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Siebert FW, Riis C, Janstrup KH, Lin H, Hüttel FB. Computer vision-based helmet use registration for e-scooter riders - The impact of the mandatory helmet law in Copenhagen. J Safety Res 2023; 87:257-265. [PMID: 38081699 DOI: 10.1016/j.jsr.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 08/13/2023] [Accepted: 09/21/2023] [Indexed: 12/18/2023]
Abstract
PROBLEM E-scooters are a new form of mobility used more frequently in urban environments worldwide. As there is evidence of an increased risk of head injuries, helmets are recommended and (less frequently) legislated. Denmark has enacted mandatory e-scooter helmet use legislation from January 1, 2022. So far, it is unclear how this newly implemented law influenced helmet use of e-scooter riders in Denmark immediately after its implementation. METHOD In this observational study, we register and compare e-scooter helmet use before the mandatory helmet use legislation (December 2021) and after (February 2022). As observational survey data collection in the field can be highly time-consuming, we conducted a video-based observation survey. We trained and applied a computer vision algorithm to automatically register e-scooter helmet use in the video data. RESULTS The trained algorithm produces accurate helmet use data, which does not differ significantly from human-registered helmet use. In applying the algorithm to video data collected in December 2021 and February 2022, we register an overall e-scooter helmet use of 4.4% in n = 1054 riders. Splitting the observation between the time before and after the implementation of the helmet use law reveals a significant increase in helmet use from 1.80% to 5.56%. DISCUSSION In this study, we successfully train and apply an object detection algorithm to register accurate helmet use data in videos collected in Copenhagen, Denmark. Using this algorithm, we find a significant impact of a new mandatory e-scooter helmet use law on e-scooter riders' helmet use behavior. Limitations of the study as well as future research needs, are discussed. PRACTICAL APPLICATIONS Computer vision algorithms can be used for accurate e-scooter helmet assessments. Implementing a mandatory helmet use law can increase helmet use of e-scooters at specific observation sites.
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Affiliation(s)
- Felix Wilhelm Siebert
- DTU Management, Technical University of Denmark, Bygningstorvet 116, Kgs. Lyngby 2800, Denmark.
| | - Christoffer Riis
- DTU Management, Technical University of Denmark, Bygningstorvet 116, Kgs. Lyngby 2800, Denmark
| | - Kira Hyldekær Janstrup
- DTU Management, Technical University of Denmark, Bygningstorvet 116, Kgs. Lyngby 2800, Denmark
| | - Hanhe Lin
- School of Science and Engineering, University of Dundee, Nethergate, Dundee DD1 4HN, Scotland, United Kingdom
| | - Frederik Boe Hüttel
- DTU Management, Technical University of Denmark, Bygningstorvet 116, Kgs. Lyngby 2800, Denmark
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Jahangiry L, Eisazadeh S, Khabiri R, Sadeghi-Bazargani H, Bakhtari-Aghdam F, Ponnet K. Health Promotion Interventions on Helmet Use: A Systematic Review and Meta-Analysis of Pre-Test and Post-Test Studies. Iran J Public Health 2023; 52:1866-1876. [PMID: 38033843 PMCID: PMC10682586 DOI: 10.18502/ijph.v52i9.13569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/19/2022] [Indexed: 12/02/2023]
Abstract
Background We aimed to review the effectiveness of health promotion interventions in the use of helmet and to identify the types of effective health promotion strategies among the examined studies. Methods A systematic search was performed on the PubMed, Scopus, Cochrane, and Embase databases up to 1 Aug 2022 to find the studies evaluated the effectiveness of health promotion interventions for helmet use among target population. In this systematic review and meta-analysis, interventions with pre- post-test design were included. The dependent variable of the study is the percentage of participants who responded positively toward helmet use in the baseline and after the interventions. Random-effects models were used to pool study results. Results Overall, 1,675 articles were found in the initial search and entered into the Endnote software. Of these, 917 duplicate articles were removed, leaving 758 articles were screened based on title and abstract. Finally, 12 eligible articles were included in the review and five with pre and post-test design were included in the meta-analysis. The overall random-effects pooled estimation of persons wearing helmets before and after interventions was 70% (95%CI 21 -119; P<0.001), without a heterogeneity (I2 =0%; P=0.94), which means that the average percentage of changing to helmet use is 70%. Community-based education program was the most commonly applied for interventional studies. The next most commonly used approaches were campaign designing. Conclusion Wearing helmet approximately increased 70% among participant. Health promotion strategies may target helmet-wearing behavior to reduce head injuries in motorcyclist road traffic accidents.
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Affiliation(s)
- Leila Jahangiry
- Road and Traffic Injury Research Center, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Health Education and Health Promotion, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saber Eisazadeh
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roghayeh Khabiri
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Homayoun Sadeghi-Bazargani
- Road and Traffic Injury Research Center, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Bakhtari-Aghdam
- Department of Health Education and Health Promotion, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Koen Ponnet
- Faculty of Social Sciences, Imec-Mict-Ghent University, Ghent, Belgium
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Rosander A, Breeding T, Ngatuvai M, Alter N, Maka P, Beeton G, Kornblith L, Elkbuli A. National analysis of motorcycle associated injuries and fatalities: Wearing helmet saves lives. Am J Emerg Med 2023; 69:108-113. [PMID: 37086655 DOI: 10.1016/j.ajem.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/20/2023] [Accepted: 04/12/2023] [Indexed: 04/24/2023] Open
Abstract
INTRODUCTION Riding a motorcycle without a helmet represents a public health risk that can result in disabling injuries or death. We aim to provide a comprehensive analysis of the impact of helmet use on motorcycle injuries, injury types, and fatalities, to highlight areas requiring future intervention. METHODS We performed a retrospective cohort study utilizing the American College of Surgeons Trauma Quality Program Participant Use File between 2017 and 2020 analyzing motorcycle associated injuries and fatalities in adult patients with moderate and severe injury severity score in relation to helmet use. Multivariable regressions were utilized and adjusted for potential confounders. A subset analysis was performed for patients presenting with abbreviated injury scale (AIS) head ≥3 and all other body regions ≤2. RESULTS 43,225 patients met study criteria, of which 24,389 (56.4%) were helmet users and 18,836 (43.6%) were not. Helmet use was associated with a 35% reduction in the relative risk of expiring in the hospital due to motorcycle-related injuries (aOR 0.65; 95% CI [0.59-0.70]; p < 0.001) and a decreased intensive care unit length of stay (ICU-LOS) by half a day (B = -0.50; 95% CI [-0.77, -0.24]; p < 0.001). CONCLUSION Motorcycle riders without a helmet had significantly greater odds of increased in-hospital mortality and longer stays in the ICU than those who used a helmet. The results of this nationwide study support the need for continued research exploring the significance of helmet use and interventions aimed at improving helmet usage among motorcyclists. LEVEL OF EVIDENCE Prognostic and epidemiological, level III.
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Affiliation(s)
- Abigail Rosander
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA
| | - Tessa Breeding
- NOVA Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, FL, USA
| | - Micah Ngatuvai
- NOVA Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, FL, USA
| | - Noah Alter
- NOVA Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, FL, USA
| | - Piueti Maka
- John A. Burns School of Medicine, Honolulu, HI, USA
| | - George Beeton
- University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Lucy Kornblith
- Department of Surgery, Division of Trauma and Surgical Critical Care, Zuckerberg Hospital and Trauma Center, San Francisco, CA, USA
| | - Adel Elkbuli
- Department of Surgery, Division of Trauma and Surgical Critical Care, Orlando Regional Medical Center, Orlando, FL, USA; Department of Surgical Education, Orlando Regional Medical Center, Orlando, FL, USA.
