Child passenger injury risk in motor vehicle crashes: a comparison of nighttime and daytime driving by teenage and adult drivers

Investigating factors influencing pedestrian injury severity at intersections

OBJECTIVE

Vehicle crashes that involve pedestrians at intersections have been reported occasionally. Pedestrian injury severity in these crashes is significantly related to driver and pedestrian attributes, vehicle characteristics, and the geometry of intersections. Identifying factors associated with pedestrian injury severity (PIS) is critical for reducing crashes and improving safety. For developing the proposed probit models, drivers involved in crashes are classified into 3 groups: young drivers (16 ≤ age ≤ 24), middle-aged drivers (25 ≤ age ≤ 64), and older drivers (age ≥ 65). This study determines that PIS is significantly but differently affected by these grouped drivers with different sets of explanatory variables.

METHODS

A total of 2,614 crash records (2011-2012) at intersections in Cook County, Illinois, were collected. An ordered probit modeling approach was employed to develop the proposed model and examine factors influencing PIS. The likelihood ratio test was used to assess model performance. Elasticity analysis was conducted to interpret the marginal effect of contributing factors on PIS associated with different driver groups by age.

RESULTS

The results show that 4 independent variables, including pedestrian age, vehicle type, point of first contact, and weather condition, significantly affect PIS at intersections for all drivers. Two additional independent variables (i.e., number of vehicles and traffic type) affect PIS for young and middle-aged drivers, and 2 other variables (i.e., divided type and hit-and-run related) are significant to PIS for both young and older drivers.

CONCLUSIONS

The independent variables significant to PIS at intersections for young, middle-aged, and older driver groups were identified and the marginal effect of each variable to the likelihood of PIS were assessed.

Factors Associated with Pediatric Mortality from Motor Vehicle Crashes in the United States: A State-Based Analysis

OBJECTIVE

To examine geographic variation in motor vehicle crash (MVC)-related pediatric mortality and identify state-level predictors of mortality.

STUDY DESIGN

Using the 2010-2014 Fatality Analysis Reporting System, we identified passengers <15 years of age involved in fatal MVCs, defined as crashes on US public roads with ≥1 death (adult or pediatric) within 30 days. We assessed passenger, driver, vehicle, crash, and state policy characteristics as factors potentially associated with MVC-related pediatric mortality. Our outcomes were age-adjusted, MVC-related mortality rate per 100 000 children and percentage of children who died of those in fatal MVCs. Unit of analysis was US state. We used multivariable linear regression to define state characteristics associated with higher levels of each outcome.

RESULTS

Of 18 116 children in fatal MVCs, 15.9% died. The age-adjusted, MVC-related mortality rate per 100 000 children varied from 0.25 in Massachusetts to 3.23 in Mississippi (mean national rate of 0.94). Predictors of greater age-adjusted, MVC-related mortality rate per 100 000 children included greater percentage of children who were unrestrained or inappropriately restrained (P < .001) and greater percentage of crashes on rural roads (P = .016). Additionally, greater percentages of children died in states without red light camera legislation (P < .001). For 10% absolute improvement in appropriate child restraint use nationally, our risk-adjusted model predicted >1100 pediatric deaths averted over 5 years.

CONCLUSIONS

MVC-related pediatric mortality varied by state and was associated with restraint nonuse or misuse, rural roads, vehicle type, and red light camera policy. Revising state regulations and improving enforcement around these factors may prevent substantial pediatric mortality.

A prospective study of children aged <16 years in motor vehicle collisions in Norway: severe injuries are observed predominantly in older children and are associated with restraint misuse

OBJECTIVE

The implementation of the compulsory wearing of seat belts (SBs) for children and improvements in child restraint systems have reduced the number of deaths and severe injuries among children involved in motor vehicle (MV) collisions (MVCs). Establishing the characteristics predictive of such injuries may provide the basis for targeted safety campaigns and lead to a further reduction in mortality and morbidity among children involved in MVCs. This study performed a multidisciplinary investigation among child occupants involved in MVCs to elucidate injury mechanisms, evaluate the safety measures used and determine the characteristics that are predictive of injury.

METHODS

A prospective study was conducted of all child occupants aged <16 years involved in severe MVCs in south-eastern Norway during 2009-2013. The exterior and interior of the MVs were investigated and the injured children were medically examined. Supplementary information was obtained from witnesses, the crash victims, police reports, medical records and reconstructions. Each case was reviewed by a multidisciplinary team to assess the mechanism of injury.

