Moped Collisions among Patients with Revoked Drivers’ Licenses are a Significant Public Health Problem: A Retrospective Cohort Study

Many states do not require a license to operate a moped, defined as a motor vehicle with less than 50-cc engine displacement. These vehicles may therefore serve as a mode of transportation for those who are driving without a license and who may have a history of prior high-risk behavior. We hypothesized that those involved in moped collisions were more likely to have previous convictions for driving while intoxicated (DWI) and other non-DWI offenses than those on conventional motorcycles. At a Level I trauma center, we queried the trauma registry from January 2005 to October 2010 for admissions after motorcycle or moped collisions. Classification of mechanism of injury was verified through chart review. Corrections databases from our state were then reviewed for previous convictions for DWI and other offenses. One thousand seventy-three patients over the study period were involved in motorcycle or moped collisions; 94 were from another state. Of the patients identified from our state, 249 had moped collisions and 730 had motorcycle collisions. Forty-nine per cent (121) of moped drivers had a history of DWI versus only 8 per cent (56) of motorcycle drivers ( P ≤ 0.05). Sixty-four per cent (161) of moped drivers were previously convicted of a crime versus 20 per cent (146) of those on motorcycles ( P ≤ 0.05). Moped drivers were significantly more likely to have a prior conviction of DWI as well as prior convictions of other crimes, establishing a pattern of disregard for the law. The use of these vehicles without a license likely presents a risk to public safety. Legislation to require licensing before moped operation should be considered.

Adult moped-related injuries treated in U.S. emergency departments

Objective: Few studies have investigated U.S. emergency department (ED) moped-related injuries. Our objective was to determine the characteristics of moped crashes among adult riders and to identify associations between key variables.Methods: Data were obtained from the National Electronic Injury Surveillance System (NEISS) for 2002-2014. Descriptive and comparative analyses of the identified cases were performed.Results: Based on a probability sample of 2,453 cases, an estimated 108,229 U.S. adult moped-related ED visits occurred during the study period. Injuries increased 2.7-fold over time. Summer months and weekdays were the most common crash times. Three-fourths of injured riders were male, two-thirds were ages 23-59 years, and 77% were Caucasian. Among cases documented, one-half were helmeted, and almost two-thirds of crashes occurred at ≤20 mph. The predominant mechanism was a non-collision crash (60%). Skin-related and musculoskeletal diagnoses were most common. Almost one-fifth of patients were admitted or transferred. Regression analyses showed that males were less likely than females to be in crashes with multiple riders, and more likely to have used alcohol/drugs and to be in a crash with another motor vehicle (MVC). Older riders (≥40 years) were more likely than those younger to have used alcohol/drugs and to suffer torso injuries, and less likely to be in an MVC. As compared to other crash mechanisms, MVCs were more likely to involve injuries to the head/neck/face and torso. The likelihood of being admitted/transferred was higher for males, with increasing age, and for collision-related crashes. The higher likelihood of being admitted/transferred was also characterized by alcohol/drug use, by lower limb and torso injuries, and almost 8 times more likely for riders with serious head injuries.Conclusions: Moped injuries increased in all adult age groups during the study period. However, there were significant differences in contributing factors, crash mechanism, and outcomes by sex, race, and age. These findings suggest the need for targeted injury prevention interventions.

MOPEDS: The high cost of cheap and poorly legislated transportation for negligent drivers

INTRODUCTION

This study evaluates the impact of moped crashes in North Carolina, a state with lenient moped legislation by(1) describing the characteristics of moped crashes and (2) estimating the cost burden of moped-related injuries.

METHODS

Health and public records of moped crash subjects treated at our hospital were reviewed. Direct costs were billed hospital charges. Indirect costs based on age and outcomes were calculated.

RESULTS

Between 2008-2013, 368 subjects were involved in 373 moped crashes. 52% of drivers were intoxicated. 38% of drivers had prior DWIs and 26% had prior revoked licenses. Hospitalized subjects (n = 305) had a combined 2687 hospital days, 695 ICU days and 449 trips to the operating room for treatment of their injuries. Average hospital charges were $70,561 per subject. Total direct and indirect costs of moped injuries were over $26 million and $81 million respectively. Medicaid absorbed most of the direct cost ($13.7 M). Estimated direct cost of moped crashes across the state totaled $133 million.