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Ahmad S, Rehman L, Afzal A, Javeed F. Outcome of head injury in motorbike riders. Pak J Med Sci 2023; 39:390-394. [PMID: 36950418 PMCID: PMC10025712 DOI: 10.12669/pjms.39.2.6371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 12/26/2022] [Accepted: 01/07/2023] [Indexed: 01/26/2023] Open
Abstract
Objective To determine the impact of helmet wearing on traumatic brain injury. Methods We analyzed 400 cases of traumatic brain injury (TBI) in motorbike riders with and without helmet, from July 2017 to December 2020 presenting to the neurosurgery department at Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan. The medical records were analyzed for CT scan findings, length of hospital stay, complications (mortality and disability), Glasgow Coma Scale (GCS) and Glasgow outcome score (GOS) at time of discharge. Result A total of 400 patients with head injury due to motorbike accidents were included and all were male patients. They were equally divided into two groups, 200 in Group-A (with helmet) and 200 in Group-B (without helmet). Majority of the unhelmeted patients i.e. 102 (51%), needed admission in the Intensive Care Unit (ICU) compared to 70 (35%) in helmeted. When comparing non-helmeted patients to helmeted patients, the total median length of hospital stay was greater among non-helmeted patients (10 vs 05 days). Mortality was higher among non-helmeted patients seen in 50 (25%) as compared to 14 (7%) in helmeted patients. Overall, the good outcome was observed in 119 (59.5%) patients in Group-A as compared to70 (35%) patients in Group-B while 81 (40.5%) showed bad outcome in Group-A and 130 (64%) in Group-B. The failure to wear a helmet was found to be strongly linked with abnormal neuroimaging more complications, poor outcome and lower GCS on discharge as compared to patients using helmet. Conclusion Lack of helmet use is linked to abnormal brain imaging, more complications, and a longer stay in the hospital after a head injury.
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Affiliation(s)
- Shakeel Ahmad
- Dr. Shakeel Ahmad, FCPS., Department of Neurosurgery, Jinnah Postgraduate Medical Center, Rafiqui Shaheed Road, Karachi, Pakistan
| | - Lal Rehman
- Dr. Lal Rehman, FRCS., Department of Neurosurgery, Jinnah Postgraduate Medical Center, Rafiqui Shaheed Road, Karachi, Pakistan
| | - Ali Afzal
- Dr. Ali Afzal, FCPS., Department of Neurosurgery, Nottingham University Hospital, Nottingham, UK
| | - Farrukh Javeed
- Dr. Farrukh Javeed, FCPS., Department of Neurosurgery, Jinnah Postgraduate Medical Center, Rafiqui Shaheed Road, Karachi, Pakistan
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Nichols JC, Sorrentino A, Hayslip M, King W, Jones A, Monroe K. Pediatric injury due to wheeled recreational devices: a single-institution retrospective study. Inj Epidemiol 2022; 9:44. [PMID: 36544196 PMCID: PMC9768874 DOI: 10.1186/s40621-022-00395-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Injuries are the number one cause of death in children and cause significant morbidity. Common scenarios for injury include wheeled recreational devices (WRDs) that allow children to be mobile and independent (example ATV-all terrain vehicles, dirt bikes, bicycles, skateboards, and scooters). We present a case series review of these external causes of injury. This study aims to evaluate epidemiologic trends in WRD injuries and patterns in usage of protective gear. RESULTS A total of 263 patients were identified as meeting criteria for inclusion with the following causes of injuries-103 bicycle, 73 ATV, 27 dirt bike, 14 skateboard, 13 motorcycle, 7 go carts, 3 hover board, 3 roller skates, 1 dune buggy, 1 motor scooter, 1 rip stick, and 1 tractor toy. Ages of patients ranged from 2 to 18 years of age with the greatest range being noted for bicycles (2-17 years) and motorcycles (3-18 years). The mean age was higher for motorcycle and skateboard (12.9 and 11.6, respectively) and lowest for scooter and bicycle (8.3 and 9.2, respectively). The majority of [overall study (97%) and for each mode of transportation] patients were Caucasian, which is in contrast to our overall ED population, which is only 42% Caucasian. The majority of patients were male [190 (72%)]. Over half of the overall patients, 159 of the 263 (60%), were not wearing a helmet (with only 10 charts having no documentation of helmet use). In regard to ATV riders specifically, 58% were not wearing helmets at the time of injury, with an additional 5 patients who reported their helmet came off. The lowest percentage of riders reporting appropriate helmet use was skateboarders with only 21% wearing helmets, and the highest percentage was dirt bike riders with 74% reporting helmet use. CONCLUSION Common scenarios for injury include WRDs that allow children to be mobile and independent. Most of these injuries were found in Caucasian males between the ages of 9-12 with low rates of helmet use. This study adds to the literature with a description of the breadth of products children use and are injured while using.
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Affiliation(s)
- John Charles Nichols
- grid.265892.20000000106344187University of Alabama School of Medicine, 1670 University Blvd, Birmingham, AL 35233 USA
| | - Annalise Sorrentino
- grid.265892.20000000106344187Division of Pediatric Emergency Medicine University of Alabama Birmingham, Department of Pediatrics, University of Alabama School of Medicine, 1600 7th Ave So, Suite 110 CPP, Children’s of Alabama, Birmingham, AL 35233 USA
| | - Margaret Hayslip
- grid.265892.20000000106344187University of Alabama School of Medicine, 1670 University Blvd, Birmingham, AL 35233 USA
| | - William King
- grid.265892.20000000106344187Children’s of Alabama University of Alabama Birmingham, 1600 7th Ave So, Suite 110 CPP, Children’s of Alabama, Birmingham, AL 35233 USA
| | - Angela Jones
- grid.265892.20000000106344187Medical Informatics, Children’s of Alabama University of Alabama Birmingham, 1600 7th Ave So, Suite 110 CPP, Children’s of Alabama, Birmingham, AL 35233 USA
| | - Kathy Monroe
- grid.265892.20000000106344187Division of Pediatric Emergency Medicine University of Alabama Birmingham, Department of Pediatrics, University of Alabama School of Medicine, 1600 7th Ave So, Suite 110 CPP, Children’s of Alabama, Birmingham, AL 35233 USA
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Haworth N, Schramm A, Twisk D. Changes in shared and private e-scooter use in Brisbane, Australia and their safety implications. Accid Anal Prev 2021; 163:106451. [PMID: 34673381 DOI: 10.1016/j.aap.2021.106451] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 09/17/2021] [Accepted: 10/09/2021] [Indexed: 06/13/2023]
Abstract
Shared electric scooter (e-scooter) schemes debuted in US cities in 2017 and have spread to many cities worldwide. Rider inexperience and the inexperience of other road users in interacting with e-scooters may be contributing to injuries. Shared e-scooters came to Brisbane, Australia, in November 2018 and our observational study in February 2019 found a high level of non-compliance with regulations by riders of shared, but not private, e-scooters. This paper examines whether e-scooter safety improved over time by comparing the numbers and behaviors of shared and private e-scooter riders with a follow-up observational study conducted in October 2019. Riders of e-scooters (and bicycles) were counted at six sites in inner-city Brisbane by trained observers over four weekdays. Type of e-scooter (private, Lime, Neuron), helmet use, gender, age group, riding location, time of day and presence of passengers were recorded. The number of shared e-scooters observed dropped from 711 in February to 495 in October but the number of private e-scooters increased from 90 to 269, resulting in a slight reduction in the total number of e-scooters. The correct helmet wearing rate increased non-significantly from 61.4% to 66.8% for shared e-scooters and remained high for riders of private e-scooters (95.5% in February and 94.3% in October). The percentage of e-scooters ridden on the road (which is illegal in central Brisbane) remained roughly the same (shared: 6.6% in February, 4.2% in October; private: 4.5% in February, 4.9% in October). The percentage of children and adolescents (illegally) riding shared e-scooters fell from 10.3% to 6.7%. The prevalence of any of these illegal behaviors among shared e-scooter riders fell significantly for shared e-scooter riders from 49.6% to 39.1% while the prevalence of illegal behaviors by other riders remained lower and did not change. The reduction in illegal behavior among shared e-scooter riders accompanied by the tripling of usage of private e-scooters suggests that e-scooter safety is likely to have improved.
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Affiliation(s)
- Narelle Haworth
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety-Queensland (CARRS-Q), 130 Victoria Park Road, Kelvin Grove, QLD 4059, Australia.
| | - Amy Schramm
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety-Queensland (CARRS-Q), 130 Victoria Park Road, Kelvin Grove, QLD 4059, Australia.
| | - Divera Twisk
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety-Queensland (CARRS-Q), 130 Victoria Park Road, Kelvin Grove, QLD 4059, Australia.
