Severity of disability related to road traffic crashes in the Spanish adult population

Injury Biomechanics Evaluation of a Driver with Disabilities during a Road Accident-A Numerical Approach

Numerical methods are often a robust way to predict how external mechanical loads affect individual biological structures. Computational models of biological systems have been developed over the years, reaching high levels of detail, complexity, and precision. In this study, two cases were analysed, differing in the airbag operation; in the first, the airbag was normally activated, and in the second case, the airbag was disabled. We analysed a model of a disabled person without a left leg who steers a vehicle using a specialized knob on the steering wheel. In both cases, a head-on collision between a car moving at an initial speed of 50 km/h and a rigid obstacle was analysed. We concluded that the activated airbag for a person with disabilities reduces the effects of asymmetries in the positioning of the belts and body support points. Moreover, all the biomechanical parameters, analysed on the 50th percentile dummy, i.e., HIC, seat belt contact force and neck injury criterion (Nij) support the use of an airbag. The resulting accelerations, measured in the head of the dummy, were induced into a finite element head model (YEAHM) to kinematically drive the head and simulate both accidents, with and without the airbag. In the latter, the subsequent head injury prediction revealed a form of contrecoup injury, more specifically cerebral contusion based on the intracranial pressure levels that were achieved. Therefore, based on the in-depth investigation, a frontal airbag can significantly lower the possibility of injuries for disabled drivers, including cerebral contusions.

The availability of psychological support following road travel injuries in Namibia: A qualitative study

Road traffic injuries (RTIs) are a major problem worldwide with a high burden of mental health problems and the importance of psychological support following road injury is well documented. However, globally there has been very little research on the accessibility of psychological services following road injury. Namibia is one of the countries most affected by RTIs but no previous studies have been done on this. In this qualitative study we investigated the availability of psychological services to RTI injured in Namibia. Our study findings are in line with those of other global studies in showing inadequate access to psychological support for injury survivors and we discuss the reasons. It is hoped these findings will help policymakers develop ways of enhancing access to psychological support for the many people injured in RTIs in Namibia. The models they develop may also be of use to other LMICs countries with high RTI rates.

Use of prehospital, hospitalization and presence of sequelae and/or disability in road traffic injury victims in Brazil

Objective

To estimate the prevalence and analyze the association between sociodemographic and behavioral variables with the use of prehospital care, hospitalization and sequelae and/or disability in victims of road traffic accidents victims in Brazil.

Methods

Data from the National Health Survey conducted in 2013 in Brazil were used. Data were collected through a direct household survey. The research sample consisted of 1,840 individuals who reported road traffic accidents in the previous 12 months. Poisson regression analysis was used to evaluate the factors associated with the use of prehospital care services, hospitalization, and the presence of sequelae and/or disability.

Results

The prevalence of road traffic accidents victims who received prehospital care was 13.0% (95% Confidence Interval [95% CI]: 10.3–16.3) and the factors associated with this outcome were: residing in the Northeast or North region of Brazil; residing in rural areas; and being a motorcycle occupant at the moment of the road traffic accident. The frequency of hospitalization was 7.7% (95% CI: 6.0–10.0) and the associated factors were: age between 40 and 59 years; being a motorcycle occupant or pedestrian and having received on-site care at the moment of the road traffic accident. The prevalence of sequelae and/or disability was 15.1% (95% CI: 12.5–18.2) and the associated factors were: age range between 30 and 39 years or 40 and 59 years; being a motorcycle occupant, being a pedestrian or belonging to other category of modes of transport and having received on-site care at the moment of the road traffic accident.

Conclusion

The study allowed to evaluate the factors associated with prehospital care, hospitalization and presence of sequelae and/or disability in the victims of road traffic accident and the results can guide the implementation of interventions that prioritize the population exposed to the highest risk of road traffic accident injuries and with less access to prehospital and hospital care services in Brazil.

