ORCID Profile
0000-0002-3691-6868
Current Organisation
Monash University
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Public Health and Health Services not elsewhere classified | Road Transportation and Freight Services | Public Policy | Public Health and Health Services
Publisher: Elsevier BV
Date: 10-2019
Publisher: Australasian College of Road Safety
Date: 08-2019
DOI: 10.33492/JACRS-D-18-00293
Abstract: To understand the current prevalence of aggressive acts on Australian roads, a large cross-sectional survey was conducted inviting drivers from all Australian jurisdictions to participate. A stratified s ling procedure was undertaken to ensure the age and gender distributions were representative of each jurisdiction. Participants were asked to report the frequency of aggressive driving behaviours as well as speeding, drink-driving and mobile phone usage while driving. Recent crash history was also obtained. The s le consisted of 2,916 drivers (males = 45%) with an average age of 42 (±16) years. Minor aggressive behaviours such as expressing annoyance to other drivers and sounding the horn in anger were reported by the majority of the s le (60% and 70% respectively). More extreme behaviour such as chasing another driver when angry was less common, however still reported by 18% of the overall s le. Aggressive driving behaviours were more common in younger, male drivers with 36% of drivers aged 22 to 39 reporting extreme aggression. Associations were found between aggressive driving with crash involvement and other forms of risky driving behaviour. The results show that aggressive driving is a problem on Australian roads. Further research is warranted to explore where aggressive driving fits within an overall risky driving pattern of behaviour, what attitudes drivers hold toward aggressive driving, and how to target the reduction of these behaviours.
Publisher: BMJ
Date: 12-05-2015
Publisher: Informa UK Limited
Date: 05-10-2015
DOI: 10.1080/15389588.2015.1065321
Abstract: The elevated crash involvement rate of young drivers is well documented. Given the higher crash risk of young drivers and the need for innovative policy and programs, it remains important to fully understand the type of crashes young drivers are involved in, and knowledge of the lifetime care cost of crashes can support effective policy development. The aim of this article is to document the number and type of young driver crashes, as well as the associated lifetime care cost over a 9-year period (2005-2013) in Victoria, Australia. In Victoria, Australia, the Transport Accident Commission (TAC) has legislated responsibility for road safety and the care of persons injured in road crashes, irrespective of fault. TAC claims data for the period 2005-2013 were used to document the number and type of young driver crashes. Lifetime care costs (past and future payment liabilities) were calculated by Taylor Fry actuarial consultancy. License and population data were used to define the crash involvement rate of young drivers. Over the 9-year period, 16,817 claims were lodged to the TAC by drivers 18-25 years of age following a crash. There were 646 fewer drivers aged 18-25 killed and injured in 2013, compared to 2005, representing an unadjusted change of -28.7% (-29.8% males -28.4% females). The total lifetime care cost of young drivers killed and injured in Victoria for the period 2005-2013 was estimated to be AU$634 million (US$493 million). Differences between males and females, single- and multivehicle crashes, and fatalities and injuries were found to be statistically significant. Run-off-road crashes and crashes from opposing direction were overrepresented in the lifetime care costs for young driver claimants. Twenty-eight injured drivers were classified as high-severity claims. These 28 claimants require additional long-term care, which was estimated to be AU$219 million of these 28, 24 were male (85.7%). The long-term care costs for these 28 drivers (0.16%) accounts for 34.5% of the total lifetime care cost of all 18- to 25-year-old injured drivers. By using no-fault lifetime care costs that account for medical and like expenses, rehabilitation, and social reintegration costs, a more accurate understanding of the cost of young driver crashes can be determined. Application of these costs to specific crash types highlights new priorities and opportunities for developing programs to reduce young driver crashes.
Publisher: Springer Science and Business Media LLC
Date: 06-10-2010
DOI: 10.1007/S00134-010-2039-6
Abstract: To determine the effect of random assignment to fluid resuscitation with albumin or saline on organ function and mortality in patients with severe sepsis. Pre-defined subgroup analysis of a randomized controlled trial conducted in the intensive care units of 16 hospitals in Australia and New Zealand. Of 1,218 patients with severe sepsis at baseline, 603 and 615 were assigned to receive albumin and saline, respectively. The two groups had similar baseline characteristics. During the first 7 days mean arterial pressure was similar in the two groups, but patients assigned albumin had a lower heart rate on days 1 and 3 (p = 0.002 and p = 0.03, respectively) and a higher central venous pressure on days 1-3 (p < 0.005 each day). There was no difference in the renal or total Sequential Organ Failure Assessment score of the two groups 113/603 (18.7%) of patients assigned albumin were treated with renal replacement therapy compared to 112/615 (18.2%) assigned saline (p = 0.98). The unadjusted relative risk of death for albumin versus saline was 0.87 [95% confidence interval (CI) 0.74-1.02] for patients with severe sepsis and 1.05 (0.94-1.17) for patients without severe sepsis (p = 0.06 for heterogeneity). From multivariate logistic regression analysis adjusting for baseline factors in patients with complete baseline data (919/1,218, 75.5%), the adjusted odds ratio for death for albumin versus saline was 0.71 (95% CI: 0.52-0.97 p = 0.03). Administration of albumin compared to saline did not impair renal or other organ function and may have decreased the risk of death.
Publisher: Elsevier BV
Date: 05-2011
DOI: 10.1016/J.AAP.2010.12.018
Abstract: While helmet usage is often mandated, few motorcycle and scooter riders make full use of protection for the rest of the body. Little is known about the factors associated with riders' usage or non-usage of protective clothing. Novice riders were surveyed prior to their provisional licence test in NSW, Australia. Questions related to usage and beliefs about protective clothing, riding experience and exposure, risk taking and demographic details. Multivariable Poisson regression models were used to identify factors associated with two measures of usage, comparing those who sometimes vs rarely/never rode unprotected and who usually wore non-motorcycle pants vs motorcycle pants. Ninety-four percent of eligible riders participated and usable data was obtained from 66% (n=776). Factors significantly associated with riding unprotected were: youth (17-25 years) (RR = 2.00, 95% CI: 1.50-2.65), not seeking protective clothing information (RR = 1.29, 95% CI = 1.07-1.56), non-usage in hot weather (RR = 3.01, 95% CI: 2.38-3.82), awareness of social pressure to wear more protection (RR = 1.48, 95% CI: 1.12-1.95), scepticism about protective benefits (RR = 2.00, 95% CI: 1.22-3.28) and riding a scooter vs any type of motorcycle. A similar cluster of factors including youth (RR = 1.17, 95% CI: 1.04-1.32), social pressure (RR = 1.32, 95% CI: 1.16-1.50), hot weather (RR = 1.30, 95% CI: 1.19-1.41) and scooter vs motorcycles were also associated with wearing non-motorcycle pants. There was no evidence of an association between use of protective clothing and other indicators of risk taking behaviour. Factors strongly associated with non-use of protective clothing include not having sought information about protective clothing and not believing in its injury reduction value. Interventions to increase use may therefore need to focus on development of credible information sources about crash risk and the benefits of protective clothing. Further work is required to develop motorcycle protective clothing suitable for hot climates.
Publisher: Informa UK Limited
Date: 17-12-2018
DOI: 10.1080/15389588.2018.1528357
Abstract: Rural roads are characterized by hazardous roadsides and suboptimal geometry yet allow for high travel speeds and unfavorable impact angles. In Victoria, 25% of persons seriously injured and 52% of fatalities occur on rural roads, with 30% occurring at intersections. In the United States, almost twice the number of traffic fatalities occur in rural areas than in urban areas, while accounting for less than half of all vehicle miles traveled and 21% of the population. The choice of safety countermeasure is therefore paramount. Simulation software provides a cost-effective means of analyzing alternative intersection treatments with a view to identifying their effectiveness in mitigating crashes. The aim of this research was to assess the safety benefits of 4 alternative intersection treatments using in-depth crash data with an advanced crash reconstruction process. Using a single serious injury real-world crash from the Monash University Accident Research Centre Enhanced Crash Investigation Study and crash reconstruction software, an exemplar rural crash was reconstructed and validated against real-world data. The crash involved a passenger vehicle (European New Car Assessment Programme 5-star) approaching from a minor road and failing to yield at a give-way sign the posted speed limit was 80 km/h. The vehicle was struck on the right/driver side by a rigid truck (B-vehicle 1990) traveling on the major approach (100 km/h). The driver of the case vehicle was seriously injured. Four alternative intersection treatments appropriate for the crash site were constructed in computer-aided design software (Rhinoceros Ver. 5): roundabout rumble strips a reduced speed limit and the combination of lower speed limit and rumbles to determine the reduction in crash forces in the presence of the countermeasures. The hypothetical scenarios demonstrate substantial reductions in impact force and different points of impact, resulting in a significantly lower injury severity for the struck driver. Speed limit reduction to 80 km/h on the main approach (from 100 km/h) in combination with rumble strips on both intersection approaches had the most favorable outcome with the crash avoided entirely, assuming speed compliance. The findings have implications for understanding the role of speed in crashes and hence the design of effective countermeasures. Simulation software, validated using real-world data, provides a cost-effective means of evaluating alternative intersection treatments for rural intersections. Scaled up, implementing these treatments would have significant safety benefits and reduce the road trauma currently associated with rural roads.
