The risky and protective motorcycling opinions and behaviours of young on-road motorcyclists in New Zealand

Road Safety Practices among Commercial Motorcyclists in a Rural Town in Nigeria: Implications for Health Education

This cross-sectional, community-based study was carried out among commercial motorcyclists in Igboora. All the commercial motor parks in Igboora were visited and all the commercial motorcyclists who consented to participate in the study were interviewed. Information on the respondents' socio-demographic characteristics, and the practice of road safety measures was collected using an interviewer administered questionnaire. A total of 299 motorcyclists were interviewed. All (100%) of them were males. The mean age of the respondents was 27.4 ± 7.4 years. One hundred eighty-two (60.7%) of the motorcyclists had the correct knowledge of the purpose of Highway Code. Only 70 (23.3%) could recognize more than half of the currently used road safety codes and 47 (15.7%) obey these road safety codes more than half of the time they see it. Only 183 (61.2%) of them had a driving license and 72 (24.1%) were able to produce these licenses on demand. All (100%) of the respondents did not use any protective helmet. Those who have longer years of working experience, higher level of education and higher knowledge of the safety codes practice it more regularly ( r = 0.198, p = 0.001, χ2 = 9.31, p = 0.025, and r = 0.28, p = 0.001 respectively). One hundred thirty-six (45.5%) have been involved in at least one accident in the preceding year. The overall incidence of road traffic accident was 2.16 per 1,000. There was however on statistically significant association between the practice of road safety codes and the occurrence of road traffic accidents (χ2 = 0.176, p = 0.916). The study shows that the practice of road safety measures was low in this rural Nigerian community and was not associated with the incidence of road traffic accidents. Introducing road safety education particularly targeted at educating the motorcyclists on the importance and practice of road safety measures would lead to an increase in the practice of the safety measures and hopefully a reduction in the incidence of road traffic accidents.

Prevalence and risk factors of alcohol and substance abuse among motorcycle drivers in Fars province, Iran

PURPOSE

The aim of this present study is to investigate the prevalence of alcohol and substance abuse (ASA) and its relationship with other risky driving behaviors among motorcycle drivers.

METHODS

This is a cross sectional study which is performed at Shiraz city of Iran. Data from motorcycle drivers were collected using a standard questionnaire in eight major streets at different times of the day. The data includes consumption of alcohol and other substances two hours before driving and some of the risky behaviors during driving.

RESULTS

A total of 414 drivers with a mean ± SD age of (27.0 ± 9.3) years participated in the study. Alcohol or substance consumptions two hours before driving was significantly associated with risky driving behaviors such as using mobile phone during driving, poor maneuvering, and driving over the speed limit (both p < 0.001). It was also associated with carelessness about safety such as driving with technical defects (p < 0.001) and not wearing a crash helmet (p=0.008).

CONCLUSION

Screening for alcohol and substance consumption among motorcycle drivers is an efficient way to identify drivers that are at a greater risk for road traffic accidents.

Correlation between crash avoidance maneuvers and injury severity sustained by motorcyclists in single-vehicle crashes

OBJECTIVES

In order to improve motorcycle safety, this article examines the correlation between crash avoidance maneuvers and injury severity sustained by motorcyclists, under multiple precrash conditions.

METHOD

Ten-year crash data for single-vehicle motorcycle crashes from the General Estimates Systems (GES) were analyzed, using partial proportional odds models (i.e., generalized ordered logit models).

RESULTS

The modeling results show that "braking (no lock-up)" is associated with a higher probability of increased severity, whereas "braking (lock-up)" is associated with a higher probability of decreased severity, under all precrash conditions. "Steering" is associated with a higher probability of reduced injury severity when other vehicles are encroaching, whereas it is correlated with high injury severity under other conditions. "Braking and steering" is significantly associated with a higher probability of low severity under "animal encounter and object presence," whereas it is surprisingly correlated with high injury severity when motorcycles are traveling off the edge of the road. The results also show that a large number of motorcyclists did not perform any crash avoidance maneuvers or conducted crash avoidance maneuvers that are significantly associated with high injury severity.

