform policymakers, researchers, and the public about the increasing burden of traffic crashes in the Kingdom. Public health interventions are warranted to reduce the severity and frequency of RTIs in order to improve traffic safety and reduce associated healthcare costs.

Motorcycle Autonomous Emergency Braking (MAEB) employed as enhanced braking: Estimating the potential for injury reduction using real-world crash modeling

OBJECTIVE

Recent field-tests on Motorcycle Autonomous Emergency Braking system (MAEB) showed that higher levels of deceleration to improve its effectiveness were feasible. However, the potential of MAEB in mitigating rider injuries is not well understood, particularly in scenarios where the efficacy of standard MAEB is limited because the rider is manually braking. The purpose of this study was first, to assess the injury mitigation potential of MAEB and second, to test MAEB as an enhanced braking system applied in circumstances where the rider is braking before a crash.

METHODS

Data from previously investigated motorcycle injury crashes that occurred on public roads in Victoria, Australia were reconstructed using a 2D model. The intervention of MAEB was applied in the simulations to test both MAEB standard and MAEB working as enhanced braking system. The effects of MAEB in mitigating crashes were separated by crash configuration and evaluated based on the modeled reductions in impact speed and injury risk, employing injury risk functions available in the literature.

RESULTS

After modeling was applied, MAEB was found to be applicable in 30 cases (91% of those in which was estimated as "possibly applicable"). The modeled Impact Speed Reduction (ISR) among the 30 cases averaged 5.0 km/h. In the cases without manual braking, the mean ISR due to standard MAEB was 7.1 km/h, whereas the relative injury risk reduction ranged from 10% for MAIS2+ to 22% for fatal injuries. In the 14 cases with manual braking, the modeled application of MAEB as enhanced braking led to an average ISR ranging from 5.3 km/h to 7.3 km/h. This resulted in an injury risk reduction ranging from 9% to 12% for MAIS2+ and from 16% to 21% for fatal injuries, depending on the different modes of MAEB.

CONCLUSIONS

This study modeled the potential benefits of the highest levels of intervention for MAEB field-tested to date. The findings estimate the degree to which MAEB could mitigate motorcycle crashes and reduce injury risks for motorcyclists. New strategies for MAEB intervention as enhanced braking were modeled through crash simulations, and suggest improvements in the benefits of MAEB when riders are braking before the crash. This highlighted the requirement to perform new field-based tests to assess the feasibility of MAEB deployed as enhanced braking system.

Severity and patterns of injury in helmeted vs. non-helmeted motorcyclists in a rural state

INTRODUCTION

Under current law in our rural state, there is no universal requirement for motorcyclists to wear helmets. Roughly 500 motorcycle crashes are reported by the state each year and only a fraction of those riders wear helmets. We sought to determine the difference in injury patterns and severity in helmeted versus non-helmeted riders.

METHODS

Retrospective review (2014-2018) of a single level 1 trauma center's registry was done for subjects admitted after a motorcycle collision. Demographic, injury and patient outcome data were collected. Patients were stratified by helmet use (n = 81), no helmet use (n = 144), and unknown helmet use (n = 194). Statistical analysis used Student's t-test or Pearson's χ²p-value ≤0.05 as significant. State Department of Transportation data registry for state level mortality and collision incidence over the same time period was also obtained.

RESULTS

Of the 2,022 state-reported motorcycle collisions, 419 individuals admitted to our trauma center were analyzed (21% capture). State-reported field fatality rate regardless of helmet use was 4%. Our inpatient mortality rate was 2% with no differences between helmet uses. Helmeted riders were found to have significantly fewer head and face injuries, higher GCS, lower face, neck, thorax and abdomen AIS, fewer required mechanical ventilation, shorter ICU length of stay, and had a greater number of upper extremity injuries and higher upper extremity AIS.