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Howard KA, Griffin SF, Rolke LJ, Sease KK. Factors related to youth self-efficacy for injury prevention bicycle skills. J Safety Res 2021; 79:94-99. [PMID: 34848024 DOI: 10.1016/j.jsr.2021.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 04/15/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Bicycle riding is a common activity for children, but they are prone to bicycle-related injuries. It is well-established that injury prevention measures such as wearing a helmet and correctly riding a bicycle can reduce the severity of an injury and the likelihood of having an accident. However, how to increase bicycle injury prevention behaviors among children, who collectively fail to engage in injury prevention behaviors, is less well understood. Self-efficacy is consistently predictive of injury prevention behavior, making it an important approach to understanding injury prevention skills among this key population. The objective of this study was to explore and identify factors internal to the child as well as factors about his or her environment that predict a child's self-efficacy for injury prevention skills. METHOD Two generalized linear mixed effects models were created from survey data collected from elementary school students (n = 2,255) as part of a school-based bicycle education program. Models focused on self-efficacy for riding a bicycle and self-efficacy for wearing a helmet correctly. RESULTS In both models, road safety knowledge, opportunity for skill building through owning appropriate equipment (a bicycle or helmet), and situation through perception of neighborhood safety were predictive. The analyses reveal these variables as key factors for greater confidence, with feeling safe riding in the neighborhood, in particular, emerging as highly predictive of self-efficacy for injury prevention skills. CONCLUSIONS These findings highlight the interplay of individual and environmental factors within confidence for injury prevention behavior. Given self-efficacy's strong relationship to prevention behavior, these findings indicate actionable strategies. Practical Applications: The key factors highlighted in this study can be used by policymakers to target specific areas (e.g., neighborhood safety) to promote self-efficacy and thus improve injury prevention. These factors can also inform strategies for establishing safety skills in bicycle-safety education programs.
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Affiliation(s)
- Kerry A Howard
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States.
| | - Sarah F Griffin
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Laura J Rolke
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Kerry K Sease
- Bradshaw Institute for Community Child Health & Advocacy, Prisma Health Children's Hospital, Greenville, SC, United States; University of South Carolina School of Medicine Greenville, Greenville, SC, United States
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Botton IN, Takagi D, Shlez A, Yechiam H, Rosenbloom E. Road accidents in children involving light electric vehicles cause more severe injuries than other similar vehicles. Eur J Pediatr 2021; 180:3255-63. [PMID: 33963903 DOI: 10.1007/s00431-021-04089-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 10/21/2022]
Abstract
Road accidents in Israel were responsible for 23% of injuries in pediatric population between 2013 and 2017. In recent years, the massive entrance of e-bike and other light electric vehicles (called collectively LEV) into the roads is significantly changing the epidemiology of road accidents among children. The study aims to describe the causes, injury types, and other epidemiological characteristics of children injured in road accident and compare injuries of LEV to regular bicycles and other light non-electric vehicles (called collectively LNEV). This retrospective study included all referrals to pediatric emergency department due to road accidents, from April 2015 through March 2017. The details of the accidents and injuries were retrieved, and the subjects' characteristics were compared based on vehicle type. A total of 1531 children met the inclusion criteria. The study found that LEV road accidents among children cause more severe injuries than other LNEV in terms of injury severity score (ISS) (mean ISS 5.8 ± 4.9 vs. 4.7 ± 3.6, P = 0.001), head and neck injuries (18.7% vs. 12.9%, respectively, P < 0.05), lower extremities (36.5% vs. 23.9%, P = 0.001), and multisystem injuries (58.6% vs. 31.8%, P < 0.001). The findings of the current study suggest that the use of LEVs is changing the epidemiology of road accidents, which requires adjustments in accident and injury prevention strategies.Conclusion: The study results should encourage authorities to provide appropriate community-based programs to promote helmet use, introduce mandatory training and licensing program for LEV riders, and enhance enforcement. What is Known: • Road accidents are the leading cause of death among children and young adults (5 to 29 years). • In recent years, there is a massive entrance of e-bikes and other light electric vehicles on the roads. What is New: • LEV (light electric vehicle) accidents among children impose more severe injuries than other LNEVs (light non-electric vehicles) in terms of ISS, hospitalizations, and multisystem injuries. • The use of LEV is changing the epidemiology of road accidents. This change requires enhancing accident and injury prevention strategies.
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Wang X, Chen J, Quddus M, Zhou W, Shen M. Influence of familiarity with traffic regulations on delivery riders' e-bike crashes and helmet use: Two mediator ordered logit models. Accid Anal Prev 2021; 159:106277. [PMID: 34246876 DOI: 10.1016/j.aap.2021.106277] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 06/13/2023]
Abstract
Micro-mobility vehicles such as electric bicycles, or e-bikes, are becoming one of the essential transportation modes in metropolitan areas, and most deliveries in large cities are dependent on them. Due to the e-bike's popularity and vulnerability, e-bike crash occurrence has become a major traffic safety problem in many cities across the world; finding the most important human factors affecting e-bike safety has thus been an important recent issue in traffic safety analysis. Since delivery riders are a key group of e-bike users, and since helmet use plays a crucial role in reducing the severity of a crash, this study conducted a city-wide online survey to analyze the helmet usage of 6,941 delivery riders in Shanghai, China. To determine the in-depth mechanisms influencing helmet use and e-bike crash occurrence, including the direct and indirect effects of the relevant factors, two mediator ordered logistic regression models were employed. The mediator ordered logistic model was compared with the traditional logistic regression model, and was found to be superior for modeling indirect as well as direct influencing factors. Results indicate that riders' familiarity with traffic regulations (FTR) is an extremely important variable mediating between the independent variables of riders' educational level and age, and the dependent variables of helmet use and e-bike crashes. Improving riders' FTR can consequently increase helmet use and decrease crash occurrence. Authorities can apply these findings to develop appropriate countermeasures, particularly in legislation and rider training, to improve e-bike safety.
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Affiliation(s)
- Xuesong Wang
- The Key Laboratory of Road and Traffic Engineering, Ministry of Education, China; School of Transportation Engineering, Tongji University, Shanghai 201804, China; Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, China.
| | - Jiawen Chen
- The Key Laboratory of Road and Traffic Engineering, Ministry of Education, China; School of Transportation Engineering, Tongji University, Shanghai 201804, China
| | - Mohammed Quddus
- Transport and Urban Planning Group, School of Architecture, Building and Civil Engineering, Loughborough University, Leicestershire LE11 3TU, UK
| | - Weixuan Zhou
- The Key Laboratory of Road and Traffic Engineering, Ministry of Education, China; School of Transportation Engineering, Tongji University, Shanghai 201804, China
| | - Ming Shen
- Traffic Police Office of Pudong Public Security Bureau, Shanghai 201135, China
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Chalathadka M, Ram B, Amudhan Cr T, Pb R, Pasha AK, Kulkarni S. Prevalence and distribution of maxillofacial trauma in tertiary care centers before/ after motorcycle helmet use law in Sullia, India-A retrospective study. Dent Traumatol 2021; 37:706-709. [PMID: 34042276 DOI: 10.1111/edt.12685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/28/2021] [Accepted: 04/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIMS In India, motorcycles are commonly involved in accidents and traffic rules negligence, most of which include some type of maxillofacial trauma. In September 2019, the rules for motorcycle and helmet use were modified to compulsory use in the state of Karnataka. The aim of this study was to assess the impact of mandatory helmet use on maxillofacial fractures and injuries in Sullia Taluk, Karnataka. MATERIALS AND METHODS The study was based on the information obtained from clinical records in the K.V.G Dental College and the K.V.G Medical College from February 2019 to February 2020. The inclusion criteria were subjects who met with two-wheeler accidents with complete case records and radiological investigations. RESULTS A total of 78 individuals reported with maxillofacial trauma from February 2019 to February 2020. The mean age was 31 ± 14 years. There were 74 (94%) males and 4 (6%) females. Forty-nine cases reported before the mandatory helmet use rule and 29 cases reported after the helmet use rule. There was a 36.3% decrease in the incidence of maxillofacial trauma, 23.5% decrease in fractures, and an 89% reduction in the number of victims who underwent open reduction and internal fixation during the post-law period. CONCLUSION There was a significant reduction in the incidence and severity of maxillofacial trauma after the implementation of the helmet rule.