CONCLUSIONS

In general, this study suggests that precrash maneuvers are an important factor associated with motorcyclists' injury severity. To improve motorcycle safety, training/educational programs should be considered to improve safety awareness and adjust driving habits of motorcyclists. Antilock brakes and such systems are also promising, because they could effectively prevent brake lock-up and assist motorcyclists in maneuvering during critical conditions. This study also provides valuable information for the design of motorcycle training curriculum.

A review of powered-two-wheeler behaviour and safety

Powered-two-wheelers (PTWs) constitute a very vulnerable type of road users. The notable increase in their share in traffic and the high risk of severe accident occurrence raise the need for further research. However, current research on PTW safety is not as extensive as for other road users (passenger cars, etc.). Consequently, the objective of this research is to provide a critical review of research on Power-Two-Wheeler behaviour and safety with regard to data collection, methods of analysis and contributory factors, and discuss the needs for further research. Both macroscopic analyses (accident frequency, accident rates and severity) and microscopic analyses (PTW rider behaviour, interaction with other motorised traffic) are examined and discussed in this paper. The research gaps and the needs for future research are identified, discussed and put in a broad framework. When the interactions between behaviour, accident frequency/rates and severity are co-considered and co-investigated with the various contributory factors (riders, other users, road and traffic environment, vehicles), the accident and injury causes as well as the related solutions are better identified.

Determinants of personal protective equipment (PPE) use in UK motorcyclists: exploratory research applying an extended theory of planned behaviour

Despite evident protective value of motorcycle personal protective equipment (PPE), no research has assessed considerations behind its uptake in UK riders. A cross-sectional online questionnaire design was employed, with riders (n=268) recruited from online motorcycle forums. Principal component analysis found four PPE behavioural outcomes. Theoretical factors of intentions, attitudes, injunctive and descriptive subjective norms, risk perceptions, anticipated regret, benefits and habit were also identified for further analysis. High motorcycle jacket, trousers and boots wear, middling high-visibility wear and low non-Personal Protective Equipment wear were found. Greater intentions, anticipated regret and perceived benefits were significantly associated with increased motorcycle jacket, trousers and boots wear, with habit presence and scooter use significantly associated with increased high-visibility wear. Lower intentions, anticipated regret and risk perceptions, being female, not holding a car licence and urban riding were significantly associated with increased non-PPE wear. A need for freedom of choice and mixed attitudes towards PPE use were evident in additional comments. PPE determinants in this sample provide a preliminary basis for future uptake interventions. Larger scale and qualitative research is needed to further investigate relevant constructs.

Naturalistic study of rider's behaviour in initial training in France: evidence of limitations in the educational content

This paper analyses motorcycle educational content in a number of French motorcycle schools on the basis of a naturalistic study of riders' and trainers' behaviour. The aim is to specify the situations delivered in motorcycle schools and to study the rider's activity in these situations. The methodology includes ethnographic observation within the motorcycle schools and the longitudinal monitoring of 14 trainee motorcyclists during their initial training. The training situations were described by the combination of audio-visual recordings and interviews data (i.e. concomitant or interruptive verbalization, and self-confrontation data). The results permit to (1) compare the "real" and "official" durations of track and on-road training, (2) characterize the real training situations, (3) describe the preferred forms of instruction, and (4) conduct an in-depth analysis of the situations used during training in traffic. The discussion show, in first, the poverty of the training situations which are based on the repetition of the exercises in the test, and, in second, disparities between the riding situations encountered during training and the demands made by riding in natural traffic. The usefulness and the applications of this type of approach--based on the integration of the rider's point of view notably by self-confrontation interview--for understanding real riding behaviours and how such approaches could supplement vehicle-based data are discussed in a large conclusion.

An epidemiological survey on road traffic crashes in Iran: application of the two logistic regression models

