Safety riding program and motorcycle-related injuries in Thailand

Improvement of riding licensing criteria based on rider's braking capability: A preliminary study

Speeding is the factor that usually associated with fatal accident. However, riders have tendency to exceed their vehicle's speed above the regulated speed. Therefore, the likelihood of traffic accidents is significantly influenced by braking ability. Unfortunately, the braking capability has not been accommodated properly in the accident risk management, such as riding license obtaining mechanism. This paper focuses on the possibility of the development of riding licensing criteria based on rider's braking capability. The parameters used in the analysis are the safety factor and margin of safety, due to the differences in riders' braking capability. All the input data were collected from the result of previous related studies. Although the sample size is varied but data source was taken from relevant objects studies. The result of this study showed that impact speed and/or rider's involvement in fatal crashes could be reduced by increasing their braking ability. It strongly indicates that each rider should realize that their speed choices should be suited to their braking ability which could be increased during the riding licensing practical test. The utilization of a rider's braking abilities, which could provide a minimum margin of safety, should therefore be taken into consideration as a basis for the criteria used to obtain a riding license.

Effectiveness of road safety interventions: An evidence and gap map

Background

Road Traffic injuries (RTI) are among the top ten leading causes of death in the world resulting in 1.35 million deaths every year, about 93% of which occur in low- and middle-income countries (LMICs). Despite several global resolutions to reduce traffic injuries, they have continued to grow in many countries. Many high-income countries have successfully reduced RTI by using a public health approach and implementing evidence-based interventions. As many LMICs develop their highway infrastructure, adopting a similar scientific approach towards road safety is crucial. The evidence also needs to be evaluated to assess external validity because measures that have worked in high-income countries may not translate equally well to other contexts. An evidence gap map for RTI is the first step towards understanding what evidence is available, from where, and the key gaps in knowledge.

Objectives

The objective of this evidence gap map (EGM) is to identify existing evidence from all effectiveness studies and systematic reviews related to road safety interventions. In addition, the EGM identifies gaps in evidence where new primary studies and systematic reviews could add value. This will help direct future research and discussions based on systematic evidence towards the approaches and interventions which are most effective in the road safety sector. This could enable the generation of evidence for informing policy at global, regional or national levels.

Search Methods

The EGM includes systematic reviews and impact evaluations assessing the effect of interventions for RTI reported in academic databases, organization websites, and grey literature sources. The studies were searched up to December 2019.

Selection Criteria

The interventions were divided into five broad categories: (a) human factors (e.g., enforcement or road user education), (b) road design, infrastructure and traffic control, (c) legal and institutional framework, (d) post-crash pre-hospital care, and (e) vehicle factors (except car design for occupant protection) and protective devices. Included studies reported two primary outcomes: fatal crashes and non-fatal injury crashes; and four intermediate outcomes: change in use of seat belts, change in use of helmets, change in speed, and change in alcohol/drug use. Studies were excluded if they did not report injury or fatality as one of the outcomes.

Data Collection and Analysis

The EGM is presented in the form of a matrix with two primary dimensions: interventions (rows) and outcomes (columns). Additional dimensions are country income groups, region, quality level for systematic reviews, type of study design used (e.g., case-control), type of road user studied (e.g., pedestrian, cyclists), age groups, and road type. The EGM is available online where the matrix of interventions and outcomes can be filtered by one or more dimensions. The webpage includes a bibliography of the selected studies and titles and abstracts available for preview. Quality appraisal for systematic reviews was conducted using a critical appraisal tool for systematic reviews, AMSTAR 2.

Main Results

The EGM identified 1859 studies of which 322 were systematic reviews, 7 were protocol studies and 1530 were impact evaluations. Some studies included more than one intervention, outcome, study method, or study region. The studies were distributed among intervention categories as: human factors (n = 771), road design, infrastructure and traffic control (n = 661), legal and institutional framework (n = 424), post-crash pre-hospital care (n = 118) and vehicle factors and protective devices (n = 111). Fatal crashes as outcomes were reported in 1414 records and non-fatal injury crashes in 1252 records. Among the four intermediate outcomes, speed was most commonly reported (n = 298) followed by alcohol (n = 206), use of seatbelts (n = 167), and use of helmets (n = 66). Ninety-six percent of the studies were reported from high-income countries (HIC), 4.5% from upper-middle-income countries, and only 1.4% from lower-middle and low-income countries. There were 25 systematic reviews of high quality, 4 of moderate quality, and 293 of low quality.