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Affiliation(s)
| | - Bhargav Ram
- Department of Oral and Maxillofacial Surgery, KVGDCH, Sullia, India
| | | | - Rachana Pb
- Department of Oral and Maxillofacial Surgery, KVGDCH, Sullia, India
| | | | - Sneha Kulkarni
- Department of Oral and Maxillofacial Surgery, KVGDCH, Sullia, India
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Hounkpe Dos Santos B, Glele Ahanhanzo Y, Kpozehouen A, Daddah D, Lagarde E, Coppieters Y. Effect of wearing a helmet on the occurrence of head injuries in motorcycle riders in Benin: a case-control study. Inj Epidemiol 2021; 8:17. [PMID: 33966628 PMCID: PMC8108325 DOI: 10.1186/s40621-021-00311-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/02/2021] [Indexed: 11/10/2022] Open
Abstract
Background In Benin, motorcycles are the main means of transport for road users and are involved in more than half of crashes. This study aims to determine the effect of wearing a helmet on reducing head injuries in road crashes in Benin. Methods This case-control study took place in 2020 and focused on road trauma victims. The sample, consisting of 242 cases (trauma victims with head injuries) for 484 controls (without head injuries), was drawn from a database of traffic crash victims recruited from five hospitals across the country from July 2019 to January 2020. Four groups of independent variables were studied: socio-demographic and economic variables, history, behavioural variables including helmet use and road-related and environmental variables. To assess the shape of the association between the independent variables and the dependent variable, a descending step-by-step binary logistic regression model was performed using an explanatory approach. Results Fewer of the subjects with a head injury were wearing a helmet at the time of the crash 69.8% (95% CI = 63.6–75.6) compared to those without a head injury 90.3% (95% CI = 87.3–92.8). Adjusting for the other variables, subjects not wearing helmets were at greater risk of head injuries (OR = 3.8, 95% CI (2.5–5.7)); the head injury rating was 1.9 (95% CI = 1.2–3.3) times higher in subjects who were fatigued during the crash than among those who were not and 2.0 (95% CI = 1.2–3.3) times higher in subjects with no medical history. Conclusion Failure to wear a helmet exposes motorcyclists to the risk of head injuries during crashes. It is important to increase awareness and better target such initiatives at the subjects most at risk.
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Affiliation(s)
- Bella Hounkpe Dos Santos
- Ecole de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgium. .,Institut Régional de Santé Publique, PB 384, Ouidah, Bénin.
| | | | | | - Donatien Daddah
- Ecole de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgium.,Institut Régional de Santé Publique, PB 384, Ouidah, Bénin
| | | | - Yves Coppieters
- Ecole de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgium
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Bloom MB, Noorzad A, Lin C, Little M, Lee EY, Margulies DR, Torbati SS. Standing electric scooter injuries: Impact on a community. Am J Surg 2021; 221:227-232. [PMID: 32778397 PMCID: PMC7933485 DOI: 10.1016/j.amjsurg.2020.07.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND This study investigates the impact of standing electric scooter-related injuries within an entire integrated hospital system. METHODS We performed a retrospective review of patients involved in standing electric scooter incidents presenting throughout an urban hospital network over a 10 month period. Rates of Google searches of scooter-related terms performed locally were used as a surrogate for ride frequency. Injury, mechanism, and cost data were analyzed. RESULTS Data on 248 patients were reviewed. Twenty-three (9%) were under 18 years old. Loss of balance was the most common cause of injury accounting for nearly half, while tripping over a scooter 14 (6%) affected the elderly disproportionately. Eight (3%) riders wore helmets. All TBI and closed head injuries occurred in unhelmeted patients. Most incidents occurred in the street, only one in a bicycle lane. Facilities costs were greater for patients under the influence of alcohol and marijuana. CONCLUSION Policies related to the use of mandated safety equipment, dedicated bicycle lanes, and the proper storage of empty vehicles should be further investigated.
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Affiliation(s)
- Matthew B Bloom
- Department of Surgery, Division of Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Ali Noorzad
- Department of Orthopedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Carol Lin
- Department of Orthopedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Milton Little
- Department of Orthopedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Ernest Y Lee
- UCLA-Caltech Medical Scientist Training Program, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
| | - Daniel R Margulies
- Department of Surgery, Division of Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Sam S Torbati
- Department of Emergency Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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13
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Wiratama BS, Chen PL, Ma ST, Chen YH, Saleh W, Lin HA, Pai CW. Evaluating the combined effect of alcohol-involved and un-helmeted riding on motorcyclist fatalities in Taiwan. Accid Anal Prev 2020; 143:105594. [PMID: 32474168 DOI: 10.1016/j.aap.2020.105594] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/22/2020] [Accepted: 05/13/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Alcohol-involved riders tend to engage in other risk-taking behaviours such as un-helmeted riding which could further increases injury severity. The combined effect of alcohol-involved and un-helmeted riding on fatal injuries is rarely investigated. This study investigated the interaction effect between blood alcohol concentration and helmet use on fatal injuries. METHODS This study used the National Taiwan Traffic Crash Dataset for the period from 2011 to 2015. Data on road crashes involving a motorcycle and an automobile were extracted and analysed. Multiple logistic regression models were used to calculate the adjusted odds ratio (AOR). We calculated an interaction effect for blood alcohol concentration and helmet use based on STROBE guidelines. RESULTS There were a total of 669,292 motorcyclist casualties; among these casualties, 3459 (0.5 %) motorcyclists sustained fatal injuries. Alcohol-involved riders were 9.47 times (AOR = 9.47; 95 % CI = 8.75-10.25) more likely than sober ones to sustain fatal injuries. Alcohol-involved and un-helmeted riders were approximately 18 times (AOR = 18.1; CI: 15.9-20.4) more likely to sustain fatal injuries than sober and helmeted riders. Riders involved in head-on crashes and approach-turn motorcycle crashes had an increased probability of sustaining fatal injuries by 240 % (AOR = 3.4; 95 % CI = 2.91-4.09) and 132 % (AOR = 2.3; 95 % CI = 2.016-2.67), respectively. CONCLUSIONS This study found that alcohol-involved riding acts synergistically with un-helmeted riding to increase motorcyclist injury severity.
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Affiliation(s)
- Bayu Satria Wiratama
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Epidemiology, Biostatistics and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia.
| | - Ping-Ling Chen
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.
| | - Shiao-Tzu Ma
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.
| | - Yi-Hua Chen
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Emergency Medicine, New Taipei City Hospital, New Taipei City, Taiwan.
| | - Wafaa Saleh
- Transport Research Institute, Edinburgh Napier University, Scotland, United Kingdom; Department of Engineering, Princess Nora bint Abdul Rahman University Riyadh, Saudi Arabia.
| | - Hui-An Lin
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Emergency Medicine, Taipei Medical University Hospital, Taipei City, Taiwan.
| | - Chih-Wei Pai
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.
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Satiennam T, Kumphong J, Satiennam W, Klungboonkrong P, Jaensirisak S, Ratanavaraha V. Change in helmet use behavior enforced by CCTV cameras with automatic helmet use detection system on an urban arterial road. Traffic Inj Prev 2020; 21:494-499. [PMID: 32559159 DOI: 10.1080/15389588.2020.1778170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Many developing countries experience a high death toll among motorcycle users (both drivers and passengers), primarily due to a relatively low rate of helmet use resulting from ineffective helmet law enforcement. The objectives of this study are to explore the change in helmet use behavior due to helmet use enforcement by closed-circuit television (CCTV) camera technology with an automatic helmet use detection system and to identify the factors associated with helmet use along an urban arterial road in the city of Khon Kaen, Thailand. METHODS Data collection was carried out on 49,128 samples by video cameras installed at 5 signalized intersections during 2 periods, namely, before and during the CCTV camera enforcement. The study applied logistic regression analysis to determine factors associated with helmet use and to compare the ratio of helmet use for each variable according to the odds ratio. RESULTS The study found that CCTV camera enforcement could increase helmet usage at all study intersections by 5.3%. The results imply that 4 factors, including riding status, number of passengers, day of week, and traffic conditions, significantly affected helmet use both before and during the CCTV camera enforcement. Remarkably, 2 more variables, age and police inspection, significantly affected helmet use during the CCTV camera enforcement period. CONCLUSIONS This study confirms that CCTV camera enforcement can be an important driving force for changing helmet use behavior, particularly for child passengers. Moreover, CCTV camera enforcement can support enforcement by extending coverage to a 24-h period and to intersections without police inspection.
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Affiliation(s)
- Thaned Satiennam
- Faculty of Engineering, Khon Kaen University, Khon Kaen, Thailand
| | - Jetsada Kumphong
- Faculty of Engineering, Khon Kaen University, Khon Kaen, Thailand
| | | | | | - Sittha Jaensirisak
- Faculty of Engineering, Ubon Ratchathani University, Ubon Ratchathani, Thailand
| | - Vatanavongs Ratanavaraha
- School of Transportation Engineering, Institute of Engineering, Suranaree University of Technology, Nakhon Ratchasima, Thailand
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Abstract
Currently in Jamaica, motorcyclists account for the largest group of fatalities among all road users. Between 2016 and 2018, a cross sectional study was conducted at the Saint Ann's Bay Regional Hospital involving 155 participants. There were 98.7% males, ages ranged from 14-64 years and more than two thirds of the motorcyclists were under 40 years. Only 29.4% wore helmets, and of those motorcyclists, 52.8% indicated they were only riding for a short distance. Increasing age correlated with increased helmet compliance. Persons with motorcycles greater than 150 cubic centimetres were also more likely to wear a helmet. Interventions to promote increased helmet compliance should take these factors into account in conjunction with enhancing law enforcement.
