Characteristics and Injury Patterns in Traumatic Brain Injury Related to E-Scooter Use in Riga, Latvia: Multicenter Case Series

Background and Objectives: In recent years, electronic scooters (e-scooters) have gained popularity, whether for private use or as a publicly available transportation method. With the introduction of these vehicles, reports of e-scooter-related accidents have surged, sparking public debate and concern. The aim of this study was to analyze the epidemiological data, characteristics, and severity of traumatic brain injury (TBI) related to e-scooter accidents. Materials and Methods: This retrospective case series evaluated patients who were admitted to the three largest neurosurgery clinics in Riga, Latvia, from the time period of April to October in two separate years-2022 and 2023-after e-scooter-related accidents. The data were collected on patient demographics, the time of the accident, alcohol consumption, helmet use, the type of TBI, other related injuries, and the treatment and assessment at discharge. Results: A total of 28 patients were admitted with TBI related to e-scooter use, with a median age of 30 years (Q1-Q3, 20.25-37.25), four individuals under the age of 18, and the majority (64%) being male. In 23 cases, the injury mechanism was falling, in 5 cases, collision. None were wearing a helmet at the time of the injury. Alcohol intoxication was evident in over half of the patients (51.5%), with severe intoxication (>1.2 g/L) in 75% of cases among them. Neurological symptoms upon admission were noted in 50% of cases. All patients had intracranial trauma: 50% had brain contusions, 43% traumatic subdural hematoma, and almost 30% epidural hematoma. Craniofacial fractures were evident in 71% of cases, and there were fractures in other parts of body in three patients. Six patients required emergency neurosurgical intervention. Neurological complications were noted in two patients; one patient died. Conclusions: e-scooter-related accidents result in a significant number of brain and other associated injuries, with notable frequency linked to alcohol influence and a lack of helmet use. Prevention campaigns to raise the awareness of potential risks and the implementation of more strict regulations should be conducted.

Blunt adrenal gland injury: The impact of extra-abdominal injury

BACKGROUND

Blunt adrenal gland injuries are considered uncommon. Moreover, the factors associated with the mechanisms of the injury following blunt trauma are unclear. In this study, we determined the factors associated with blunt adrenal gland injury (BAGI).

MATERIALS AND METHODS

A total of 315 patients with blunt abdominal trauma were admitted to our institution during a 12-year period. After excluding 26 patients who were under 18 years old and 27 patients who were in cardiopulmonary arrest on arrival, 262 eligible patients were retrospectively reviewed. Patient characteristics, mechanism of injury, intervention, and associated organ injuries were compared between those with and without BAGI.

RESULTS

Blunt adrenal gland injury was identified in 38 of 262 patients (14.5%). The right side was the predominant site of injury (68%). There were no differences in vital sign, in-hospital mortality, intervention, and concomitant abdominal organ injuries between those with and without adrenal gland injury. Patients with BAGI had a higher frequency of fall and motorcycle collision as mechanisms of injury. In addition, patients with BAGI had a higher injury severity score and a higher frequency of concomitant severe head, chest, and pelvic injuries.

CONCLUSION

The results of the present study suggest that the deceleration injury leading to concomitant head, chest, or pelvic injuries with blunt abdominal trauma may be associated with the mechanism of BAGI.

LEVEL OF EVIDENCE

Prognostic study, level IV.

Determining passenger car equivalent (PCEs) for pretimed signalized intersections with severe motorcycle composition using Bayesian linear regression

Pretimed signalized intersection is known as a common source of congestion, especially in urban heterogeneous traffic. Furthermore, the accuracy of saturation flow rate is found to cause efficient and vital capacity estimation, in order to ensure optimal design and operation of the signal timings. Presently, the traffic also consists of diverse vehicle presence, each with its own static and dynamic characteristics. The passenger car equivalent (PCE) in an essential unit is also used to measure heterogenous traffic into the PCU (Passenger Car Unit). Based on the collection of observed data at three targets in Banda Aceh City, this study aims to redetermine the PCEs by using Bayesian linear regression, through the Random-walk Metropolis-Hastings and Gibbs sampling. The result showed that the obtained PCE values were 0.24, 1.0, and 0.80 for motorcycle (MC), passenger car (PC), and motorized rickshaw (MR), respectively. It also showed that a significant deviation was found between new and IHCM PCEs, as the source of error was partially due to the vehicle compositions. The present traffic characteristics were also substantially different from the prevailing conditions of IHCM 1997. Therefore, the proposed PCEs enhanced the accuracy of base saturation flow prediction, provided support for traffic operation design, alleviated congestion, and reduced delay within the city, which in turn improved the estimation of signalized intersection capacity.

Loss of years of healthy life due to road incidents of motorcyclists in the city of Medellin, 2012 to 2015

Objective

Determine the loss of years of healthy life due to road incidents of motorcyclists in the city of Medellin from 2012 to 2015.

Methods

Descriptive study with data on health care of injured motorcyclists and deaths adjusted with the Preston and Coale method, and OPS proportional distribution for the period 2012–2015. The years of life lost due to premature death (YLLs), years lived with disability (YLDs), and the disability-adjusted life years (DALYs) were calculated according to the new methodology designed for that purpose.

Results

The loss of years of healthy life due to road incidents of motorcyclists in the four-year period was 80,046 DALYs (823.8 per 100,000 inhabitants), with a higher proportion in men (81.3% and a ratio of 5 to 1 compared to women); the YLDs was 66.6% with marked differences in favor of men. There was nearly a 38% difference in the ages of 15 to 19 as well as a 19% difference from 30 to 49, compared to women. Premature death (YLLs) contributed to 33.4% of DALYs, with significant presentation in the above-mentioned age groups.

Conclusions

The greatest loss of years of healthy life due to road incidents of motorcyclists in Medellin was due to non-fatal injuries and was concentrated in young men. If the trend of motorcycle road incidents continues, both local and national road safety plans will fail to accomplish the expected results, especially among motorcycle users.

The effect of motorcyclists' age on injury severities in single-motorcycle crashes with unobserved heterogeneity

INTRODUCTION

Due to the myriad of unique characteristics associated with motorcycle operation, motorcycle safety is a public health concern as complex as it is serious. National crash data suggest motorcyclists are 28 times more likely to be killed when compared to passenger car occupants. In the state of Florida, motorcycle crashes are 1.5 times more likely to result in the death of the rider, placing Florida among the top deadliest states for motorcyclists in the nation. Using police-reported data from 2016, this study addresses the complex and interconnected nature of the many characteristics associated with motorcycle operation by investigating the effect of age on motorcyclists' riding behavior as it relates to injury severity for single-motorcycle crashes in the state of Florida.

METHOD

To account for unobserved heterogeneity in the crash data, mixed logit models with heterogeneity in means and variances were estimated to model three injury severity outcomes (non-visible, severe, and fatal) for three age groups (under 30, 30-49, and 50 and above).

RESULTS

Model results indicate that age affects motorcyclists' safety perception and ability to assess risks, thereby influencing their involvement in risky behaviors. Characteristics unique to motorcycle operation-spatial characteristics, speed, motorcycle type, time of day, helmet usage, alcohol consumption, ejection from motorcycle, passenger presence, endorsement status, and lighting-are further complicated by their dependency on the characteristics of the individual motorcyclist. Age of motorcyclist indicates a relationship between motorcyclists' behavior and perceived safety.

CONCLUSION

The model results indicated that statistically significant parameters constituted different models and they were not equal across the age groups of motorcyclists: aged under 30, aged 30-49, and aged 50 and above. Through advanced econometric modeling, this study fills a gap in the existing literature and assists the safety professionals, motorcycle trainers, policymakers, law enforcement agencies, and roadway designers in developing countermeasures.

A comparison of motorcycle instructor candidate selection practices in the United States

INTRODUCTION

An essential aspect of motorcycle rider education is how the instructor selection process impacts student learning, sometimes referred to as the human element, as it is a significant factor influencing curriculum success. Student and program achievements are partially contingent on instructors who understand the curriculum and facilitate student learning during instruction. Previous research on motorcycle rider education has emphasized a need for the examination of instructor selection and development, stating that quality education is reliant on instructors who are competent and qualified.

METHOD

By applying an exploratory study method, state and military Motorcycle Safety Education Program Managers and Instructor Trainers were examined and compared through telephonic interviews to develop a greater understanding of instructor candidate selection criteria and vetting processes.

RESULTS

The results suggest that changes in instructor candidate selection systems may improve decisions about a candidate's job and organizational fit.

CONCLUSIONS

Study conclusions indicate that use of multiple and thorough assessments to determine a candidate's motivation, social disposition, and emotional intelligence before preparation courses may better identify candidates and align potential job and organization fit within the discipline. Practical Application: Applications of the findings would include a standardized selection process with improved interviews and pre-course auditing, and candidate expectation management before the selection to attend preparation or certification courses. The efforts potentially decrease long-term costs and deficiencies when candidates have an inconsistent job or organizational fit, departing from organizations after short periods or by not providing consistent quality instruction to students. The study recommendations, when implemented, can improve most educational disciplines where instructors are selected for technical instructional positions where students risk injury or harm.

Comparison of motor vehicle-involved e-scooter and bicycle crashes using standardized crash typology

INTRODUCTION

The market share of e-scooters in the United States has proliferated in cities: 86 million trips were made on shared e-scooters in 2019, a more than 100% increase compared to 2018. However, the interaction of e-scooters with other road users and infrastructure remains uncertain.

METHOD

This study scrutinized 52 e-scooter and 79 bicycle police-reported crashes in Nashville, Tennessee, from April 2018 to April 2020 from the Tennessee Integrated Traffic Analysis Network (TITAN) database. We used descriptive analysis and a recent prototype version of the Pedestrian and Bicycle Crash Analysis Tool (PBCAT) to classify crashes based on the locations of the crashes relative to roadway segments or intersections, as well as the maneuver of the motor vehicle and e-scooter/bicycle relative to the motor vehicle.