Risk factors of human-related traffic crashes are the most important and preventable challenges for community health due to their noteworthy burden in developing countries in particular. The present study aims to investigate the role of human risk factors of road traffic crashes in Iran. Through a cross-sectional study using the COM 114 data collection forms, the police records of almost 600,000 crashes occurred in 2010 are investigated. The binary logistic regression and proportional odds regression models are used. The odds ratio for each risk factor is calculated. These models are adjusted for known confounding factors including age, sex and driving time. The traffic crash reports of 537,688 men (90.8%) and 54,480 women (9.2%) are analysed. The mean age is 34.1 ± 14 years. Not maintaining eyes on the road (53.7%) and losing control of the vehicle (21.4%) are the main causes of drivers' deaths in traffic crashes within cities. Not maintaining eyes on the road is also the most frequent human risk factor for road traffic crashes out of cities. Sudden lane excursion (OR = 9.9, 95% CI: 8.2-11.9) and seat belt non-compliance (OR = 8.7, CI: 6.7-10.1), exceeding authorised speed (OR = 17.9, CI: 12.7-25.1) and exceeding safe speed (OR = 9.7, CI: 7.2-13.2) are the most significant human risk factors for traffic crashes in Iran. The high mortality rate of 39 people for every 100,000 population emphasises on the importance of traffic crashes in Iran. Considering the important role of human risk factors in traffic crashes, struggling efforts are required to control dangerous driving behaviours such as exceeding speed, illegal overtaking and not maintaining eyes on the road.

Motorcycle protective clothing: protection from injury or just the weather?

BACKGROUND

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.

METHODS AND FINDINGS

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.

RESULTS

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.

CONCLUSIONS

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.

Determinants of helmet use behaviour among employed motorcycle riders in Yazd, Iran based on theory of planned behaviour

This paper reports on predictors of helmet use behaviour, using variables based on the theory of planned behaviour model among the employed motorcycle riders in Yazd-Iran, in an attempt to identify influential factors that may be addressed through intervention efforts. In 2007, a cluster random sample of 130 employed motorcycle riders in the city of Yazd in central Iran, participated in the study. Appropriate instruments were designed to measure the variables of interest (attitude, subjective norms, perceived behaviour control, intention along with helmet use behaviour). Reliability and validity of the instruments were examined and approved. The statistical analysis of the data included descriptive statistics, bivariate correlations, and multiple regression. Based on the results, 56 out of all the respondents (43.1%) had history of accident by motorcycle. Of these motorcycle riders only 10.7% were wearing their helmet at the time of their accident. Intention and perceived behavioural control showed a significant relationship with helmet use behaviour and perceived behaviour control was the strongest predictor of helmet use intention, followed by subjective norms, and attitude. It was found that that helmet use rate among motorcycle riders was very low. The findings of present study provide a preliminary support for the TPB model as an effective framework for examining helmet use in motorcycle riders. Understanding motorcycle rider's thoughts, feelings and beliefs about helmet use behaviour can assist intervention specialists to develop and implement effective programs in order to promote helmet use among motorcycle riders.

The frequency and predictors of helmet use among Iranian motorcyclists: A quantitative and qualitative study

OBJECTIVE

This study examines the rate of helmet use and identifies barriers and facilitators of wearing helmets among Iranian motorcyclists. A mixed-method approach was used, including a structured seasonal survey with specific observations of a random sample of 6010 riders and qualitative methods that included 29 in-depth interviews and seven focus groups (n=31).

RESULTS

Only 10% of motorcyclists wear a standard helmet while riding. However, another 23% of motorcyclists used non-standard or partial helmets that covered only part of the head and do not prevent head trauma injuries effectively. We observed only 2 of 264 child passengers and 22 of 1951 adult passengers wearing helmets. Almost no one used protective pants or clothing made to be more visible in traffic. Themes emerged from qualitative interviews and were grouped into three main categories: (1) helmet characteristics; (2) social and cultural factors; and (3) personal and psychological factors.

CONCLUSION

Overall, the motorcyclists in our study believed that wearing a safety helmet protects them against serious injuries or death during a crash; however, only a small percentage of the motorcyclists used safety helmets. National intervention programs addressing motorcycle safety should aim to overcome barriers to and promote facilitators of helmet use, including providing inexpensive standard helmets, banning manufacturing/using unsafe partial or dummy helmets, as well as enforcing helmet use on a consistent basis.

