Road Injuries Associated With Cellular Phone Use While Walking or Riding a Bicycle or an Electric Bicycle: A Case-Crossover Study

Exploring the heterogeneous effects of riding behaviours and road conditions on delivery rider severities in scooter-style electric bicycle crashes involving vehicles

Delivery riders are more vulnerable than other traffic participants, especially in vehicle-involved delivery crashes. This study aims at identifying the unobserved heterogeneities in different factors, based on 4251 vehicle-scooter-style electric bicycle (SSEB) crashes. First, some potential factors are selected from seven perspectives, and the spatiotemporal characteristics are analysed. Second, a latent class clustering method is proposed to clarify the optimal number of clusters by maximizing the heterogeneities across clusters. Third, partial proportional odds (PPO) models for the whole dataset and sub-datasets are developed to explore the heterogeneities across various clusters. Besides, marginal effects are implemented to quantify the heterogeneities. The results evidence that there are remarkable heterogeneities across different clusters, especially in riding behaviours and road conditions. Several factors only significantly affect particular clusters but not the whole dataset. The PPO models for the sub-datasets perform better in identifying the underlying heterogeneities. The results also highlight the greater roles of riding behaviours and road conditions in delivery SSEB-vehicle crashes. The top five influencing factors are running red light, using cell phones, vehicle type, reverse riding and bike lane (their maximum marginal effects exceeding +35%). The findings could support to mitigate the related crash losses.

Cell phone distraction behavior of young pedestrians: evidence from China

Cell phone use while walking escalates pedestrian safety risks, particularly among students, given their heavy reliance on these devices. Psychological factors wield significant influence on individual behavior, particularly among adolescents who navigate a blend of rational and social-reactive pathways in decision-making. Therefore, this paper employs the Prototype Willingness Model (PWM) to scrutinize psychological determinants of students' cell phone use while walking, drawing on data from 368 valid samples. Structural equation modeling (SEM) dissects the impact of psychological constructs on this behavior, highlighting the significance of both the social response and reasoning pathways within PWM. The study comprehensively analyzes direct, indirect, and overall effects of exogenous variables on behavioral intention and behavior.

What's that on Your Phone? Effects of Mobile Device Task Type on Pedestrian Performance

BACKGROUND

The number of accidents due to distracted pedestrian is on the rise and many governments and institutions are enacting public policies which restrict texting while walking. However, pedestrians do more than just texting when they use their mobile devices on the go.

OBJECTIVE

Exploring pedestrian multitasking, this paper aims to examine the effects of mobile device task type on pedestrian performance outcomes.

METHOD

We performed two studies in lab simulations where 78 participants were asked to perform different tasks on a mobile device (playing a game, reading, writing an email, texting one person, group texting) while performing a pedestrian visual discrimination task while either standing or walking on a treadmill. Behavioral performance as well as neurophysiological data are collected.

RESULTS

Results show that compared to a no-phone control, multitasking with any of the tasks on a mobile device leads to poor performance on a pedestrian visual discrimination task. Playing a game is the most cognitively demanding task and leads to the greatest performance degradation.

CONCLUSION

Our studies show that multitasking with a mobile device has the potential to negatively impact pedestrian safety, regardless of task type. However, the impacts of different mobile device tasks are not all equivalent. More research is needed to tease out the different effects of these various tasks and to design mobile applications which effectively and safely capture pedestrians' attention.

APPLICATION

Public policy, infrastructure, and smart technologies can be used to mitigate the negative effects of mobile multitasking. A more thorough understanding of mobile device task-specific factors at play can help tailor these counter-measures to better aid distracted pedestrians.

Riding practices of e-bike riders after the implementation of electric bike management regulations: An observational study in Hangzhou, China

Objective

This study aimed to understand the riding behaviors of electric bike (e-bike) users in Hangzhou after the "Regulations of Zhejiang Province on the Administration of Electric Bicycles".

Methods

The study consisted of two parts, including a questionnaire survey of local e-bike users in Shangcheng District and Jiande County in Hangzhou City, and a cross-sectional observational study of 16 intersections.