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Affiliation(s)
- Cary Fletcher
- Department of Orthopaedics, Saint Ann's Bay Regional Hospital, Saint Ann's Bay, St. Ann, Jamaica
| | - Derrick McDowell
- Department of Orthopaedics, Saint Ann's Bay Regional Hospital, Saint Ann's Bay, St. Ann, Jamaica
| | - Camelia Thompson
- Department of Community Health and Psychiatry, University of the West Indies at Mona, Mona, Jamaica
| | - Kenneth James
- Department of Community Health and Psychiatry, University of the West Indies at Mona, Mona, Jamaica
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Chen H, Scarborough J, Zens T, Brummeyer B, Agarwal S, Haines KL. Race and Insurance Status as Predictors of Bicycle Trauma Outcome in Adults. J Surg Res 2019; 245:198-204. [PMID: 31421362 DOI: 10.1016/j.jss.2019.07.064] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 07/10/2019] [Accepted: 07/19/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Race and insurance status have been shown to predict outcomes in pediatric bicycle traumas. It is unknown how these factors influence outcomes in adult bicycle traumas. This study aims to evaluate the association, if any, between race and insurance status with mortality in adults. METHODS This retrospective cohort study used the National Trauma Data Bank Research Data Set for the years 2013-2015. Multivariate logistic regression models were used to determine the independent association between patient race and insurance status on helmet use and on outcomes after hospitalization for bicycle-related injury. These models adjusted for demographic factors and comorbid variables. When examining the association between race and insurance status with outcomes after hospitalization, injury characteristics were also included. RESULTS A study population of 45,063 met the inclusion and exclusion criteria. Multivariate regression demonstrated that black adults and Hispanic adults were significantly less likely to be helmeted at the time of injury than white adults [adjusted odds ratio of helmet use for blacks 0.25 (95% CI 0.22-0.28) and for Hispanics 0.33 (95% CI 0.30-0.36) versus whites]. Helmet usage was also independently associated with insurance status, with Medicare-insured patients [AOR 0.51 (95% CI 0.47-0.56) versus private-insured patients], Medicaid-insured patients [AOR 0.18 (95% CI 0.17-0.20)], and uninsured patients [AOR 0.29 (95% CI 0.27-0.32)] being significantly less likely to be wearing a helmet at the time of injury compared with private-insured patients. Although patient race was not independently associated with hospital mortality among adult bicyclists, we found that uninsured patients had significantly higher odds of mortality [AOR 2.02 (AOR 1.31-3.12)] compared with private-insured patients. CONCLUSIONS Minorities and underinsured patients are significantly less likely to be helmeted at the time of bicycle-related trauma when compared with white patients and those with private insurance. Public health efforts to improve the utilization of helmets during bicycling should target these subpopulations.
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Affiliation(s)
- HuaFu Chen
- Division of Trauma and Acute Care Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - John Scarborough
- Division of Trauma and Acute Care Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Tiffany Zens
- Division of Trauma and Acute Care Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Brandon Brummeyer
- Division of Trauma and Acute Care Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Suresh Agarwal
- Division of Trauma, Acute, and Critical Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Krista L Haines
- Division of Trauma, Acute, and Critical Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
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Fan HP, Chiu WT, Lin MR. Effects of helmet nonuse and seating position on patterns and severity of injuries in child motorcycle passengers. BMC Public Health 2019; 19:1070. [PMID: 31395038 PMCID: PMC6686244 DOI: 10.1186/s12889-019-7434-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 08/02/2019] [Indexed: 11/23/2022] Open
Abstract
Background A prospective study was conducted to investigate the effects of helmet nonuse and seating position on patterns and severity of motorcycle injuries among child passengers in Taiwan. Methods In total, 305 child passengers aged ≤14 years who visited the emergency departments of three teaching hospitals following a motorcycle crash were recruited. Children’s injury data were collected from medical records, and their riding behaviors along with operators’ demographics were sourced from telephone interviews. Parental responses over the telephone about children’s riding behaviors were checked by roadside observations. Results Results of the multivariable logistic regression analysis revealed that compared to child passengers aged ≥7 years, those aged ≤3 (odds ratio (OR), 2.88; 95% confidence interval (CI), 1.37~6.06) and 4~6 years (OR, 2.93; 95% CI, 1.50~5.70) were significantly more likely to have sustained a head/face injury, while those aged 4~6 years (OR, 2.76; 95% CI, 1.01~7.55) were significantly more likely to have sustained a severe injury. Compared to child passengers who were wearing a full-coverage helmet, those who were not wearing a helmet were significantly more likely to have sustained a head/face injury (OR, 3.12; 95% CI, 1.02~9.52) and a severe injury (OR, 3.02; 95% CI, 1.19~7.62). Children seated in front of the operator were significantly more likely to have experienced a head/face injury (OR, 2.22; 95% CI, 1.25~3.94) than those seated behind the operator. For each increment in the riding speed of 1 km/h, the odds of a severe injury to child passengers increased by 5% (OR, 1.05; 95% CI, 1.01~1.09). Conclusions For the safety of child motorcycle passengers, laws on a minimum age restriction, helmet use, an adequate seating position, and riding speed need to be enacted and comprehensively enforced.
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Affiliation(s)
- Hsiu-Ping Fan
- Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, 250 Wu-Hsing St, Taipei, 110, Taiwan.,Division of Emergency Medicine, Department of Emergency and Critical Care Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, 69 Guizi Road, Taishan District, New Taipei City, 243, Taiwan.,School of Medicine, Fu-Jen Catholic University, 510 Zhongzheng Rd., Xinzhuang Dist., New Taipei City, 242, Taiwan
| | - Wen-Ta Chiu
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan
| | - Mau-Roung Lin
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan.
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Siebert FW, Albers D, Naing UA, Perego P, Santikarn C. Patterns of motorcycle helmet use - A naturalistic observation study in Myanmar. Accid Anal Prev 2019; 124:146-150. [PMID: 30639687 DOI: 10.1016/j.aap.2019.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 12/06/2018] [Accepted: 01/07/2019] [Indexed: 06/09/2023]
Abstract
Developing countries are subject to increased motorization, particularly in the number of motorcycles. As helmet use is critical to the safety of motorcycle riders, the goal of this study was to identify observable patterns of helmet use, which allow a more accurate assessment of helmet use in developing countries. In a video based observation study, 124,784 motorcycle riders were observed at seven observation sites throughout Myanmar. Recorded videos were coded for helmet use, number of riders on the motorcycle, rider position, gender, and time of day. Generally, motorcycle helmet use in Myanmar was found to be low with only 51.5% percent of riders wearing a helmet. Helmet use was highest for drivers (68.1%) and decreased for every additional passenger. It was lowest for children standing on the floorboard of the motorcycle (11.3%). During the day, helmet use followed a unimodal distribution, with the highest use observed during the late morning and lowest use observed in the early morning and late afternoon. Helmet use varied significantly between observation sites, ranging from 74.8% in Mandalay to 26.9% in Pakokku. In Mandalay, female riders had a higher helmet use than male riders, and helmet use decreased drastically on a national holiday in the city. Helmet use of motorcycle riders in Myanmar follows distinct patterns. Knowledge of these patterns can be used to design more precise helmet use evaluations and guide traffic law policy and police enforcement measures. Video based observation proved to be an efficient tool to collect helmet use data.
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Affiliation(s)
- Felix Wilhelm Siebert
- Department of Psychology and Ergonomics, Technische Universität Berlin, Marchstraße 12, 10587 Berlin, Germany.
| | - Deike Albers
- Technical University of Munich, Arcisstraße 21, 80333 Munich, Germany.
| | - U Aung Naing
- Myanmar Organization for Road Safety, People's Park, U Wisara Road, Yangon, Myanmar.
| | - Paolo Perego
- Catholic University of Milan, Largo Agostino Gemelli, 1, 20123 Milan, Italy.
| | - Chamaiparn Santikarn
- World Health Organization, No. 403, Shwe Taung Kyar Street, 11201 Yangon, Myanmar.