Publisher: Australasian College of Road Safety
Date: 10-2021
Abstract: Recent advances in vehicle technology permit the real-time monitoring of driver state to reduce distraction-related crashes, particularly within the heavy vehicle industry. Relatively little published research has evaluated the human machine interface (HMI) design for these systems. However, the efficacy of in-vehicle technology depends in large part on the acceptability among drivers of the system’s interface. Four variations of the HMI of a prototype multi-modal warning system developed by the authors for driver distraction were evaluated in a truck simulator with eight car drivers and six truck drivers. Driver acceptance of the HMIs was assessed using the System Acceptability Scale and salience, comprehension and perceived effectiveness of components of the HMIs (modality, intensity of warning) were assessed using likert scales. The results showed that participants considered the HMIs to be acceptable and useful, and that the warning components were largely noticed, understood correctly, and perceived to be effective. Although this study identified no major design flaws with the recently developed HMIs, further simulator testing with a larger s le size is recommended to validate the findings. On-road evaluations to assess the impact of the HMIs on real world safety are a necessary pre-requisite for implementation.
Publisher: Springer Science and Business Media LLC
Date: 10-12-2013
DOI: 10.1038/SC.2013.135
Abstract: Population modelling--forecasting. To estimate the global incidence of traumatic spinal cord injury (TSCI). An initiative of the International Spinal Cord Society (ISCoS) Prevention Committee. Regression techniques were used to derive regional and global estimates of TSCI incidence. Using the findings of 31 published studies, a regression model was fitted using a known number of TSCI cases as the dependent variable and the population at risk as the single independent variable. In the process of deriving TSCI incidence, an alternative TSCI model was specified in an attempt to arrive at an optimal way of estimating the global incidence of TSCI. The global incidence of TSCI was estimated to be 23 cases per 1,000,000 persons in 2007 (179,312 cases per annum). World Health Organization's regional results are provided. Understanding the incidence of TSCI is important for health service planning and for the determination of injury prevention priorities. In the absence of high-quality epidemiological studies of TSCI in each country, the estimation of TSCI obtained through population modelling can be used to overcome known deficits in global spinal cord injury (SCI) data. The incidence of TSCI is context specific, and an alternative regression model demonstrated how TSCI incidence estimates could be improved with additional data. The results highlight the need for data standardisation and comprehensive reporting of national level TSCI data. A step-wise approach from the collation of conventional epidemiological data through to population modelling is suggested.
Publisher: Informa UK Limited
Date: 12-10-2018
DOI: 10.1080/15389588.2017.1360492
Abstract: This study used medico-legal data to investigate fatal older road user (ORU, aged 65 years and older) crash circumstances and risk factors relating to 4 key components of the Safe System approach (e.g., roads and roadsides, vehicles, road users, and speeds) to identify areas of priority for targeted prevention activity. The Coroners' Court of Victoria's (CCOV) Surveillance Database was searched to identify and describe the frequency and rate per 100,000 population of fatal ORU crashes in the Australian state of Victoria for 2013-2014. Information relating to the deceased ORU, crash characteristics and circumstances, and risk factors was extracted and analyzed. One hundred and thirty-eight unintentional fatal ORU crashes were identified in the CCOV Surveillance Database. Of these fatal ORU crashes, most involved older drivers (44%), followed by older pedestrians (32%), older passengers (17%), older pedal cyclists (4%), older motorcyclists (1%), and older mobility scooter users (1%). The average annual rate of fatal ORU crashes per 100,000 population was 8.1 (95% confidence interval [CI], 6.0-10.2). In terms of the crash characteristics and circumstances, most fatal ORU crashes involved a counterpart (98%), of which the majority were passenger cars (50%) or fixed/stationary objects (25%), including trees (46%) or embankments (23%). In addition, most fatal ORU crashes occurred close to home (73%), on-road (87%), on roads that were paved (94%), on roads with light traffic volume (37%), and during low-risk conditions: between 12 p.m. and 6 p.m. (44%), on weekdays (80%), during daylight (75%), and under dry/clear conditions (81%). Road user (RU) error was identified by the police and/or the coroner for the majority of fatal crashes (55%), with a significant proportion of deceased ORUs deemed to have failed to yield (54%) or misjudged (41%). RU error was the most significant factor identified in fatal ORU crashes, which suggests that there is a limited capacity of the road system to fully accommodate RU errors. Initiatives related to safer roads and roadsides, vehicles, speed zones, as well as behavioral approaches are key areas of priority for targeted activity to prevent fatal ORU crashes in the future.
Publisher: Springer Science and Business Media LLC
Date: 26-01-2012
DOI: 10.1007/S10926-012-9354-4
Abstract: Understanding in idual factors associated with return to work (RTW) post-injury is an important goal of compensation systems research. The aim of the present study was to determine factors associated with time to return to work following acute unintentional injuries. A prospective cohort study was conducted in Victoria, Australia. The cohort comprised 133 persons who were employed at the time they were admitted to one of three study hospitals. Baseline health status data was obtained retrospectively at one-week post-injury and participants were further surveyed at 1, 6, 12, 26 and 52 weeks post-injury to measure recovery. Multivariate Cox proportional hazards regression analysis was used to examine the association between potential prognostic factors and time to RTW during the 12 month study. At the end of 12 months follow-up, 81.2% of the study cohort had returned to work. Older age, increased injury severity, self reported symptomatic pain and poor mental health at 1 week post-injury were associated with extended time to RTW. A significant statistical interaction between the receipt of compensation and high social functioning as measured by the SF-36 or strong social relationships as measured by the Assessment of Quality of Life was associated with earlier RTW. Participants reporting strong social relationships and high social functioning at 1 week post-injury and entitled to injury compensation returned to work 2.05 and 3.66 times earlier respectively, than similar participants with no entitlement to compensation. Both injury-related and psychosocial factors were associated with the duration of time to RTW following acute unintentional injuries. This study replicated previously reported findings on social functioning and compensation from an independent acute trauma s le. Programs or policies to improve social functioning early post-injury may provide opportunities to improve the duration of time to RTW following injury.
Publisher: SAGE Publications
Date: 2010
DOI: 10.3141/2194-09
Abstract: Graduated licensing schemes have been found to reduce the crash risk of young novice drivers, but there is less evidence of their success with novice motorcycle riders. This study examined the riding experience of a s le of Australian learner–riders to establish the extent and variety of their riding practice during the learner stage. Riders completed an anonymous questionnaire at a compulsory rider-training course for the licensing test. The majority of participants were male (81%) with an average age of 33 years. They worked full time (81%), held an unrestricted driver's license (81%), and owned the motorcycle that they rode (79%). These riders had held their learner's license for an average of 6 months. On average, they rode 6.4 h/week. By the time they attempted the rider-licensing test, they had ridden a total of 101 h. Their total hours of on-road practice were comparable to those of learner–drivers at the same stage of licensing, but they had less experience in adverse or challenging road conditions. A substantial proportion had little or no experience of riding in the rain (57%), at night (36%), in heavy traffic (22%), on winding rural roads (52%), or on high-speed roads (51%). These findings highlight the differences in the learning processes between unsupervised novice motorcycle riders and supervised novice drivers. Further research is necessary to clarify whether specifying the conditions under which riders should practice during the graduated licensing process would likely reduce or increase their crash risk.
Publisher: Informa UK Limited
Date: 2003
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.INJURY.2011.02.013
Abstract: Helicopter Emergency Medical Services (HEMS) have been incorporated into modern health systems for their speed and coverage. In the state of New South Wales (NSW), nine HEMS operate from various locations around the state and currently there is no clear picture of their resource implications. The aim of this study was to assess the cost of HEMS in NSW and investigate the factors linked with the variation in the costs, coverage and activities of HEMS. We undertook a survey of HEMS costs, structures and operations in NSW for the 2008/2009 financial year. Costs were estimated from annual reports and contractual agreements. Data related to the structure and operation of services was obtained by face-to-face interviews, from operational data extracted from in idual HEMS, from the NSW Ambulance Computer Aided Despatch system and from the Aeromedical Operations Centre database. In order to estimate population coverage for each HEMS, we used GIS mapping techniques with Australian Bureau of Statistics census information. Across HEMS, cost per mission estimates ranged between $9300 and $19,000 and cost per engine hour estimates ranged between $5343 and $15,743. Regarding structural aspects, six HEMS were run by charities or not-for-profit companies (with partial government funding) and three HEMS were run (and fully funded) by the state government through NSW Ambulance. Two HEMS operated as 'hub' services in conjunction with three associated 'satellite' services and in contrast, four services operated independently. Variation also existed between the HEMS in the type of helicopter used, the clinical staffing and the hours of operation. The majority of services undertook both primary scene responses and secondary inter-facility transfers, although the proportion of each type of transport contributing to total operations varied across the services. This investigation highlighted the cost of HEMS operations in NSW which in total equated to over $50 million per annum. Across services, we found large variation in the cost estimates which was underscored by variation in the structure and operations of HEMS.