Results

A total of 789 e-bike riders participated in the questionnaire survey, and the riding behavior of 99,407 e-bike users was observed. The main purpose of using e-bike was work and daily life, 46.0% of them used e-bikes more than 5 days a week, and 58.5% used e-bikes for less than 30 min each time. A vast majority (81.7%) of e-bike riders believe that the implementation of Zhejiang Regulations has significantly improved the safety level of e-bike riding in the region. The field survey found that the correct rates of helmet wearing by e-bike riders and passengers were 78.83% and 42.27%. The main violations were invalid/non-helmet wearing (21.17%), followed by carrying passengers and running red lights (7.94% and 4.26%). The rates of invalid/non-helmet wearing and running red lights were significantly higher during non-morning rush hour, weekends, and roads without separate non-motorized vehicle lanes than in other conditions (all P < 0.05). Additionally, sunny days and crossroads were risk factors for passenger-carrying and invalid/non-helmet wearing compared to rainy/cloudy days and T-intersections.

Conclusions

The phenomenon that e-bike users' correct practice lags far behind the awareness of various violations has shown some improvement. To further enhance safety measures for e-bike riders, it is necessary to promote education, improve infrastructure, and strengthen law enforcement, in support of the "Zhejiang Regulations" and behavioral interventions.

Occupational hand trauma - Mechanism of injury and transient risk factors in Jerusalem

INTRODUCTION

Although prevalent, and variable geographically, there is little information on the incidence and risk factors for occupation hand trauma in our health care system. This pilot study was designed to determine the optimal data collection methods for transient risk factors locally METHODS: All adult patients with occupational hand trauma treated at an emergency department (ED) during a three-month period were interviewed, either in person or by phone, using a case crossover designed questionnaire, regarding occupation and exposure to potential transient risk factor.

RESULTS

Of 206 patients treated with occupational trauma during the study period, 94 had trauma distal to the elbow (46%). Patient compliance was high - 89% of the patients consented to phone interviews and 83% completed in-person ED interviews. In the 75 patients which participated in the study, several risk factors were found to be significant, including machine maintenance and being distracted, including by a cellular phone. We found lack of job experience, limited training on the job site and reports of previous injuries in these workplaces to be prevelent.

DISCUSSION

The risk factors implicated in this study are similar to those reported in previous studies at other locations and are modifiable although this is the first report linking cellular phone use and occupation trauma. This finding should be further examined in a larger group and according to occupational categories. Compliance with the study was high, in person or with phone interviews, making these options viable for further studies. Several minor changes to the questionnaire were suggested although it did conform with the case-crossover study design. According to this study, standard preventive measures may be lacking in Jerusalem and should be implemented more uniformly, including specific workplace safety plans and education and taking into consideration the risk factors documented here.

Nomophobia, attitude and mobile phone use while riding an E-bike: Testing a dual-process model of self-control

Using a mobile phone while participating in traffic is a growing safety concern all over the world. However, mobile phone use (MPU) while riding an e-bike has not yet been given enough attention by researchers and practitioners. To fill this gap, this study conducted a preliminary online interview and a questionnaire-based survey in China to study what kinds of MPU behaviors e-bikers commonly engaged in and the prevalence of these behaviors. A conceptual dual-process framework consisting of e-bikers' demographics, e-bike usage pattern, nomophobia, attitude and self-control was also proposed to analyze the psychological mechanism underlying this phenomenon. The preliminary online interview revealed 7 typical types of MPU behaviors performed by e-bikers on the road. Results of the questionnaire survey showed that though the overall frequencies of MPU behaviors were low, nearly 60% of the respondents reported a history of mobile phone use during riding in the last three months. E-bikers' MPU frequencies were significantly impacted by e-bikers' gender, attitude, self-control and information-related nomophobia. Besides, self-control also significantly moderated the predictive effects of information-related nomophobia and attitude on MPU frequencies while ring an e-bike. Fears of being unable to access information on the mobile phone only contributed to MPU at low levels of self-control. In contrast, the protective effect of unfavorable attitude against engagement in the behavior became stronger at high self-control levels. The results not only offer deeper insights into the current situation of MPU among e-bikers in China, but also could facilitate the development of intervention and safety promotion strategies targeting this specific road user group.

