Prevalence and characteristics of road traffic injuries among young drivers in Oman, 2009-2011

Magnitude and factors associated with motor road traffic injuries in Brazil: Results from the National Health Survey, 2019

OBJECTIVE

To estimate the magnitude and factors associated with self-reported road traffic injuries (RTI) in Brazil.

METHODS

Cross-sectional study conducted using data from individuals aged 18 years or older, participants in the 2019 National Health Survey, a population-based conducted on 88,531 adult individuals in Brazil. Three indicators were analyzed: (i) Proportion (%) of individuals aged 18 years or older who were involved in RTI in the past 12 months; (ii) Proportion (%) of car drivers who were involved in RTI in the past 12 months; and (iii), Proportion (%) of motorcycle drivers who were involved in RTI in the past 12 months. In the inferential analysis, multiple Poisson regression was used to analyze the association between demographic and socioeconomic variables and RTI, stratified for the general population, population of car and motorcycle drivers.

RESULTS

The estimated prevalence of self-reported RTI in the past 12 months was 2.4%. The South, Southeast, Northeast, Central-West, and North regions of Brazil had prevalences of 2.0%, 2.1%, 2.7%, 3.2%, and 3.4%, respectively. The results also show that most developed regions (South and Southeast) showed the lowest prevalence's, the highest frequencies were observed in those with lower socioeconomic development levels (Central-West, North, and Northeast). The prevalence was also higher in the subgroup of motorcyclists when compared to car drivers. In the general sample, the Poisson model showed an association between male sex, younger age, low level of education, residing outside capitals and metropolitan regions, in the North, Northeast and South regions and the prevalence of RTI. In car drivers, similar associations were found, except for area of residence. In motorcycle drivers, young age, low level of education, living in urban areas were associated with increased prevalence of RTI.

CONCLUSION

The prevalence of RTI is still high within the country, with disparities between regions, affecting more motorcyclists, young people, males, individuals with low education, and residents of the countryside.

A data fusion approach of police-hospital linked data to examine injury severity of motor vehicle crashes

Injury severity studies typically rely on police-reported crash data to examine risk factors associated with traffic injuries. The police crash database includes essential information on roadways, crashes and driver-vehicle characteristics but may not contain accurate and sufficient information on traffic injuries. Despite sizable efforts on injury severity modelling, very few studies have employed hospital records to classify injury severities accurately. As such, the inferences drawn from the police-recorded injury severity classifications may be questionable. This study investigates factors affecting road traffic injuries of motor vehicle crashes in two approaches (1) police-reported injury severity data and (2) a data fusion approach linking police and hospital records. Data from 2015 to 2019 were collected from the Abu Dhabi Traffic Police Department and linked with hospital records by the Department of Health, Abu Dhabi. A total of 6,333 casualty crashes were categorised into non-severe, severe, and fatal crashes following police-reported data and non-hospitalised, hospitalised and fatal crashes based on the police-hospital linked data. The state-of-the-art random thresholds random parameters hierarchical ordered Probit models were then employed to examine the differences in factors affecting crash-injury severities between police-reported and police-hospital linked data. While there are similarities between these two approaches, there are numerous notable differences in injury severity factors. For instance, head-on collisions are associated with high crash-injury severities in the model with police-hospital linked data, but they tend to show low injury severities in the model with police-reported data. In addition, the police-reported approach identifies that crashes occurred in remote areas and angle collisions are associated with low injury severities, which is not intuitive. These findings highlight that modelling the misclassified injury severity in police crash data may lead to wrong estimations and misleading inferences. Instead, the data fusion approach of police-hospital linked data provides critical and accurate insights into road traffic injuries and is a valuable approach for understanding traffic injuries.

Predicting and Analyzing Road Traffic Injury Severity Using Boosting-Based Ensemble Learning Models with SHAPley Additive exPlanations

Road traffic accidents are one of the world’s most serious problems, as they result in numerous fatalities and injuries, as well as economic losses each year. Assessing the factors that contribute to the severity of road traffic injuries has proven to be insightful. The findings may contribute to a better understanding of and potential mitigation of the risk of serious injuries associated with crashes. While ensemble learning approaches are capable of establishing complex and non-linear relationships between input risk variables and outcomes for the purpose of injury severity prediction and classification, most of them share a critical limitation: their “black-box” nature. To develop interpretable predictive models for road traffic injury severity, this paper proposes four boosting-based ensemble learning models, namely a novel Natural Gradient Boosting, Adaptive Gradient Boosting, Categorical Gradient Boosting, and Light Gradient Boosting Machine, and uses a recently developed SHapley Additive exPlanations analysis to rank the risk variables and explain the optimal model. Among four models, LightGBM achieved the highest classification accuracy (73.63%), precision (72.61%), and recall (70.09%), F1-scores (70.81%), and AUC (0.71) when tested on 2015–2019 Pakistan’s National Highway N-5 (Peshawar to Rahim Yar Khan Section) accident data. By incorporating the SHapley Additive exPlanations approach, we were able to interpret the model’s estimation results from both global and local perspectives. Following interpretation, it was determined that the Month_of_Year, Cause_of_Accident, Driver_Age and Collision_Type all played a significant role in the estimation process. According to the analysis, young drivers and pedestrians struck by a trailer have a higher risk of suffering fatal injuries. The combination of trailers and passenger vehicles, as well as driver at-fault, hitting pedestrians and rear-end collisions, significantly increases the risk of fatal injuries. This study suggests that combining LightGBM and SHAP has the potential to develop an interpretable model for predicting road traffic injury severity.

