Increased Rural Vehicular Mortality Rates: Roadways With Higher Speed Limits or Excessive Vehicular Speed?

Comparative analysis of pedestrian crash severity at United Kingdom rural road intersections and Non-Intersections using latent class clustering and ordered probit model

Pedestrian safety is a critical issue in the United Kingdom (UK) as pedestrians are the most vulnerable road users. Despite numerous studies on pedestrian-vehicle crashes globally, limited research has been conducted to explore the factors contributing to such incidents in the UK, especially on rural roads. Therefore, this study aimed to investigate the severity of pedestrian injuries sustained on rural roads in the UK, including crashes at intersections and non-intersections. We utilized the STATS19 dataset, which provided comprehensive road safety data from 2015 to 2019. To overcome the challenges posed by heterogeneity in the data, we employed a Latent Class Analysis to identify homogeneous clusters of crashes. Additionally, we utilized the Ordered Probit model to identify contributing factors within each cluster. Our findings revealed that various factors had distinct effects on the severity of pedestrian injuries at intersections and non-intersections. Several parameters like the pedestrian location in footway and one-way roads are only statistically significant in the intersection section. Certain factors such as the day of the week, the pedestrian's location in a refuge, and minor roads (class B roads) were found to be significant only in the non-intersection section.Parameters includingpedestrians aged over 65 years and under 15 years, drivers under 25 years, male drivers and pedestrians, darkness, heavy vehicles, speed limits exceeding 96 km/h (60 mph), major roads (class A roads), and single carriageway roadsare significant in both sections. The study proposes various measures to mitigate the severity of pedestrian-vehicle crashes, such as improving lighting conditions, enhancing pedestrian infrastructure, reducing speed limits in crash-prone areas, and promoting education and awareness among pedestrians and drivers. The findings and suggested measures could help policymakers and practitioners develop effective strategies and interventions to reduce the severity of these incidents and enhance pedestrian safety.

A Hybrid of Random Forests and Generalized Path Analysis: A Causal Modeling of Crashes in 52,524 Suburban Areas

BACKGROUND

Determining suburban area crashes' risk factors may allow for early and operative safety measures to find the main risk factors and moderating effects of crashes. Therefore, this paper has focused on a causal modeling framework.

STUDY DESIGN

A cross-sectional study.

METHODS

In this study, 52524 suburban crashes were investigated from 2015 to 2016. The hybrid-random-forest-generalized-path-analysis technique (HRF-gPath) was used to extract the main variables and identify mediators and moderators.

RESULTS

This study analyzed 42 explanatory variables using a RF model, and it was found that collision type, distinct, driver misconduct, speed, license, prior cause, plaque description, vehicle maneuver, vehicle type, lighting, passenger presence, seatbelt use, and land use were significant factors. Further analysis using g-Path demonstrated the mediating and predicting roles of collision type, vehicle type, seatbelt use, and driver misconduct. The modified model fitted the data well, with statistical significance ( χ230 =81.29, P<0.001) and high values for comparative-fit-index and Tucker-Lewis-index exceeding 0.9, as well as a low root-mean-square-error-of-approximation of 0.031 (90% confidence interval: 0.030-0.032).

CONCLUSION

The results of our study identified several significant variables, including collision type, vehicle type, seatbelt use, and driver misconduct, which played mediating and predicting roles. These findings provide valuable insights into the complex factors that contribute to collisions via a theoretical framework and can inform efforts to reduce their occurrence in the future.

Characteristics of Crashes Caused by Distracted Driving on Rural and Suburban Roadways in Jordan

The objective of this study was to identify the most salient driver faults that cause crashes on some Jordanian rural and suburban roadway segments, to examine crashes with distracted driving as the driver’s fault, and to investigate the differences between crashes caused by distracted driving. Data for more than 10,200 crashes on nine roadway segments (five rural and four suburban) were accessed from the relevant government agency, but only n = 2472 were used for analysis after controlling for crashes specified as being caused by drivers’ distracted driving. IBM SPSS version 22 was used to perform descriptive analysis and independent samples’ t-tests. The results revealed that distracted driving was the second most common driver fault to cause crashes and the second main cause of fatalities and injuries on both rural and suburban roadways. Distracted driving on rural highways appears to be more fatal, whereas it caused more crashes with severe injuries on suburban roads. The variables at junction, road grade, number of lanes, weather condition, crash type, and number of vehicles involved were found to be statistically significant but with a small effect size. The following categories showed high percentages of distracted driving crashes on rural and suburban roadways: males, drivers 25–39 years old, non-holidays, weekdays, tangent sections, two-way divided roads, not at junction, level roads, two-lane roads, clear weather, dry surface, daylight, and automobile vehicles showed high percentages of distracted driving crashes on rural and suburban roadways. Differences between crashes on rural and suburban roadways caused by distracted driving were found to be small.