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Abstract
Background: It is essential to identify factors that predict helmet use, so as to mitigate the injury and mortality from bicycle accidents.Objective: To examine the relationship between helmet use and the bicycle-related trauma injury outcomes among bicyclists with head/neck injury in the US.Methods: Data from the 2002-2012 National Trauma Data Bank were used, including all trauma bicycle riders involved in bicycle-related accidents whose primary reason for the hospital or Intensive Care Unit stay was head or neck injury. Using multiple logistic regression, the association between helmet use, Injury severity score (ISS), length of stay in hospital (HLOS) and Intensive Care Unit (ICULOS), and mortality was examined.Results: Of the 76,032 bicyclists with head/neck injury, 22% worn helmets. The lowest was among Blacks, Hispanics, and <17 years old. Wearing a helmet significantly reduces injury severity, HLOS, ICULOS, and mortality (i.e total and in-hospital). Males had a severe injury, longer HLOS, ICULOS, and higher mortality than female. Blacks and Hispanics had longer HLOS and ICULOS and higher total mortality than Whites, but had a similar chance for in-hospital mortality.Conclusions: More effort is needed to enhance helmet use among at-risk bicycle riders, which may reduce injury severity, HLOS, ICULOS, and mortality.
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Affiliation(s)
- Lagina R. Scott
- David Geffen School of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA
| | - Shahrzad Bazargan-Hejazi
- David Geffen School of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA
| | - Anaheed Shirazi
- Psychiatry, Charles Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Deyu Pan
- Preventive and Social Medicine, Charles Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Steven Lee
- General Surgery Residency at Harbor-UCLA Division of Pediatric Surgery, UCLA and Harbor-UCLA Harbor-UCLA Academic Office, Los Angeles, CA, USA
| | - Stacey A. Teruya
- David Geffen School of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA
| | - Magda Shaheen
- David Geffen School of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA
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Popa I, Ferraro OE, Orsi C, Morandi A, Montomoli C. Bicycle helmet use patterns in Italy. A description and analysis of survey data from an Italian friends of cycling association. Accid Anal Prev 2017; 108:268-274. [PMID: 28923517 DOI: 10.1016/j.aap.2017.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 08/30/2017] [Accepted: 09/01/2017] [Indexed: 06/07/2023]
Abstract
Cycling is becoming one of the most popular forms of recreation and transport the world over, but cyclists still have a high level of vulnerability. A bicycle helmet is an important safety device available to cyclists, but little is known regarding possible determinants of helmet use among adults. This study aims at providing information on helmet usage patterns in Italy and identifying the factors associated with bicycle helmet use. Data on 2072 bicycle riders from an Italian friends of cycling association aged 18 years or older who had ridden a bicycle in the last month were collected using an ad-hoc questionnaire via the web. The sample was equally distributed among subjects who always, most of the time, sometimes, rarely, or never use a helmet. To evaluate the association among socio-demographic and bicycle use characteristics and helmet use, a multinomial logistic regression model was performed. The results show a higher propensity to use a helmet among males, riders coming from Central and Southern Italy, people who cycles more than 60kilometres in a week, cyclists who have already had a crash, people who do not cycle daily or almost daily, riders of sport bikes. Moreover, the propensity to use a helmet increases with age. The survey provided a first step in approaching the lack of data on cycling behaviour and the wearing of a helmet in Italy.
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Affiliation(s)
- Ioana Popa
- Centre of Study and Research on Road Safety (CIRSS), Section of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini, 2, 27100 Pavia, Italy
| | - Ottavia E Ferraro
- Centre of Study and Research on Road Safety (CIRSS), Section of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini, 2, 27100 Pavia, Italy
| | - Chiara Orsi
- Centre of Study and Research on Road Safety (CIRSS), Section of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini, 2, 27100 Pavia, Italy.
| | - Anna Morandi
- Centre of Study and Research on Road Safety (CIRSS), Section of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini, 2, 27100 Pavia, Italy
| | - Cristina Montomoli
- Centre of Study and Research on Road Safety (CIRSS), Section of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini, 2, 27100 Pavia, Italy
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Milan M, Jhajj S, Stewart C, Pyle L, Moulton S. Helmet use and injury severity among pediatric skiers and snowboarders in Colorado. J Pediatr Surg 2017; 52:349-53. [PMID: 27876383 DOI: 10.1016/j.jpedsurg.2016.11.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 11/03/2016] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Skiing and snowboarding are popular winter recreational activities that are commonly associated with orthopedic type injuries. Unbeknownst to most parents, however, are the significant but poorly described risks for head, cervical spine and solid organ injuries. Although helmet use is not mandated for skiers and snowboarders outside of resort sponsored activities, we hypothesized that helmet use is associated with a lower risk of severe head injury, shorter ICU stay and shorter hospital length of stay. METHODS The trauma registry at a level I pediatric trauma center in the state of Colorado was queried for children ages 3-17years, who sustained an injury while skiing or snowboarding from 1/1/1999 to 12/31/2014. Injury severity was assessed by Abbreviated Injury Severity (AIS) score, injury severity score (ISS) and admission location. Head injury was broadly defined as any trauma to the body above the lower border of the mandible. Regression analysis was used to test associations of variables with injury severity. RESULTS 549 children sustained snow sport related injuries during the 16year study period. The mean patient age was11±3years, most were male (74%) and the majority were Colorado residents (54%). The overall median ISS was 9 (IQR 4-9) and 78 children (14%) were admitted to the ICU. Colorado residents were nearly twice as likely to be wearing a helmet at the time of injury, compared to visitors from out-of-state (adjusted OR 1.86, 95% CI 1.24-2.76, p=0.002). In a multivariate analysis injury severity was significantly associated with injury while skiing (p=0.026), helmet use (p=0.0416), and sustaining a head injury (p<0.0001). In a separate multivariate analysis ICU admission was associated with head injury (p<0.0001) and wearing a helmet (p=0.0257); however, those wearing a helmet and admitted to the ICU had significantly lower ISS (p=0.007) and head AIS (p=0.011) scores than those who were not wearing a helmet at the time of injury. CONCLUSION Visitors from out of state were less likely to be wearing a helmet when injured and more likely to be severely injured, suggesting Colorado residents have a better understanding of the benefits of helmet usage. Helmeted skiers and snowboarders who were admitted to the ICU had significantly lower ISS and head AIS scores than those who were not helmeted. Pediatric skiers, snowboarders and their parents should be educated on the significant risks associated with these activities and the benefits of helmet usage. LEVEL OF EVIDENCE III.
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Lagerstrom E, Magzamen S, Stallones L, Gilkey D, Rosecrance J. Understanding risk factor patterns in ATV fatalities: A recursive partitioning approach. J Safety Res 2016; 59:23-31. [PMID: 27846996 PMCID: PMC7045363 DOI: 10.1016/j.jsr.2016.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/23/2016] [Accepted: 10/05/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Although there are hundreds of ATV-related deaths each year in the United States, contributing factors have not been clearly identified. The purpose of this study was to investigate associations between factors contributing to ATV fatalities using the agent-host-environment epidemiological triangle. METHOD Incident reports of ATV fatalities occurring between 2011 and 2013 were obtained from the United States Consumer Product Safety Commission (CPSC). Narrative reports included details of the decedent and a description of the ATV crash. A chi-square automatic interaction detector (CHAID) analysis was performed for three major risk factors representing each facet of the epidemiologic triangle: helmet use (host), type of crash (agent), and location where death occurred (environment). The output of the CHAID analysis is a classification tree that models the relationship between the predictor variables and a single outcome variable. RESULTS A total of 1193 ATV fatalities were reported to the CPSC during the 3-year study period. In cases with known helmet and/or drug and alcohol use status, descriptive statistics indicated helmets were not worn in 88% of fatalities and use of alcohol or drugs was present in 84% of fatalities. Reoccurring factors within the CHAID analysis included age, helmet use, geographic region of the country, and location (e.g., farm, street, home, etc.) at the time of death. Within the three CHAID models, there were seven significant partitions related to host, one related to agent, and eight related to the environment. CONCLUSIONS This research provides a model for understanding the relationship between risk factors and fatalities. The combination of the CHAID analysis method and the epidemiologic triangle allows for visualization of the interaction between host-agent-environment factors and fatalities. PRACTICAL APPLICATIONS By modeling and characterizing risk factors associated with ATV fatalities, future work can focus on developing solutions targeted to specific factions of ATV users.