Analysis of Risky Riding Behavior Characteristics of the Related Road Traffic Injuries of Electric Bicycle Riders

Electric bicycle (EB) riders, being vulnerable road users (VRUs), are increasingly becoming victims of road traffic injuries (RTIs). This study aimed to determine the current status and epidemiological characteristics of RTIs among EB riders through a questionnaire survey and roadside observations in Shantou to provide a scientific basis for the prevention and control of electric bicycle road traffic injuries (ERTIs). A total of 2412 EB riders were surveyed, and 34,554 cyclists were observed in the study. To analyze the relationship between riding habits and injuries among EB riders, chi-square tests and multi-factor logistic regression models were employed. The findings reveal that the prevalence of ERTIs in Shantou was 4.81%, and the most affected group was children under 16 years old, accounting for 9.84%. Risky behavior was widespread among EB riders, such as the infrequent wearing of safety helmets, carrying people on EBs, riding on sidewalks, and listening to music with headphones while bicycling. Notably, over 90% of those who wore headphones while bicycling engaged in this risky behavior. The logistic regression analysis showed that honking the horn (odds ratio (OR): 2.009, 95% CI: 1.245-3.240), riding in reverse (OR: 4.210, 95% CI: 2.631-6.737), and continuing to ride after a fault was detected (OR: 2.010, 95% CI: 1.188-3.402) all significantly increased the risk of ERTIs (all p < 0.05). Risky riding behavior was significantly less observed at traffic intersections with traffic officers than at those without (all p < 0.001).

Characterizing the effects of contributing factors on crash severity involving e-bicycles: a study based on police-reported data

Mitigating e-bicycle crash occurrence has become a great challenge across the world. It is of paramount importance for improving traffic safety to characterize the relationship between e-bicycle crash injury severities and contributing factors. This study positions itself at clarifying the roles of the factors in e-bicycle crashes from time, space, road, environment, rider and object characteristics. The partial proportional odds (PPOs) model as well as its elasticity analysis was employed to identify the influences based on 15,138 police-reported e-bicycle crashes in Shangyu District of Shaoxin City, China. The results evidenced that there were 12 factors having significant effects. Especially, the results emphasized the greater influences of rider gender, age, object hit and road type. Their maximum of the absolutes of elasticities was greater than 24%. Increased crash severity was associated with females, younger riders, and higher speed collisions. However, the remaining significant variables had minor effects (no more than 10%). The findings provide meaningful insights for advancing e-bicycle development, when making related policies and prioritizing safety countermeasures.

Secondary task engagement, risk-taking, and safety-related equipment use in German bicycle and e-scooter riders - An observation

The behavioral safety of e-bike and e-scooter riders is a significant concern in traffic safety. In an observational study in Braunschweig, Germany, 4,514 bicycle and e-scooter riders were observed concerning their used vehicles type, secondary task engagement, use of additional safety equipment, and traffic rule violation. Overall, 13.4% of all riders were engaged in any secondary task, wearing headphones or earphones being the most frequent behavior (6.7%), followed by conversations with other cyclists (3.7%). Banned mobile phone use was low (0.8%). Secondary task engagement was positively correlated with traffic rule violations and at-fault conflicts and negatively with the use of additional safety equipment. Cluster analysis on vehicle types and behaviors revealed five groups of riders, two with relatively high numbers of risky behaviors: young and middle-aged, predominantly male riders of conventional bicycles, and a group of demographically similar users of electric bikes and e-scooters. Campaigns targeted at these specific groups may help reduce risky behaviors.

Risk Factors for Road-Traffic Injuries Associated with E-Bike: Case-Control and Case-Crossover Study