Differences in rural and urban drivers' attitudes and beliefs about seat belts

In the United States, a disproportionate number of motor vehicle crash fatalities occur in rural areas. While many factors likely contribute to the discrepancy between fatality rates in rural and urban areas, prior studies suggest that rural drivers may be more likely to engage in risky driving behaviors like seat belt non-use. Although having favorable attitudes or beliefs about seat belts increases the likelihood of wearing them, few studies have investigated the possibility that lower rates of seat belt use in rural areas may result from a greater prevalence of unfavorable seat belt attitudes and beliefs-one part of a distinct rural "traffic safety culture." In the current study, we analyzed responses from the 2016 Motor Vehicle Occupant Safety Survey (MVOSS) to test the hypotheses that rural drivers are more likely than urban drivers to hold unfavorable attitudes and beliefs about seat belts, and that these unfavorable attitudes and beliefs predict lower self-reported seat belt use. We found that rural and urban drivers differed significantly on several seat belt attitudes and beliefs and that these differences persisted after controlling for possible demographic differences between rural and urban drivers. We also found that drivers who hold less favorable attitudes and beliefs were less likely to always wear their seat belts. However, even after accounting for demographic factors and differences in attitudes and beliefs, rural drivers continued to be less likely to report full-time seat belt use than urban drivers. Our findings suggest that rural drivers should be treated as a distinct market segment for seat belt messaging and public awareness campaigns, and that interventions designed to change the unfavorable attitudes and beliefs about seat belts held by rural drivers may help reduce the disparity between rural and urban traffic fatality rates.

The relationship between geographic location and outcomes following injury: A scoping review

INTRODUCTION

Globally, injury incidence and injury-fatality rates are higher in regional and remote areas. Recovery following serious injury is complex and requires a multi-disciplinary approach to management and community re-integration to optimise outcomes. A significant knowledge gap exists in understanding the regional variations in hospital and post-discharge outcomes following serious injury. The aim of this study was to review the evidence exploring the association between the geographic location, including both location of the event and place of residence, and outcomes following injury.

MATERIALS AND METHODS

A scoping review was used to investigate this topic and provide insight into geographic variation in outcomes following traumatic injury. Seven electronic databases and reference lists of relevant articles were searched from inception to October 2018. Studies were included if they measured injury-related mortality, outcomes associated with hospital admission, post-injury physical or psychological function and analysed these outcomes in relation to geographic location.

RESULTS

Of the 2,213 studies identified, 47 studies were included revealing three key groups of outcomes: mortality (n = 35), other in-hospital outcomes (n = 8); and recovery-focused outcomes (n = 12). A variety of measures were used to classify rurality across studies with inconsistent definitions of rurality/remoteness. Of the studies reporting injury-related mortality, findings suggest that there is a greater risk of fatality in rural areas overall and in the pre-hospital phase. For those patients that survived to hospital, the majority of studies included identified no difference in mortality between rural and urban patient groups. In the small number of studies that reported other in-hospital and recovery outcomes no consistent trends were identified.

CONCLUSION

Rural patients had a higher overall and pre-hospital mortality following injury. However, once admitted to hospital, there was no significant difference in mortality. Inconsistencies were noted across measures of rurality measures highlighting the need for more specific and consistent international classification methods. Given the paucity of data on the impact of geography on non-mortality outcomes, there is a clear need to develop a larger evidence base on regional variation in recovery following injury to inform the optimisation of post-discharge care services.