Authors' Conclusions

The EGM shows that the distribution of available road safety evidence is skewed across the world. A vast majority of the literature is from HICs. In contrast, only a small fraction of the literature reports on the many LMICs that are fast expanding their road infrastructure, experiencing rapid changes in traffic patterns, and witnessing growth in road injuries. This bias in literature explains why many interventions that are of high importance in the context of LMICs remain poorly studied. Besides, many interventions that have been tested only in HICs may not work equally effectively in LMICs. Another important finding was that a large majority of systematic reviews are of low quality. The scarcity of evidence on many important interventions and lack of good quality evidence-synthesis have significant implications for future road safety research and practice in LMICs. The EGM presented here will help identify priority areas for researchers, while directing practitioners and policy makers towards proven interventions.

Motorcyclist injury severity analysis: a comparison of Artificial Neural Networks and random parameter model with heterogeneity in means and variances

In Thailand, the motorcyclist mortality rate is steadily on the rise and remains a serious concern for highway administrators and burden on both economic and local people. Using motorcycle-crash data in Thailand from 2016 to 2019, this study empirically employed and compared the Artificial Neural Networks (ANN) model and random parameters binary probit model with heterogeneity in means and variances (RPBPHM) to explore the effects of a wide range of associated risk characteristics on the severity outcomes of the motorcyclist. Study results revealed that probabilities of injury or fatal crash increase for crashes that involve male riders, riding with pillion, speeding, improper overtaking, riders under influence of alcohol, fatigue riders, undivided road and so on. The probability of non-injury crash increases for crashes on main or frontage traffic lane, four-lane road, concrete road, during rain, involving collision with other motorcycles, rear-end crashes, sideswipe crashes, single-motorcycle crashes and crashes within urban areas. The RPBPHM models were found to outperform the ANN model (quadratic support vector machine) in all performance metrics. The findings could potentially assist policymaker, safety professionals, practitioners, trainers, government agencies or highway designers in future planning and serve as guidance for mitigation policies directed at safety improvement for motorcyclists.

Evidence From the Decade of Action for Road Safety: A Systematic Review of the Effectiveness of Interventions in Low and Middle-Income Countries

Objectives: To evaluate the effectiveness of road safety interventions in low and middle-income countries (LMICs), considering the principles of systems theory presented in the Global Plan for the Decade of Action for Road Safety.

Methods: We conducted a systematic review according to PRISMA guidelines. We searched for original research studies published during 2011–2019 in the following databases: Medline, Embase, PsycInfo, Scopus, Web of Science, Cochrane library, Global Health Library, ProQuest and TRID. We included studies conducted in LMICs, evaluating the effects of road traffic safety interventions and reporting health-related outcomes.

Results: Of 12,353 non-duplicate records, we included a total of 33 studies. Most interventions were related to legislation and enforcement (n = 18), leadership (n = 5) and speed management (n = 4). Overall, legislation and enforcement interventions appear to have the largest impact. Few studies were found for road infrastructure, vehicle safety standard and post crash response interventions.

Conclusion: Based on the currently available evidence, legislation and enforcement interventions appear most impactful in LMICs. However, many interventions remain understudied and more holistic approaches capturing the complexity of road transport systems seem desirable.

Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=197267, identifier CRD42020197267.

The effects of road safety education on the occurrence of motorcycle violations and accidents for novice riders: An analysis of population-based data