Novice riders and the predictors of riding without motorcycle protective clothing

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

Correlates of motorcycle helmet use among recent graduates of a motorcycle training course

Helmets significantly decrease morbidity and mortality from motorcycle crashes, but many areas of the world lack universal helmet laws. To educate motorcyclists in areas without helmet laws, more knowledge of motorcyclists' helmet beliefs is needed. A web-based survey was therefore designed to assess motorcyclists' attitudes, norms and behaviors towards helmets in a U.S. state with a limited helmet law. Of 445 survey respondents, 68.4% of respondents reported always wearing a helmet. The not-always-helmeted riders were more likely than the always-helmeted to be male; to bave less education; and to have a history of previous motorcycle crashes and injuries. Although both groups had taken rider training classes, fewer of the not-always-helmeted had learned how to ride in a class. The strongest correlates of being not-always-helmeted (vs. always-helmeted) were attitudes that helmets were not protective and impaired sight/hearing; and the normative belief that they would only wear helmets if forced by law. Because attitudes are often more easily changed than normative beliefs, education may increase helmet use. However, less than half of riders in this state with a mandatory education program learned how to ride from a rider education course, and 44% of non-helmeted said they would only wear a helmet if forced by law. Legislation may therefore be a more efficient and effective strategy than education to increase helmet use.

Risk-taking behaviors among motorcyclists in middle east countries: a case of islamic republic of Iran

OBJECTIVE

Injuries caused by motor vehicle crashes in Middle Eastern countries are among the highest in the world. In Iran, road traffic crashes are the second most common cause of mortality. Particularly, motorcycle-related injuries among men are the second most common type of traffic-related crash in this country. This study used qualitative research methods to elicit and explore the personal experiences of Iranian motorcyclists in respect to factors that facilitate their engagement in risk-taking behaviors within the PRECEDE (predisposing, reinforcing, and enabling constructs in educational diagnosis, and evaluation) framework.

METHODS

Focus groups, in-depth interviews, and field observation were conducted among motorcyclists, pillion passengers, and police officers.

RESULTS

Our data show that being young and single, living in lower socioeconomic conditions, and suffering from poor physical health and daily stress influence risk-taking behaviors. Additionally, lack of defined traffic rules and regulations, the availability and accessibility of motorcycles among unlicensed underaged persons, the cost-effectiveness of motorcycle transportation, unsafe roads and a lack of special pathways for motorcycles, and aggressive car and van/truck drivers are among the enabling factors that provoke risk-taking behavior. Finally, the participants verified that the enjoyment of motorcycling reinforced their decision to continue engaging in risky behaviors, and being penalized for disobeying traffic laws prevented them from further risk-taking behaviors.

CONCLUSION

Enabling and reinforcing factors to reduce risk-taking behaviors among motorcyclist could include (1) promoting smart driving practices among motorcyclists; (2) training pediatricians and emergency physicians to deliver brief motivational interventions to their young patients to avoid risky behaviors while riding; (3) training traffic enforcement officers to appreciate the value of providing consistent law enforcement services; (4) enhancing local efforts to increase the number of pathways for motorcyclists and improve the condition of deteriorated roads; (5) revising legislation and policies in association with motorcycle ownership among underaged and unlicensed individuals; (6) limiting an excessive number of passengers (particularly children) and cargo on motorcycles; and (7) identifying solutions to reduce the negative attitudes of car drivers toward motorcyclists and increase systematic compliance of traffic laws by motorcyclists and car drivers.

A review of risk factors and patterns of motorcycle injuries

Per vehicle mile traveled, motorcycle riders have a 34-fold higher risk of death in a crash than people driving other types of motor vehicles. While lower-extremity injuries most commonly occur in all motorcycle crashes, head injuries are most frequent in fatal crashes. Helmets and helmet use laws have been shown to be effective in reducing head injuries and deaths from motorcycle crashes. Alcohol is the major contributing factor to fatal crashes. Enforcement of legal limits on the blood alcohol concentration is effective in reducing motorcycle deaths, while some alcohol-related interventions such as a minimal legal drinking age, increased alcohol excise taxes, and responsible beverage service specifically for motorcycle riders have not been examined. Other modifiable protective or risk factors comprise inexperience and driver training, conspicuity and daytime headlight laws, motorcycle licensure and ownership, riding speed, and risk-taking behaviors. Features of motorcycle use and potentially effective prevention programs for motorcycle crash injuries in developing countries are discussed. Finally, recommendations for future motorcycle-injury research are made.