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Affiliation(s)
- Elise Lagerstrom
- Department of Environmental and Occupational Health Sciences, Colorado State University, Fort Collins, CO, United States.
| | - Sheryl Magzamen
- Department of Environmental and Occupational Health Sciences, Colorado State University, Fort Collins, CO, United States; Colorado School of Public Health, Colorado State University, Fort Collins, CO, United States
| | - Lorann Stallones
- Department of Psychology, Colorado State University, Fort Collins, CO, United States; Colorado School of Public Health, Colorado State University, Fort Collins, CO, United States
| | - David Gilkey
- Department of Environmental and Occupational Health Sciences, Colorado State University, Fort Collins, CO, United States
| | - John Rosecrance
- Department of Environmental and Occupational Health Sciences, Colorado State University, Fort Collins, CO, United States; Colorado School of Public Health, Colorado State University, Fort Collins, CO, United States
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Ethan D, Basch CH, Johnson GD, Hammond R, Chow CM, Varsos V. An Analysis of Technology-Related Distracted Biking Behaviors and Helmet Use Among Cyclists in New York City. J Community Health 2016; 41:138-45. [PMID: 26323983 DOI: 10.1007/s10900-015-0079-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Bicycling is becoming an increasingly utilized mode of transportation in New York City. Technology-related distracted bicycling and helmet use are behaviors that can impact bike safety. The aims of this study were twofold: (1) to determine rates and types of technology-related distracted behaviors among bicyclists in the borough of Manhattan in New York City; and (2) to assess the rate of bicycle helmet use among these cyclists. Bicyclists in five popular riding areas in Manhattan were observed for a total of 50 h using a digital video camera during summer months in 2014. Videos were coded and enumerated for the total number and gender of cyclists, type of bicycle, number wearing headphones/earbuds and/or using a mobile phone, and whether the cyclist was wearing a helmet. Almost 25,000 cyclists were observed across the five selected locations (n = 24,861). Riders were almost four times more likely not to wear a helmet on rental bikes as compared with non-rentals (Citi Bike(®) OR 3.8; 95% CI 2.5, 5.9: other rental OR 3.8; 95% CI 3.0, 4.9). Significantly increased odds of not wearing a helmet were observed for females relative to males (OR 1.4; 95% CI 1.1, 1.8) across varied times and locations. Overall, rates of technology-related distraction were low, with headphone use being most prevalent. Males were more likely to wear headphones/earbuds (OR 2.0; 95% CI 1.4, 2.9), as were cyclists on Citi Bikes relative to other rental bikes (OR 2.2; 95% CI 1.3, 3.6). Findings from this study contribute to the growing literature on distracted biking and helmet use among bike share program riders and other cyclists and can inform policymakers and program planners aiming to improve bicycle safety in urban settings.
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Hothem Z, Simon R, Barnes W, Mohammad A, Sevak S, Ziegler K, Iacco A, Janczyk R. Effects of repealing the motorcycle helmet law in Michigan. Am J Surg 2016; 214:407-412. [PMID: 27823755 DOI: 10.1016/j.amjsurg.2016.09.052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/15/2016] [Accepted: 09/16/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND In 2012, Michigan repealed its universal helmet law. Our study assessed the clinical impact of this repeal. METHODS Our trauma database was queried retrospectively for 2 motorcycle riding seasons before and 3 seasons after repeal. On-scene death data was obtained from the Medical Examiner. RESULTS Helmet use in hospitalized patients decreased after the helmet law repeal. Non-helmeted patients had a significant increased rate of head injury. Non-helmeted patients were more likely to die during hospitalization. While, helmet use and drugs/alcohol status significantly affected the risk for head injury, only drug/alcohol had a significant effect on overall mortality. CONCLUSIONS Following helmet law repeal, helmet use has decreased. Helmet status and drug/alcohol use was found to significantly increase risk of head injury. Although overall mortality was only affected by drug/alcohol use, non-helmeted patients did have a higher inpatient mortality. These findings deserve furthermore study and may provide a basis for reinstating the universal helmet law.
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Affiliation(s)
- Zachary Hothem
- General Surgery Resident at Beaumont Health, Royal Oak, MI, USA.
| | - Robert Simon
- General Surgery Resident at Beaumont Health, Royal Oak, MI, USA.
| | - Wesley Barnes
- General Surgery Resident at Beaumont Health, Royal Oak, MI, USA.
| | - Azmath Mohammad
- General Surgery Resident at Beaumont Health, Royal Oak, MI, USA.
| | - Shruti Sevak
- General Surgery Resident at Beaumont Health, Royal Oak, MI, USA.
| | - Kathryn Ziegler
- Department of General Surgery at Beaumont Health, Royal Oak, MI, USA.
| | - Anthony Iacco
- Department of General and Trauma Surgery at Beaumont Health, Royal Oak, MI, USA.
| | - Randy Janczyk
- Department of General and Trauma Surgery at Beaumont Health, Royal Oak, MI, USA.
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Sheehan CC, Lind M, Mahida JB, Essig G, Elmaraghy CA. Outcomes in pediatric patients with recreational vehicle related forceful head impact. Int J Pediatr Otorhinolaryngol 2016; 84:97-100. [PMID: 27063761 DOI: 10.1016/j.ijporl.2016.02.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 02/19/2016] [Accepted: 02/26/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE To compare outcomes in pediatric patients suffering forceful head impact during recreational vehicle use to patients with forceful head impact from other mechanisms. METHODS Retrospective cohort study of all patients 3-18 years old who suffered forceful head impact (any traumatic mechanism strong enough to result in a face or skull fracture) in our institutional trauma registry between January 2011 and September 2013. RESULTS Out of 252 events involving forceful head impact, 64 events were a result of riding a recreational vehicle. Although there is no difference in rates of temporal bone fractures, recreational vehicle accidents have higher rates of otic capsule violation (21% vs. 5%) and higher rates of hearing loss (30% vs 16%) compared to patients with forceful head impact from other mechanisms. All incidents of otic capsule violation and sensorineural hearing loss in recreational vehicle accidents were associated with a temporal bone fracture. CONCLUSION Despite the increasing use of head protective gear while operating a recreational motor vehicle there is still heightened risk for temporal bone fractures and subsequent hearing loss. The comparative associations in this study suggest that helmets used with recreational vehicles do not protect the temporal bone thus leaving vital structures within the otic capsule at risk for damage and long term consequences. When treating these patients Otolaryngologists should be aware of the elevated risk of otic capsule violation and late hearing loss with temporal bone fractures.
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Affiliation(s)
- Cameron C Sheehan
- The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, OH, United States
| | - Meredith Lind
- The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, OH, United States
| | - Justin B Mahida
- The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, OH, United States; Center for Surgical Outcomes Research, Nationwide Children's Hospital, Columbus, OH, United States
| | - Garth Essig
- The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, OH, United States
| | - Charles A Elmaraghy
- Center for Surgical Outcomes Research, Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, OH, United States.
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Haqverdi MQ, Seyedabrishami S, Groeger JA. Identifying psychological and socio-economic factors affecting motorcycle helmet use. Accid Anal Prev 2015; 85:102-110. [PMID: 26410724 DOI: 10.1016/j.aap.2015.09.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 09/08/2015] [Accepted: 09/10/2015] [Indexed: 06/05/2023]
Abstract
Sixty percent of motorcyclist fatalities in traffic accidents of Iran are due to head injuries, but helmet use is low, despite it being a legal requirement. This study used face-to-face interviews to investigate the factors associated with helmet use among motorcycle riders in Mashhad city, the second largest city in Iran. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were used for data reduction and identification of consistent features of the data. Ordered and multinomial logit analyses were used to quantify the influences on helmet use and non-use. The data show that 47% of the sample used a helmet, but a substantial proportion of these did not wear their helmet properly. In addition, 5% of motorcyclists believed that helmets reduced their safety. Norms, attitudes toward helmet use, risky traffic behavior and awareness of traffic rules were found to be the key determinants of helmet use, but perceptions of enforcement lacked influence. Duration of daily motorcycle trips, riding experience and type of job also affected helmet use. Results indicate that motorcyclist training, safety courses for offending motorcyclists and social programs to improve social norms and attitudes regarding helmet use are warranted, as are more effective law enforcement techniques, in order to increase proper use of helmets in Iranian motorcyclists. In addition, special safety courses should be considered for motorcyclists who have committed traffic violations.
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Affiliation(s)
| | | | - John A Groeger
- Department of Psychology, University of Hull, Cottingham Road, Hull HU6 7RX, United Kingdom.