Traffic Injury Risk Based on Mobility Patterns by Gender, Age, Mode of Transport and Type of Road

The role of gender and age in the risk of Road Traffic Injury (RTI) has not been fully explored and there are still significant gaps with regard to how environmental factors, such as road type, affect this relationship, including mobility as a measure of exposure. The aim of this research is to investigate the influence of the environmental factor road type taking into account different mobility patterns. For this purpose, a cross-sectional study was carried out combining two large databases on mobility and traffic accidents in Andalusia (Spain). The risk of RTI and their severity were estimated by gender and age, transport mode and road type, including travel time as a measure of exposure. Significant differences were found according to road type. The analysis of the rate ratio (Ratemen/Ratewomen), regardless of age, shows that men always have a higher risk of serious and fatal injuries in all modes of transport and road types. Analysis of victim rates by gender and age groups allows us to identify the most vulnerable groups. The results highlight the need to include not only gender and age but also road type as a significant environmental factor in RTI risk analysis for the development of effective mobility and road safety strategies.

Road Traffic Injuries and Related Safety Measures: A Multicentre Analysis at Military Hospitals in Tabuk, Saudi Arabia

Background

Road traffic injuries are one of the major public safety issues around the world, as they put a great burden on countries' economies. Saudi Arabia has a good road transportation system, but still, road-related fatalities are higher in this country. The main purpose of this study was to determine the association between the severity of injuries caused by road traffic collision and safety measures taken by the drivers admitted to the emergency departments at two military hospitals in Tabuk, a city in Saudi Arabia.

Methods

A total of 342 male drivers who had injuries due to road traffic collision took part in this multicentre, cross-sectional study. The research sites were King Salman Armed Forces Hospital and King Khalid Armed Forces Hospital in Tabuk, Saudi Arabia. The data were collected using a common protocol and a self-reported questionnaire with the help of convenience sampling approach. Descriptive statistics and logistic regression analysis were done using IBM SPSS version 23.

Results

Nearly 62.0% of the male drivers were aged less than 36 years. About 90% of the drivers were from low- and middle-income groups. Logistic regression analysis indicated that drivers who had road traffic collision and used mobile phones while driving were four times more likely to have severe injuries (OR = 3.89; 95% CI (2.53, 5.95)), those who drove the vehicle at an excessive speed limit were three times more likely to have severe injuries (OR = 2.71; 95% CI (1.01, 4.97)), and those who attempted to overtake another vehicle were two times more likely to have severe injuries (OR = 1.85; 95% CI (1.24, 3.77)).

Conclusion

Based on the results of the present study, the most important safety measures which contributed the most to road traffic collision were use of mobile phones while driving the vehicle, driving at an excessive speed limit, irregularity in maintaining the vehicle, attempt to pass other vehicles, and not following the traffic rules. All the safety measures are protective, but if care is not taken, they will risk the life. There is an urgent need to spread traffic safety awareness in this region.

Approaching autonomous driving with cautious optimism: analysis of road traffic injuries involving autonomous vehicles based on field test data

OBJECTIVES

To examine the patterns and associated factors of road traffic injuries (RTIs) involving autonomous vehicles (AVs) and to discuss the public health implications and challenges of autonomous driving.

METHODS

Data were extracted from the reports of traffic crashes involving AVs. All the reports were submitted to the California Department of Motor Vehicles by manufacturers with permission to operate AV test on public roads. Descriptive analysis and χ² analysis or Fisher's exact test was conducted to describe the injury patterns and to examine the influencing factors of injury outcomes, respectively. Binary logistic regression using the Wald test was employed to calculate the OR, adjusted OR (AOR) and 95% CIs. A two-tailed probability (p<0.05) was adopted to indicate statistical significance.

RESULTS

133 reports documented 24 individuals injured in 19 crashes involving AVs, with the overestimated incidence rate of 18.05 per 100 crashes. 70.83% of the injured were AV occupants, replacing vulnerable road users as the leading victims. Head and neck were the most commonly injured locations. Driving in poor lighting was at greater risk of RTIs (AOR 6.37, 95% CI 1.47 to 27.54). Collisions with vulnerable road users or incidents happening during commute periods led to a greater number of victims (p<0.05). Autonomous mode cannot perform better than conventional mode in road traffic safety to date (p=0.468).