Publisher: Springer Science and Business Media LLC
Date: 12-01-2009
Abstract: Traffic crashes and consequent injuries represent a growing public health concern in India, particularly in light of increasing motorization. Motorised two-wheeled vehicles (MTV) constitute a large portion of the vehicle fleet in India. We report the crash characteristics and injury patterns among a cohort of MTV riders and pillions presenting to hospital post-crash. Consecutive MTV riders and pillions, whether alive or dead, injured in a road traffic crash presenting to the emergency departments of two government hospitals and three branches of a private hospital in urban Hyderabad, India, were recruited to this study. 378 MTV users were enrolled to the study of whom 333 (88.1%) were male, 252 (66.7%) were riders and median age was 31.3 years. A total of 223 (59%) MTV users were injured in multi-vehicle crashes while one-third had a frontal impact. The majority (77%) were assessed as having a Glasgow coma score (GCS) of 13–15, 12% a GCS of 9–12 and 11% a GCS of 3–8. No difference was seen in the severity distribution of injuries based on GCS among riders and pillions. Open wounds and superficial injuries to the head (69.3%) and upper extremity (27%) and lower extremity (24%) were the most common injuries. 43 (11%) sustained an intracranial injury, including 12 (28%) with associated fracture of the bones of the head. There were few differences in types of injuries sustained by riders and pillions though riders had a significantly lower risk of crush injuries of the lower extremity than pillions (relative risk, RR 0.25, 95% CI 0.08–0.81) and female pillions were at a significantly lower risk of sustaining fractures of the lower extremity than male pillions (RR 0.30, 95% CI 0.09 – 0.94). Overall, 42 (11%) MTV users died, of which 42.8% died before reaching the hospital. Only 74 (19.6%) MTV users had worn a helmet correctly and failure to wear a helmet was associated with a five times greater risk of intracranial injury (RR 4.99, 95% CI 1.23–20.1). Of the 19 pre-hospital deaths, 16 (84%) had not worn a helmet. Head injuries accounted for the major proportion of injuries sustained in MTV users. Non-helmet use was associated with increased risk of serious head injuries. The data presented on the nature and severity of injuries sustained by MTV users can assist with planning to deal with these consequences as well as prevention of these injuries given the high use of MTV in India.
Publisher: Elsevier BV
Date: 05-2013
Publisher: AMPCo
Date: 03-2008
DOI: 10.5694/J.1326-5377.2008.TB01647.X
Abstract: To examine the relationship between child weight and vehicle booster seat usage in the context of current Australasian booster seat standards. Questionnaire survey conducted between February and April 2005. A convenience s le of parents with children aged 4-11 years in New South Wales and Victoria completed a questionnaire, reporting on the height and weight of their children and the nature of restraint devices used in the family vehicle. Proportion of children meeting standard-specified weight and height criteria who are not restrained in booster seats proportion of children who meet the specified height criteria but whose weight exceeds the specified weight. 699 of 3959 questionnaires were returned (response rate, 18%), of which seven lacked essential details. The remaining 692 responses provided information on 1500 children. Of these children, 633 aged 4-11 years fell within the recommended height range for using booster seats, but only 29% were typically restrained in booster seats, the majority (70%) being restrained in normal seatbelts. A key finding was that 37% of the children who met the recommended height criteria exceeded the maximum weight for booster seats stipulated by the current Australasian safety standard. In view of increasing rates of overweight and obesity in children, it is important to reassess current Australasian standards for child restraints in vehicles. A concerted parental education c aign is also needed to raise awareness of which restraint types are appropriate for children of various heights and weights.
Publisher: Informa UK Limited
Date: 09-2003
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.AAP.2017.08.021
Abstract: Drink-driving and alcohol-related crashes are a significant problem globally. Alcohol interlocks are used to prevent drivers with a blood alcohol concentration above a pre-determined level from starting their vehicle, making the technology highly effective in preventing drink-drive episodes. While alcohol interlocks are commonly used in drink-drive offender groups, their broader use as a preventative road safety strategy is considered increasingly feasible. In this context it is important to understand attitudes towards the technology, and to investigate whether these attitudes vary according to alcohol consumption patterns as this influences the acceptability of a broad-based preventative alcohol interlock program. A representative s le of 2994 Australian drivers participated in an online cross-sectional survey. Participants reported their alcohol consumption, drink-drive behaviour and attitudes towards the use of alcohol interlocks for personal use and for drink-drive offenders. Half of the s le stated that alcohol interlocks would be of use personally. Seventy-four percent of high-risk drinkers (defined by an AUDIT score ≥20) stated they would find the technology personally useful when compared to 49% of low-risk drinkers (AUDIT ≤7). Overwhelmingly, more than 80% of participants agreed with the mandatory instalment of alcohol interlocks and compulsory clinical interventions for drink-drive offenders, with more low-risk drinkers supporting this than the high-risk drinkers. While there were mixed opinions regarding the perceived personal usefulness of alcohol interlocks, higher-risk drinkers were most likely to perceive interlocks as being of use for themselves. This high-risk group however, was less likely to provide support for clinical interventions and additional re-licensing requirements aimed at eliciting changes in drinking behaviour. These findings have important implications for drink-drive offender relicensing and the likely success of drink-driver education, and interventions aimed at curbing risky alcohol consumption.
Publisher: Springer Science and Business Media LLC
Date: 26-10-2011
Publisher: Informa UK Limited
Date: 28-04-2017
DOI: 10.1080/15389588.2017.1311014
Abstract: Laboratory studies have demonstrated that impact protectors (IP) used in motorcycle clothing can reduce fracture severities. While crash studies have reported IP are associated with reduced likelihood of soft tissue injury, there is little evidence of their effectiveness in reducing fracture likelihood. This discrepancy might be related to IP quality. There are mandatory requirements for IP supplied with protective clothing in Europe, but not elsewhere. This study examines the energy attenuation performance of IP used by Australian riders. IP were harvested from clothing worn by crashed riders admitted to hospital. The IP were examined and energy attenuation properties were determined using EN 1621-1 test procedures. Impact injury was identified from medical records and defined as fractures, dislocations, and avulsions that occurred following impact to the rider's shoulders, elbows, hips, and/or knees. Fisher's exact test was used to examine the relationship between meeting the EN 1621-1 energy attenuation requirements and impact injury. The association between the average and maximum transmitted force, and impact injury was examined using generalized estimating equations. Motorcycle riders were recruited as part of an in-depth crash study through three hospitals in New South Wales, Australia, between 2012 and 2014. Riders were interviewed, and engineers conducted site, vehicle, and clothing inspections. Clothing was collected, or identical garments were purchased. Clothing was inspected for 62 riders. Of these, 19 wore clothing incorporating 76 IP. Twenty-six of these were impacted in the crash event. Almost all impacted IP (96%) were CE marked, and most (83%) met Level 1 energy attenuation requirements of EN 1621-1 when tested. Of the 26 impacted IP, four were associated with impact injuries, including midshaft and distal clavicle fractures and a scapula and olecranon fracture. No associations between meeting EN 1621-1 requirements and impact injury were found (p = 0.5). There was no association between average force transmitted and impact injury (95% CI: 0.91-1.24) however, as maximum force transmitted increased, the odds of impact injury increased (95% CI: 1.01-1.2). These results indicate a high probability of impact injury at 50 kN, the limit of maximum transmitted force specified in EN 1621-1. The allowable transmitted force of EN 1621-1 may be too high to effectively reduce the probability of impact injury. This is not surprising, given human tolerance levels that are reported in literature. Reducing the force limit below the reported fracture tolerance limits might be difficult with current technology. However, there is scope to reduce the EN 1621-1 maximum limit of 50 kN transmitted force. A reduction in the maximum force limit would improve rider protection and appears feasible, as 77% of tested IP recorded a maximum force <35 kN. This level of transmitted force is estimated to be associated with <20% probability of impact injury. While the performance of IP available to Australian riders is not regulated, most IP was CE marked. The results indicate a significant association between maximum transmitted force, tested according to EN 1621-1 procedures, and impact injury. Further investigation of the EN 1621-1 requirements may be warranted. This work will interest those targeting protective equipment for motorcyclists as a mechanism for reducing injury to these vulnerable road users.
Publisher: Informa UK Limited
Date: 16-10-2008
Publisher: Elsevier BV
Date: 05-2017
DOI: 10.1016/J.AAP.2017.03.007
Abstract: Motorcycle riders are over-represented in road fatalities in Australia. While riders represent 18% of the road users killed each year, motorcycle registrations constitute only 4.5% of the registered vehicle fleet. The Motorcycle Rider Behaviour Questionnaire (MRBQ) was developed with a view toward understanding behaviours likely to be associated with crash risk. These include behaviours that are either intentional (such as violations of road and speed regulations and stunts) or unintentional (such as errors relating to traffic or control of the motorcycle), as well as protective behaviours related to use of safety equipment. The dual aims of the current study were, first, to determine the appropriate structure of a modified version of the MRBQ for use in a representative s le of riders in Australia and, second, to understand which MRBQ factors are associated with crash involvement. A stratified s ling procedure was undertaken to ensure the socio-economic status of local government area, age and gender of the s le was representative of the broader population of riders in New South Wales, Australia. The s le consisted of 470 riders (males=89%). Exploratory factor analysis revealed a 29-item, five factor structure was suitable on the Australian data encompassing traffic errors, speed violations, protective gear, control errors and stunts. Overall, riders reported relatively safe behaviours, with frequent use of protective gear and infrequent aberrant behaviours. However, even though infrequent, violations of speed and errors related to control of the motorcycle increased the odds of near-crash involvement, whilst stunt behaviours were associated with increased odds of crash involvement. Interventions and countermeasures need to target these specific behaviours.