Perfil do trabalho e acidentes de trânsito entre motociclistas de entregas em dois municípios de médio porte do Estado do Paraná, Brasil

Com o objetivo de analisar o perfil de motociclistas que fazem entregas (conhecidos como motoboys) de Londrina e Maringá, Estado do Paraná, Brasil, suas condições de trabalho, situações de risco e ocorrência de acidentes de trânsito, foi realizado um estudo transversal por meio de um questionário auto-aplicável, com coleta de dados em 2005/2006. Foram pesquisados 377 motoboys em Londrina e 500 em Maringá, com idade média, respectivamente, de 28 e 29 anos. Houve maior proporção, em Londrina, de trabalhadores com ganho por produtividade, que trabalhavam durante dia e noite ou à noite e com jornada diária superior a dez horas (p < 0,05). Apesar da maior exposição dos motociclistas de Londrina a más condições de trabalho e a situações de risco no trânsito, não houve diferença significativa entre as taxas de acidentes relatados nos 12 meses anteriores à pesquisa em Londrina e Maringá (2,89 e 2,80 por 100 pessoas-mês, respectivamente). Este estudo evidenciou precárias condições de trabalho, alta exposição de motoboys a situações de risco no trânsito e elevadas taxas de acidentes envolvendo esses profissionais.

The role of motorcyclist and other driver behaviour in two types of serious accident in the UK

Motorcycle accidents have somewhat different characteristics from accidents involving other classes of road user. They include in particular 'right of way' accidents, and accidents involving loss of control on curves or bends. A sample of 1790 accident cases was considered, including 1003 in detail, from UK midland police forces, involving motorcyclists of all ages, and covering the years 1997-2002 inclusive. Significant differences were discovered in the sample with respect to types of accidents involving motorcyclists (and their blameworthiness). There seems to be a particular problem surrounding other road users' perception of motorcycles, particularly at junctions. Such accidents often seem to involve older drivers with relatively high levels of driving experience who nonetheless seem to have problems detecting approaching motorcycles. Motorcyclists themselves seem to have far more problems with other types of accident, such as those on bends or curves. The implications of these findings are discussed.

The prevalence and reliability of visibility aid and other risk factor data for uninjured cyclists and pedestrians in Edmonton, Alberta, Canada

This study was conducted to determine the prevalence and reliability of risk factors collected on uninjured cyclists-pedestrians in Edmonton, Alberta, and what characteristics predict cyclist-pedestrian visibility. At randomly selected locations from July 2004 to August 2004, two independent observers recorded cyclist-pedestrian characteristics such as age, sex, clothing color, use of reflectors, flags, helmets, and a subjective impression of visibility. Data were collected on 836 individuals; most were either walking/jogging (approximately 63%) or cycling (approximately 33%). For non-cyclists, the prevalence of bright colored clothing on the trunk ranged from 12.7 to 14.7%. Few people used any kind of reflective strips. Inter-observer agreement (Kappa) ranged from 0.37 (visibility assessment) to 0.99 (sex). For cyclists, 17-19% of headgear was brightly colored, and 13-14% was white. Approximately one-fourth had a front light; half had a rear reflector. Few cyclists used a flag and just over half used spoke reflectors. Kappa ranged from 0.35 (observer assessed speed) to 0.95 (head gear and sex). A major trunk color of orange, red, yellow or white resulted in a higher visibility rating for both cyclists and pedestrians. The results indicate a low prevalence of visibility aid use among cyclists and pedestrians, but there appears to be acceptable inter-observer reliability for most data collected. Further work is required before an overall visibility rating can be used in place of component scores.

Traffic behaviour among adolescents using mopeds and light motorcycles

INTRODUCTION

Motorcycling is recognized to be a relatively risky activity. Powered two wheelers (PTW) are classified as mopeds, light, and heavy motorcycles, the first two categories being denoted light PTWs. This paper reviews the scientific literature on accident risks and traffic behavior among users of light PTWs with the aim of clarifying the current state of knowledge.

METHOD

Based on a risk analytical and an anthropological perspective on motorcycling, the paper discusses the significance of cultural and social factors as important aspects of safety. More targeted and effective safety measures, for example better training programs, are needed to prevent motorcycle accidents. This means developing a deeper understanding of the rider as an individual, and the individuals within different groups and settings. Why and how motorcyclists approach the road, its function as a social arena, the varieties of goals and values, and the motorcyclists' own perceptions of the behavior that ensures their "achievements" or "successes", are some of the issues. Today, this kind of knowledge is scarce and almost entirely absent from the scientific literature.

