Raised crosswalks on entrance to the roundabout-a case study on effectiveness of treatment on pedestrian safety and convenience

Effectiveness of road safety interventions: An evidence and gap map

Background

Road Traffic injuries (RTI) are among the top ten leading causes of death in the world resulting in 1.35 million deaths every year, about 93% of which occur in low- and middle-income countries (LMICs). Despite several global resolutions to reduce traffic injuries, they have continued to grow in many countries. Many high-income countries have successfully reduced RTI by using a public health approach and implementing evidence-based interventions. As many LMICs develop their highway infrastructure, adopting a similar scientific approach towards road safety is crucial. The evidence also needs to be evaluated to assess external validity because measures that have worked in high-income countries may not translate equally well to other contexts. An evidence gap map for RTI is the first step towards understanding what evidence is available, from where, and the key gaps in knowledge.

Objectives

The objective of this evidence gap map (EGM) is to identify existing evidence from all effectiveness studies and systematic reviews related to road safety interventions. In addition, the EGM identifies gaps in evidence where new primary studies and systematic reviews could add value. This will help direct future research and discussions based on systematic evidence towards the approaches and interventions which are most effective in the road safety sector. This could enable the generation of evidence for informing policy at global, regional or national levels.

Search Methods

The EGM includes systematic reviews and impact evaluations assessing the effect of interventions for RTI reported in academic databases, organization websites, and grey literature sources. The studies were searched up to December 2019.

Selection Criteria

The interventions were divided into five broad categories: (a) human factors (e.g., enforcement or road user education), (b) road design, infrastructure and traffic control, (c) legal and institutional framework, (d) post-crash pre-hospital care, and (e) vehicle factors (except car design for occupant protection) and protective devices. Included studies reported two primary outcomes: fatal crashes and non-fatal injury crashes; and four intermediate outcomes: change in use of seat belts, change in use of helmets, change in speed, and change in alcohol/drug use. Studies were excluded if they did not report injury or fatality as one of the outcomes.

Data Collection and Analysis

The EGM is presented in the form of a matrix with two primary dimensions: interventions (rows) and outcomes (columns). Additional dimensions are country income groups, region, quality level for systematic reviews, type of study design used (e.g., case-control), type of road user studied (e.g., pedestrian, cyclists), age groups, and road type. The EGM is available online where the matrix of interventions and outcomes can be filtered by one or more dimensions. The webpage includes a bibliography of the selected studies and titles and abstracts available for preview. Quality appraisal for systematic reviews was conducted using a critical appraisal tool for systematic reviews, AMSTAR 2.

Main Results

The EGM identified 1859 studies of which 322 were systematic reviews, 7 were protocol studies and 1530 were impact evaluations. Some studies included more than one intervention, outcome, study method, or study region. The studies were distributed among intervention categories as: human factors (n = 771), road design, infrastructure and traffic control (n = 661), legal and institutional framework (n = 424), post-crash pre-hospital care (n = 118) and vehicle factors and protective devices (n = 111). Fatal crashes as outcomes were reported in 1414 records and non-fatal injury crashes in 1252 records. Among the four intermediate outcomes, speed was most commonly reported (n = 298) followed by alcohol (n = 206), use of seatbelts (n = 167), and use of helmets (n = 66). Ninety-six percent of the studies were reported from high-income countries (HIC), 4.5% from upper-middle-income countries, and only 1.4% from lower-middle and low-income countries. There were 25 systematic reviews of high quality, 4 of moderate quality, and 293 of low quality.

Authors' Conclusions

The EGM shows that the distribution of available road safety evidence is skewed across the world. A vast majority of the literature is from HICs. In contrast, only a small fraction of the literature reports on the many LMICs that are fast expanding their road infrastructure, experiencing rapid changes in traffic patterns, and witnessing growth in road injuries. This bias in literature explains why many interventions that are of high importance in the context of LMICs remain poorly studied. Besides, many interventions that have been tested only in HICs may not work equally effectively in LMICs. Another important finding was that a large majority of systematic reviews are of low quality. The scarcity of evidence on many important interventions and lack of good quality evidence-synthesis have significant implications for future road safety research and practice in LMICs. The EGM presented here will help identify priority areas for researchers, while directing practitioners and policy makers towards proven interventions.

The role of traffic conflicts in roundabout safety evaluation: A review

The roundabout is one type of at-grade intersection commonly seen in many countries. The evaluation of roundabout safety is usually counted on conflict analysis of the roundabout traffic due to random and limited records of real accidents. This paper surveyed published papers and reports that investigate the role of traffic conflicts in roundabout safety evaluation. It summarized the definitions and observation methods of roundabout conflicts and classified the attributing factors of roundabout conflicts and the countermeasures to control the conflicts. This study found that although unique traffic flow movements at roundabouts create special patterns of roundabout conflicts, the methods of roundabout conflict analysis used in most existing studies were inherited from the studies of highway or cross-intersection conflicts, including conflict definitions, conflict measurements, and thresholds of conflict severity. Special or improper designs of roundabout configurations or basic geometry elements could arouse roundabout conflicts. The most common vehicle-to-vehicle conflicts were entering-circulating conflicts, sideswipe conflicts, and exiting-circulating conflicts. The conflicts among vehicles and vulnerable road users (VRUs) easily evolved into serious collisions, but these conflicts did not get deserved attention in previous studies. Drivers' familiarity with roundabouts also affected road users' safety. Traffic signs and pavement markings were commonly used to control roundabout conflicts, while traffic signals were more effective methods for the roundabouts with uneven distribution of approaching traffic or high traffic volume. Based on the analysis of existing studies, this paper pointed out seven future directions of further research in term of conflict measurement, data collection, infrastructure and access management, geometry, drivers and VRUs, signal control, and vehicle control.