Publisher: American Society of Mechanical Engineers
Date: 10-09-2000
DOI: 10.1115/DETC2000/DAC-14248
Abstract: Systems Modeling evaluates the fleetwide crashworthiness of a vehicle design across the full range of potential impact speeds, angles, collision partners, occupant seating locations, and occupant restraints. Although this approach provides a more thorough assessment of crash protection than provided by a single crash test or simulation, the development of a complete Systems Model requires exhaustive simulation of every potential crash mode — a computationally prohibitive approach. This paper presents a methodology in which real world highway accident data is used to systematically develop Systems Modeling strategies that fully expose the tradeoffs between computational expense and model fidelity as measured by Harm. Using Australian side impact accident data, the paper illustrates the methodology by developing two computationally efficient strategies for developing a Systems Model for the evaluation and optimization of Side Impact protection.
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.AAP.2016.10.011
Abstract: Alcohol contributes to approximately 30% of all serious crashes. While the majority of drivers acknowledge the risks associated with drink-driving, a significant proportion of the population continue to engage in this behaviour. Attitudes towards drink-driving as well as personal alcohol consumption patterns are likely to underpin a driver's decision to drink-drive. These associations were explored in the current study. A large (N=2994) cross-sectional online survey of a representative s le of drivers in Australia was conducted. Participants provided information about their own alcohol consumption patterns, drink-driving behaviour as well as attitudes towards drink-driving (own and others) and enforcement strategies. Alcohol consumption patterns differed according to age, gender and work status. Drivers who reported drink-driving behaviour and had high risk alcohol consumption patterns were less likely to agree that drink-driving leads to increased crash risk and more likely to agree they drink and drive when they believed they could get away with it. In contrast, drivers who did not report drink-driving and had low risk consumption patterns were more likely to report that the enforcement strategies are too lenient. Binary logistic regression showed that high risk alcohol consumption patterns and agreement from drivers that they drink and drive when they believe they can get away with it had the strongest associations with drink-driving. These findings highlight the relationships between one's drinking patterns, drink-drive behaviour and attitudes towards drink-driving and drink-driving enforcement CONCLUSIONS AND IMPLICATIONS: The patterns of associations that emerged suggest that drink-driving is the expression of a broader health issue for the most "at-risk" cohort of drinkers. The decision to drink and drive may result from a need borne from an alcohol dependent lifestyle exacerbated by a social acceptability of the behaviour and positive attitudes towards one's ability to drink-drive with few adverse consequences. Therefore, the broader alcohol consumption patterns of drink-drivers needs to be considered when targeting drink-drive reductions.
Publisher: Elsevier BV
Date: 11-2004
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.AAP.2015.10.030
Abstract: The Driver Behaviour Questionnaire (DBQ) is a widely used measure of driving behaviours that may increase a driver's risk of crash involvement. However, there are several different versions of the DBQ varying in terms of number of items and factor structure. The aim of the current research was to assess the construct validity of the popular 28-item four-factor DBQ solution in a representative s le of drivers in Australia. A further aim was to test the factorial invariance of the measure across gender, age and also between fleet and non-fleet drivers using multigroup confirmatory factor analyses. Data on a range of attitudes towards road safety were collected using an online survey. A stratified s ling procedure was undertaken to ensure the age, gender and location distributions of participants were representative of the Australian population. A total of 2771 responses were obtained from fully licensed motor vehicle drivers (male: 46%). Confirmatory factor analysis supported the 28-item four-factor DBQ in the Australian s le. The DBQ was also found to be gender-invariant and strong partial measurement invariance was found for drivers aged from 26 to 64, but not for younger (17-25) or older (65-75) drivers. Modifications to the DBQ suggest how the DBQ can be improved for use in these two age groups.
Publisher: SAGE Publications
Date: 04-02-2021
Abstract: This paper aimed to investigate the robustness of driver cognitive workload detection based on electrocardiogram (ECG) when considering temporal variation and in idual differences in cognitive workload. Cognitive workload is a critical component to be monitored for error prevention in human–machine systems. It may fluctuate instantaneously over time even in the same tasks and differ across in iduals. A driving simulation study was conducted to classify driver cognitive workload underlying four experimental conditions (baseline, N-back, texting, and N-back + texting distraction) in two repeated 1-hr blocks. Heart rate (HR) and heart rate variability (HRV) were compared among the experimental conditions and between the blocks. Random forests were built on HR and HRV to classify cognitive workload in different blocks and for different in iduals. HR and HRV were significantly different between repeated blocks in the study, demonstrating the time-induced variation in cognitive workload. The performance of cognitive workload classification across blocks and across in iduals was significantly improved after normalizing HR and HRV in each block by the corresponding baseline. The temporal variation and in idual differences in cognitive workload affects ECG-based cognitive workload detection. But normalization approaches relying on the choice of appropriate baselines help compensate for the effects of temporal variation and in idual differences. The findings provide insight into the value and limitations of ECG-based driver cognitive workload monitoring during prolonged driving for in idual drivers.
Publisher: Elsevier BV
Date: 09-2012
Publisher: AMPCo
Date: 11-2008
Publisher: Informa UK Limited
Date: 16-08-2007
DOI: 10.1080/15389580701216533
Abstract: With increasing rates of survival associated with traffic crashes, a shift to understand the consequences of injury has risen to prominence. This prospective cohort study set out to examine general health status and functional disability at 2 months and 6-8 months post-crash. Participants were otherwise healthy adults aged 18-59 years admitted to hospitals, excluding those with moderate-severe head injury and spinal cord injury. Sixty-two adults completed interviews prior to discharge and at 2 months and 8 months post-discharge. By 8 months post-crash, 89 percent had resumed employment and or study, two thirds rated the resolution of their medical problems to be excellent (14.5 percent) or good (53 percent), and 82 percent were considered to be fully self-sufficient with respect to activities of daily living. Despite this, results from the SF-36 indicated significant reductions in health status at 2 and 8 months post-crash relative to pre-crash health, with domain scores up to 26 percent lower than pre-crash scores, while assessment of activities of daily living indicated residual functional disability at both follow-up times. Self-reported pain was higher for both males and females at both follow-up times compared with pre-crash self-reported pain. This study demonstrated significant, ongoing loss of health-related quality of life and impairment associated with injuries sustained in road crashes, highlighting the need for continuing care post-discharge to facilitate a rapid return to optimal health.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2004
DOI: 10.1097/01.TA.0000088015.83951.D0
Abstract: Using in-depth, real-world motor vehicle crash data from the United States and the United Kingdom, we aimed to assess the incidence and risk factors associated with thoracic aorta injuries. De-identified National Automotive S ling System Crashworthiness Data System (U.S.) and Co-operative Crash Injury Study (U.K.) data formed the basis of this retrospective analysis. Logistic regression was used to assess the level of risk of thoracic aorta injury associated with impact direction, seat belt use and, given the asymmetry of the thoracic cavity, whether being struck toward the left side of the body was associated with increased risk in side-impact crashes. A total of 13,436 U.S. and 3,756 U.K. drivers and front seat passengers were analyzed. The incidence of thoracic aorta injury in the U.S. and U.K. s les was 1.5% (n = 197) and 1.9% (n = 70), respectively. The risk was higher for occupants seated on the side closest to the impact than for occupants involved in frontal impact crashes. This was the case irrespective of whether the force was applied toward the left (belted: relative risk [RR], 4.6 95% confidence interval [CI], 2.9-7.1 p < 0.001) or the right side (belted: RR, 2.6 95% CI, 1.4-5.1 p < 0.004) of the occupant's body. For occupants involved in side-impact crashes, there was no difference in the risk of thoracic aorta injury whether the impacting force was applied toward the left or toward the right side of the occupant's body. Seat belt use provided a protective benefit such that the risk of thoracic aorta injury among unbelted occupants was three times higher than among belted occupants (RR, 3.0 95% CI, 2.2-4.3 p < 0.001) however, the benefit varied across impact direction. Thoracic aorta injuries were found to be associated with high impact severity, and being struck by a sports utility vehicle relative to a passenger vehicle (RR, 1.7 95% CI, 1.2-2.3 p = 0.001). Aortic injuries have been conventionally associated with frontal impacts. However, emergency clinicians should be aware that occupants of side-impact crashes are at greater risk, particularly if the occupant was unbelted and involved in a crash of high impact severity.
Publisher: Elsevier BV
Date: 04-2010
DOI: 10.1111/J.1753-6405.2010.00500.X
Abstract: To explore the relationships between injury, disability, work role and return-to-work outcomes following admission to hospital as a consequence of injury sustained in a road crash. Prospective cohort study of patients admitted to an adult trauma centre and two metropolitan teaching hospitals in Victoria, Australia. Participants were interviewed in hospital, 2.5 and eight months post-discharge. Participants were 60 employed and healthy adults aged 18 to 59 years admitted to hospital in the period February 2004 to March 2005. Despite differences in health between the lower extremity fracture and non-fracture groups eight months post-crash the proportions having returned to work was approximately 90%. Of those returning to work, 44% did so in a different role. After adjustment for baseline parameters, lower extremity injuries were associated with a slower rate of return to work (HR: 0.31 95%CI: 0.16-0.58) as was holding a manual occupation (HR: 0.16 95%CI: 0.09-0.57). There were marked differences in physical health between and within the injury groups at both follow-up periods. These results demonstrate that both injury type and severity and the nature of ones occupation have a considerable influence on the rate and pattern of return to work following injury. Further, persisting disability has a direct influence on the likelihood of returning to work. The implications of these findings and the types of data required to measure outcome post-injury are discussed.