Injury Severity and Contributing Driver Actions in Passenger Vehicle-Truck Collisions

Large-scale truck-involved crashes attract great attention due to their increasingly severe injuries. The majority of those crashes are passenger vehicle–truck collisions. This study intends to investigate the critical relationship between truck/passenger vehicle driver’s intentional or unintentional actions and the associated injury severity in passenger vehicle–truck crashes. A random-parameter model was developed to estimate the complicated associations between the risk factors and injury severity by using a comprehensive Virginia crash dataset. The model explored the unobserved heterogeneity while controlling for the driver, vehicle, and roadway factors. Compared with truck passengers, occupants in passenger vehicles are six times and ten times more likely to suffer minor injuries and serious/fatal injuries, respectively. Importantly, regardless of whether passenger vehicle drivers undertook intentional or unintentional actions, the crashes are more likely to associate with more severe injury outcomes. In addition, crashes occurring late at night and in early mornings are often correlated with more severe injuries. Such associations between explanatory factors and injury severity are found to vary across the passenger vehicle–truck crashes, and such significant variations of estimated parameters further confirmed the validity of applying the random-parameter model. More implications based on the results and suggestions in terms of safe driving are discussed.

A study of fatal pedestrian crashes at rural low-volume road intersections in southwest China

OBJECTIVE

Although intersections correspond to a small proportion of the entire roadway system, they account for a disproportionally high number of fatal pedestrian crashes, especially on rural roads situated in low- and middle-income countries. This article examines pedestrian safety at rural intersections and suggests applicable accident prevention treatments by providing an in-depth analysis of 28 fatal pedestrian crashes from 8 low-volume roads in southwest China.

METHODS

The driving reliability and error analysis method (DREAM) is a method to support a systematic classification of accident causation information and to facilitate aggregation of that information into patterns of contributing factors. This is the first time that DREAM was used to analyze pedestrian-vehicle crashes and provide suggestions for road improvements in China.

RESULTS

The key issues adversely affecting pedestrian safety can be organized in 4 distinctive thematic categories, namely, deficient intersection safety infrastructure, lack of pedestrian safety education, inadequate driver training, and insufficient traffic law enforcement. Given that resources for traffic safety investments in rural areas are limited, it is determined that the potential countermeasures should focus on low-cost, easily implementable, and long-lasting measures increasing the visibility and predictability of pedestrian movement and reducing speeding and irresponsible driving among drivers and risk-taking behaviors among pedestrians.

CONCLUSIONS

Accident prevention treatments are suggested based on their suitability for rural areas in southwest China. These countermeasures include introducing better access management and traffic calming treatments, providing more opportunities for pedestrian education, and enhancing the quality of driver training and traffic law enforcement.

The Association between Regional Environmental Factors and Road Trauma Rates: A Geospatial Analysis of 10 Years of Road Traffic Crashes in British Columbia, Canada

Background

British Columbia, Canada is a geographically large jurisdiction with varied environmental and socio-cultural contexts. This cross-sectional study examined variation in motor vehicle crash rates across 100 police patrols to investigate the association of crashes with key explanatory factors.

Methods

Eleven crash outcomes (total crashes, injury crashes, fatal crashes, speed related fatal crashes, total fatalities, single-vehicle night-time crashes, rear-end collisions, and collisions involving heavy vehicles, pedestrians, cyclists, or motorcyclists) were identified from police collision reports and insurance claims and mapped to police patrols. Six potential explanatory factors (intensity of traffic law enforcement, speed limits, climate, remoteness, socio-economic factors, and alcohol consumption) were also mapped to police patrols. We then studied the association between crashes and explanatory factors using negative binomial models with crash count per patrol as the response variable and explanatory factors as covariates.

Results

Between 2003 and 2012 there were 1,434,239 insurance claim collisions, 386,326 police reported crashes, and 3,404 fatal crashes. Across police patrols, there was marked variation in per capita crash rate and in potential explanatory factors. Several factors were associated with crash rates. Percent roads with speed limits ≤ 60 km/hr was positively associated with total crashes, injury crashes, rear end collisions, and collisions involving pedestrians, cyclists, and heavy vehicles; and negatively associated with single vehicle night-time crashes, fatal crashes, fatal speeding crashes, and total fatalities. Higher winter temperature was associated with lower rates of overall collisions, single vehicle night-time collisions, collisions involving heavy vehicles, and total fatalities. Lower socio-economic status was associated with higher rates of injury collisions, pedestrian collisions, fatal speeding collisions, and fatal collisions. Regions with dedicated traffic officers had fewer fatal crashes and fewer fatal speed related crashes but more rear end crashes and more crashes involving cyclists or pedestrians. The number of traffic citations per 1000 drivers was positively associated with total crashes, fatal crashes, total fatalities, fatal speeding crashes, injury crashes, single vehicle night-time crashes, and heavy vehicle crashes. Possible explanations for these associations are discussed.