Impact of Disabled Driver’s Mass Center Location on Biomechanical Parameters during Crash

Adapting a car for a disable person involves adding additional equipment to compensate for the driver’s disability. During this process, the change in the driver’s position and kinematics and their impact on safety levels during crash is not considered. There is also a lack of studies in the literature on this problem. This paper describes a methodology for conducting a study of the behavior of a disabled driver during a crash using the finite element method, based on an explicit time integration method. A validated car model and a commercial dummy model were used. The results show that the use of a handle on the steering wheel and a hand control unit causes dangerous lateral displacements relative to the seat. Amputation of the left leg or right arm causes significant shoulder rotations, amputation of the left leg causes increased thoracic loads. Amputation or additional equipment have no significant impact on head injuries.

Road Safety in Low-Income Countries: State of Knowledge and Future Directions

Road safety in low-income countries (LICs) remains a major concern. Given the expected increase in traffic exposure due to the relatively rapid motorisation of transport in LICs, it is imperative to better understand the underlying mechanisms of road safety. This in turn will allow for planning cost-effective road safety improvement programs in a timely manner. With the general aim of improving road safety in LICs, this paper discusses the state of knowledge and proposes a number of future research directions developed from literature reviews and expert elicitation. Our study takes a holistic approach based on the Safe Systems framework and the framework for the UN Decade of Action for Road Safety. We focused mostly on examining the problem from traffic engineering and safety policy standpoints, but also touched upon other sectors, including public health and social sciences. We identified ten focus areas relating to (i) under-reporting; (ii) global best practices; (iii) vulnerable groups; (iv) disabilities; (v) road crash costing; (vi) vehicle safety; (vii) proactive approaches; (viii) data challenges; (ix) social/behavioural aspects; and (x) capacity building. Based on our findings, future research ought to focus on improvement of data systems, understanding the impact of and addressing non-fatal injuries, improving estimates on the economic burden, implementation research to scale up programs and transfer learnings, as well as capacity development. Our recommendations, which relate to both empirical and methodological frontiers, would lead to noteworthy improvements in the way road safety data collection and research is conducted in the context of LICs.

Inequalities in the risk of disability due to traffic injuries in the Spanish adult population, 2009-2010

BACKGROUND

Although traffic injuries (TIs) are an important cause of disability the related factors are little known. We aimed to estimate the differences in risk of TI-related disability according to individual characteristics that might generate health inequalities.

METHODS

Cross-sectional study using a representative Spanish population sample drawn from the European Health Interview Survey 2009/2010. We calculated traffic crashes in the preceding year which resulted in injuries. Disability was measured using the Global Activity Limitation Indicator and four indicators of limitations (sensory, physical functional, self-care and domestic activities). Principal socio-demographic and behavioural/lifestyle variables were studied. We used multivariate logistic regression to estimate the risk (ORs) of TI-related disability in the sample as whole and disability-related factors in persons who had experienced TIs.

RESULTS

Persons with TIs had a higher risk of global disability (OR = 1.61; 95%CI:1.17-2.20), physical functional limitations (OR = 1.96; 95%CI:1.33-2.89) and self-care limitations (OR = 1.73; 95%CI:0.98-3.05). Among persons with TIs, GALI-related risk was higher in women (OR = 3.06, p = 0.002) and persons aged over 30 years (OR_31-45years = 6.81, p < 0.001; OR_46-64years = 5.96, p = 0.011; OR_>64years = 4.54, p = 0.047). Lower risk was observed among persons with a higher educational level (OR = 0.22, p = 0.003). The risk of disability among persons with TIs who consumed illegal drugs was OR = 3.9 (p = 0.023).

CONCLUSIONS

Traffic injuries in the preceding year are associated with higher risk of disability, which is unevenly distributed. Individual (women and persons over 30 years), socio-economic (lower educational level) and behavioural (illegal drug use) factors are involved. Actions aimed at changing the unequal risk among vulnerable subgroups and providing health, social and protective services should be implemented.