Publisher: Elsevier BV
Date: 05-2008
DOI: 10.1016/J.AAP.2007.11.006
Abstract: Whilst there has been a significant increase in the amount of consumer interest in the safety performance of privately owned vehicles, the role that it plays in consumers' purchase decisions is poorly understood. The aims of the current study were to determine: how important vehicle safety is in the new vehicle purchase process what importance consumers place on safety options/features relative to other convenience and comfort features, and how consumers conceptualise vehicle safety. In addition, the study aimed to investigate the key parameters associated with ranking 'vehicle safety' as the most important consideration in the new vehicle purchase. Participants recruited in Sweden and Spain completed a questionnaire about their new vehicle purchase. The findings from the questionnaire indicated that participants ranked safety-related factors (e.g., EuroNCAP (or other) safety ratings) as more important in the new vehicle purchase process than other vehicle factors (e.g., price, reliability etc.). Similarly, participants ranked safety-related features (e.g., advanced braking systems, front passenger airbags etc.) as more important than non-safety-related features (e.g., route navigation systems, air-conditioning etc.). Consistent with previous research, most participants equated vehicle safety with the presence of specific vehicle safety features or technologies rather than vehicle crash safety/test results or crashworthiness. The key parameters associated with ranking 'vehicle safety' as the most important consideration in the new vehicle purchase were: use of EuroNCAP, gender and education level, age, drivers' concern about crash involvement, first vehicle purchase, annual driving distance, person for whom the vehicle was purchased, and traffic infringement history. The findings from this study are important for policy makers, manufacturers and other stakeholders to assist in setting priorities with regard to the promotion and publicity of vehicle safety features for particular consumer groups (such as younger consumers) in order to increase their knowledge regarding vehicle safety and to encourage them to place highest priority on safety in the new vehicle purchase process.
Publisher: Informa UK Limited
Date: 06-05-2019
Publisher: Elsevier BV
Date: 2010
Publisher: Informa UK Limited
Date: 12-12-2018
DOI: 10.1080/15389588.2018.1536822
Abstract: Crash and injury surveillance studies have identified a range of rider-related factors, including age, sex, licensure, training and experience, as being associated with motorcycle crash risk. The aim of this study was to establish whether these previously identified factors were associated with crash involvement in an Australian-based population. Data obtained from motorcyclists recruited from road authority licensing offices in a population-based survey design were analyzed. In addition to descriptive analysis, survey logistic regression was used to examine predictors of self-reported motorcycle crashes. A statewide population prevalence study of motorcyclists in New South Wales, Australia, was conducted using a multistage stratified random s ling plan. Participants (n = 503) represented 47% of eligible riders invited to participate. The distribution of responses was weighted to represent the population based on motorcycle registrations as a proxy for active motorcyclists, adjusted for age, sex, and variations in s le size and population density between survey sites. This analysis investigated factors associated with having crashed in the past 12 months. The key predictors of increased crash risk included frequent near-crash experiences (6-10) in the past year (adjusted odds ratio [OR These findings provide important population-level information and insights about risk exposure for motorcyclists. Taking a more tailored approach to data collection meant that factors associated with crash involvement were identified that are not commonly observed in studies relying on administrative data. In particular, the study highlights the importance of near-crash experiences as warnings to riders and the need to use such experiences as learning opportunities to improve their riding style and safety.
Publisher: Springer Science and Business Media LLC
Date: 26-02-2013
DOI: 10.1038/SC.2012.158
Abstract: Literature review. Update the global maps for traumatic spinal cord injury (TSCI) and incorporate methods for extrapolating incidence data. An initiative of the International Spinal Cord Society (ISCoS) Prevention Committee. A search of Medline/Embase was performed (1959-Jun/30/2011). Enhancement of data-quality 'zones' including in idual data-ranking as well as integrating regression techniques to provide a platform for continued regional and global estimates. A global-incident rate (2007) is estimated at 23 TSCI cases per million (179,312 cases per annum). Regional data are available from North America (40 per million), Western Europe (16 per million) and Australia (15 per million). Extrapolated regional data are available for Asia-Central (25 per million), Asia-South (21 per million), Caribbean (19 per million), Latin America, Andean (19 per million), Latin America, Central (24 per million), Latin America-Southern (25 per million), Sub-Saharan Africa-Central (29 per million), Sub-Saharan Africa-East (21 per million). It is estimated that globally in 2007, there would have been between 133 and 226 thousand incident cases of TSCI from accidents and violence. The proportion of TSCI from land transport is decreasing/stable in developed but increasing in developing countries due to trends in transport mode (transition to motorised transport), poor infrastructure and regulatory challenges. TSCIs from low falls in the elderly are increasing in developed countries with ageing populations. In some developing countries low falls, resulting in TSCI occur while carrying heavy loads on the head in young people. In developing countries high-falls feature, commonly from trees, balconies, flat roofs and construction sites. TSCI is also due to crush-injuries, ing and violence. The online global maps now inform an extrapolative statistical model, which estimates incidence for areas with insufficient TSCI data. The accuracy of this methodology will be improved through the use of prospective, standardised-data registries.
Publisher: S. Karger AG
Date: 2015
DOI: 10.1159/000371884
Abstract: b i Objective: /i /b To compare the effects of different types of clinician feedback (auditory knowledge of performance, KP, kinaesthetic KP and knowledge of results, KR) on the production of a voice task during acquisition. KP conditions directed attention to auditory or kinaesthetic cues. KR feedback was provided as to how close the speaker's production was to a model. b i Patients and Methods: /i /b A factorial multivariate 3 × 8 design was used. Thirty-six females were randomly assigned to 3 different feedback groups and trained in the production of a vocal siren. The production of sirens was measured by variants of vocal intensity, cepstral peak prominence, phonation time and pitch phase compliance. b i Results: /i /b All groups showed significant improvement over time in measures of vocal intensity, timing of pitch change and phonation time. The KP group (auditory and kinaesthetic combined) showed significantly more improvement over time in vocal intensity than the KR group. The kinaesthetic KP group maintained better control of vocal clarity across attempts while reducing vocal intensity than the auditory KP group. b i Conclusion: /i /b Optimal feedback paradigms during acquisition may be different depending on the parameters of voicing being trained. Learners may benefit from KP feedback to control intensity, and kinaesthetic cues to control vocal clarity.
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.INJURY.2016.03.033
Abstract: Motorcyclists represent an increasing proportion of road traffic casualties but, while factors associated with crashes are readily identifiable, little is known about the prevalence of those risk factors in the motorcycling population. A stratified random-s ling frame was used to survey the population of registered motorcycles owners in New South Wales (NSW) when they attended motor registry offices. The postal codes in the State database of registered motorcycle were used to stratify the population into quartiles based on socioeconomic characteristics and to determine s le weights. Participants (n=506) represented 47% of eligible riders approached. On average participants were aged 43, rode 7h/week and had 17 years of riding experience. Estimates based on multiple ownership rates suggest motorcycle registration numbers exceed the active riding population by approximately 15%. Less than half rode under 101km/week, 25% rode over 300km/week and just 42% rode every day. More rode frequently for leisure (70%) than for commuting (53%) and over half rarely rode in dark (52%) or wet (67%) conditions. Most wore protective clothing - helmets (100%), jackets (82%), pants (56%), boots (57%) and gloves (73%). Those with traffic infringements (32%) were mostly for driving (25%), not riding (10%) offences. In the past year, 13% had one or more motorcycle crashes including minor spills and 76% one or more near-crash experiences. The youngest riders (15-19) reported the highest rates of exposure in kilometres, hours, frequency of riding and commuting. They also reported lower crash involvement (3%) but more near-crashes (80%). This study provides an account of the prevalence of key risk factors across age groups in a population of active motorcycle riders in NSW. Novice riders were represented in all age groups although most novices were under 40 years. These data can be used to guide the development of targeted countermeasures aimed at improving motorcycling safety for riders of different age groups.
Publisher: Informa UK Limited
Date: 12-2004
DOI: 10.1080/15389580490509464
Abstract: Most licensing jurisdictions in Australia maintain mandatory assessment programs targeting older drivers, whereby a driver reaching a specified age is required to prove his or her fitness to drive through medical assessment and/or on-road testing. Previous studies both in Australia and elsewhere have consistently failed to demonstrate that age-based mandatory assessment results in reduced crash involvement for older drivers. However studies that have based their results upon either per-population or per-driver crash rates fail to take into account possible differences in driving activity. Because some older people maintain their driving licenses but rarely if ever drive, the proportion of inactive license-holders might be higher in jurisdictions without mandatory assessment relative to jurisdictions with periodic license assessment, where inactive drivers may more readily either surrender or lose their licenses. The failure to control for possible differences in driving activity across jurisdictions may be disguising possible safety benefits associated with mandatory assessment. The current study compared the crash rates of drivers in Melbourne, Australia, where there is no mandatory assessment and Sydney, Australia, where there is regular mandatory assessment from 80 years of age onward. The crash rate comparisons were based on four exposure measures: per population, per licensed driver, per distance driven, and per time spent driving. Poisson regression analysis incorporating an offset to control for inter-jurisdictional road safety differences indicated that there was no difference in crash risk for older drivers based on population. However drivers aged 80 years and older in the Sydney region had statistically higher rates of casualty crash involvement than their Melbourne counterparts on a per license issued basis (RR: 1.15, 1.02-1.29, p=0.02) and time spent driving basis (RR: 1.19, 1.06-1.34, p=0.03). A similar trend was apparent based on distance travelled but was of borderline statistical significance (RR: 1.11, 0.99-1.25, p=0.07). Collectively, it can be inferred from these findings that mandatory license re-testing schemes of the type evaluated have no demonstrable road safety benefits overall. Further research to resolve this on-going policy debate is discussed and recommended.