RESULTS

We conclude that the massive quantities of data on numbers of accidents, the categorization of situations, the causal explanations related to speed, gender, age, lack of concentration so forth, can only be employed as support for safety measures as long as they are linked to social and cultural factors.

IMPACT ON INDUSTRY

Risk informed decision making has become an integral part of authorities' and manufacturers' implementation of safety measures. This tendency is strengthened by the fact that the responsibility of product safety rests upon the manufacturers, cf. for example EU safety regulations. Therefore it is paramount that a thorough understanding of social and cultural factors related to the PTW driving is necessary for the industry to develop targeted and efficient safety measures.

Risky behaviors among motorcycling adolescents in Italy

OBJECTIVE

To investigate the relationship between risky behaviors and motorcycling in adolescents in Italy.

STUDY DESIGN

A questionnaire was administered to a random sample of 1000 adolescents attending randomly selected public secondary schools to assess personal characteristics and lifestyle; motorcycle and helmet use; behavior while driving a motorcycle; traffic-related accidents, and receipt of tickets.

RESULTS

Of the 894 responders, 54% and 29.2% routinely use the helmet as driver or passenger, respectively. Routine helmet use was higher among males, current smokers, alcohol drinkers, and those who reported that at least one close friend used a helmet. Motorcycling after consuming alcohol was higher in males, in current smokers, and in those who used cell phones and were tired while driving. An accident in the past year occurred in 25.7% of riders and was significantly higher in those who used cell phones while driving and in those who were interested in learning about motorcycle use. Adolescents who reported always motorcycling over the speed limit were at lower risk of smoking, talking with the passenger, and using a cell phone while driving. Being male, being older, learning about motorcycle use from someone outside the family, talking with a passenger, and using a cell phone while driving increased the risk of receiving a ticket.

CONCLUSIONS

Educational programs, legislative measures, and policies to reduce risk behaviors in adolescents who use motorcycles are needed.

Identifying best practices states in motorcycle rider education and licensing

PROBLEM

After decreasing to a historic low in 1997, motorcycle crash-related fatalities are increasing. Although causes remain unclear, motorcycle rider education and licensing play key roles in reducing motorcycle crashes and injuries. Yet, little is known about what constitutes effective rider training and licensing. This study develops a model of best practices in motorcycle rider education and licensing and combines primary and secondary data to identify states that most closely adhere to this model. Evidence on the validity of the model is also examined.

METHOD

States were rated along three areas of best practices: (a) program administration; (b) rider education; and (c) licensing based on 2001 data collected for a National Highway Traffic Safety Administration (NHTSA)-sponsored study.

RESULTS

Results indicate wide variation in states' adherence to best practices; several states meet most, others very few. When the areas of best practices are considered separately, a state tends to behave similarly on all three. Initial evidence supports the validity of the model, with high best practices states having the lowest rates of motorcycle fatalities.

IMPACT ON TRAFFIC SAFETY

As motorcycle-related crashes increase and state and federal support for rider education programs diminishes, it is critical that states identify deficiencies in their program and learn from successful states about efficient, cost-effective strategies for increasing best practices in motorcycle rider education and licensing.

Mechanisms of Pediatric Trauma Deaths in Canada and the United States: The Role of Firearms

BACKGROUND

This study aimed to determine whether firearms are a more prevalent cause of pediatric death in the United States than in Canada.

METHODS

All pediatric trauma deaths from 1991 to 1996 in Ontario and Missouri were reviewed. Socioeconomic data were compiled for the two jurisdictions.

RESULTS

During the period reviewed, there were 1,146 pediatric trauma deaths in Ontario (10.4 per 100,000 population) and 1,782 in Missouri (32.4 per 100,000 population). Firearm injuries accounted for 19% of the trauma deaths in Missouri and 0.5% of such deaths in Ontario. Overall, a child was 100 times more likely to die of firearm injury in Missouri (6 per 100,000 population) than in Ontario (0.06 per 100,000 population). The incidences of violent acts unrelated to firearms were similar between the two groups. Both populations were similar in terms of socioeconomic and education parameters, but differed in their rates for guns carried.