CONCLUSIONS

Poor lighting improvement and the regulation of commute-period traffic and vulnerable road users should be strengthened for AV-related road safety. So far AVs have not demonstrated the potential to dramatically reduce RTIs. Cautious optimism about AVs is more advisable, and multifaceted efforts, including legislation, smarter roads, and knowledge dissemination campaigns, are fairly required to accelerate the development and acceptance.

Effectiveness of a pre-licensing driver education program on five psycho-social factors over twelve months

A pre and post (1, 4, and 9-12 months follow up) survey of psychosocial variables was used to examine the effect of a compulsory pre-licence driver education program for drivers aged 16-20 years, in the Australian Capital Territory. While the final survey was collected by telephone, all other surveys were completed online. Two-way mixed ANOVAs revealed that sensation seeking and optimism bias increased over time while illusionary invulnerability and differential association fell. Participants perceived driving as more risky 9-12 months after completing the course compared to their views prior to the course. These results suggest that the program may have a limited effect on these five psychosocial factors over time. Policy makers may need to carefully consider the reasons for providing driver education, the optimal time during the licensing process to provide this education, and the financial and social costs of doing so.

Risk of Injury and Mortality among Driver Victims Involved in Single-Vehicle Crashes in Taiwan: Comparisons between Vehicle Types

Vehicle-type specific injury severity has rarely been investigated mainly because of a lack of such information in hospital-based studies that normally exclude those who are severely injured and die on the scene. No study has been conducted either on driver characteristics in single vehicle crashes in Taiwan according to vehicle type. This was the first population-based study aiming to describe demographic characteristics in association with vehicle-specific rates of injury and fatality among driver victims involved in single-vehicle crashes in Taiwan. We presented sex and age-specific number and proportion of driver victims according to vehicle type. We calculated sex and age-specific rates of injury and fatality. Injury and fatality rates were also graphically presented. Bicycle and motorcycle rider victims generally had higher injury rates but lower fatality rates. However, older (45+) bicycle rider victims had greater fatality risk. By contrast, truck and car driver victims were generally associated with lower injury rates but with higher fatality rates. Elderly (65+ years) truck driver victims suffered from higher rates of injury and fatality. Male victims were found to have a higher fatality rate than female victims regardless of vehicle type. The vehicle-type-specific analyses of injury and fatality are considered useful in identifying single-vehicle crash victims at greater risks of injury and fatality.

Methylphenidate improves executive functions in patients with traumatic brain injuries: a feasibility trial via the idiographic approach

Background

Road traffic accidents are known to be the main cause of traumatic brain injury (TBI). TBI is also a leading cause of death and disability. This study, by means of the idiographic approach (single-case experimental designs using multiple-baseline designs), has examined whether methylphenidate (MPH - trade name Ritalin) had a differential effect on cognitive measures among patients with TBI with the sequel of acute and chronic post-concussion syndromes. The effect on gender was also explored.

Methods

In comparison with healthy controls, patients with TBI (acute and chronic) and accompanying mild cognitive impairment (MCI) were screened for their integrity of executive functioning. Twenty-four patients exhibiting executive dysfunction (ED) were then instituted with the pharmacological intervention methylphenidate (MPH). The methylphenidate was administered using an uncontrolled, open label design.

Results

The administration of methylphenidate impacted ED in the TBI group but had no effect on mood. Attenuation of ED was more apparent in the chronic phases of TBI. The effect on gender was not statistically significant with regard to the observed changes.

Conclusions

To our knowledge, this is the first feasibility trial from the Arabian Gulf to report the performance of a TBI population with mild cognitive impairment according to the IQCODE Arabic version. This investigation confirms anecdotal observations of methylphenidate having the potential to attenuate cognitive impairment; particularly those functions that are critically involved in the integrity of executive functioning. The present feasibility trial should be followed by nomothetic studies such as those that adhere to the protocol of the randomized controlled trial. This evidence-based research is the foundation for intervention and future resource allocation by policy- or public health decision-makers.