RESULTS

Two crash typologies can explain the majority of e-scooter crashes, while bicycle crashes are distributed over several crash typologies. Additionally, 1 in 10 e-scooter- and bicycle-motor vehicle crashes leads to the injury or fatality of the e-scooter rider or bicyclist. Furthermore, we noted statistically significant differences in spatial and temporal distribution, demographics, lighting conditions, and crash distance from home for e-scooter and bicycle crashes.

CONCLUSIONS

The police crash report provides a comprehensive picture of e-scooter safety complementing existing literature. We found that e-scooter crash characteristics do not fully overlap with features of bicycle crashes.

PRACTICAL IMPLICATIONS

A generalized engineering, education, and enforcement treatment to reduce and prevent e-scooter and bicycle crashes, injuries, and fatalities might not result in equal outcomes for each mode. More rigorous enforcement could be implemented to deter e-scooters riders under the age of 18 years and e-scooter safety campaigns could target female riders.

Severity and patterns of injury in helmeted vs. non-helmeted motorcyclists in a rural state

INTRODUCTION

Under current law in our rural state, there is no universal requirement for motorcyclists to wear helmets. Roughly 500 motorcycle crashes are reported by the state each year and only a fraction of those riders wear helmets. We sought to determine the difference in injury patterns and severity in helmeted versus non-helmeted riders.

METHODS

Retrospective review (2014-2018) of a single level 1 trauma center's registry was done for subjects admitted after a motorcycle collision. Demographic, injury and patient outcome data were collected. Patients were stratified by helmet use (n = 81), no helmet use (n = 144), and unknown helmet use (n = 194). Statistical analysis used Student's t-test or Pearson's χ²p-value ≤0.05 as significant. State Department of Transportation data registry for state level mortality and collision incidence over the same time period was also obtained.

RESULTS

Of the 2,022 state-reported motorcycle collisions, 419 individuals admitted to our trauma center were analyzed (21% capture). State-reported field fatality rate regardless of helmet use was 4%. Our inpatient mortality rate was 2% with no differences between helmet uses. Helmeted riders were found to have significantly fewer head and face injuries, higher GCS, lower face, neck, thorax and abdomen AIS, fewer required mechanical ventilation, shorter ICU length of stay, and had a greater number of upper extremity injuries and higher upper extremity AIS.

CONCLUSIONS

Helmeted motorcyclists have fewer head, face, and cervical spine injuries, and lower injury severities: GCS and face, neck, thorax, abdomen AIS. Helmeted riders had significantly less mechanical ventilation requirement and shorter ICU stays. Non-helmeted riders sustained worse injuries. Practical Applications: Helmets provide safety and motorcycle riders have a 34-fold higher risk of death following a crash. Evaluating injury severities and patterns in motorcycle crash victims in a rural state with no helmet laws may provide insight into changing current legislation.

Motorcycle helmet selection and usage for improved safety: A systematic review on the protective effects of helmet type and fastening

OBJECTIVE

Motorcycle helmets are the most common and effective protective device to reduce head injuries and mortality in crashes among powered two-wheeler riders. Even if they are globally recognized as effective, there are still concerns regarding their correct use, which is necessary to achieve maximum head protection. The goal of this systematic review is to assess which characteristics of helmet design and use showed a positive influence on rider safety, in order to provide insights to improve end-user helmet usage.

METHODS

A literature search was carried out combining two sets of keywords, one related with either motorcycle or rider and the other referring to either protective equipment or injuries. After the exclusion of duplicates, 977 papers were screened by reviewers, thus identifying 32 papers that were analyzed in group discussions.

RESULTS

Among the papers included in this study, no strong conflicting conclusions emerged in their results. The studies focusing on the use of different types of helmets highlighted that full-face helmets, compared with other standard helmets, have a positive influence on head injuries and facial injuries. Correct fastening was clearly beneficial for head and facial injuries, induced injuries, and helmet ejection.

CONCLUSIONS

This systematic review provides important insights to improve the usage of helmets by end-users. Correct fastening is a crucial factor to avoid helmet roll-off during a crash. Most studies agreed that full-face helmets provide higher protection in comparison with other standard helmets, especially for facial injuries, and no negative influence with respect to neck and spinal injuries.

Compliance of commercial motorcycle riders with road safety regulations in a peri-urban town of Ghana

BACKGROUND

While motorcycles are essential for moving people and goods, they are also, a significant contributor to Road Traffic Accidents (RTAs), making it a public health issue of concern globally. The Hohoe Municipal Hospital records increasing RTAs due to commercial motorcycles. Determining motorcycle riders' compliance with road safety regulations is critical in helping to curb this menace.

METHOD

A cross-sectional study was employed involving a multistage sample of 238 motorcycle riders. Data were collected using a pretested structured questionnaire and entered into Epi Data version 3.2 software and exported to STATA software version 12 for analysis. Descriptive and inferential analyses were done while statistical significance was determined at 95% reliability interval and p-value of 0.05.

FINDINGS

The level of compliance with road safety regulations among respondents was 59.2%. The mean age of respondents was 29.9 ± 7.9 years, and all respondents were males. Respondents who did not own their motorbikes were 0.39 times less likely to comply with road safety regulations compared to their counterparts who owned one, while those without alternate occupations were 0.51times less likely to comply with road safety regulations compared to those with an additional occupation. Those aged between 30-39 years and 40-49 years were 2.37 and 4.1 times more likely to comply with road safety regulations, respectively, compared to those aged ≤29 years, and those who did not smoke were 3.15 times more likely to comply with road safety regulations than those who smoked.

CONCLUSION

Compliance to safety regulations are fairly low and although motorcycle usage on a commercial basis is yet to be legalised in Ghana, routine education targeting riders who smoke, do not have alternate occupations, do not own motorbikes and younger riders will improve their compliance. Also, riders should be encouraged to obtain their license from the appropriate authorities.

Human error in motorcycle crashes: A methodology based on in-depth data to identify the skills needed and support training interventions for safe riding

OBJECTIVE

Human error by either rider or other vehicle driver is the primary contributing factor in crashes involving powered-two-wheelers. A human-factor-based crash analysis methodology is key to enhancing the road safety effectiveness of rider training interventions. Our aim is to define a methodology that uses in-depth data to identify the skills needed by riders in the highest risk crash configurations to reduce casualty rates.

METHODS

The methodology is illustrated through a case study using in-depth data of 803 powered-two-wheeler crashes. Seven types of high-risk crash configuration based on pre-crash trajectories of the road-users involved were considered to investigate the human errors as crash contributors. Primary crash contributing factor, evasive maneuvers performed, horizontal roadway alignment and speed-related factors were identified, along with the most frequent crash configurations and those with the greatest risk of severe injury.

RESULTS

Straight Crossing Path/Lateral Direction was the most frequent crash configuration and Turn Across Path/Opposing Direction was identified as that with the highest risk of serious injury. Multi-vehicle crashes cannot be considered as a homogenous category of crashes to which the same human failure is attributed, as different interactions between motorcyclists and other road users are associated with both different types of human error and different rider reactions. Human error in multiple-vehicle crashes differed between those configurations related to crossroads and those related to rear-end and head-end crashes. Both single-vehicle crashes and multi-vehicle head-on crashes frequently occur along curves. The involved collision avoidance maneuvers of the riders differed significantly among the highest risk crash configurations. The most relevant lack of skills are identified and linked to their most representative context. In most cases a combination of different skills was required simultaneously to avoid the crash.

CONCLUSIONS

The results contribute to understand the motorcyclists' responses in high-risk crash scenarios. The findings underline the need to group accident cases, beyond the usual single-vehicle versus multi-vehicle collision approach. The different interactions with other road users should be considered to identify the competencies of the motorcyclists needed to reduce crash risks. Our methodology can be applied to increase the motorcyclists' safety by supporting preventive actions based on riders' training and eventually ADAS design.

Field testing the applicability of motorcycle autonomous emergency braking (MAEB) during pre-crash avoidance maneuver

OBJECTIVE

Autonomous Emergency Braking (AEB) is a promising technology for crash avoidance or pre-crash impact speed reduction through the automatic application of braking force. Implementation of AEB technology on motorcycles (MAEB) is still problematic as its interaction with the rider may compromise the safety. In previous studies, MAEB interventions at low decelerations were shown to be easily manageable by common riders in straight line condition, but they were not previously tested in lateral maneuvers such as lane change and swerving, which are common in pre-crash situations. The objective of this paper is to assess the applicability of MAEB activation during lateral avoidance maneuver and to estimate its benefits in this scenario.

METHODS

Field tests were carried out involving common riders as participants, using a test protocol developed on the experience of previous studies. The test vehicle was a sport-touring motorcycle equipped with an automatic braking system that could be activated remotely by researchers to simulate MAEB intervention. The motorcycle was equipped with outriggers to prevent capsizing. The Automatic Braking (AB) interventions using a nominal deceleration of 0.3 g were deployed at pseudo-random times in conditions of straight-line travel and a sharp lane-change maneuver emulating a pre-crash avoidance action. The straight-line trials were used as the reference condition for analysis.

RESULTS

Thirty-one participants experienced AB interventions in straight-line and lane-change at an average speed of 44.5 km/h. The automatic braking was deployed in all the key phases of the avoidance maneuver. The system reached a deceleration of 0.3 g for a time of intervention of approximately 1 s. The participants were consistently able to control the vehicle during the automatic braking interventions and were always able to complete the lane-change maneuver. The speed reductions obtained with the AB interventions during lane change were very similar to those obtained in the straight-line conditions.

CONCLUSIONS

MAEB interventions with decelerations up to 0.3 g can be easily managed by motorcycle riders not only in straight-line conditions but also during an avoidance maneuver. Further investigations using higher deceleration values are now possible.

The safety potential of enhanced lateral vehicle positioning

OBJECTIVE

The objective of this study is to estimate the potential safety benefits of Emergency Lane Keeping (ELK) and Autonomous Emergency Steering (AES) systems with precise and reliable lateral positioning.