Exploratory Analysis of Pedestrian Road Trauma in Finland

In Finland, all fatal on-road and off-road motor vehicle crashes are subject to an in-depth investigation coordinated by the Finnish Crash Data Institute (OTI). This study presents an exploratory and two-step cluster analysis of fatal pedestrian crashes between 2010 and 2019 that were subject to in-depth investigations. In total, 281 investigations occurred across Finland between 2010 and 2019. The highest number of cases were recorded in the Uusimaa region, including Helsinki, representing 26.4% of cases. Females (48.0%) were involved in fewer cases than males; however, older females represented the most commonly injured demographic. A unique element to the patterns of injury in this study is the seasonal effects, with the highest proportion of crashes investigated in winter and autumn. Cluster analysis identified four unique clusters. Clusters were characterised by crashes involving older pedestrians crossing in low-speed environments, crashes in higher speed environments away from pedestrian crossings, crashes on private roads or in parking facilities, and crashes involving intoxicated pedestrians. The most common recommendations from the investigation teams to improve safety were signalisation and infrastructure upgrades of pedestrian crossings, improvements to street lighting, advanced driver assistance (ADAS) technologies, and increased emphasis on driver behaviour and training. The findings highlight road safety issues that need to be addressed to reduce pedestrian trauma in Finland, including provision of safer crossing facilities for elderly pedestrians, improvements to parking and shared facilities, and addressing issues of intoxicated pedestrians. Efforts to remedy these key issues will further Finland’s progression towards meeting Vision Zero targets while creating a safer and sustainable urban environment in line with the United Nations sustainable development goals.

Mobile device use while crossing the street: Utilizing the theory of planned behavior

Every year, thousands of pedestrians are killed and tens-of-thousands are nonfatally injured as a result of traffic crashes. The year 2016 holds the record for the most pedestrians killed in one year since 1990. Mobile device use while crossing the street has been associated with unsafe crossing behaviors and gait abnormalities, potentially increasing the risk of pedestrian injury or death. Expanding upon the small body of literature, the present study utilized the theory of planned behavior to guide the development of a questionnaire used to collect data from 480 adults on predictors of intentions to use a mobile device while crossing the street. Questionnaire development involved one round of expert panel review (N = 4), subsequent pilot testing of a revised questionnaire, and a test-retest reliability assessment. Results demonstrate that attitude toward the behavior, subjective norm, and perceived behavioral control significantly predicted the intention to use a mobile device while crossing the street in this population. Such a questionnaire can be used in the design and evaluation of TPB-based interventions to decrease distracted mobile device use while crossing the street.

Effects of parallelogram-shaped pavement markings on vehicle speed and safety of pedestrian crosswalks on urban roads in China

The primary objective of this study was to evaluate the effects of parallelogram-shaped pavement markings on vehicle speed and crashes in the vicinity of urban pedestrian crosswalks. The research team measured speed data at twelve sites, and crash data at eleven sites. Observational cross-sectional studies were conducted to identify if the effects of parallelogram-shaped pavement markings on vehicle speeds and speed violations were statistically significant. The results showed that parallelogram-shaped pavement markings significantly reduced vehicle speeds and speed violations in the vicinity of pedestrian crosswalks. More specifically, the speed reduction effects varied from 1.89km/h to 4.41km/h with an average of 3.79km/h. The reduction in the 85th percentile speed varied from 0.81km/h to 5.34km/h with an average of 4.19km/h. Odds ratios (OR) showed that the parallelogram-shaped pavement markings had effects of a 7.1% reduction in the mean speed and a 6.9% reduction in the 85th percentile speed at the pedestrian crosswalks. The reduction of proportion of drivers exceeding the speed limit varied from 8.64% to 14.15% with an average of 11.03%. The results of the crash data analysis suggested that the use of parallelogram-shaped pavement markings reduced both the frequency and severity of crashes at pedestrian crosswalks. The parallelogram-shaped pavement markings had a significant effect on reducing the vehicle-pedestrian crashes. Two crash prediction models were developed for vehicle-pedestrian crashes and rear-end crashes. According to the crash models, the presence of parallelogram-shaped pavement markings reduced vehicle-pedestrian crashes at pedestrian crosswalks by 24.87% with a 95% confidence interval of [10.06-30.78%]. However, the model results also showed that the presence of parallelogram-shaped pavement markings increased rear-end crashes at pedestrian crosswalks by 5.4% with a 95% confidence interval of [0-11.2%].