CONCLUSION

Healthcare and financial ramifications of moped collisions are substantial. Laws governing moped drivers and stricter penalties for intoxicated drivers are needed.

Moped Crashes are Just as Dangerous as Motorcycle Crashes

Mopeds’ (MP) limited speed gives the impression that they are safer than motorcycles (MCs), but factors other than speed may contribute to crash outcome. Records of patients involved in MC or MP crashes evaluated at the University of Louisville Hospital emergency department between 2010 and 2014 were reviewed. Among patients who required hospital admission, the frequency of rib fractures, hemo- or pneumothorax, abdominal injury, extremity injury, and vertebral body fractures were greater in the MC group, whereas head and facial injuries were more common in the MP group. Positive toxicology screens were equivalent (MC 51.8% vs MP 56.8%, P = 0.25), and fewer MP riders wore helmets (33.8% vs 9.2%, P < 0.01). The injury severity score for MC was higher (15.2 vs 13.9, P = 0.039), but mortality was equivalent between groups (7.5 vs 7.6%, P = 0.98). Among patients discharged from the emergency department with minor injuries, frequency of all injury types were equivalent. Although MC patients had a statistically higher injury severity score, differences were clinically similar with equal mortality rate. Moped riders are just as likely to suffer death or serious injury after a crash compared with MC riders, and injury prevention efforts should be aimed at both groups.

How Postmortem Redistribution of MDMA in Acute Alcohol-MDMA Combined-Use Rats Change under Effects of Alcohol

MDMA is often taken recreationally with alcohol as combined-use. The objective was to determine MDMA postmortem redistribution (PMR) and corresponding effects in combined-style under different storage conditions. Steps were 20%-mixture of alcohol-water for initial 4 weeks to Group-A&B and intragastric infusions of MDMA (150 mg/kg) to Group-A later; in the same time, drinking pure water to Group-C&D first and then MDMA-fed to Group-C. The sacrificed rats were kept under different conditions for 10-d, during which the body fluids and tissues were collected on 15 continuous time-points and then detected. The MDMA concentrations were quite different along with postmortem interval (PMI) went by; the area under concentration-PMI curve significantly increased with combined-alcohol in comparison to MDMA alone, while that significantly decreased by lowering preservation temperature, allied with corresponding humidity. Combined-alcohol could exacerbate PMR of MDMA, as concentrations of combined-use rats’ samples were quite higher than mono-MDMA ones under any conditions, while different for body fluids and tissues; meanwhile lowering storage temperature could alleviate effects of alcohol. The study implies that in case of combined-use, the changes of concentrations are probably effected by some combined component, especially when come to identification of toxic level or even death.

Increase in moped injuries requiring emergency care

BACKGROUND

There has been a marked increased in moped use over the past few years. In addition, there has been an increase in moped-related injuries presenting to the emergency department (ED). The objective of this study is to characterize moped-related injuries presenting to US EDs and obtain national estimates of moped injury incidence over time.

METHODS

Data regarding moped injuries were queried from the National Electronic Injury Surveillance System from calendar year 2007 to 2015. Data included diagnosis, body part injured, ED disposition, and patient demographics.

RESULTS

There were an estimated 114 729 moped-related injuries treated in US EDs from 2007 to 2015 (95% confidence interval, 102 156-127 302). In addition, there was an increase in the number of moped injuries annually (B = 762.1, P < .01). The average number of moped injuries yearly was 12 748. The mean age was 34 years. Patients between ages 19 and 38 years represented 42% of the study population. Men (74%) and whites (55%) accounted for most of the injured population. Most injuries were stabilized in the ED and discharged home (85%). Approximately 9% of injuries were admitted to the hospital, and fractures constituted 59% of all diagnoses admitted to the hospital. Contusions (27%) and fractures (24%) accounted for most diagnoses. The most common body part injured was the head (16%).