CONCLUSIONS

Helmeted motorcyclists have fewer head, face, and cervical spine injuries, and lower injury severities: GCS and face, neck, thorax, abdomen AIS. Helmeted riders had significantly less mechanical ventilation requirement and shorter ICU stays. Non-helmeted riders sustained worse injuries. Practical Applications: Helmets provide safety and motorcycle riders have a 34-fold higher risk of death following a crash. Evaluating injury severities and patterns in motorcycle crash victims in a rural state with no helmet laws may provide insight into changing current legislation.

The effectiveness of different types of motorcycle helmets - A scoping review

BACKGROUND

Protective helmets may reduce the risk of death and head injury in motorcycle collisions. However, there remains a large gap in knowledge regarding the effectiveness of different types of helmets in preventing injuries.

OBJECTIVE

To explore and evaluate the effectiveness of different types of motorcycle helmets; that is the association between different helmet types and the incidence and severity of head, neck, and facial injuries among motorcyclists. Also, to explore the effect of different helmet types on riders.

METHODS

A systematic search of different scientific databases was conducted from 1965 to April 2019. A scoping review was performed on the included articles. Eligible articles were included regarding defined criteria. Study characteristics, helmet types, fixation status, retention system, the prevention of injury or reduction of its severity were extracted.

RESULTS

A total of 137 studies were included. There was very limited evidence for the better protection of full-face helmets from head and facial injury compared to open-face and half-coverage helmets. There was however scarce evidence for the superiority of a certain helmet type over others in terms of protection from neck injury. The retention system and the fixation status of helmets were two important factors affecting the risk of head and brain injury in motorcyclists. Helmets could also affect and limit the riders in terms of vision, hearing, and ventilation. Multiple solutions have been discussed to mitigate these effects.

CONCLUSION

Full-face helmets may protect head and face in motorcycle riders more than open-face and half-coverage helmets, but there is not enough evidence for better neck protection among these three helmet types. Helmets can affect the rider's vision, hearing, and ventilation. When designing a helmet, all of these factors should be taken into account.

Field testing the applicability of motorcycle autonomous emergency braking (MAEB) during pre-crash avoidance maneuver

OBJECTIVE

Autonomous Emergency Braking (AEB) is a promising technology for crash avoidance or pre-crash impact speed reduction through the automatic application of braking force. Implementation of AEB technology on motorcycles (MAEB) is still problematic as its interaction with the rider may compromise the safety. In previous studies, MAEB interventions at low decelerations were shown to be easily manageable by common riders in straight line condition, but they were not previously tested in lateral maneuvers such as lane change and swerving, which are common in pre-crash situations. The objective of this paper is to assess the applicability of MAEB activation during lateral avoidance maneuver and to estimate its benefits in this scenario.

METHODS

Field tests were carried out involving common riders as participants, using a test protocol developed on the experience of previous studies. The test vehicle was a sport-touring motorcycle equipped with an automatic braking system that could be activated remotely by researchers to simulate MAEB intervention. The motorcycle was equipped with outriggers to prevent capsizing. The Automatic Braking (AB) interventions using a nominal deceleration of 0.3 g were deployed at pseudo-random times in conditions of straight-line travel and a sharp lane-change maneuver emulating a pre-crash avoidance action. The straight-line trials were used as the reference condition for analysis.

RESULTS

Thirty-one participants experienced AB interventions in straight-line and lane-change at an average speed of 44.5 km/h. The automatic braking was deployed in all the key phases of the avoidance maneuver. The system reached a deceleration of 0.3 g for a time of intervention of approximately 1 s. The participants were consistently able to control the vehicle during the automatic braking interventions and were always able to complete the lane-change maneuver. The speed reductions obtained with the AB interventions during lane change were very similar to those obtained in the straight-line conditions.

CONCLUSIONS

MAEB interventions with decelerations up to 0.3 g can be easily managed by motorcycle riders not only in straight-line conditions but also during an avoidance maneuver. Further investigations using higher deceleration values are now possible.