METHODS

The material comprised in-depth studies of fatal road crashes in Sweden in 2017. Crashes resulting in passenger car occupant fatality (n = 114) were included; single vehicle (n = 60) and head-on (n = 31), intersection (n = 9), rear-end (n = 5), overtaking (n = 5), animal (n = 1), other (n = 1, U-turn), and train (n = 2). Additionally, fatal collisions between motor vehicles and vulnerable road users (VRUs) were included; pedestrians (n = 36), cyclists/moped users (n = 15), and motorcyclists (n = 17). A case-by-case analysis was conducted to identify crashes potentially prevented by ELK and AES with precise (within 0.1 m accuracy) and reliable lateral positioning. The identified crashes potentially avoided by ELK systems involved unintentional drift-out-of-lane on roads with posted speed limits of ≥70 km/h (43 mph). For comparison, the same material was used to identify the potential safety benefits of the more traditional lane departure warning (LDW) and Lane Keeping Assist (LKA) systems without enhanced lateral positioning. Crashes potentially avoided by LDW/LKA occurred on roads with visible lane markings and without rumble strips on the departure side while ELK with enhanced lateral positioning is not reliant on lane markings. Collisions potentially avoided by AES occurred on roads with sufficient escape zones and road friction.

RESULTS

The study shows that ELK systems with enhanced lateral positioning could potentially avoid 33 - 45 (36 - 49%) out of 91 head-on and single car crashes resulting in passenger car occupant fatality, which corresponds to a further 18% (5/28) compared to traditional lane support (LDW/LKA) without enhanced lateral positioning. The improved lane keeping addresses crashes involving absent or nonvisible lane markings that are covered by snow. Furthermore, the study shows that the evasive steering features of AES systems with enhanced lateral positioning could potentially prevent 28 (54%) out of 52 collisions resulting in passenger car occupant fatalities (i.e., head-on, intersection, rear-end, overtaking, and animal collision). Additionally, AES with enhanced lateral positioning could potentially prevent 16 (31%) out of 51 collisions between motor vehicles and vulnerable road users resulting in fatally injured pedestrians, cyclists or moped users. The total potential safety benefits of AES include both lane keeping and evasive steering features including lane escaping. The study identified that the total number of crashes potentially avoided by AES corresponds to 42% out of all crashes resulting in passenger car occupant fatalities (n = 48/114).

CONCLUSIONS

This is a first attempt to identify and quantify the increase in potential safety benefits, based on the assumption that robust lateral vehicle positioning has been applied to lane keeping as well as lane escaping. In addition to the potentially increased number of prevented crashes compared to traditional lane support, a robust lateral positioning system may have the potential to improve the redundancy in positioning systems. Previous research suggests several techniques to improve lateral vehicle positioning. However, further research is required, including testing for implementation of adequately improved lateral vehicle awareness to establish which techniques are appropriate.

Investigation of accidents involving powered two wheelers and bicycles - A European in-depth study

INTRODUCTION

The number of road fatalities have been falling throughout the European Union (EU) over the past 20 years and most Member States have achieved an overall reduction. Research has mainly focused on protecting car occupants, with car occupant fatalities reducing significantly. However, recently there has been a plateauing in fatalities amongst 'Vulnerable Road Users' (VRUs), and in 2016 accidents involving VRUs accounted for nearly half of all EU road deaths.

METHOD

The SaferWheels study collected in-depth data on 500 accidents involving Powered Two-Wheelers (PTWs) and bicycles across six European countries. A standard in-depth accident investigation methodology was used by each team. The Driver Reliability and Error Analysis Method (DREAM) was used to systematically classify accident causation factors.

RESULTS

The most common causal factors related to errors in observation by the PTW/bicycle rider or the driver of the other vehicle, typically called 'looked but failed to see' accidents. Common scenarios involved the other vehicle turning or crossing in front of the PTW/bicycle. A quarter of serious or fatal injuries to PTW riders occurred in accidents where the rider lost control with no other vehicle involvement.

CONCLUSIONS

Highly detailed data have been collected for 500 accidents involving PTWs or bicycles in the EU. These data can be further analyzed by researchers on a case-study basis to gain detailed insights on such accidents. Preliminary analysis suggests that 'looked but failed to see' remains a common cause, and in many cases the actions of the other vehicle were the critical factor, though PTW rider speed or inexperience played a role in some cases. Practical Applications: The collected data can be analyzed to better understand the characteristics and causes of accidents involving PTWs and bicycles in the EU. The results can be used to develop policies aimed at reducing road deaths and injuries to VRUs.

Patterns of traumatic injuries and outcomes to motorcyclists in a developing country: A cross-sectional study

OBJECTIVE

Motorcyclists are frequently involved in road traffic accidents and may suffer polytraumatic injuries, contributing a substantial burden on healthcare systems particularly in lower-middle-income countries. This study aimed to describe patterns of injury, in-hospital course, and outcomes of road accident trauma in motorcyclists, including polytrauma, at a Trauma Facility in Pakistan.

METHODS

A retrospective review was conducted by using relevant trauma codes to extract data from records for all victims presenting with motorcycle trauma between January 2018 and June 2019, to a tertiary care hospital in Pakistan. Data collected included victim characteristics, mechanism of accident, patterns of traumatic injury, management, in-hospital complications, and outcomes. Polytrauma was defined as traumatic injuries in two or more anatomic regions with abbreviated injury scale (AIS) ≥ 3. Multivariable logistic regression, adjusted for age, gender, and mechanism of accident, was performed to identify in-hospital complications and outcomes associated with polytrauma.

RESULTS

A total of 514 victims, 90.9% male and 39.5% aged between 18-30 years, were included in this study. The victim was the motorcycle driver in 94.6% of cases. The most common mechanism of accident was motorcycle vs. other motor vehicle (56.2%). Patients were mostly admitted under the services of Orthopedic Surgery (50.8%) and Neurosurgery (30%), with common sites of injury being the lower extremity (42.6%), head (38.1%), and upper extremity (26.8%). Polytrauma occurred in 19.5% of victims. Patients were managed surgically in 77.3% of cases, with the most common procedure being open reduction of fractures (48.1%). Blood transfusion was required in 4.1% of patients. The commonest in-hospital complication was acute kidney injury (23.7%). The median length of stay was 3 days, and 4.1% of patients expired in the hospital. Polytrauma was significantly associated with the need for blood transfusion (2.642 [1.053-6.630]), AKI (2.212 [1.339-3.652]) and hospital length of stay (1.059 [1.025-1.094]), but not with mortality.

CONCLUSION

Although orthopedic injuries occur most frequently in motorcycle trauma, polytrauma necessitating multi-disciplinary management and complicating hospital stay is also common. Understanding patterns of injuries and management in motorcycle trauma will enable trauma teams in a developing country like Pakistan to devise evidence-based management protocols, especially for cases of polytrauma.

Are motorcycles really "donorcycles"? Examining organ donation rates between unhelmeted and helmeted motorcyclists

INTRODUCTION

Motorcycles are colloquially referred to as "donorcycles" among medical staff. However, the actual impact of helmet laws and helmet use on organ donation is unknown. Michigan's 35-year-old universal helmet law (UHL) was repealed in April 2012 and replaced by a partial-helmet law. We hypothesized that there would be an increase in organ donation rates from unhelmeted motorcyclist fatalities.

METHODS

Michigan's Gift of Life Michigan organ donation database was queried from April 2008 through May 2015 in conjunction with the Michigan Trauma Quality Improvement Program database from the same time period. All in-hospital motorcycle crash fatalities were examined.

RESULTS

A three-fold increase was found in the rate of organ donation for unhelmeted motorcyclists compared to helmeted motorcyclists (p = 0.006). Motorcycle crash fatalities tended to be younger in age after the UHL repeal with an average age of 32.8 years versus 40.8, however, this finding was not statistically significant (p = 0.071). Additionally, there was no significant difference in organ donation rates pre-UHL repeal (2008-2012) versus post-repeal (2012-2015).

CONCLUSIONS

This is the first study to demonstrate an increased rate of organ donation among unhelmeted motorcyclist fatalities compared to helmeted rider fatalities. There was no significant increase in the rate of organ donation following the Michigan UHL repeal. However, we identified that some motorcycle crash fatalities were from illegally unhelmeted riders in the past, prior to the repeal. Practical Application: Unhelmeted motorcyclists are three times more likely than helmeted riders to become organ donors, possibly due to the well documented increase in severe traumatic brain injuries in this population. From a public health perspective, helmets should be required for all motorcyclists and efforts to advocate in favor of helmet legislation should be supported by trauma systems and health professionals.

Modelling two-vehicle crash severity by generalized estimating equations

The crash severity levels of two parties involved in a two-vehicle accident may differ markedly and may be correlated. Separately estimating the severity levels of two parties ignoring their potential correlation may lead to biased estimation; however, modelling their severity levels simultaneously by using a bivariate modelling approach requires a complex model setting. Thus, this study used generalized estimating equations (GEE) to accommodate potential correlations when estimating the crash severity levels of two parties. To investigate the performance of the GEE models, a case study on a total of 2493 crashes at 214 signalized intersections in Taipei City in 2013 is conducted. Univariate ordered probit model, bivariate ordered probit model, and GEE ordered probit model (GEE-OP) with different working matrices are respectively estimated and compared. The estimation results of GEE models showed that the GEE-OP with the exchangeable working matrix performs best and the most influential factor contributing to crash severity is vehicle type (motorcycle), followed by speeding, angle impact, and alcoholic use. Thus, to curtail motorcycle usage by increasing parking fee or reducing parking space of motorcycles, to crack down on speeding and alcoholic use, and to redesign the signal timings to avoid possible angle impact accidents are identified as key countermeasures.

Turn signal use among motorcyclists and car drivers: The role of environmental characteristics, perceived risk, beliefs and lifestyle behaviours

Turn signal neglect is considered to be a key contributor to crashes at intersections, yet relatively little research has been undertaken on this topic, particularly in developing countries. Using a case study of Vietnam, this research aimed to explore the role of environmental characteristics, perceived risk, beliefs and lifestyle behaviours on the frequency of turn signal use at intersections. A self-administered questionnaire was distributed to motorcyclists (n = 527) and car drivers (n = 326) using online and offline methods. Using partial least squares structural equation modelling (PLS-SEM), key findings indicate that perceived risk, beliefs and environmental characteristics play a significant role in affecting the frequency of turn signal use among motorcycle riders and car drivers at intersections. While lifestyle behaviours were not found to be a good predictor of turn signal use among car drivers, they were found to indirectly affect turn signal use among motorcycle riders through the mediation of beliefs and perceived risk. The findings can help inform the development of more targeted measures to increase turn signal use.