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Mahida JB, Asti L, Patel K, Deans KJ, Minneci PC, Groner JI, Raval MV. A comparison of injuries sustained from recreational compared to organized motorized vehicle use in children. J Pediatr Surg 2015; 50:1188-91. [PMID: 25783309 DOI: 10.1016/j.jpedsurg.2014.10.047] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 10/06/2014] [Accepted: 10/08/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To examine the injury severity and patterns of injury for pediatric motorized recreational vehicle (MRV) drivers injured during organized events (OE) compared to recreational use (RU). METHODS All pediatric MRV injuries between 2006 and 2012 in our institutional trauma registry were studied for mechanism of injury, initial evaluation, and treatment. Injuries with an Abbreviated Injury Scale ≥2 were categorized by body region and diagnosis. RESULTS Out of 589 collisions, 92 (16%) occurred during an OE. Compared to RU drivers, OE drivers were more likely to wear helmets (92% vs. 40%, p<0.001) and other protective equipment (79% vs. 6%, p<0.001). There was no difference in rates of hospital admission, rates of surgical intervention, injury severity scores, rates of intensive care unit admission, or lengths of stay. There were no differences in injuries by body region or injury type, except that dislocations were more common in OE drivers (2% vs. 0%, p=0.038). CONCLUSION Despite higher rates of helmet and protective gear use, pediatric MRV drivers participating in OEs sustain similarly severe injuries as drivers using MRVs recreationally. No differences were observed in body regions involved or outcomes. Public perception that OE use of MRV for children is safe should be addressed.
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Affiliation(s)
- Justin B Mahida
- Center for Surgical Outcomes Research, Nationwide Children's Hospital, Columbus, OH, United States; Division of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, United States; The Ohio State University College of Medicine, Columbus, OH, United States
| | - Lindsey Asti
- Center for Surgical Outcomes Research, Nationwide Children's Hospital, Columbus, OH, United States
| | - Kishan Patel
- Division of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, United States; The Ohio State University College of Medicine, Columbus, OH, United States
| | - Katherine J Deans
- Center for Surgical Outcomes Research, Nationwide Children's Hospital, Columbus, OH, United States; Division of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, United States; The Ohio State University College of Medicine, Columbus, OH, United States
| | - Peter C Minneci
- Center for Surgical Outcomes Research, Nationwide Children's Hospital, Columbus, OH, United States; Division of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, United States; The Ohio State University College of Medicine, Columbus, OH, United States
| | - Jonathan I Groner
- Division of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, United States; The Ohio State University College of Medicine, Columbus, OH, United States; Trauma Program, Nationwide Children's Hospital, Columbus, OH, United States
| | - Mehul V Raval
- Division of Pediatric Surgery, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, United States.
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Williams AF, Oesch SL, McCartt AT, Teoh ER, Sims LB. On-road all-terrain vehicle (ATV) fatalities in the United States. J Safety Res 2014; 50:117-123. [PMID: 25142368 DOI: 10.1016/j.jsr.2014.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 04/11/2014] [Accepted: 05/01/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND The study was designed to describe the characteristics of all-terrain vehicle (ATV) rider fatalities and fatal crashes involving ATVs that occur on public roads. METHODS Information on fatal crashes occurring on public roads during the years 2007-2011 was obtained from the Fatality Analysis Reporting System (FARS). RESULTS There were 1,701 ATV rider deaths during the 5-year study period, including 1,482 drivers, 210 passengers, and 9 with unknown rider status. An additional 19 non-ATV occupants, primarily motorcyclists, died in crashes with ATVs. About half of the ATV passenger deaths were teenagers or younger, and the majority of passenger deaths were female. Ninety percent of the fatally injured drivers were 16 or older, and 90% were male. The crashes were most likely to occur in relatively rural states, and in rural areas within states. Only 13% of drivers and 6% of passengers killed wore helmets. Forty-three percent of the fatally injured drivers had blood alcohol concentrations (BACs) of 0.08% or greater. Seventy-five percent of the fatal crashes involved single ATVs; 5% involved multiple ATVs but no non-ATV vehicles, and 20% involved ATVs and non-ATVs, usually passenger vehicles. Speeding was reported by police as a contributing factor in the crash for 42% of ATV drivers in single-vehicle crashes and 19% of ATV drivers in multiple-vehicle crashes. PRACTICAL APPLICATIONS Although ATVs are designed exclusively for off-road use, many ATV occupant deaths occur on roads, despite most states having laws prohibiting many types of on-road use. Attention needs to be given to ways to reduce these deaths.
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Sullins VF, Yaghoubian A, Nguyen J, Kaji AH, Lee SL. Racial/ethnic and socioeconomic disparities in the use of helmets in children involved in bicycle accidents. J Pediatr Surg 2014; 49:1000-3; discussion 1003. [PMID: 24888851 DOI: 10.1016/j.jpedsurg.2014.01.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 01/27/2014] [Indexed: 11/22/2022]
Abstract
PURPOSE While bicycle helmet use reduces bicycle-related head injury, few children wear them regularly. We aimed to describe racial/ethnic and socioeconomic differences in pediatric helmet use in Los Angeles County (LAC) to help target groups for injury prevention programs. METHODS A retrospective review of all pediatric patients involved in bicycle-related accidents in LAC between 2006 and 2011 was performed. Our primary analysis examined the association between helmet use and age, gender, insurance status, and race/ethnicity. We also evaluated the association between helmet use and the need for emergency surgery, mortality, and length of hospital stay (LOH), after adjusting for injury severity score (ISS), age, insurance status, and race/ethnicity. RESULTS Of 1248 patients, 11.3% wore helmets, with decreased use among children 12years and older, minorities, and those without private insurance. Overall, 5.9% required an emergency operation, 34.1% returned to their pre-injury capacity, and mortality was 0.7%. On multivariable analysis, higher ISS increased LOH, the risk for emergency surgery, and mortality. CONCLUSION Nearly 90% of children involved in bicycle-related accidents were not wearing helmets. Helmet use was lower among older children, minorities, and those from a low socioeconomic status. Injury prevention programs targeting low-income middle and high schools and minority communities may help increase helmet use in children in LAC.
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Swaroop M, Marie Siddiqui S, Sagar S, Crandall ML. The problem of the pillion rider: India's helmet law and New Delhi's exemption. J Surg Res 2014; 188:64-8. [PMID: 24529884 DOI: 10.1016/j.jss.2014.01.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 12/17/2013] [Accepted: 01/06/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND In India, motorized two-wheeler (MTW) road traffic accidents injure or kill 72,000 women annually. Before the Motor Vehicle Act of 1988, which required mandatory helmet use for MTW riders, a study found 0.6% of all MTW pillions (backseat passengers) were helmeted. Citing religious protests to the legislation, Delhi's high court exempted the city's 12 million women from the law. We hypothesize that currently male pillions use helmets more frequently than females, and that overall pillion helmet usage has increased over the last 20 y. METHODS Continuous video was recorded in half-hour blocks at four locations in Delhi on separate days, totaling 8 hours of high- and low-volume traffic. Videos were reviewed with at least two reviewers extracting the number of MTW pillions, as well as their gender, approximate age, and helmet usage. RESULTS Of 4010 pillions identified, 63.8% were male, 32.4% female, and 3.3% children. Among males, there were significantly more helmeted pillions (88.4%, P < 0.001); among females, there were significantly more unhelmeted pillions (99.4%, P < 0.001). Among unhelmeted pillions, significantly more were female (81.4%) than male (P < 0.001). Current overall pillion helmet use is significantly higher than historical rate (P < 0.001). CONCLUSIONS The significantly higher male pillion helmet usage compared with females indicates Delhi's helmet law is associated with increased compliance among those who fall under its jurisdiction. This augments the growing body of evidence that mandatory helmet laws are efficacious, thus repealing the exemption of women is an important step in increasing female pillion helmet usage.
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Affiliation(s)
- Mamta Swaroop
- Division of Trauma and Critical Care, Department of Surgery, Northwestern University, Chicago, Illinois.
| | - Selma Marie Siddiqui
- Division of Trauma and Critical Care, Department of Surgery, Northwestern University, Chicago, Illinois; Department of Surgery, St. Joseph Hospital, Chicago, Illinois
| | - Sushma Sagar
- Department of Trauma Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Marie L Crandall
- Division of Trauma and Critical Care, Department of Surgery, Northwestern University, Chicago, Illinois
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