CONCLUSIONS

Moped injuries have increased since 2007 and mopeds are associated with severe injuries. Education and reexamination of current moped laws may decrease the number and severity of moped-related injuries.

Prevalence of alcohol and drugs among motorcycle riders killed in road crashes in Norway during 2001-2010

The aim of the study was to examine the prevalence of alcohol and drugs in blood samples from motorcycle riders who died in road crashes in Norway from 2001 to 2010. An additional aim was to compare the prevalence of alcohol and drugs in blood samples from fatally injured motorcycle riders and car drivers who died during the same time period. Blood samples from motorcycle riders who died within 24h after the accident (n=207, 63% of all killed riders), were analysed for alcohol, psychoactive drugs (medicinal and illicit drugs). The cut-off concentrations for alcohol and drugs findings in blood samples (i.e., the drug concentrations above which a finding was regarded as positive) were set according to the legislative limits under the Norwegian Road Traffic Act. Results were assessed in relation to age, sex, time of the day and week, and single versus multiple-vehicle accidents. Alcohol or drugs were found in 27.1 percent of all investigated riders. For riders killed in single or multiple-vehicle accidents, alcohol or drugs were found in 44.6 and 15.3 percent, respectively. Alcohol was the most frequently found substance for all age groups and most prevalent in samples from riders below 25 years who died in single-vehicle accidents (45.8 percent). Drugs were most often found among riders between 25 and 34 years (19.6 percent in total and 25.9% for those killed in single-vehicle crashes). The prevalence of alcohol or drugs was highest among riders killed in single-vehicle accidents during weekend days and nights (60.9 and 65.2 percent). Alcohol and drugs were less often found in samples from killed motorcycles riders than in samples from car and van drivers (40.2 percent). For single-vehicle accidents, the total prevalence of alcohol or drugs among killed motorcycles riders and car drivers was 44.6 percent and 63.8 percent, respectively. The same pattern of alcohol and drugs was found among the two groups, except that the prevalence among motorcycle riders was lower compared to car drivers in all age groups and time periods, which may be related to the fact that they are more vulnerable for fatal injury compared to car drivers in similar accidents.

A comparison of injuries to moped/scooter and motorcycle riders in Queensland, Australia

BACKGROUND

The popularity of moped and motor scooter riding in Australia is increasing. However, there is a paucity of information about their safety, especially in comparison to motorcycle riding where riders require specific licensing, education and training. Given it is widely established that motorcycle riders are overrepresented in road injury statistics, consideration of moped and scooter riders as a sub-group of all motorcyclists is required for accurate understanding of injury patterns and the acute care needs of this group.

METHOD

A comparison of demographic, injury and acute care characteristics between seriously injured moped/scooter riders and motorcycle riders was undertaken using data from the state-wide trauma registry in Queensland, Australia, from 2006 to 2010.

RESULTS

A total of 206 moped/scooter riders and 2667 motorcycle riders were identified. Motorcycle rider injury admissions significantly decreased over time (p<0.01), whereas no change was observed for injured moped/scooter riders. Moped/scooter riders sustained a greater percentage of head/neck (+8.6%), facial (+3.0%) and abdominal injuries (+2.3%), whereas motorcycle riders sustained a greater percentage of upper extremity (+4.0%), thoracic (+3.9%), spinal (+3.6%) and lower extremity injuries (+2.6%). There was no statistically significant difference in injury severity, length of acute hospital stay, admission to ICU or survival to discharge from acute care between injured moped/scooter riders and motorcycle riders.

CONCLUSION

The results of this study suggest that riders of mopeds/scooters and motorcycles may have different injury patterns, but sustain similar overall injury severity. This analysis fills a gap in transport crash data, where there is limited information on the nature of injuries sustained. While moped-related injuries cannot be isolated in ICD-10 health coding, it is anticipated that ICD-11, due for release in 2015, may provide a moped-specific code; however, this will not address the issue of the apparent interchangeable use of the terms 'moped' and 'scooter' when reporting or documenting such injuries in health data systems including the medical record. Improved identification of moped-related cases in health data is required to increase potential for linkage across health and transport crash data, which may be used for further evaluation of injuries sustained by moped and scooter riders.