Helmet use among motorcycle riders in Ho Chi Minh City, Vietnam: results of a five-year repeated cross-sectional study

OBJECTIVE

In Vietnam, motorcycle riders comprise about three-quarters of road traffic fatalities, the most common cause of which is head injuries that can be prevented by wearing a helmet. This study aims to assess helmet-wearing behaviors in Ho Chi Minh City, the largest city in Vietnam.

METHODS

Eight rounds of observational studies were conducted in six randomly selected locations between July 2015 and April 2019. Given the multinomial nature of the outcome measure (not wearing a helmet; wearing a substandard helmet; wearing an unstrapped standard helmet; wearing a strapped standard helmet), a multinomial model was developed to estimate the level and trend of helmet use and identify the related individual and environmental factors.

FINDINGS

A total of 479,892 motorcycle riders were observed, over 90 % of whom were wearing helmets (range over the eight rounds: 92.5 %-96.0 %). However, the prevalence of correct helmet use (defined as wearing a strapped standard helmet) gradually declined from 80.8 % in round 1-55.6 % in round 8. Results from a multinomial model showed the probability of wearing a strapped standard helmet had declined by 22.4 percentage points from round 3 to round 8 while holding other factors constant (95 % CI: 21.8-23.0). The prevalence of correct use is 11.3 percentage points higher for adults than for children (95 % CI: 10.5-12.1). During the same period, unstrapped standard helmet use increased by 24.5 percentage points (95 % CI: 24.1-24.9); substandard helmet use declined but remained high.

CONCLUSION

The upward trend of incorrect helmet wearing behaviors and wearing substandard helmets sends a rallying call for multisectoral interventions.

A random parameter logistic model of fatigue-related motorcycle crash involvement in Hanoi, Vietnam

Since motorcycle taxi drivers often work long hours, fatigue would affect their riding abilities, impacting crash risks. However, there is limited understanding about motorcycle taxi drivers' fatigue-related crashes. This study investigates self-reported fatigue-related crashes among motorcycle taxi drivers in Hanoi, Vietnam. Results from a survey showed that approximately 16% of the motorcycle taxi drivers reported fatigue-related crash involvement. It was also found that nearly 37% of all crashes reported by motorcycle taxi drivers were related to fatigue while riding a motorcycle taxi. Results of the heterogeneity-in-means random parameter logistic model suggested that working fulltime, more delivery trips, and overweight conditions were associated with increased likelihoods of fatigue-related crash involvement. Hybrid taxi drivers, who operate as either traditional or ride-hailing taxi drivers at different times, and most ride-hailing taxi drivers had a reduced likelihood of fatigue-related crash involvement when compared to traditional taxi drivers. Overall, this study has revealed a significant issue of fatigue-related crashes among motorcycle taxi drivers. Immediate interventions via publicity or educational campaigns should be considered by authorities to address this important issue. Ride-hailing companies should contribute by sending warnings of excessive riding hours to ride-hailing taxi drivers.

Age and engine displacement are associated with unsafe motorcycle rider actions

BACKGROUND

Our goal was to examine the relationship between age and engine displacement in cubic centimeters (CCs) and crash responsibility.

METHODS

Male motorcyclists, aged 16-94, involved in a fatal crash in the United States (1987-2015) who tested negative for both drugs and alcohol were included. Employing a case control design, cases had committed one or more Unsafe Motorcyclist Actions (UMAs), the proxy measure of responsibility; controls had no UMAs recorded. Odds ratios were computed via multinomial regression examining the effect of motorcyclists' age and motorcycle displacement (up to 1500 CCs, in 250 CC increments) on crash responsibility by any UMA and top three individual UMAs committed.

RESULTS

A total of 19,166 motorcyclists met our inclusion criteria. Increased displacement was observed in older motorcyclists and in more recent crashes. Fifty-six percent of motorcyclists committed one or more UMAs (n = 10,743). The top three individual UMAs were: Speeding (35%, n = 6,728), Weaving (24%, n = 3,269), and Erratic Operation (6%, n = 1,162). Odds ratios for committing any UMA were the greatest for riders on 750 CC motorcycles, followed closely by 500 and 1000 CC motorcycles. By 1250 CCs the effect of displacement on rider crash responsibility (any UMA) was no longer statistically significant. Typically, younger ages (e.g., 20-30) on motorcycles with 500-1000 CCs were associated with the highest odds of either speeding, weaving, or erratic riding compared to similar aged riders on 250 CC motorcycles. Exceptions were observed, for example riders at 70 years of age on 1500 CCs having higher odds of speeding than younger riders on equivalent CC motorcycles.

CONCLUSION

Education and legislative measures should be considered. Educationally, the development of training interventions focusing on control, stability, and breaking differences with more powerful motorcycles (750 to 1250 CCs) is needed. Legislatively, licensing tiers could be employed based on displacement and educational requirements. Education and legislative measures could help to curb the trend seen between high-powered motorcycles and crash responsibility.

The characteristics of dockless electric rental scooter-related injuries in a large U.S. city

OBJECTIVE

To describe the characteristics of dockless electric rental scooter ("e-scooter")-related injuries presenting to two emergency departments in one large U.S. city.

METHODS

This observational cohort study utilized the city's public health syndromic surveillance system to prospectively identify patients with e-scooter-related injuries presenting between September and November 2018. The medical records for all adult patients treated at the two participating emergency departments were manually reviewed to extract demographic and clinical data. Cases involving mobility scooters or non-electric scooters were excluded.

RESULTS

For the 124 included adult patients with e-scooter-related injuries, the median age was 30 years (IQR: 22-43), they were predominantly male (59.7%), and approximately half (51.6%) arrived by ambulance. Falling from the scooter (84.7%) was the most common mechanism; twelve patients (9.7%) had collided with a motor vehicle. Head and face injuries (45.5%) were common; only 2 patients (1.6%) were documented as wearing a helmet at the time of injury. Most patients (n = 112, 90.3%) required imaging, more than half (n = 78, 62.9%) required an emergency department procedure, and 26 (21.0%) required surgical intervention. Most patients were discharged home, but 35 (28.2%) were admitted to hospital. Two patients (1.6%) were admitted to the intensive care unit.

CONCLUSIONS

E-scooters are an emerging transportation technology associated with a wide range of potentially serious injuries that consume substantial emergency department and hospital resources. Head injuries are a particular concern, as few e-scooter riders are wearing helmets at the time of injury.

Evaluating the combined effect of alcohol-involved and un-helmeted riding on motorcyclist fatalities in Taiwan

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.

Mobile phone use among car drivers and motorcycle riders: The effect of problematic mobile phone use, attitudes, beliefs and perceived risk

Mobile phone use while driving presents significant risks, potentially leading to injury or death through distracted driving. Using a case study of Vietnam, this research aimed to understand the effect of problematic mobile phone use (also known as mobile phone addiction or compulsive mobile phone use), attitudes and beliefs, and perceived risk on the frequency of mobile phone use among motorcyclists and car drivers. A self-administered questionnaire was distributed to motorcyclists (n₁= 529) and car drivers (n₂= 328) using an online survey and face-to-face survey. The survey took around 20-min to complete and participants were entered into a lottery for supermarket vouchers. Of the motorcyclists, 42% of the sample (the highest proportion) was in the 18-25 age group while the 36-45 age group accounted for the highest proportion among car drivers (34.8%). Using structural equation modelling (SEM), key findings showed that each construct influenced mobile phone use, but in different ways for motorcycle riders and car drivers. Attitudes and beliefs had the largest effect on mobile phone use while riding among motorcyclists, with problematic mobile phone use having the smallest influence. In contrast, problematic mobile phone use had the largest effect on mobile phone use while driving a car, with attitudes and beliefs having the smallest effect. The findings of this study point to the need for tailored interventions involving a range of actors (policymakers, police enforcement, mental health professionals, advocacy groups and the wider community) to raise awareness, modify attitudes and increase risk perception associated with mobile phone use while driving/riding. This can be achieved thorough educational tools and road safety campaigns which are focused on reducing this risky driving behaviour. This includes customising road safety programs for individuals and groups affected by problematic mobile phone use such as targeted advertising.

Mobile phone use among Indonesian motorcyclists: prevalence and influencing factors

OBJECTIVE

Indonesia is one of many developing countries that relies on motorcycles as a major mode of transportation. Unfortunately, the widespread use of motorcycles in Indonesia coincides with a high number of motorcycle accidents which can often be attributed to unsafe behaviors of the motorcyclist. One unsafe behavior that is common and hypothetically associated with accidents is the use of a mobile phone while motorcycling. The aim of the present study was to observe the prevalence and behavior of mobile phone use among Indonesian motorcyclists and the factors that might have influenced their behavior.

METHODS

Five hundred Indonesian motorcyclists voluntarily participated in this study by filling out a questionnaire that gathered demographic data, motorcycling behaviors, and a statement related to what factors might influence their likelihood to use a mobile phone while motorcycling. A descriptive statistic and Structural Equation Modeling were applied in analyzing the data.

RESULTS

Results showed that the prevalence of mobile phone use among Indonesian motorcyclists was 75%. The demographic data that significantly influenced mobile phone use during motorcycling were age, education level, marital status, and number of children. Occupation, gender, and prior experiences that included accidents and tickets with fines did not influence the use of mobile phones during motorcycling. The behavioral model showed that the factors that influenced motorcyclist's intentions to avoid mobile phone use during motorcycling were attitude, perceived behavioral control, and cues to action.

CONCLUSIONS

This study supports previous findings regarding the high prevalence of mobile phone use among motorcyclists in developing countries. The models implied that further investigation on intervention strategy to minimize mobile phone use during motorcycling is a necessity.

A multinomial logit model of motorcycle crash severity at Australian intersections

INTRODUCTION

Motorcyclists are exposed to more fatalities and severe injuries per mile of travel as compared to other vehicle drivers. Moreover, crashes that take place at intersections are more likely to result in serious or fatal injuries as compared to those that occur at non-intersections. Therefore, the purpose of this study is to evaluate the contributing factors to motorcycle crash severity at intersections.