The prevalence of motorcycle riding among novice riders in most Southeast Asia countries presents an alarming rate of traffic violations and fatal accidents. Since 2013, Taiwan's government has gradually required a road safety class (RSC) for the rider's licensing process. The RSC consisted of watching videotapes of motorcycle-involved crashes followed by lectures on safety measures. Our study tried to see whether a compulsory RSC could lower the likelihood and frequency of road accidents and traffic violations among novice riders. To avoid self-selection bias, we selected 480,114 novice riders aged 18-20 years, licensed one year before starting the trial period and one year after full implementation of RSC. Using the 2012-2018 data from the Taiwan Ministry of Transportation and Communication (MOTC), we applied the logistic model to evaluate RSC effects on the risk of violations and accidents. Then, we used the negative binomial regression to model their frequency in response to RSC exposure. Following the novice drivers 1-3 years after licensing, our results showed that the RSC has a short-term effect in lowering their traffic violations' likelihood by 12%∼17% and their frequency by 11%; however, the RSC effects only last two years in reducing the counts of motorcycle-involved offenses and accidents. The RSC reduction effect was lower for the tendency of accidents than the violations, probably because committing traffic violations was self-determined; in contrast, the collision occurrence was more or less related to the riders' own or other road users' carelessness. The RSC could be more effective if a certification test for road safety education were required or if a penalty is imposed on distracted learners during the training.

A spatiotemporal analysis of motorcyclist injury severity: Findings from 20 years of crash data from Pennsylvania

Motorcyclists face higher risks of severe injuries in crashes compared to motor vehicle drivers who are often protected by seatbelts and airbags during collisions. A report by the National Highway Traffic Safety Administration reveals that motorcyclists have 27 times the risk of fatality in traffic crashes as much as motor vehicle drivers. Previous studies have identified a list of risk factors associated with motorcyclist injury severity and generated valuable insights for countermeasures to protect motorcyclists in crashes. These studies have shown that wearing helmets and/or motorcycle-specific reflective clothing and boots, driving alcohol/drug-free, and obeying traffic regulations are good practices for safe motorcycling. However, these practices and other risk factors are likely to interact with local geographic, socio-economic, and cultural contexts, leading to diversified correlations with motorcyclist injury severity, which remains under-explored. Such correlations may exhibit variations across space and time. The objective of this study is to revisit the correlates of motorcyclist injury severity with a focus on the spatial and temporal variations of correlations between risk factors and injury severity. This study employed an integrated spatiotemporal analytical approach to mine comprehensive statewide 20 years' motorcycle-involved traffic crashes (N = 50,823) in Pennsylvania. Non-stationarity tests were performed to examine the significance of variations in spatially and temporally local correlations. The results show that most factors, such as helmet, engine size, vehicle age, pillion passenger, at-fault striking, and speeding, hold significant non-stationary relationships with motorcyclist injury severity. Furthermore, cluster analysis of estimations reveals the regional similarities of correlates, which may help practitioners develop regional motorcyclist safety countermeasures.

Motorcycle taxi programme is associated with reduced risk of road traffic crash among motorcycle taxi drivers in Kampala, Uganda

SafeBoda is a transportation company that provides road safety training and helmets to its motorcycle taxi drivers in Kampala. We sought to determine whether risk of road traffic crash (RTC) was lower in SafeBoda compared to regular (non-SafeBoda) motorcycle taxi drivers during a 6-month follow-up period. We collected participant demographic and behavioural data at baseline using computer-assisted personal interview, and occurrence of RTC every 2 months using text messaging and telephone interview from a cohort of 342 drivers. There were 85 crashes (31 in SafeBoda and 54 in regular drivers) during follow-up. Over the 6-month follow-up period, SafeBoda drivers were 39% less likely to be involved in a RTC than regular drivers after adjusting for age, possession of a driver's license, and education (RR: 0.61, 95% CI: 0.39-0.97, p = .04). These findings suggest that the SafeBoda programme results in safer driving and fewer RTCs among motorcycle taxi drivers in Kampala.

Motorcycle taxi programme increases safe riding behaviours among its drivers in Kampala, Uganda

BACKGROUND

SafeBoda is a motorcycle taxi company that provides road safety training and helmets to its drivers in Kampala, Uganda. We sought to determine whether SafeBoda drivers are more likely to engage in safe riding behaviours than regular drivers (motorcycle taxi drivers not part of SafeBoda). METHODS : We measured riding behaviours in SafeBoda and regular drivers through: (1) computer-assisted personal interview (CAPI), where 400 drivers were asked about their riding behaviours (eg, helmet and mobile phone use) and (2) roadside observation, where riding behaviours were observed in 3000 boda-boda drivers and their passengers along major roads in Kampala.