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.INJURY.2011.10.025
Abstract: Little is known about the contribution of protective clothing worn in motorcycle crashes to subsequent health-related outcomes, impairment and quality of life. A prospective cohort of 212 adult motorcyclists were recruited following presentations to hospitals or crash repair services in a defined geographic area in Australia between June 2008 and July 2009. Data was obtained from participant interviews and medical records at baseline, then by mailed survey two and six months post-crash (n=146, 69%). The exposure factor was usage of protective clothing classified as full protection (motorcycle jacket and pants), partial protection (motorcycle jacket) and unprotected (neither). Outcomes of interest included general health status (Short Form SF-36), disability (Health Assessment Questionnaire) treatment and recovery progress, quality of life and return to work in the six months post-crash. Odds ratios (OR) were estimated for categorical outcomes using multiple logistic regression to assess differences in outcomes associated with levels of protection adjusted for potential confounders including age, sex, occupation, speed and type of impact. Non-parametric procedures were used for data that was not normally distributed. Compared to unprotected riders, both fully and partially protected riders had fewer days in hospital and reported less pain immediately post-crash at two months both protection groups were less likely to have disabilities or reductions in physical function. By six months there were no significant differences in disability or physical function between groups, but both protection groups were more likely to be fully recovered and returned to pre-crash work than unprotected riders. Fully protected riders achieved better outcomes than either partially or unprotected riders on most measures. There were few significant differences between the full and partial protection groups although the latter showed greater impairment in physical health two months post-crash. We found strong associations between use of protective clothing and mitigation of the consequences of injury in terms of post-crash health and well-being. Given this evidence it seems likely that the use of protective clothing will confer significant benefits to riders in the event of a crash.
Publisher: Elsevier BV
Date: 08-2007
DOI: 10.1111/J.1753-6405.2007.00092.X
Abstract: While advances in nanotechnology promise to deliver significant benefits to many aspects of health care, there is increasing concern that regulatory regimes do not adequately capture the potential risks associated with this new technology. Concerns have arisen due to preliminary evidence suggesting that some engineered nanoparticles may display undesirable toxicological properties, presenting potential risks to human and environmental health and safety. Within this context, the role of Australia's National Industrial Chemicals and Assessment Scheme and the Therapeutic Goods Administration in regulating nano-based substances is explored. Drawing on earlier regulatory failures, combined with the scientific uncertainty surrounding nanotechnology, this article recommends that Australia adopt a proactive regulatory approach to nanotechnology through amendments to present legislative regimes. The approach articulated in this article strikes a balance between the current approach and that of the European Union's comprehensive new chemicals regime. Immediate regulatory change is called for in order to ensure that the health of the Australian public is adequately protected over the coming years.
Publisher: Informa UK Limited
Date: 17-02-2019
DOI: 10.1080/15389588.2018.1540867
Abstract: Fractures are a common injury among motorcycle riders and can have serious health implications. Impact protection (IP) has been designed to help prevent fractures, yet there are conflicting opinions as to whether this IP does in fact help prevent fractures in real-world crashes. This work aimed to (1) use simulated dummy impacts to examine whether existing types of IP could reduce the force transferred to the underlying bone to below fracture tolerance levels and (2) investigate whether current European Standard (EN 1621-1) test procedures for impact protectors designed for motorcyclists are sufficient to ensure fracture protection. Twenty-three shoulder and 7 knee IP specimens were tested using a 23-kg impactor contacting axially along the clavicle and femur of an anthropomorphic test device (ATD) at an energy level corresponding to the fracture tolerance of these bones. Sixteen IP specimens were the same as those worn by motorcycle riders involved in crashes where injury outcome was known (knee: n = 3 shoulder: n = 13) and the IP had been previously tested to EN 1621-1. Other IP tested represented a wide range of IP available for purchase at a motorcycle accessory store. Double and triple layers of IP were also tested. Energy attenuated during the dummy impacts was compared to energy attenuated when tested to EN 1621-1. Of the 23 shoulder IP tested, the average percentage reduction of transferred force to the shoulder from the baseline test was 7.6 ± 4.8%. The percentage reduction of transferred force to the knee from the baseline was 43.9 ± 7.5%. The entire group of knee IP tested reduced the transferred force to the knee to below the 10-kN injury threshold for the femur. There was a positive but nonsignificant correlation between the ATD test and the EN 1621-1 impact test performance, suggesting that the European standard test method likely provides a good indication of IP performance. However, given the low correlation coefficient, the relationship between IP performance in the European standard test method and injury protection remains unclear. Though the energy attenuation test method in the European standard may be an appropriate approach, distinct differences in injury protection performance observed between knee and shoulder IP indicate that there may be a need for different performance criteria for IP designated to protect different body regions.
Publisher: Oxford University Press (OUP)
Date: 04-09-2010
Abstract: the burden of falls and fall-related injuries among older adults is well established. Contention surrounds the effectiveness, and hence value, of multi-component fall prevention interventions delivered in the community. using consensus-based analytic guidelines rather than time-to-first fall as the primary endpoint, the objective was to examine the effectiveness of the Whitehorse NoFalls trial on all falls, falls resulting in injury and falls requiring medical care to be sought. the study was a community-based randomised controlled trial, with 1,090 participants assigned to one of eight groups, these being a combination of one or more of exercise, vision and or home hazard reduction or alternatively assignment to the control group. using negative binomial regression, the incidence of all falls, falls resulting in injury and those requiring medical care in the intervention groups were examined. Falls were reported using a monthly return calendar. exercise alone and in combination with vision and/or home hazard reduction was associated with fewer falls. For falls resulting in injury and the subset requiring medical care, the vision plus exercise intervention was associated with fewer falls. the findings confirm the effectiveness of exercise in preventing falls among community-dwelling older adults and supports contention that multi-component interventions do not prevent more falls than a single intervention. The results highlight the effectiveness of vision plus exercise in preventing more serious falls, a finding which warrants further consideration.
Publisher: Elsevier BV
Date: 09-2012
Publisher: Informa UK Limited
Date: 24-09-2016
DOI: 10.1080/00140139.2015.1082632
Abstract: Motorcycle protective clothing can be uncomfortably hot during summer, and this experiment was designed to evaluate the physiological significance of that burden. Twelve males participated in four, 90-min trials (cycling 30 W) across three environments (25, 30, 35 °C [all 40% relative humidity]). Clothing was modified between full and minimal injury protection. Both ensembles were tested at 25 °C, with only the more protective ensemble investigated at 30 and 35 °C. At 35 °C, auditory canal temperature rose at 0.02 °C min(-1) (SD 0.005), deviating from all other trials (p 38.5 °C) and profound hyperthermia (>40.0 °C) were predicted to occur within 105 min (SD 20.6) and 180 min (SD 33.0), respectively. Profound hyperthermia might eventuate in ~10 h at 30 °C, but should not occur at 25 °C. These outcomes demonstrate a need to enhance the heat dissipation capabilities of motorcycle clothing designed for summer use in hot climates, but without compromising impact protection. Practitioner's Summary: Motorcycle protective clothing can be uncomfortably hot during summer. This experiment was designed to evaluate the physiological significance of this burden across climatic states. In the heat, moderate (>38.5 °C) and profound hyperthermia (>40.0 °C) were predicted to occur within 105 and 180 min, respectively.
Publisher: Elsevier BV
Date: 03-2008
DOI: 10.1016/J.AAP.2007.09.005
Abstract: This study investigated the factors associated with the premature graduation into seatbelts for Australian children aged 4-11 years. From 699 child restraint use questionnaires, 195 children were identified as meeting the booster seat height-weight criteria (height: 100-145 cm and weight: 14-26 kg). Of these children, 44% were correctly traveling in a booster seat, while 56% had been moved prematurely into a seatbelt. A multivariable logistic regression model showed that there were a number of key predictors associated with the premature graduation to seatbelts. For ex le, children who were moved prematurely into a seatbelt were more likely to be older, have other children travelling in the vehicle and have younger parents compared to children appropriately restrained in a booster seat. In addition, there was a significant interaction between vehicle type and parent's household income. Based on the findings of this study, a number of recommendations are made for strategies to enhance appropriate restraint use for this age group, as well as for future research.