METHOD

A data set of 7,714 motorcycle crashes at intersections in the State of Victoria, Australia was analyzed over the period of 2006-2018. The multinomial logit model was used for evaluating the motorcycle crashes. The severity of motorcycle crashes was divided into three categories: minor injury, serious injury and fatal injury. The risk factors consisted of four major categories: motorcyclist characteristics, environmental characteristics, intersection characteristics and crash characteristics.

RESULTS

The results of the model demonstrated that certain factors increased the probability of fatal injuries. These factors were: motorcyclists aged over 59 years, weekend crashes, midnight/early morning crashes, morning rush hours crashes, multiple vehicles involved in the crash, t-intersections, crashes in towns, crashes in rural areas, stop or give-way intersections, roundabouts, and uncontrolled intersections. By contrast, factors such as female motorcyclists, snowy or stormy or foggy weather, rainy weather, evening rush hours crashes, and unpaved roads reduced the probability of fatal injuries. Practical Applications: The results from our study demonstrated that certain treatment measures for t-intersections may reduce the probability of fatal injuries. An effective way for improving the safety of stop or give-way intersections and uncontrolled intersections could be to convert them to all-way stop controls. Further, it is recommended to educate the older riders that with ageing, there are physiological changes that occur within the body which can increase both crash likelihood and injury severity.

Crash risk factors for novice motorcycle riders

BACKGROUND

Motorcycle riders have the highest injury and fatality rates among all road users. This research sought in-depth understanding of crash risk factors to help in developing targeted measures to reduce motorcycle crash injuries and fatalities.

METHODS

We used interview data from a study of 2,399 novice motorcycle riders in Victoria, Australia from 2010 to 2012 linked with their police-recorded crash and offence data. The outcome measure was self and/or police reported crash. The association between potential risk factors and crashes was explored in multivariable logistic regression models.

RESULTS

In the multivariable analysis, riders who reported being involved in three or more near crashes had 1.74 times (95% CI 1.11-2.74) higher odds of crashing compared to riders who reported no near-crash events, and riders who participated in a pre-learner course had 1.41 times higher odds of crashing (95% CI 1.07-1.87) compared with riders who did not attend a pre-learner course. Riders who had been involved in a crash before the study had 1.58 times (95% CI 1.14-2.19) higher odds of crashing during the study period compared with riders who were not involved in a crash. Each additional month of having held a license and learner permit decreased the odds of crashing by 2%, and each additional 1,000 km of riding before the study increased the odds of crashing by 2%.

CONCLUSION

Measures of pre-learner training and riding experience were the strongest predictors of crashing in this cohort of novice motorcycle riders. At the time of the study there was no compulsory rider training to obtain a learner permit in Victoria and no on-road courses were available. It may be plausible that riders who voluntarily participated in an unregulated pre-learner course became or remained at high risk of crash after obtaining a rider license. We suggest systematically reviewing the safety benefits of voluntary versus mandatory pre-learner and learner courses and the potential need to include on-road components.

Pattern of mandibular fractures and helmet use among motorcycle crash victims in Tanzania

BACKGROUND

The maxillofacial structures are commonly affected in motorcycle crashes, with the mandible being one of the most frequently fractured bones. Helmets have been shown to have a protective effect in preventing maxillofacial injuries, however, its effect on the occurrence of mandibular fractures is not very well established.

OBJECTIVES

To evaluate the pattern of mandibular fractures among motorcycle crash victims in Tanzania, and determine the role of helmets in occurrence of mandibular fractures among the motorcyclists.

METHODOLOGY

This was a 6-months prospective, cross-sectional study that recruited motorcycle crash victims who reported with mandibular fractures following motorcycle crash at Muhimbili National Hospital. A specially designed questionnaire was used for data collection. For purpose of analysis, the Statistical Package for Social Sciences software version 20 was used.

RESULTS

The study included a total of 132 participants of whom majority were male (120, 90.9%). The peak age incidence was 21-40 years in 76.5% of the victims. More than half (89, 67.4%) of the victims were riders during the crash. Helmet use was reported in 42.3% of the victims, and majority (67.3%) were usinghalf-face helmets. The symphysis region was the frequently fractured anatomical location (50, 37.9%). More than half of the victims had multiple site involvement, with higher odds observed in individuals wearing half-face helmets.

CONCLUSION

Young males were affected ten times more than females. Most of the victims were riders during the crash. The symphysis region was the frequently fractured anatomical site. There was no difference in occurrence of mandibular fractures between those who wore and those who did not wear helmets during the crashes. However, the severity of mandibular fractures was dependent on the type of helmet used.

The effects of economic stress and urbanization on driving behaviours of Boda-boda drivers and accidents in Gulu, Northern Uganda: a qualitative view of drivers

INTRODUCTION

Understanding motorcyclists' on-the-road behaviour is critical for developing and evaluating interventions specifically targeting them. Risky on-the-road behaviours have historically been subdivided into errors and violations of the rules of road use. Police records could be used to record cyclists' behaviours, however these documents do not necessarily capture all errors and violations. None use of protective wears have been documented in many studies conducted on Boda-boda drivers in Uganda. The relationship between drivers' economic stress and road safety have been studied for many years but the effects of global and economic stress, its joint effects on behaviours of drivers in relations to accidents have received very little attention. This study aimed at assessing the relationship between injuries and the Boda-boda drivers' behaviours in Northern Uganda.

METHODS

Two hundred Boda-boda drivers from Gulu Municipality had face-to-face interviews to assess views and underlying factors on the issue of high prevalence of motorcycle road traffic accidents and injuries. Descriptive statistics were used to describe factors on road accidents including personal information, knowledge, skills and attitudes towards road use and safety. The study was approved by a local Institutional Review Board (IRB).

RESULTS

Collectively, the results showed that economic stress is an important factor that affects drivers' behaviour and increases their risks to motorcycle accidents.

CONCLUSION

These authors suggest that more studies should be conducted to determine the relationship between economic stress, anger and dangerous behaviours among Boda-boda drivers and accidents in Gulu Municipality using a Motorcycle Rider Behaviour Questionnaire (MRBQ).

Mapping fractures from traffic accidents in Sweden: How do cyclists compare to other road users?

Introduction: Cyclists account for a large share of injured road users in traffic. The crash data analysis for cyclist safety and protection should be based on a representative dataset of real-world crashes. This manuscript aimed to explore the patterns of cyclists' fractures and factors associated with fractures of higher severity.Methods: This paper exemplifies a methodology that combines injuries from a crash database, including both hospital and police reports and fracture registry database from orthopedic centers nationally in Sweden.Results: Car occupants were most frequently involved in crashes resulting in fractures (37%), followed by motorcyclists (27.6%) and bicyclists (15.4%). Common fracture locations differed by the type of road user, where cyclists were more frequently fractured in the lower arm, compared to other road users, such as car drivers, motorcyclists and pedestrians who suffered mostly of fractures in the lower leg. Within cyclists, injuries also differed by gender, suggesting that combination of different countermeasures may be needed in order to provide sufficient protection for all cyclist. In the analyzed data, male cyclists with an average age of 49 were the most frequently fractured cyclists. Fractures of cyclists to the acetabulum (100%), pelvis (84.2%), vertebra (75%) and tibia (70.3%) were most frequently high energy fractures. Single bicycle incidents (OR = 0.165) and collisions with another bicycle (OR = 0.148) were significantly less likely to result in a high energy fracture than a collision with a car.Conclusions: The results of this study may guide the design of appropriate protective devices for the cyclists based on the different injury mechanisms and provide implications for prioritizing new countermeasures, campaigns, or regulations.

The importance of flow composition in real-time crash prediction

Previous real-time crash prediction models have scarcely used data disaggregated by vehicle type such as light, heavy and motorcycles. Thus, little effort has been made to quantify the impact of flow composition variables as crash precursors. We analyze the advantages of having access to this data by analyzing two scenarios, namely, with aggregated and disaggregated data. For each case, we build Logistics Regressions and Support Vector Machines models to predict accidents in a major urban expressway in Santiago, Chile. Our results show that having access to disaggregated data by vehicle type increases the prediction power up to 30 % providing, at the same time, much better intuition about the actual traffic conditions that may lead to accidents. These results may be useful when evaluating technology investments and developments in urban freeways.

The injury epidemiology of adult riders in vehicle-two-wheeler crashes in China, Ningbo, 2011-2015

INTRODUCTION

We used road crashes between vehicles and two-wheelers from Yinzhou District Ningbo in 2011-2015 from the China In-depth Accident Study (CIDAS) as sample cases. The risk factors of different injury severity grades were analyzed.

METHOD

The classification tree model was used to screen the possible interaction items, and the corresponding regression model was constructed according to the results of the tree model to explore the influencing factors of cyclist injury.

RESULTS

The road types, weather types, gender, age of the riders, and vehicle speed were significantly correlated with the dependent variables. The interaction effect of gender*road type, weather*age, weather*speed and speed*age were obtained through a tree model.

CONCLUSIONS

The risk of male casualties at the crossroads was 3.31 times higher than that of female casualties at the straight roads. On sunny days, the risk of crash casualties in Ningbo was low, and the fatality risk when the speed reached 38 km/h was 10%. Under the interaction effect of weather and age, the fatality risk in cloudy/foggy and rainy days was almost coincident, and the serious risk in cloudy/foggy conditions was the highest. Practical applications: Through factor analysis, it is confirmed that there is interaction effect among the factors, and it can provide reference for relevant departments to formulate more targeted and effective governance strategies.