CONCLUSION

The significantly higher death rate from firearm injuries in Missouri likely reflects differing gun control attitudes and legislation, and provides a rationale for prevention and future investigation.

Adolescent injury morbidity in New Zealand, 1987-96

OBJECTIVES

Adolescents are over-represented in injury statistics. New Zealand is privileged in having a hospital discharge database allowing for analysis of non-fatal injury data at a national level. An epidemiological description of adolescent injury morbidity is provided and options for prevention are discussed.

METHOD

People aged 15-19 years admitted to hospital for their injuries in the period 1 987-96 were identified from the New Zealand Health Information Service morbidity data files. The manner, causes, and nature of injury were examined. Injury prevention strategies were reviewed.

RESULTS

The incidence of hospitalised injury was 1,886 per 100,000 person years. The victims were male (70%). The leading causes of injury were road traffic crashes, sports injuries, and self poisoning. The most common injury diagnoses were head injuries (29%) and limb fractures (21%). Road traffic crashes produced the highest proportion of serious injuries.

CONCLUSIONS

Road traffic crashes, sports injuries, and self inflicted poisoning, stood out as areas with the greatest potential for reducing the burden of injury in late adolescence. Graduated driver licensing shows promise as an injury prevention measure but remains inadequately implemented. Policies to reduce self inflicted poisoning are of unknown efficacy, and evidence is awaited on the effectiveness of measures to reduce injury in sport.

The new Brazilian traffic code and some characteristics of victims in southern Brazil

OBJECTIVE

The aim was to study characteristics of traffic accident victims before and after the implementation of the new Brazilian traffic code, in January 1998.

SUBJECTS AND METHODS

The study population was car and motorcycle occupants seen in a pre-hospital care service in Londrina, Parana State (Brazil) before the introduction of the new Brazilian traffic code, from 22 January to 21 July 1997, and after its implementation during the same period in 1998. Victims were analyzed over the time periods according to helmet and seat belt use, gender, underage driving, and alcohol on the breath.

RESULTS

Use of seat belts increased from 45% to 62.6% and of helmets from 31.2% to 66.2% after the introduction of the new Brazilian code. The proportion driving under age 18 and with perceptible alcoholic breath declined significantly only among motorcycle riders. There was a 20% decline in car occupant injuries along with a 9% reduction in motorcycle related injuries after the change of the law.

CONCLUSION

Results favor the hypothesis that rigorous legislation increases safer practices in traffic, at least during the first months of its implementation.

[Present status of traffic accidents in the age of speed: an overview]

This article takes an interdisciplinary perspective to studies on traffic accidents on a national and international scale. It begins by analyzing the great increase in the manufacturing and use of motor vehicles worldwide and the resulting social transformations. Particular attention is given to the degradation of the urban environment and the enormous social costs represented by traffic accidents. The author follows with an epidemiological perspective on the victims of traffic accidents. The relationship between personality and traffic accidents deserved special attention, mainly in that it relates to the consumption of alcohol and other drugs, in addition to other law breaking behavior. The article concludes by emphasizing the need for government to implement specifically consistent public policies to control the problem.

Factors affecting motorcycle helmet use in the population of Greater Athens, Greece

OBJECTIVES

Helmet use is the best preventive measure available against two wheel motorized vehicle (TWMV) related head injuries. In some countries, however, helmets are used only by a minority of TWMV riders. In collaboration with the Road Traffic Police Department, an inspection survey was undertaken to assess the prevalence and to determine predictors of helmet use.

SETTING

The Greater Athens area, Greece, during July and August 1998.

METHODS

A total of 982 TWMVs were stopped, 349 of which had two riders (36%). All riders were interviewed by staff members of the Centre for Research and Prevention of Injuries among the Young.

RESULTS

The average prevalence of helmet use was 20.2%. It ranged from 9.7% on small suburban roads to 50.8% on highways. Prevalence of use was significantly lower during the weekend days and at night. Women were significantly more likely to wear a helmet and, controlling for gender, drivers were significantly more likely to be helmet users. Riders of more powerful TWMVs and passengers, who themselves had a TWMV driving license, were helmet users more frequently. Among non-users, the majority (46%) indicated that "the helmet made them feel uncomfortable", particularly in warm weather, whereas 18% claimed that there was little need for a helmet in low speed riding.