Conclusions

There is wide variation in per capita rates of motor vehicle crashes across BC police patrols. Some variation is explained by factors such as climate, road type, remoteness, socioeconomic variables, and enforcement intensity. The ability of explanatory factors to predict crash rates would be improved if considered with local traffic volume by all travel modes.

Emergency Department-Based Brief Intervention to Reduce Risky Driving: A Life Course Perspective

Screening, Brief Intervention, and Referral to Treatment (SBIRT) has promise as a clinical intervention for health-compromising behaviors. We used a randomized controlled design in an Emergency Department (ED) setting to determine the efficacy of a nurse-delivered SBIRT to address risky driving in people 18 to 44 years of age. Risky drivers (n = 476) were randomized to brief intervention (BIG), contact-control (CCG), or no-contact-control (NCG) groups and were followed at 3, 6, 9, and 12 months. Outcomes included safety belt use, speeding, and driving through traffic lights. Safety belt use, times speeding between 10 and 19 mph over speed limit, and times driving through a yellow light declined significantly in the BIG as compared with the CCG at 3, 6, and 9 months. SBIRT reduced risky driving in our sample, but its effects did not persist after 9 months. We suggest that SBIRT has the potential to reduce vehicular-related injury in the 9 months after a brief intervention.

Emergency department-based brief intervention to reduce risky driving and hazardous/harmful drinking in young adults: a randomized controlled trial

BACKGROUND

Risky driving and hazardous drinking are associated with significant human and economic costs. Brief interventions for more than one risky behavior have the potential to reduce health-compromising behaviors in populations with multiple risk-taking behaviors such as young adults. Emergency department (ED) visits provide a window of opportunity for interventions meant to reduce both risky driving and hazardous drinking.

METHODS

We determined the efficacy of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocol addressing risky driving and hazardous drinking. We used a randomized controlled trial design with follow-ups through 12 months. ED patients aged 18 to 44 who screened positive for both behaviors (n = 476) were randomized to brief intervention (BIG), contact control (CCG), or no-contact control (NCG) groups. The BIG (n = 150) received a 20-minute assessment and two 20-minute interventions. The CCG (n = 162) received a 20-minute assessment at baseline and no intervention. The NCG (n = 164) were asked for contact information at baseline and had no assessment or intervention. Outcomes at 3, 6, 9, and 12 months were self-reported driving behaviors and alcohol consumption.

RESULTS

Outcomes were significantly lower in BIG compared with CCG through 6 or 9 months, but not at 12 months: Safety belt use at 3 months (adjusted odds ratio [AOR], 0.22; 95% confidence interval [CI], 0.08 to 0.65); 6 months (AOR, 0.13; 95% CI, 0.04 to 0.42); and 9 months (AOR, 0.18; 95% CI, 0.06 to 0.56); binge drinking at 3 months (adjusted rate ratio [ARR] 0.84; 95% CI, 0.74 to 0.97) and 6 months (ARR, 0.81; 95% CI, 0.67 to 0.97); and ≥5 standard drinks/d at 3 months (AOR, 0.43; 95% CI, 0.20 to 0.91) and 6 months (AOR, 0.41; 95% CI, 0.17 to 0.98). No substantial differences were observed between BIG and NCG at 12 months.

CONCLUSIONS

Our findings indicate that SBIRT reduced risky driving and hazardous drinking in young adults, but its effects did not persist after 9 months. Future research should explore methods for extending the intervention effect.