High-speed helmeted head impacts in motorcycling: A computational study

The motorcyclist is exposed to the risk of falling and impacting ground head-first at a wide range of travelling speeds - from a speed limit of less than 50 km/h on the urban road to the race circuit where speed can reach well above 200 km/h. However, motorcycle helmets today are tested at a single and much lower impact speed, i.e. 30 km/h. There is a knowledge gap in understanding the dynamics and head impact responses at high travelling speeds due to the limitation of existing laboratory rigs. This study used a finite element head model coupled with a motorcycle helmet model to simulate head-first falls at travelling speed (or tangential velocity at impact) from 0 to 216 km/h. The effect of different falling heights (1.6 m and 0.25 m) and coefficient of frictions (0.20 and 0.45) between the helmet outer shell and ground were also examined. The simulation results were analysed together with the analytical model to better comprehend rolling and/or sliding phenomena that are often observed in helmet oblique impacts. Three types of helmet-to-ground interactions are found when the helmet impacts ground from low to high tangential velocities: (1) helmet rolling without slipping; (2) a combination of sliding and rolling; and (3) continuous sliding. The tangential impulse transmitted to the head-helmet system, peak angular head kinematics and brain strain increase almost linearly with the tangential velocity when the helmet rolls but plateaus when the helmet slides. The critical tangential velocity at which the motion transit from the rolling regime to the sliding regime depends on both the falling height and friction coefficient. Typically, for a fall height of 1.63 m and a friction coefficient of 0.45, the rolling/sliding transition occurs at a tangential velocity of 10.8 m/s (38.9 km/h). Low sliding resistance in helmet design, i.e. by the means of a lower friction coefficient between the helmet outer shell and ground, has shown a higher reduction of brain tissue strain in the sliding regime than in the rolling regime. This study uncovers the underlying dynamics of rolling and sliding phenomena in high-speed oblique impacts, which largely affect head impact biomechanics. Besides, the study highlights the importance of testing helmets at speeds covering both the rolling and sliding regime since potential designs for improved head protection at high-speed impacts can be more distinguishable in the sliding regime than in the rolling regime.

Different demographic and drinking profiles of motorcyclists and car drivers with the first-time offense of driving/riding under the influence of alcohol

BACKGROUND

Driving/riding under the influence (DUI) of alcohol is a major public concern worldwide. Only a few studies have distinguished DUI-related variables between motorcyclists and car drivers. This study examined the differences in demographic characteristics and drinking behaviors among first-time DUI offenders operating different transportation vehicles, and risk factors for frequent DUI (fDUI) among them.

METHODS

We conducted an anonymous survey for 561 first-time DUI offenders who attended a mandatory educational program. Participants self-administered questionnaires concerning alcohol drinking behaviors and DUI. We defined fDUI as at least two DUI behaviors per month based on self-reported information. Demographic and drinking characteristics were compared between DUI offenders, car drivers and motorcyclists. Logistic regression analysis was used to examine risk factors for fDUI.

RESULTS

Two-thirds of first-time DUI offenders were motorcyclists. Compared with car drivers, motorcyclists were younger and less educated, with a higher percentage of them being women and unmarried. Car drivers reported a higher rate of fDUI than motorcyclists (16.5% vs. 9.7%). Regression analysis revealed that binge drinkers had a higher fDUI risk in both groups. Regarding the drinking place prior to DUI behavior, workplace was significantly associated with fDUI in car drivers.

CONCLUSIONS

Distinct strategies may be required for motorcyclists and car drivers for DUI recidivism prevention, and drinking place interventions should also be considered.

Detecting motorcycle helmet use with deep learning

The continuous motorization of traffic has led to a sustained increase in the global number of road related fatalities and injuries. To counter this, governments are focusing on enforcing safe and law-abiding behavior in traffic. However, especially in developing countries where the motorcycle is the main form of transportation, there is a lack of comprehensive data on the safety-critical behavioral metric of motorcycle helmet use. This lack of data prohibits targeted enforcement and education campaigns which are crucial for injury prevention. Hence, we have developed an algorithm for the automated registration of motorcycle helmet usage from video data, using a deep learning approach. Based on 91,000 annotated frames of video data, collected at multiple observation sites in 7 cities across the country of Myanmar, we trained our algorithm to detect active motorcycles, the number and position of riders on the motorcycle, as well as their helmet use. An analysis of the algorithm's accuracy on an annotated test data set, and a comparison to available human-registered helmet use data reveals a high accuracy of our approach. Our algorithm registers motorcycle helmet use rates with an accuracy of -4.4% and +2.1% in comparison to a human observer, with minimal training for individual observation sites. Without observation site specific training, the accuracy of helmet use detection decreases slightly, depending on a number of factors. Our approach can be implemented in existing roadside traffic surveillance infrastructure and can facilitate targeted data-driven injury prevention campaigns with real-time speed. Implications of the proposed method, as well as measures that can further improve detection accuracy are discussed.

A data mining approach to investigate patterns of powered two-wheeler crashes in Spain

Powered two-wheelers (PTWs) are growing globally each year as they are considered an attractive alternative to cars (flexible, small, affordable, fast and easy to park), especially on congested traffic situations. However, PTWs represent an important challenge for road safety. In fact, in 2016, Spain ranked fifth in terms of PTW fatalities among EU 28. For this reason, this paper aims to investigate which are the patterns among crash characteristics contributing to PTW crashes in Spain. Data from 78,611 crashes involving PTWs occurred in Spain in the period 2011-2013 were analyzed. The analysis was performed by using classification trees and rules discovery which are suitable models aimed at extracting knowledge and identifying valid and understandable patterns from large amounts of data previously unknown and indistinguishable. The response variables assessed in this study were severity and crash type. As a result, several combinations of road, environmental and drivers' characteristics associated with severity and typology of PTW crashes in Spain were identified. Based on the analysis results, several countermeasures to solve or mitigate the safety issues identified in the study were proposed. From the methodological point of view, study results show that both the classification trees and the a priori algorithm were effective in providing non-trivial and unsuspected relations in the data. Classification trees structure allowed a simpler understanding of the phenomenon under study while association discovery provided new information which was previously hidden in the data. Given that the results of the two different techniques were never contradictory, we recommend using classification trees and association discovery as complementary approaches since their combination is effective in exploring data providing meaningful insights about PTW crash characteristics and their interdependencies.

Riding behavior and electric bike traffic crashes: A Chinese case-control study

Objective: The present case-control study sought to explore at-risk riding behaviors associated with e-bike related traffic crashes among e-bike riders in China.Methods: Cases were recruited from residents aged 16 years and over in communities which stated "selected e-bikes as travel tools and experienced traffic crashes in the last year". Two controls for each case were randomly selected from a population of e-bike riders who had not experienced a traffic crash in the past year. The cases and controls were matched by gender, age (within 5 years) and school education level. Data were collected using questionnaires and face-to-face interviews from July 2015 to September 2015 in China. After conducting univariate logistic analysis on study variables, a conditional logistic regression model based on the 1:2 matched case-control study design was developed.Results: Multiple-factor conditional logistic regression analysis of e-bike related traffic crashes showed that running red lights (always vs. never, AOR = 3.094, 95% CI, 1.077-8.891, P < .05), riding after drinking (yes vs. no, AOR = 1.578, 95% CI, 1.102-2.259, P < .05), carrying adults while riding (always vs. never, AOR = 2.140, 95% CI, 1.273-3.595, P < .05), turning without signaling (sometimes vs. never, AOR = 1.446, 95% CI, 1.805-1.928, P < .05), riding in the motor vehicle lane (always vs. never, AOR = 2.413, 95% CI, 1.576-3.695, P < .01), prior crash history (yes vs. no, AOR = 1.670, 95% CI, 1.257-2.220, P < .05), and type of e-bikes (scooter-style e-bikes vs. bicycle-style e-bikes, AOR = 1.471, 95% CI, 1.068-2.026, P < .05) were identified as possible risk factors for e-bike traffic crashes.Conclusion: The findings of this research provide evidence about specific risky behaviors related to road traffic crashes involving e-bikes and indicated that behavioral intervention and education need to be strengthened to reduce dangerous riding behaviors. These results will be helpful for design of e-bike road risk prevention programs.

Mobile phone related crashes among motorcycle taxi drivers

In many countries, motorcycle taxis remain an important mode of travel due to their fast, flexible, and inexpensive service. The recent advent of ride-hailing services has led to dramatic growth in the fleet of motorcycle taxis and additional types of motorcycle taxi drivers. Furthermore, mobile phone use while riding a motorcycle is an emerging safety issue, particularly among ride-hailing motorcycle taxi drivers. This paper investigates mobile phone use while riding, crashes and mobile phone related crashes among ride-hailing, traditional, and hybrid motorcycle taxi drivers, using data from a survey in Hanoi, Vietnam. Results show that ride-hailing motorcycle taxi drivers had the highest prevalence of mobile phone use while riding a motorcycle taxi (95.3%), followed by hybrid (88.6%) and traditional taxi drivers (64%). Approximately 32.6%, 19.3%, and 9.7% of motorcycle taxi drivers reported being involved in a crash, injury crash, and mobile phone related crash respectively. Mobile phone related crashes represent 20.5% of all reported crashes. Logistic and negative binomial regression were used to explore factors influencing mobile phone use while riding and crash frequencies. Regression results indicate that ride-hailing taxi drivers were more likely to be involved in a mobile phone related crash. Delivery trips were found to be associated with increases in crashes whereas passenger trips were found to be associated with decreases in crashes. Policy implications are also discussed.

The road to recovery for vulnerable road users hospitalised for orthopaedic injury following an on-road crash

BACKGROUND

Pedestrians, cyclists and motorcyclists are vulnerable to serious injury due to limited external protective devices. Understanding the level of recovery, and differences between these road user groups, is an important step towards improved understanding of the burden of road trauma, and prioritisation of prevention efforts. This study aimed to characterise and describe patient-reported outcomes of vulnerable road users at 6 and 12 months following orthopaedic trauma.

METHODS

A registry-based cohort study was conducted using data from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) and included pedestrians, cyclists and motorcyclists who were hospitalised for an orthopaedic injury following an on-road collision that occurred between January 2009 and December 2016. Outcomes were measured using the 3-level EuroQol 5 dimensions questionnaire (EQ-5D-3 L), Glasgow Outcome Scale - Extended (GOS-E) and return to work questions. Outcomes were collected at 6 and 12 months post-injury. Multivariable generalized estimating equations (GEE), adjusted for confounders, were used to compare outcomes between the road user groups over time.