RESULTS

Across the two cross-sectional studies, a higher proportion of SafeBoda drivers than regular drivers engaged in safe riding behaviours. For instance, helmet use among SafeBoda compared with regular drivers was 21% points higher (95% CI 0.15 to 0.27; p<0.001) based on the CAPI and 45% points higher (95% CI 0.43 to 0.47; p<0.001) based on roadside observation. Furthermore, compared with regular drivers, SafeBoda drivers were more likely to report having a driver's license (66.3% vs 33.5 %; p<0.001) and a reflective jacket (99.5% vs 50.5 %; p<0.001) and were less likely to report driving towards oncoming traffic (4% vs 45.7 %; p<0.001) in the past 30 days.

CONCLUSION

The SafeBoda programme is associated with increased safe riding behaviours among motorcycle taxi drivers in Kampala. Therefore, the promotion and expansion of such programmes may lead to a reduction in morbidity and mortality due to road injuries.

Crashes and Traffic Signal Violations Caused by Commercial Motorcycle Couriers

Background

Motorcycles are one of the important members of commercial transportation because of the convenient use during congested traffic conditions and the ease of parking in narrow streets. This study investigates the characteristics of crashes and traffic signal violations caused by motorcycle couriers.

Methods

From the national compensation data, this study analyzed the traffic crashes caused by 671 motorcycle couriers.

Results

Among 671 injured couriers, 50.6% were aged less than 40 years, 49.2% run in a small business of <5 employees, and 47.2% had work experience of <6 months. Motorcycle crashes occurred mainly due to "rider overturned alone" (67.5%), in the daytime (73.5%), or on cloudy or clear days (77.2%). However, the violation rate caused by motorcycle couriers was high in couriers in a small business of <5 employees (13.9%), with work experience of <6 months (13.9%), on cloudy or clear days (12.4%), on an intersection (29.8%), in the type of "crash with a vehicle" (31.2%), or in a death accident (35.7%).

Conclusion

The findings of this study can be used as a baseline in devising policies for preventing crashes of motorcycle couriers.

Impact of passenger engagement through road safety bus stickers in public service vehicles on road traffic crashes in Zambia: a randomized controlled trial

Background

Road Traffic Crashes (RTCs) are the third highest cause of death in Zambia, claiming about 2000 lives annually, with pedestrians and cyclists being the most vulnerable. Human error accounts for 87.3% of RTCs. Minibus and big bus public service vehicles (PSVs) are among the common vehicle types involved in these crashes. Given the alarmingly high rate of road traffic crashes involving PSV minibuses and big buses within Zambia, there is a need to mitigate this through innovative solutions. In other settings, it has been shown that stickers in PSVs encouraging passengers to speak out against reckless driving can reduce RTCs, but it is unclear whether such an intervention could work in Zambia. Based on this evidence, the Zambia Road Transport and Safety Agency (RTSA) has developed a road safety bus sticker campaign for PSVs and before national scale-up, RTSA is interested in evidence of the impact of these stickers.

Methods

This evaluation will be a stratified two-arm randomized controlled trial with a one-to-one ratio. The sample will be stratified by vehicle type, thus creating a two-arm trial for minibuses and a separate two-arm trial for big buses. The sample will include 2110 minibuses and 300 big buses from four towns in Zambia. The primary outcome of interest will be the difference in the rate of RTCs over a 14-month period (7-months before the intervention and 7 months after) between buses with and without the new RTSA road safety bus stickers.

Discussion

This study will provide evidence on the impact of the Zambian sticker program on road traffic crashes as implemented through minibuses and big buses, that can help inform the scale up of a national ‘Zambia road safety bus sticker campaign’.

Trial registration

PACT-R, PACTR201711002758216. Registered 13 November 2017-Retrospectively registered.

Registry Data Coordinator (RDC): a Proper Accessible Strategy for Improving Road Traffic Injury (RTI) Hospital Based Trauma Registry Systems in Developing Countries and Low Income Countries

INTRODUCTION

Evidence suggested that a significant level of trauma mortality can be prevented using registry system.

AIM

This study aimed to improve Kashan Hospital Based Trauma Registry System (KHBTRS) for Road Traffic Injury (RTI).