An examination of the environmental, driver and vehicle factors associated with the serious and fatal crashes of older rural drivers

Motor vehicle crashes involving rural drivers aged 75 years and over are more than twice as likely to result in a serious or fatal injury as those involving their urban counterparts. The current study examined some of the reasons for this using a database of police-reported crashes (2004-2008) to identify the environmental (lighting, road and weather conditions, road layout, road surface, speed limit), driver (driver error, crash type), and vehicle (vehicle age) factors that are associated with the crashes of older rural drivers. It also determined whether these same factors are associated with an increased likelihood of serious or fatal injury in younger drivers for whom frailty does not contribute to the resulting injury severity. A number of environmental (i.e., undivided, unsealed, curved and inclined roads, and areas with a speed limit of 100km/h or greater) and driver (i.e., collision with a fixed object and rolling over) factors were more frequent in the crashes of older rural drivers and additionally associated with increased injury severity in younger drivers. Moreover, when these environmental factors were entered into a logistic regression model to predict whether older drivers who were involved in crashes did or did not sustain a serious or fatal injury, it was found that each factor independently increased the likelihood of a serious or fatal injury. Changes, such as the provision of divided and sealed roads, greater protection from fixed roadside objects, and reduced speed limits, appear to be indicated in order to improve the safety of the rural driving environment for drivers of all ages. Additionally, older rural drivers should be encouraged to reduce their exposure to these risky circumstances.

Assessing the role of pavement macrotexture in preventing crashes on highways

OBJECTIVE

The objective of this article is to assess the role of pavement macrotexture in preventing crashes on highways in the State of North Carolina.

METHODS

Laser profilometer data obtained from the North Carolina Department of Transportation (NCDOT) for highways comprising four corridors are processed to calculate pavement macrotexture at 100-m (approximately 330-ft) sections according to the American Society for Testing and Materials (ASTM) standards. Crash data collected over the same lengths of the corridors were integrated with the calculated pavement macrotexture for each section. Scatterplots were generated to assess the role of pavement macrotexture on crashes and logarithm of crashes. Regression analyses were conducted by considering predictor variables such as million vehicle miles of travel (as a function of traffic volume and length), the number of interchanges, the number of at-grade intersections, the number of grade-separated interchanges, and the number of bridges, culverts, and overhead signs along with pavement macrotexture to study the statistical significance of relationship between pavement macrotexture and crashes (both linear and log-linear) when compared to other predictor variables.

RESULTS

Scatterplots and regression analysis conducted indicate a more statistically significant relationship between pavement macrotexture and logarithm of crashes than between pavement macrotexture and crashes. The coefficient for pavement macrotexture, in general, is negative, indicating that the number of crashes or logarithm of crashes decreases as it increases. The relation between pavement macrotexture and logarithm of crashes is generally stronger than between most other predictor variables and crashes or logarithm of crashes.

CONCLUSIONS

Based on results obtained, it can be concluded that maintaining pavement macrotexture greater than or equal to 1.524 mm (0.06 in.) as a threshold limit would possibly reduce crashes and provide safe transportation to road users on highways.

Risk and type of crash among young drivers by rurality of residence: findings from the DRIVE Study

BACKGROUND

Most previous literature on urban/rural differences in road crashes has a primary focus on severe injuries or deaths, which may be largely explained by variations of medical resources. Little has been reported on police-reported crashes by geographical location, or crash type and severity, especially among young drivers.

METHODS

DRIVE is a prospective cohort study of 20,822 drivers aged 17-24 in NSW, Australia. Information on risk factors was collected via online questionnaire and subsequently linked to police-reported crashes. Poisson regression was used to analyse risk of various crash types by three levels of rurality of residence: urban, regional (country towns and surrounds) and rural.

RESULTS

Compared to urban drivers, risk of crash decreased with increasing rurality (regional adjusted RR: 0.7, 95% CI 0.6-0.9; rural adjusted RR: 0.5, 95% CI 0.3-0.7). Among those who crashed, risk of injurious crash did not differ by geographic location; however, regional and rural drivers had significantly higher risk of a single versus multiple vehicle crash (regional adjusted RR 1.8, 95% CI 1.3-2.5; rural adjusted RR: 2.0, 95% CI 1.1-3.6), which was explained by speeding involvement and road alignment at the time or site of crash.

CONCLUSIONS

Although young urban drivers have a higher crash risk overall, rural and regional residents have increased risk of a single vehicle crash. Interventions to reduce single vehicle crashes should aim to address key issues affecting such crashes, including speeding and specific aspects of road geometry.