RESULTS

6186 orthopaedic trauma patients met the inclusion criteria during the 8-year period. Most patients were motorcyclists (42.8%) followed by cyclists (32.6%) and pedestrians (24.6%). Problems were most prevalent on the usual activities item of the EQ-5D-3 L at 6-months post-injury, and the pain/discomfort item of the EQ-5D-3 L at 12 months. The adjusted odds of reporting problems on all EQ-5D-3 L items were lower for cyclists when compared to pedestrians. Moreover, an average cyclist had a greater odds of a good recovery on the GOS-E, (AOR 2.75, 95% CI 2.33, 3.25) and a greater odds of returning to work (AOR = 3.13, 95% CI 2.46, 3.99) compared to an average pedestrian.

CONCLUSION

Pedestrians and motorcyclists involved in on-road collisions experienced poorer patient-reported outcomes at 6 and 12 months post-injury when compared to cyclists. A focus on both primary injury prevention strategies, and investment in ongoing support and treatment to maximise recovery, is necessary to reduce the burden of road trauma for vulnerable road users.

When policy meets the pedal: A reduction in motorcyclist fatalities following the implementation of a road traffic law in Lagos, Nigeria

Objective: The Lagos State Road Traffic Law of 2012 sought to curb reckless okada use and the objective of this study is to determine its impact on motorcyclist fatalities in Nigeria's most densely populated state. This is the first study to date that analyzes the potential impact of the Law on motorcyclist fatalities across Lagos State.Methods: We retrospectively reviewed monthly motorcyclist fatalities in Lagos between January 2012 and December 2015. We analyzed the data using Geographic Information Systems (GIS) software, and used Quantum GIS ver. 2.16.2 to create maps illustrating the spatial-epidemiological distribution of motorcyclist fatalities across Lagos' health facilities. The data was collated into three eight-month periods for analysis (pre-intervention, immediate post-intervention, and sustained post-intervention). Period 1 was January to August 2012, Period 2 was September 2012 to April 2013, and Period 3 was May to December 2013. The data were compared in SPSS using the Welch's ANOVA and Tanhame (post-hoc) tests with a 5% significance level.Results: Motorcyclist fatalities in Lagos fell by an average of 76% over the study period. Over 55% of the fatalities were recorded in five health facilities, located in an area of high road network density. The number of newly registered motorcycles also declined by an average of 69%. The Welch's ANOVA yielded a statistically significant difference between the Periods' means (p < 0.0001). The Tamhane post-hoc test showed significant differences in the mean decrease in fatalities between Period 1 and Period 2 (p = 0.002), and Period 1 and Period 3 (p < 0.0001).Conclusions: This study shows a significant decline in motorcyclist fatalities following the implementation of the Lagos State Road Traffic Law of 2012. A more comprehensive approach to data collection along with an updated law could contribute towards a sustainable reduction of motorcyclist mortality.

Driver-related risk factors of fatal road traffic crashes associated with alcohol or drug impairment

Fatal road traffic crashes are often related to speeding, non-use of a seatbelt, and alcohol/drug-impaired driving. The aim of this study was to examine associations between driving under the influence of drugs and/or alcohol and driver-related risk factors that have been reported as significantly contributing causes of fatal road traffic crashes. The data were extracted from Norwegian road traffic crash registries and forensic toxicology databases. Drug/alcohol investigated car and van drivers and motorcycle riders fatally injured in road traffic crashes in Norway during 2005-2015 were included in this study (n = 772). Drug and alcohol concentrations corresponding to 0.5 g/kg alcohol in blood were used as the lower limits for categorising drivers/riders as impaired; 0.2 g/kg was the upper limit for being categorised as sober. Associations between driver-related risk factors and impairment from specific substance groups were calculated using multivariable logistic regression, adjusted for other substance groups, age, and sex, and were reported when the confidence intervals did not contain the value 1 or lower. Substances found in concentrations above the impairment limits were mainly alcohol (20%), medicinal drugs (10%: benzodiazepines, opioids, z-hypnotics), stimulants (5%: amphetamines, methylphenidate, and cocaine), and cannabis (4%: THC). The drug/alcohol-impaired drivers had compared to the sober drivers more often been speeding (68% versus 32%), not used a seatbelt (69% versus 30%), and been driving without a valid driver license (26% versus 1%). Logistic regression analysis showed that impairment from alcohol or stimulants (mainly amphetamines) was associated with all three risk factors, medicinal drugs with all except speeding, and impairment from cannabis (THC) with not having a valid driver license. Among motorcycle riders, drug/alcohol impairment was associated with not having a valid driver license and non-use of a helmet. At least one of the risk factors speeding, non-use of a seatbelt/helmet, and driving without a valid license were present among the vast majority of the drug/alcohol-impaired fatally injured drivers and riders, and also among more than half of the fatally injured sober drivers.

A Comparison of Skeletal Injuries Arising from Moped and Motorcycle Collisions

Motorcycle and moped injuries remain a significant cause of motor-vehicle related morbidity and mortality. There is a paucity of literature describing the skeletal injuries of moped riders and how these compare to those of motorcyclists, however. This study seeks to examine the skeletal injuries sustained in such incidents and determine if there are significant differences. Hospitalized riders injured on powered two-wheeled vehicles (PTW) between 2004 and 2007 were entered into a registry along with their presentation and clinical course. This registry was sorted by PTW type. Riders with injuries of the appendicular skeleton, bony pelvis, and spine were extracted. Injuries were categorized by bone location. Demographic data, helmet use, head injury, facial fracture, Injury Severity Score (ISS), and mortality were extracted. Overall, 406/578 motorcyclists, 197/357 moped riders, and 62/92 dirt-bike riders sustained fractures of the appendicular skeleton, pelvis and/or spine. Motorcyclists had a significantly higher ISS upon presentation and had increased first-hospital day mortality in addition to more skeletal injuries, more fractures of the upper extremity, and more fractures of the spine, pelvis, and foot. Moped riders had a significantly lower rate of helmet use and higher rate of head injuries and facial fractures. In summary, while both moped and motorcycle riders share a risk for injuries of the lower extremity, their overall pattern of injury differs. Motorcyclists appear to be at increased risk for more severe injuries and injuries of the upper extremity, spine, and pelvis, while moped riders are at increased risk for significant head and facial injury.

Investigating injury severities of motorcycle riders: A two-step method integrating latent class cluster analysis and random parameters logit model

Due to the wide existence of heterogeneous nature in traffic safety data, traditional methods used to investigate motorcyclist rider injury severity always lead to masking of some underlying relationships which may be critical for the formulation of efficient safety countermeasures. Instead of applying one single model to the whole dataset or focusing on pre-defined crash types as done in previous studies, the present study proposes a two-step method integrating latent class cluster analysis and random parameters logit model to explore contributing factors influencing the injury levels of motorcyclists. A latent class cluster approach is first used to segment the motorcycle crashes into relatively homogeneous clusters. A mixed logit model is then elaborately developed for each cluster to identify its unique influential factors. The analysis was based on the police-reported crash dataset (2015-2017) of Hunan province, China. The goodness-of-fit indicators and the Receiver Operating Characteristic curves show that the proposed method is more accurate when modeling the riders' injury severities. The heterogeneity found in each homogeneous subgroup supports the application of the random parameters logit model in the study. More importantly, the results demonstrate that segmenting motorcycle crashes into relatively homogeneous clusters as a preliminary step helps to uncover some important influencing factors hidden in the whole-data model. The proposed method is proved to have great potential for accounting for the source of heterogeneity. The injury risk factors identified in specific cases provide more reliable information for traffic engineers and policymakers to improve motorcycle traffic safety.

Examining correlations between motorcyclist's conspicuity, apparel related factors and injury severity score: Evidence from new motorcycle crash causation study

Motorcyclists are vulnerable road users at a particularly high risk of serious injury or death when involved in a crash. In order to evaluate key risk factors in motorcycle crashes, this study quantifies how different "policy-sensitive" factors correlate with injury severity, while controlling for rider and crash specific factors as well as other observed/unobserved factors. The study analyzes data from 321 motorcycle injury crashes from a comprehensive US DOT FHWA's Motorcycle Crash Causation Study (MCCS). These were all non-fatal injury crashes that are representative of the vast majority (82%) of motorcycle crashes. An anatomical injury severity scoring system, termed as Injury Severity Score (ISS), is analyzed providing an overall score by accounting for the possibility of multiple injuries to different body parts of a rider. An ISS ranges from 1 to 75, averaging at 10.32 for this sample (above 9 is considered serious injury), with a spike at 1 (very minor injury). Preliminary cross-tabulation analysis mapped ISS to the Abbreviated Injury Scale (AIS) injury classification and examined the strength of associations between the two. While the study finds a strong correlation between AIS and ISS classification (Kendall's tau of 0.911), significant contrasts are observed in that, when compared to ISS, AIS tends to underestimate the severity of an injury sustained by a rider. For modeling, fixed and random parameter Tobit modeling frameworks were used in a corner-solution setting to account for the left-tail spike in the distribution of ISS and to account for unobserved heterogeneity. The developed random parameters Tobit framework additionally accounts for the interactive effects of key risk factors, allowing for possible correlations among random parameters. A correlated random parameter Tobit model significantly out-performed the uncorrelated random parameter Tobit and fixed parameter Tobit models. While controlling for various other factors, we found that motorcycle-specific shoes and retroreflective upper body clothing correlate with lower ISS on-average by 5.94 and 1.88 units respectively. Riders with only partial helmet coverage on-average sustained more severe injuries, whereas, riders with acceptable helmet fit had lower ISS Methodologically, not only do the individual effects of several key risk factors vary significantly across observations in the form of random parameters, but the interactions between unobserved factors characterizing random parameters significantly influence the injury severity score as well. The implications of the findings are discussed.