MATERIAL AND METHODS

After conducting focus group discussion absence of minimum data set (MDS) and poor data collection process (DCP) were identified as main problems for KHBTRS- RTI. Proposed MDS were surveyed by 20 experts of trauma research center of throughout the Iran. Then approved MDS applied for trauma registry system data base in form of SQL. DCP were reform from prospective data collection (review of medical record) to concurrent (through the interview) approach.

RESULTS

Most of participants for MDS approval belonged to clinical group 13(65%). 146 MDS in eighteen main categories were proposed for RTI. The maximum score for each MDS main categories were attributed to body parts injured 220 (100%) and patient vital signs 139 (99.29%) respectively. Pilot testing of KHBTRS- RTI database of 50 (50%) riders indicated fully completeness 50 (100%) for concurrent approach. It was concluded that based on experts' viewpoints MDS relating to injury nature and place of occurrence have more priority in comparisons to MDS relating to causes of injury. It may attribute to health care providers focus on clinical care and treatment.

CONCLUSION

It was concluded that based on experts' viewpoints MDS relating to injury nature and place of occurrence have more priority in comparisons to MDS relating to RTI prevention; it may attribute to health care providers focus on clinical care and treatment. To develop injury interventions based on given data, recruitment of professionals as registry data coordinator with specific job description to collect and advocacy of injury external causes data seems imperative.

Trends in helmet use by motorcycle riders in the decades following the repeal of mandatory helmet laws

Several US states repealed universal motorcycle helmet laws in the 1990s and 2000s. The purpose of this study was to examine national trends in helmet use among adult trauma patients with motorcycle-related injuries. We hypothesized that motorcycle helmet use declined over time. We retrospectively analyzed the National Trauma Data Bank's National Sample Program for 2003-2010. We also obtained data on US motorcycle fatalities reported in the Fatality Analysis Reporting System and population data from the U.S. Census Bureau to calculate motorcycle-related fatality rates over time. A total of 255,914 patients met inclusion criteria, of whom 148,524 (58%) were helmeted. During the study period, helmet use increased from 56% in 2003 to 60% in 2010 (p < 0.001). However, motorcycle-related fatality rates also increased in states with and without universal helmet laws. Nationally, rates of helmet use have increased. However, fatalities due to motorcycle crashes have also increased during the same period.

Factors Associated with Injuries among Commercial Motorcyclists: Evidence from a Matched Case Control Study in Kampala City, Uganda

INTRODUCTION

Road traffic injuries are the eighth leading cause of death globally and the most affected are young people aged 15-29. By 2030 road traffic deaths will become the fifth leading cause of death unless urgent action is taken. Motorcyclists are among the most vulnerable road users and in Uganda they contribute 41% of all road traffic injuries. This paper establishes factors associated with the injuries of commercial motorcycle riders also known as boda-boda riders in Kampala, Uganda's capital city.

METHODS

The study was matched case-control with a case being a boda-boda rider that was seen at one of the 5 major city hospitals with a road traffic injury while a control was a boda-boda rider that was at the parking stage where the case operated from before the injury. The sample size was 289 riders per arm and data collection took 7 months. A structured questionnaire was used to collect data on background and exposing factors. Being matched case-control data conditional logistic regression was used in the analysis.

RESULTS

Factors independently associated with injury among motorcyclists were younger age group, being a current alcohol drinker (OR = 2.30, 95%CI: 1.19-4.45), lower engine capacity (<100 cc) (OR = 5.03, 95%CI: 2.91-8.70), riding experience of less than 3 years, not changing a motorcycle in past 1 year (OR = 2.04, 95%CI: 1.19-3.52), riding for a longer time in a day (OR = 6.05, 95%CI: 2.58-14.18) and sharing a motorcycle (OR = 8.25, 95%CI:2.62-25.9). Other factors associated with injury were low level of knowledge of traffic rules, being stopped by police for checks on condition of motorcycle/license/insurance, working till late.

RECOMMENDATIONS

More road safety sensitization is required among riders to raise awareness against sharing motorcycles, working for a longer time and alcohol consumption. Police enforcement of drink-driving laws should include riders of commercial motorcycles. Investigate the validity of motorcycle riding licenses and test the riding competency of all who got licenses in last 3 years.

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.