The Electric Bike (EB) has become an ideal mode of transportation because of its simple operation, convenience, and because it is time saving, economical and environmentally friendly. However, electric bicycle road-traffic injuries (ERTIs) have become a road-traffic safety problem that needs to be solved urgently, bringing a huge burden to public health. In order to provide basic data and a theoretical basis for the prevention and control of ERTIs in Shantou, mixed research combining a case-control study and a case-crossover study was carried out to investigate the cycling behavior characteristics and injury status of EB riders in Shantou city, and to explore the influencing factors of ERTI. The case-control study selected the orthopedic inpatient departments of three general hospitals in Shantou. The case-crossover study was designed to assess the effect of brief exposure on the occurrence of ERTIs, in which each orthopedic inpatient serves as his or her own control. Univariable and multivariable logistic regressions were used to examine the associated factors of ERTIs. In the case-control study, multivariable analysis showed that chasing or playing when cycling, finding the vehicle breakdown but continuing cycling, not wearing the helmet, and retrograde cycling were risk factors of ERTIs. Compared with urban road sections, suburb and township road sections were more likely to result in ERTIs. Astigmatism was the protective factor of ERTI. The case-crossover study showed that answering the phone or making a call and not wearing a helmet while cycling increased the risk of ERTIs. Cycling in the motor-vehicle lane and cycling on the sidewalk were both protective factors. Therefore, the traffic management department should effectively implement the policy about wearing a helmet while cycling, increasing the helmet-wearing rate of EB cyclists, and resolutely eliminate illegal behaviors such as violating traffic lights and using mobile phones while cycling. Mixed lanes were high-incidence road sections of ERTIs. It was suggested that adding people-non-motor-vehicles/motor vehicles diversion and isolation facilities in the future to ensure smooth roads and safety would maximize the social economic and public health benefits of EB.

Intelligent Mobility in the City: The Influence of System and Context Factors on Drivers’ Takeover Willingness and Trust in Automated Vehicles

Automated driving in urban environments not only has the potential to improve traffic flow and heighten driver comfort but also to increase traffic safety, particularly for vulnerable road users such as pedestrians. For these benefits to take effect, drivers need to trust and use automated vehicles. This decision is influenced by both system and context factors. However, it is not yet clear how these factors interact with each other, especially for automated driving in city scenarios with crossing pedestrians. Therefore, we conducted an online experiment in which participants (N = 68) experienced short automated rides from the driver’s perspective through an urban environment. In each of the presented videos, a pedestrian crossed the street in front of the automated vehicle while system and context factors were varied: 1) the crossing pedestrian’s intention was either visualized correctly (as crossing) or incorrectly (visualization missing) by the automated vehicle (system factor), 2) the pedestrian was either distracted by using a smartphone while crossing or not (context factor), and 3) the scenario was either more or less complex depending on the number of other vehicles and pedestrians being present (context factor). In situations with a system malfunction where the crossing pedestrian’s intention was not visualized, participants perceived the situation as more critical, had less trust in the automated system, and a higher willingness to take over control regardless of any context factors. However, when the system worked correctly, the crossing pedestrian’s smartphone usage came into play, especially in the less complex scenario. Participants perceived situations with a distracted pedestrian as more critical, trusted the system less, indicated a higher willingness to take over control, and were more uncertain about their decision. As this study demonstrates the influence of distracted pedestrians, more research is needed on context factors and their inclusion in the design of interfaces to keep drivers informed during automated driving in urban environments.

Seizures and status epilepticus may be risk factor for cardiac arrhythmia or cardiac arrest across multiple time frames

OBJECTIVE

To determine if Emergency Department (ED) or inpatient encounters for epilepsy or status epilepticus are associated with increased odds of cardiac arrhythmia or cardiac arrest over successively longer time frames.

METHODS

The State Inpatient and ED Databases (from New York, Florida, and California) are statewide datasets containing data on 97% of hospitalizations and ED encounters from these states. In this retrospective, case-crossover study, we used International Classification of Diseases, Ninth Revision, Clinical Modification codes to identify index cardiac arrhythmia encounters. Exposures were inpatient or ED encounters for epilepsy or status epilepticus. The case-crossover analysis tested whether an epilepsy or status epilepticus encounter within various case periods (1, 3, 7, 30, 60, 90, and 180 days prior to index encounter) was associated with subsequent ED or inpatient encounter for cardiac arrhythmia, as compared to control periods of equal length one year prior.

RESULTS

The odds ratio (OR) for cardiac arrhythmia after an epilepsy encounter was significant at all time intervals (OR range 2.37-3.36), and highest at 1 day after epilepsy encounter (OR 3.63, 95% confidence interval [CI] 1.66-7.93, p = 0.0013). The OR after status epilepticus was significant at 7- to 180-day intervals (OR range 2.25-2.74), and highest at 60 days (OR 2.74, CI 2.09-3.61, p < 0.0001).

SIGNIFICANCE

Epilepsy and status epilepticus events are associated with increased odds of subsequent cardiac arrhythmia or cardiac arrest over multiple chronic timeframes. Increased cardiac surveillance may be warranted to minimize morbidity and mortality in patients with epilepsy.