Publisher: American Public Health Association
Date: 04-2015
Abstract: Objectives. We identified the features of a land use–transportation system that optimizes the health and well-being of the population. Methods. We developed a quantitative system dynamics model to represent relationships among land use, transport, economic development, and population health. Simulation experiments were conducted over a 10-year simulation period to compare the effect of different baseline conditions and land use–transport policies on the number of motor vehicle crash deaths and disability-adjusted life years lost. Results. Optimal reduction in the public health burden attributable to land transport was demonstrated when transport safety risk reduction policies were combined with land use and transport polices that minimized reliance on in idual motorized transport and maximized use of active transport modes. The model’s results were particularly sensitive to the level of development that characterized each city at the start of the simulation period. Conclusions. Local, national, and international decision-makers are encouraged to address transport, land use, and health as an integrated whole to achieve the desired societal benefits of traffic safety, population health, and social equity.
Publisher: Elsevier BV
Date: 11-2011
DOI: 10.1016/J.AAP.2011.04.027
Abstract: Apart from helmets, little is known about the effectiveness of motorcycle protective clothing in reducing injuries in crashes. The study aimed to quantify the association between usage of motorcycle clothing and injury in crashes. Cross-sectional analytic study. Crashed motorcyclists (n=212, 71% of identified eligible cases) were recruited through hospitals and motorcycle repair services. Data was obtained through structured face-to-face interviews. The main outcome was hospitalization and motorcycle crash-related injury. Poisson regression was used to estimate relative risk (RR) and 95% confidence intervals for injury adjusting for potential confounders. Motorcyclists were significantly less likely to be admitted to hospital if they crashed wearing motorcycle jackets (RR=0.79, 95% CI: 0.69-0.91), pants (RR=0.49, 95% CI: 0.25-0.94), or gloves (RR=0.41, 95% CI: 0.26-0.66). When garments included fitted body armour there was a significantly reduced risk of injury to the upper body (RR=0.77, 95% CI: 0.66-0.89), hands and wrists (RR=0.55, 95% CI: 0.38-0.81), legs (RR=0.60, 95% CI: 0.40-0.90), feet and ankles (RR=0.54, 95% CI: 0.35-0.83). Non-motorcycle boots were also associated with a reduced risk of injury compared to shoes or joggers (RR=0.46, 95% CI: 0.28-0.75). No association between use of body armour and risk of fracture injuries was detected. A substantial proportion of motorcycle designed gloves (25.7%), jackets (29.7%) and pants (28.1%) were assessed to have failed due to material damage in the crash. Motorcycle protective clothing is associated with reduced risk and severity of crash related injury and hospitalization, particularly when fitted with body armour. The proportion of clothing items that failed under crash conditions indicates a need for improved quality control. While mandating usage of protective clothing is not recommended, consideration could be given to providing incentives for usage of protective clothing, such as tax exemptions for safety gear, health insurance premium reductions and rebates.
Publisher: Informa UK Limited
Date: 26-09-2014
DOI: 10.1080/15389588.2014.926009
Abstract: In 2006, Motorcycle Autonomous Emergency Braking (MAEB) was developed by a European Consortium (Powered Two Wheeler Integrated Safety, PISa) as a crash severity countermeasure for riders. This system can detect an obstacle through sensors in the front of the motorcycle and brakes automatically to achieve a 0.3 g deceleration if the collision is inevitable and the rider does not react. However, if the rider does brake, full braking force is applied automatically. Previous research into the potential benefits of MAEB has shown encouraging results. However, this was based on MAEB triggering algorithms designed for motorcycle crashes involving impacts with fixed objects and rear-end crashes. To estimate the full potential benefit of MAEB, there is a need to understand the full spectrum of motorcycle crashes and further develop triggering algorithms that apply to a wider spectrum of crash scenarios. In-depth crash data from 3 different countries were used: 80 hospital admittance cases collected during 2012-2013 within a 3-h driving range of Sydney, Australia, 40 crashes with Injury Severity Score (ISS)>15 collected in the metropolitan area of Florence, Italy, during 2009-2012, and 92 fatal crashes that occurred in Sweden during 2008-2009. In the first step, the potential applicability of MAEB among the crashes was assessed using a decision tree method. To achieve this, a new triggering algorithm for MAEB was developed to address crossing scenarios as well as crashes involving stationary objects. In the second step, the potential benefit of MAEB across the applicable crashes was examined by using numerical computer simulations. Each crash was reconstructed twice-once with and once without MAEB deployed. The principal finding is that using the new triggering algorithm, MAEB is seen to apply to a broad range of multivehicle motorcycle crashes. Crash mitigation was achieved through reductions in impact speed of up to approximately 10 percent, depending on the crash scenario and the initial vehicle pre-impact speeds. This research is the first attempt to evaluate MAEB with simulations on a broad range of crash scenarios using in-depth data. The results give further insights into the feasibility of MAEB in different speed ranges. It is clear then that MAEB is a promising technology that warrants further attention by researchers, manufacturers, and regulators.
Publisher: Informa UK Limited
Date: 02-09-2016
DOI: 10.1080/15389588.2016.1193171
Abstract: Autonomous emergency braking (AEB) is a safety system that detects imminent forward collisions and reacts by slowing down the host vehicle without any action from the driver. AEB effectiveness in avoiding and mitigating real-world crashes has recently been demonstrated. Research suggests that a translation of AEB to powered 2-wheelers could also be beneficial. Previous studies have estimated the effects of a motorcycle AEB system (MAEB) via computer simulations. Though effects of MAEB were computed for motorcycle crashes derived from in-depth crash investigation, there may be some inaccuracies due to limitations of postcrash investigation (e.g., inaccuracies in preimpact velocity of the motorcycle). Furthermore, ideal MAEB technology was assumed, which may lead to overestimation of the benefits. This study sought to evaluate the sensitivity of the simulations to variations in reconstructed crash cases and the capacity of the MAEB system in order to provide a more robust estimation of MAEB effects. First, a comprehensive classification of accidents was used to identify scenarios in which MAEB was likely to apply, and representative crash cases from those available for this study were populated for each crash scenario. Second, 100 variant cases were generated by randomly varying a set of simulation parameters with given normal distributions around the baseline values. Variants reflected uncertainties in the original data. Third, the effects of MAEB were estimated in terms of the difference in the impact speed of the host motorcycle with and without the system via computer simulations of each variant case. Simulations were repeated assuming both an idealized and a realistic MAEB system. For each crash case, the results in the baseline case and in the variants were compared. A total of 36 crash cases representing 11 common crash scenarios were selected from 3 Australian in-depth data sets: 12 cases from New South Wales, 13 cases from Victoria, and 11 cases from South Australia. The reduction in impact speed elicited by MAEB in the baseline cases ranged from 2.8 to 10.0 km/h. The baseline cases over- or underestimated the mean impact speed reduction of the variant cases by up to 20%. Constraints imposed by simulating more realistic capabilities for an MAEB system produced a decrease in the estimated impact speed reduction of up to 14% (mean 5%) compared to an idealized system. The small difference between the baseline and variant case results demonstrates that the potential effects of MAEB computed from the cases described in in-depth crash reports are typically a good approximation, despite limitations of postcrash investigation. Furthermore, given that MAEB intervenes very close to the point of impact, limitations of the currently available technologies were not found to have a dramatic influence on the effects of the system.
Publisher: IEEE
Date: 06-2015
Publisher: BMJ
Date: 13-10-2011
DOI: 10.1136/INJURYPREV-2011-040216
Abstract: Injuries are a major source of mortality and morbidity in China with approximately 66 million citizens requiring emergency medical care. Trauma registries provide the basis for quality assurance processes and inform the treatment of the injured patient. Against the backdrop of the recently established Chinese National Injury Surveillance System, the feasibility of establishing a multicentre trauma registry in a limited number of hospitals was examined. Seven hospital directors reported on a range of hospital characteristics including patient volume information and the types of patient information routinely collected. The findings indicate significant numbers of patients presenting due to injury, though little comparability in the type of information collected both between hospitals and with international trauma registry systems. The development of multicentre trauma registry is suggested as a way to monitor trauma system performance. The integration of clinical indicators into the National Injury Surveillance System in the long term is also recommended.