An analysis of cyclists' speed at combined pedestrian and cycle paths

Objective: In Sweden, cyclists, pedestrians, and moped riders share the space on combined pedestrian and cycle paths, and their speeds may differ greatly. Both actual speed and speed differences can potentially influence the number of accidents on the shared paths. As a starting point, this article studies the speed component and how cyclists' speed varies at pedestrian and cycle paths depending on the day, week, and year; road user composition; and road design.Methods: Three data sources were used: Existing measurements of cycle speed and flow in 3 different Swedish municipalities, Eskilstuna (1 site, January-December 2015), Linköping (6 sites, 4 weeks in September-October 2015), and Stockholm (10 sites, 1-5 days in August-September 2015); complementary measurements of cycle speed and flow in Linköping (4 sites, 1-10 days in August-September 2016) and Stockholm (1 site, only part of 2 days in August 2016) were also conducted within the project, in addition to roadside observations of bicycle types at the 5 new sites.Results: The average speed of cyclists on the paths varied between 12.5 and 26.5 km/h. As expected, the lower average speeds were found in uphill directions, near intersections, and on paths with high pedestrian flows. The higher speeds were found in downhill directions and on commuter routes. In all, 70%-95% of road users observed on pedestrian and cycle paths were cyclists, and 5%-30% were pedestrians. The most common type of bicycle was a comfort bike, followed by a trekking bike. Electric-assisted bicycles and racer bikes occurred at all sites, with proportions of 1%-10% and 1%-15%, respectively. The 2 sites with the highest proportion of electric-assisted bicycles and racer bicycles also had the highest average speeds. The differences in average speed throughout the day, week, and year could only be assessed at one of the sites. Only small differences were found, with the most noticeable being that the average speed was lower in January and February (13.8 km/h) compared to the rest of the year (15.3-16.1 km/h). The average speed was also lower during daytime (14.7 km/h) than during other parts of the day (15.4-15.8 km/h).Conclusions: The relationship between bicycle type and measured speed was not entirely clear, but the results suggest that paths with higher proportions of electric and racer bicycles have higher average speeds. There also appears to be a connection between average speed and the width of the distribution; that is, the higher the average speed, the wider the speed distribution. More research is needed on how speed levels and speed variance affect accident risk.

Psychosocial risk factors at work associated with the level of physical activity among motorcycle taxi drivers

Objective: To analyze the association of psychosocial risk factors at work, sociodemographic, and occupational characteristics with the level of physical activity among motorcycle taxi drivers.Methods: Cross-sectional study with 750 male motorcycle taxi drivers from the municipality of Jequié, Bahia, Brazil. A form containing sociodemographic and occupational characteristics was utilized. The psychosocial risk factors at work were evaluated by the Job Content Questionnaire and the level of physical activity by the International Physical Activity Questionnaire. The adjusted associations were analyzed by means of the Poisson regression with robust variance. Results: the prevalence of an insufficiently active level of physical activity was of 59.6%. The crude prevalence ratios (PR) showed an association between physical inactivity in motorcycle taxi drivers and high strain job (PR: 1.31), with 5 or more years of experience (PR: 1.67), in night shifts (PR: 1.36) and 40 or more years old (PR: 1.77). In the multivariate model, adjusted by income, work in high strain is kept associated to a situation of being insufficiently active (PR: 1.13), duration of employment of five or more years raised by 51.0% the frequency of insufficiently active physical activity (PR: 1.51) and the work in predominantly nocturnal shifts increased it by 26.0% (PR: 1.26). It is made evident that age was an effect modifier (p < 0.001) and its interaction was evaluated by including the corresponding product term (job Demand-Control model), which shows that the association between highly straining work and being insufficiently active was observed only among the youngest (21-39 years old) (PR: 1,21).Conclusions: the age and exposure to unfavorable working conditions, like long duration of employment, night work and work under high psychological demand and low control, have an influence on the insufficient physical activity among motorcycle taxi drivers.

E-bikers' braking behavior: Results from a naturalistic cycling study

Objective: The number of e-bike users has increased significantly over the past few years and with it the associated safety concerns. Because e-bikes are faster than conventional bicycles and more prone to be in conflict with road users, e-bikers may need to perform avoidance maneuvers more frequently. Braking is the most common avoidance maneuver but is also a complex and critical task in emergency situations, because cyclists must reduce speed quickly without losing balance. The aim of this study is to understand the braking strategies of e-bikers in real-world traffic environments and to assess their road safety implications. This article investigates (1) how cyclists on e-bikes use front and rear brakes during routine cycling and (2) whether this behavior changes during unexpected conflicts with other road users.Methods: Naturalistic data were collected from 6 regular bicycle riders who each rode e-bikes during a period of 2 weeks, for a total of 32.5 h of data. Braking events were identified and characterized through a combined analysis of brake pressure at each wheel, velocity, and longitudinal acceleration. Furthermore, the braking patterns obtained during unexpected events were compared with braking patterns during routine cycling.Results: In the majority of braking events during routine cycling, cyclists used only one brake at a time, favoring one of the 2 brakes according to a personal pre-established pattern. However, the favored brake varied among cyclists: 66% favored the rear brake and 16% the front brake. Only 16% of the cyclists showed no clear preference, variously using rear brake, front brake, or combined braking (both brakes at the same time), suggesting that the selection of which brake to use depended on the characteristics of the specific scenario experienced by the cyclist rather than on a personal preference. In unexpected conflicts, generally requiring a larger deceleration, combined braking became more prevalent for most of the cyclists; still, when combined braking was not applied, cyclists continued to use the favored brake of routine cycling. Kinematic analysis revealed that, when larger decelerations were required, cyclists more frequently used combined braking instead of single braking.Conclusions: The results provide new insights into the behavior of cyclists on e-bikes and may provide support in the development of safety measures including guidelines and best practices for optimal brake use. The results may also inform the design of braking systems intended to reduce the complexity of the braking operation.

Young driver fatal motorcycle accident analysis by jointly maximizing accuracy and information

While young drivers (YDs) constitute ∼10% of the driver population, their fatality rate in motorcycle accidents is up to three times higher. Thus, we are interested in predicting fatal motorcycle accidents (FMAs), and in identifying their key factors and possible causes. Accurate prediction of YD FMAs from data by risk minimization using the 0/1 loss function (i.e., the ordinary classification accuracy) cannot be guaranteed because these accidents are only ∼1% of all YD motorcycle accidents, and classifiers tend to focus on the majority class of minor accidents at the expense of the minority class of fatal ones. Also, classifiers are usually uninformative (providing no information about the distribution of misclassifications), insensitive to error severity (making no distinction between misclassification of fatal accidents as severe or minor), and limited in identifying key factors. We propose to use an information measure (IM) that jointly maximizes accuracy and information and is sensitive to the error distribution and severity. Using a database of ∼3600 motorcycle accidents, a Bayesian network classifier optimized by IM predicted FMAs better than classifiers maximizing accuracy or other predictive or information measures, and identified fatal accident key factors and causal relations.

Scenarios of crashes involving light mopeds on urban bicycle paths

In the Netherlands, cyclists have to share the bicycle path with light moped riders. These riders are allowed to ride 25 km/h and do not have to wear a helmet (Dutch regulation). Due to several trends such as traffic congestion and the introduction of the scooter model, light mopeds have become more popular, both among older and younger people. This has led to an increased traffic density on bicycle paths as well as concerns about the safety of cyclists. In response to these concerns, several Dutch cities would like to ban light moped riders (LMRs) from the bicycle path and let them ride on the carriageway. However, it is uncertain what the consequences would be for the safety of light moped riders. Moreover, it is not clear to what extent the shared use of bicycle paths leads to serious crashes between cyclists and LMRs. Therefore, an in-depth crash investigation study was carried out to gain more insight into the factors and circumstances that influence the occurrence and consequences of light moped crashes on bicycle paths. A dedicated team for in-depth road crash investigation collected and analyzed detailed information on 36 light moped crashes that occurred on an urban bicycle path. This resulted in a description of the course of events for every crash that was analyzed, including a list of factors that contributed to the occurrence of the crash and possible injuries. Crashes with a similar course of events and a comparable combination of contributory factors were grouped into (sub)types of light moped crashes. Six types of crashes were identified. Based on the contributory crash factors of the identified crash types, remedial measures can be developed to prevent similar crashes from occurring in the future. Moving the LMR to the carriageway is only advisable on 30 km/h roads. Alternative measures to improve the safety of both cyclists and light moped riders include: 1) removing obstacles such as poles from the bicycle path, 2) following guidelines on the minimum width of bicycle paths given traffic volumes, 3) improving sight distances at intersections, 4) traffic light control without conflicts between traffic flows, and 5) introducing a helmet law for light moped riders and their passengers.

Comparison of epidemiology and injury profile between vulnerable road users and motor vehicle occupants in road traffic fatalities

Objective: Road traffic injuries (RTIs) are a major global health issue causing a global burden of mortality and morbidity. Half of all fatalities on the world's roads are vulnerable road users (VRUs). The targeted intervention strategies based on fatality analysis focusing on VRUs can effectively contribute to reducing RTIs. This study aimed to compare VRUs and motor vehicle occupants (MVOs) in terms of epidemiology and injury profile. Methods: We utilized a nationwide, prospective database of RTI-related mortality cases for patients who visited 23 emergency departments between January 2011 and December 2015. All fatalities due to RTIs in the prehospital phase or in-hospital were eligible, excluding patients with unknown mode of transport and those admitted to general wards. The primary and secondary outcomes were fracture injuries and visceral injuries diagnosed using the International Classification of Diseases, Tenth Revision (ICD-10). We compared fracture injuries between VRUs and MVOs using Abbreviated Injury Scale (AIS) 2- and 2+ classification. Results: Among a total 3,694 road traffic fatalities (RTFs), 43.3% were pedestrians, followed by MVOs (27.0%), motorcyclists (18.9), bicyclists (6.6%), and agricultural vehicle users (4.2%). The elderly (>60 years old) accounted for 54.9% of VRU fatalities. RTFs occurred most frequently in the autumn and the VRU group and the MVO group showed significant differences in weekly and diurnal variation in RTFs. The injury severities (AIS 2+) of the head, neck, and thorax were significantly different between the 2 groups (P < 0.05). Head (32.1%) and intracranial (58.6%) injuries were the most common fracture and visceral injury sites for RTFs, followed by the thorax and intrathoracic organs (25.3 and 28.8%, respectively). Conclusions: Elderly pedestrians should be targeted for decreases in RTFs, and road traffic safety interventions for VRUs should be made based on the analysis of temporal epidemiology and injury profiles of RTFs.