Determinants of speeding among new generations of car drivers from the Arabian Peninsula. An investigation based among Omani drivers using the theory of planned behaviour

In high-income countries of the Arabian Peninsula, including the Sultanate of Oman, motorization has been extremely rapid. As a result, road traffic crashes are by far the highest cause of premature mortality, and speeding is an acknowledged key risk factor. Theory-based interventions are needed to target prevention of this unsafe practice. This study sheds light on determinants of speeding among new generations of Omani drivers applying the Theory of Planned Behaviour (TPB). A questionnaire covering all five main constructs of the TPB was first contextualized and administered to two target groups: male drivers of all ages (n = 1107) approached in person when renewing their driving license and university students drivers (men and women) reached through internet contact (n = 655). Multiple, stepwise linear regression analyses were used to explore factors associated with speeding. Results indicate that driving fast and not respecting the posted speed limits was common in both groups of drivers, although rates were higher among students; 41.8% reported driving a bit faster than other drivers and 24.1% faster than the posted speed limit compared with 31.4% and 14.2% in male drivers of all ages. In both groups the TPB model predicted to a limited extent the determinants of speeding behaviour. However, the intention to speed was associated with a negative attitude towards the respect of rules for men of all ages (β = -0.30 (p<0.001)) and for students (β = -0.26 (p<0.001)); a positive view regarding subjective norms (β = 0.25 (p<0.001) and β = 0.28 (p<0.001) respectively), and behavioural control (β = 0.15 (p<0.001) and β = 0.20 (p<0.001) respectively). Intention was the only significant predictor of speeding behaviour (β = 0.48 (p<0.001); and β = 0.64 (p<0.001)). To conclude, speeding is widespread among Omani drivers of all ages and the intention to respect posted speed limits meets a range of barriers that need greater consideration in order to achieve a better safety culture in the country.

The characteristics and patterns of utilization of healthcare services among Omanis with substance use disorders attending therapy for cessation

BACKGROUND

It is indicated that Oman is witnessing an increase in issues pertinent to alcohol and psychoactive substance use.

AIM

The aim of this study was to identify the characteristics of Omanis with substance use disorder attending a specialized hospital in Oman and the pattern of their utilization of healthcare services. A related aim was to ascertain the age group most vulnerable to alcohol and substance use in Oman.

METHOD

A cross-sectional study was conducted in a tertiary care center specialized for treatment of those engaging in substance use in Oman. The participants in the study were selected from a convenience sample among patients seeking consultation at the center for alcohol and substance use. A six-part questionnaire was designed to obtain information regarding socio-demographic background, clinical history, healthcare utilization and perceived hurdles to access. Chi-square analyses were used to evaluate the significance of differences among categorical data. Logistic regression modelling was used to obtain measures of association after adjusting for confounding factors.

RESULTS

Among the patients (n = 293) seeking cessation therapy, 99% were male and less than 30 years of age. Peer influences on the initiation of substance use were significant. Most patients had a history of polysubstance use, including intravenous substance use. Cannabis and alcohol were the first substances consumed by most patients and Hepatitis C and psychiatric disorders were found to be the most common co-morbidities. The participants that reported use of cannabis and benzodiazepines were more likely to perceive "improvement" upon receiving treatment.

CONCLUSION

This study indicated that males below 30 years of age with a history of polysubstance use were likely to attend a hospital specialized in treating substance use disorder in Oman. This study identified information regarding socio-demographic background, risk factors and perceived hurdles to healthcare that could serve as groundwork for further studies conducted on newly emerging issues of substance use in Oman.

Disentangling age-gender interactions associated with risks of fatal and non-fatal road traffic injuries in the Sultanate of Oman

Objective

Road traffic injuries (RTIs) are the leading cause of disability-adjusted life years lost in Oman, Saudi Arabia and United Arab Emirates. Injury prevention strategies often overlook the interaction of individual and behavioural risk factors in assessing the severity of RTI outcomes. We conducted a systematic investigation of the underlying interactive effects of age and gender on the severity of fatal and non-fatal RTI outcomes in the Sultanate of Oman.

Methods

We used the Royal Oman Police national database of road traffic crashes for the period 2010–2014. Our study was based on 35 785 registered incidents: of these, 10.2% fatal injuries, 6.2% serious, 27.3% moderate, 37.3% mild injuries and 19% only vehicle damage but no human injuries. We applied a generalised ordered logit regression to estimate the effect of age and gender on RTI severity, controlling for risk behaviours, personal characteristics, vehicle, road, traffic, environment conditions and geographical location.

Results

The most dominant group at risk of all types of RTIs was young male drivers. The probability of severe incapacitating injuries was the highest for drivers aged 25–29 (26.6%) years, whereas the probability of fatal injuries was the highest for those aged 20–24 (26.9%) years. Analysis of three-way interactions of age, gender and causes of crash show that overspeeding was the primary cause of different types of RTIs. In particular, the probability of fatal injuries among male drivers attributed to overspeeding ranged from 3%–6% for those aged 35 years and above to 13.4% and 17.7% for those aged 25–29 years and 20–24 years, respectively.

Conclusions

The high burden of severe and fatal RTIs in Oman was primarily attributed to overspeed driving behaviour of young male drivers in the 20–29 years age range. Our findings highlight the critical need for designing early gender-sensitive road safety interventions targeting young male and female drivers.