CONCLUSIONS

A multipronged campaign is urgently needed in Greece to increase the prevalence of helmet use by TWMV riders. The campaign should include not only police enforcement but also initiatives to make helmets more convenient to wear and less expensive.

An evaluation of the general effect of the New Zealand graduated driver licensing system on motorcycle traffic crash hospitalisations

In 1987, New Zealand introduced a comprehensive Graduated Driver Licensing System (GDLS) which was designed to allow new drivers to gain driving experience while being excluded from high risk situations. This study sought to evaluate the impact of the GDLS on motorcycle traffic crashes that resulted in serious injury. Injury crash data were obtained from the New Zealand Health Information Services national public hospital inpatient data files for the years 1978-1994, inclusive. Cases were disaggregated into three age groups, 15-19 years, 20-24 years, and 25 years or older, for which injury trends were obtained. In order to determine whether trends in motorcycle traffic crashes simply followed national trends in other injury events, two non-traffic comparison groups for the main target group (15-19 years) were included. Using time series analyses, the introduction of the GDLS was found to be closely followed by a significant reduction (22%) in motorcycle traffic crash hospitalizations for the 15-19 year age group. An examination of vehicle registration and driver licensure data suggests that the reduction in injury crashes may, largely, be attributable to an overall reduction in exposure to motorcycle riding.

Psychological and social predictors of motorcycle use by young adult males in New Zealand

Motorcycle riding is a significant cause of serious injuries to young males. Little is known about the psychological and social characteristics of these riders, despite such knowledge being potentially important for the targeting of appropriate injury prevention interventions. Using problem-behaviour theory to broadly guide and structure the research, the present study focused on identifying predictors of motorcycle riding. Previous research investigating differences between riders and non-riders has tended to be inconclusive, methodologically limited, and lacking in explicit theoretical foundations. The present research was based on the birth cohort enrolled in the Dunedin Multidisciplinary Health and Development Study (DMHDS), a comprehensive New Zealand longitudinal study of health, development, attitudes, and behaviours. Logistic regression models were built using prior measures of health risk behaviour, other psychological and social factors, and motorcycle riding history as potential predictors of any motorcycle use at the age of 18 years. The strongest predictors were early motorcycle riding, including illegal on-road driving at age 13 (OR 4.0; 95% CI 1.7, 9.1), below average reading skills (OR 2.4; 95% CI 1.3, 4.6) and fighting in a public place at age 15 (OR 2.9; 95% CI 1.2, 6.9). It was of particular interest that this profile tended to fit less well those subgroups of riders with greatest exposure to on-road motorcycle driving. Although based on small numbers, this finding was consistent with earlier cross-sectional research that linked casual and unlicensed driving with less protective motorcycling opinions and behaviours. Some implications for injury prevention and public policies regarding motorcycling are discussed. In particular, stricter enforcement of present licensing regulations and stronger penalties for their violation could help to reduce the number of less responsible riders.

Rider training, reasons for riding, and the social context of riding among young on-road motorcyclists in New Zealand

Serious injuries to young motorcyclists represent an important public health problem. Little is known about the opinions and behaviours of the young riders at risk. We document the training experiences of young motorcyclists, and their reasons for riding or discontinuing riding, and identify the role models and sources of disapproval of motorcycling. The research was part of a longitudinal study of health, development, attitudes and behaviours of a birth cohort. At age 18 years, cohort members who had ridden a motorcycle during the past year completed a comprehensive questionnaire. Initial riding instruction was rarely received from a qualified instructor but was usually informal, from a male friend or father, and occurred off the road, usually on a farm. The most commonly given reasons for riding were excitement and economy. Most motorcyclists who had ceased riding attributed this to the lack of access to a motorcycle, and few mentioned safety. Mothers were the main source of disapproval. The young riders were not a homogeneous group. More licensed than unlicensed riders said manoeuvrability in traffic and ease of parking were reasons for riding. Licensed motorcyclists had more friends who rode and were more likely than unlicensed riders to have received paternal instruction. Early informal training off the road may establish attitudes and behaviours inappropriate in a traffic context. The main reasons for motorcycling (excitement, economical and manoeuvrable transport, freedom from supervision) and for discontinuing riding (lack of access) indicate motivations that should be considered before implementation of injury prevention interventions.