Publisher: Informa UK Limited
Date: 07-2016
DOI: 10.1080/15389588.2015.1136061
Abstract: Pelvic injuries are a serious and commonly occurring injury to motorcycle riders involved in crashes, yet there has been limited research investigating the mechanisms involved in these injuries. This study aimed to investigate the mechanisms involved in pelvic injuries to crashed motorcyclists. This study involved in-depth crash investigation and 2 convenience-based data sets were used. These data sets investigated motorcycle crashes in the Sydney, Newcastle, and Adelaide regions. Participants included motorcycle riders who had crashed either on a public road or private property within the study areas. The mechanism of injury and the type of injuries were investigated. The most frequent cause of pelvic injuries in crashed motorcyclists was due to contact with the motorcycle fuel tank during the crash (85%). For riders who had come into contact with the fuel tank, the injury types were able to be grouped into 3 categories based on the complexity of the injury. The complexity of the injury appeared to increase with impact speed but this was a nonsignificant trend. The pelvic injuries that did not occur from contact with the fuel tank in this s le differed in asymmetry of loading and did not commonly involve injury to the bladder. They were commonly one-sided injuries but this differed based on the point of loading however, a larger s le of these injuries needs to be investigated. Overall improvements in road safety have not been replicated in the amelioration of pelvic injuries in motorcyclists and improvements in the design of crashworthy motorcycle fuel tanks appear to be required.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 06-2022
Publisher: Informa UK Limited
Date: 21-07-2016
DOI: 10.1080/15389588.2016.1155210
Abstract: Autonomous emergency braking (AEB) acts to slow down a vehicle when an unavoidable impending collision is detected. In addition to documented benefits when applied to passenger cars, AEB has also shown potential when applied to motorcycles (MAEB). However, the feasibility of MAEB as practically applied to motorcycles in the real world is not well understood. In this study we performed a field trial involving 16 riders on a test motorcycle subjected to automatic decelerations, thus simulating MAEB activation. The tests were conducted along a rectilinear path at nominal speed of 40 km/h and with mean deceleration of 0.15 g (15% of full braking) deployed at random times. Riders were also exposed to one final undeclared brake activation with the aim of providing genuinely unexpected automatic braking events. Participants were consistently able to manage automatic decelerations of the vehicle with minor to moderate effort. Results of undeclared activations were consistent with those of standard runs. This study demonstrated the feasibility of a moderate automatic deceleration in a scenario of motorcycle travelling in a straight path, supporting the notion that the application of AEB on motorcycles is practicable. Furthermore, the proposed field trial can be used as a reference for future regulation or consumer tests in order to address safety and acceptability of unexpected automatic decelerations on a motorcycle.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 09-2016
Publisher: Elsevier BV
Date: 10-2013
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.JSR.2017.02.001
Abstract: Motorcyclists represent an increasing proportion of road users globally and are increasingly represented in crash statistics. Soft tissue injuries are the most common type of injuries to crashed motorcyclists. These injuries can be prevented through the use of protective clothing designed for motorcycle use. However, the quality of such clothing is not controlled in many countries around the world. A European Standard was developed to assess the performance of clothing but as this is not mandatory, clothing certified to this Standard is difficult to obtain. Given the importance of this Standard, and that it has been validated only once, further validation work is required. In-depth crash investigation data were used to investigate the relationship between the abrasion resistance performance of clothing and real-world injury outcome. Clothing was collected from riders who crashed on public roads in Sydney and Newcastle, Australia. This clothing was tested according to the EU Standard and the time to hole was recorded. Hospital medical records were reviewed and the association between a rider suffering a soft tissue injury and the time-to-hole for the garment was examined. The probability of soft tissue injury for Level 1 Standard garments was between 40-60%, but more than 60% of garments tested failed to meet the minimum requirement. The findings of this study provide qualified support for the Standard, with a marginal association between time-to-hole and injury being found. This work supports the need for improved safety performance and an increased number of high performing garments being available to motorcyclists.
Publisher: Informa UK Limited
Date: 21-04-2017
DOI: 10.1080/15389588.2017.1306855
Abstract: Real-time driver monitoring systems represent a solution to address key behavioral risks as they occur, particularly distraction and fatigue. The efficacy of these systems in real-world settings is largely unknown. This article has three objectives: (1) to document the incidence and duration of fatigue in real-world commercial truck-driving operations, (2) to determine the reduction, if any, in the incidence of fatigue episodes associated with providing feedback, and (3) to tease apart the relative contribution of in-cab warnings from 24/7 monitoring and feedback to employers. Data collected from a commercially available in-vehicle camera-based driver monitoring system installed in a commercial truck fleet operating in Australia were analyzed. The real-time driver monitoring system makes continuous assessments of driver drowsiness based on eyelid position and other factors. Data were collected in a baseline period where no feedback was provided to drivers. Real-time feedback to drivers then occurred via in-cab auditory and haptic warnings, which were further enhanced by direct feedback by company management when fatigue events were detected by external 24/7 monitors. Fatigue incidence rates and their timing of occurrence across the three time periods were compared. Relative to no feedback being provided to drivers when fatigue events were detected, in-cab warnings resulted in a 66% reduction in fatigue events, with a 95% reduction achieved by the real-time provision of direct feedback in addition to in-cab warnings (p < 0.01). With feedback, fatigue events were shorter in duration a d occurred later in the trip, and fewer drivers had more than one verified fatigue event per trip. That the provision of feedback to the company on driver fatigue events in real time provides greater benefit than feedback to the driver alone has implications for companies seeking to mitigate risks associated with fatigue. Having fewer fatigue events is likely a reflection of the device itself and the accompanying safety culture of the company in terms of how the information is used. Data were analysed on a per-truck trip basis, and the findings are indicative of fatigue events in a large-scale commercial transport fleet. Future research ought to account for in idual driver performance, which was not possible with the available data in this retrospective analysis. Evidence that real-time driver monitoring feedback is effective in reducing fatigue events is invaluable in the development of fleet safety policies, and of future national policy and vehicle safety regulations. Implications for automotive driver monitoring are discussed.
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.AAP.2017.03.020
Abstract: Vehicle speed is a major contributor to road trauma, both in terms of increased crash risk and injury severity. In Australia, approximately one third of fatal crashes occur in speed zones of 100km/h. This proportion has remained the same, despite the reduction in the number of road fatalities over the past decade. To drive further reductions in speed-related crashes, an improved understanding of the underlying determinants of speed choice is required. A community attitude survey designed to understand speed behaviour and attitudes towards speeding was distributed to a large (N=5179) representative s le of drivers in Australia. Participants provided information regarding their normal speed choices across four different speed zones (40, 50, 60 and 100km/h), beliefs about the risks and enforcement of speeding behaviour as well as technology to reduce speeding. Almost half of the s le (47%) reported exceeding the speed limit in 100km/h zones, although only a small number of these drivers (<0.5%) did so by 11km/h or more. Age and sex were related to speed limit non-compliance. Males were more likely to be classified as mid-level speeders, defined as being up to 10km/h over the limit, and excessive speeders (11+km/h over the limit). Younger drivers were also more likely to be non-compliant. When compared to compliant drivers, non-compliers perceived less risk of a serious crash, reported greater likelihood of exceeding the speed limit when they believed they would not be detected, and reported a higher level of social acceptability of speeding. Only one-third of the s le reported prior knowledge of intelligent speed assist (ISA) technology, however, once explained, the majority agreed it would be personally useful (64%). Speed non-compliers were somewhat less likely to support the usefulness of ISA than speed limit compliant drivers. These findings can be used to target appropriate interventions and road safety messages, aimed at reducing speeding behaviour. Measures designed to address perceived social acceptability of speed behaviour, the increased crash risk associated with speeding, and the threat of detection are recommended.
Publisher: Informa UK Limited
Date: 28-02-2018
DOI: 10.1080/15389588.2018.1426911
Abstract: This study used medicolegal data to investigate fatal older road user (ORU) crash circumstances and risk factors relating to four key components of the Safe System approach (e.g., roads and roadsides, vehicles, road users, and speeds) to identify areas of priority for targeted prevention activity. The Coroners Court of Victoria's Surveillance Database was searched to identify coronial records with at least one deceased ORU in the state of Victoria, Australia, for 2013-2014. Information relating to the ORU, crash characteristics and circumstances, and risk factors was extracted and analyzed. The average rate of fatal ORU crashes per 100,000 population was 8.1 (95% confidence interval [CI] 6.0-10.2), which was more than double the average rate of fatal middle-aged road user crashes (3.6, 95% CI 2.5-4.6). There was a significant relationship between age group and deceased road user type (χ Road user error was the most significant risk factor identified in fatal ORU crashes, which suggests that there is a limited capacity of the Victorian road system to fully accommodate road user errors. Initiatives related to safer roads and roadsides, vehicles, and speed zones, as well as behavioral approaches, are key areas of priority for targeted activity to prevent fatal older road user crashes in the future.
Publisher: BMJ
Date: 20-07-2002
Abstract: To test the effectiveness of, and explore interactions between, three interventions to prevent falls among older people. A randomised controlled trial with a full factorial design. Urban community in Melbourne, Australia. 1090 aged 70 years and over and living at home. Most were Australian born and rated their health as good to excellent just over half lived alone. Three interventions (group based exercise, home hazard management, and vision improvement) delivered to eight groups defined by the presence or absence of each intervention. Time to first fall ascertained by an 18 month falls calendar and analysed with survival analysis techniques. Changes to targeted risk factors were assessed by using measures of quadriceps strength, balance, vision, and number of hazards in the home. The rate ratio for exercise was 0.82 (95% confidence interval 0.70 to 0.97, P=0.02), and a significant effect (P<0.05) was observed for the combinations of interventions that involved exercise. Balance measures improved significantly among the exercise group. Neither home hazard management nor treatment of poor vision showed a significant effect. The strongest effect was observed for all three interventions combined (rate ratio 0.67 (0.51 to 0.88, P=0.004)), producing an estimated 14.0% reduction in the annual fall rate. The number of people needed to be treated to prevent one fall a year ranged from 32 for home hazard management to 7 for all three interventions combined. Group based exercise was the most potent single intervention tested, and the reduction in falls among this group seems to have been associated with improved balance. Falls were further reduced by the addition of home hazard management or reduced vision management, or both of these. Cost effectiveness is yet to be examined. These findings are most applicable to Australian born adults aged 70-84 years living at home who rate their health as good.
Start Date: 05-2014
End Date: 04-2017
Amount: $510,000.00
Funder: Australian Research Council
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