RESULTS

In total, 158 child occupants involved in 100 MVCs were investigated, of which 27 (17%) exhibited Abbreviated Injury Scale (AIS) scores of 2+ injuries and 15 (9%) exhibited AIS 3+ injuries. None of the children died. Of those with AIS 2+ injuries (n=27), 89% (n=24) were involved in frontal impact collisions and 11% (3/27) were involved in side impacts. Multivariate analysis revealed that restraint misuse, age, the prevailing lighting conditions and ΔV were all independently correlated with AIS 2+ injuries. Safety errors were found in 74% (20/27) of those with AIS 2+ injuries and 93% (14/15) of those with AIS 3+ injuries. The most common safety error was misuse of restraints, and in particular loose and/or improperly positioned SBs.

CONCLUSION

The risk of injury among child occupants is significantly higher when the child occupants are exposed to safety errors within the interior of the vehicle. Future campaigns should focus on the prevention of restraint misuse and unsecured objects in the passenger compartment or boot.

Injury risk among children in motor vehicle crashes: older versus younger drivers

AIM

To explore the relationship between injury risk among child occupants involved in motor vehicle collisions according to the age of the vehicle driver.

METHODS

The National Automotive Sampling System Crashworthiness Data System 2000-2009 (n = 10 797) was used to identify demographic, vehicle-, collision- and injury-related characteristics among motor vehicle collision occupants ≤15 years of age. The association between the age of the driver (older vs. younger, defined as individuals <50 years of age vs. individuals ≥50 years of age, respectively) and injury occurrence was estimated using logistic regression adjusting for the potentially confounding effect of occupant, vehicle and collision characteristics.

RESULTS

Of the child occupants in motor vehicle collisions, 2.9% were driving with an older driver, and approximately 2.9% were injured while driving with a younger driver (odds ratio 1.03; 95% confidence interval 0.55-1.91). After adjusting for child occupant age, gender, restraint use, seat position and vehicle type, there remained no significant association between the age of the driver (older vs. younger) and the risk of injury (odds ratio 0.92; 95% confidence interval 0.49-1.74).

CONCLUSIONS

These findings add to the body of literature indicating no difference in injury risk found among children when considering the age of the driver. Research is needed to ascertain the association and further evaluate characteristics more specific to the relationship being explored in this study.

[Traffic injuries among youth in Goiânia, Goiás State]

Traffic injuries are currently one of the world's main public health issues in both developed and developing countries. This study aimed to describe the circumstances involved in the traffic accidents and the profile of the victims attended at the Emergency Hospital of Goiânia, aged 15 to 24 years and residents in Goiânia, Goiás State, Brazil. It's a prospective cross-sectional study carried out from August 2005 to August 2006 by systematic sampling. Data were analyzed by descriptive statistics. Most of the 301 victims were male, mean age of 19.94 +/- 2.73 years, and drivers. Motorcycles (67.33%) and bicycles (16.67%) were frequently mode of transport. Accidents usually occurred around 6 pm, on Fridays and Sundays. The victims were generally traveling/walking to/from exercise, sports, school, recreational or entertainment activities. Suspicion of alcohol use was reported by 15.16% of the cases. More motorcyclists believed that there was imprudence/ negligence than the cyclists. Security equipment was not used by 8.58% of motorcyclists, 95.45% of cyclists. Educational measures for motorcyclists and law enforcement highlighting the nights and weekends are needed.

Morbidade por acidentes de transporte entre jovens de Goiânia, Goiás

Acidentes de transporte constituem problema mundial de saúde pública, especialmente nos países em desenvolvimento. O objetivo foi descrever o perfil das vítimas e circunstâncias dos acidentes de transportes com residentes de Goiânia (GO), na faixa etária de 15 a 24 anos e atendidos no Hospital de Urgências. Estudo transversal prospectivo, realizado de agosto de 2005 a agosto de 2006, por amostragem sistemática de 301 vítimas de acidentes de transporte. Os dados primários foram tratados por meio de estatística descritiva. A maioria era do sexo masculino, com idade média de 19,88 + 2,7 anos e condutor dos veículos. O meio de transporte mais utilizado foi motocicleta (67,33%), seguido da bicicleta (16,67%). Os acidentes ocorreram predominantemente em torno das 18h, sextas-feiras e domingos. As vítimas estavam principalmente no trajeto para atividades físicas, esportivas, escolares, lazer e entretenimento. A suspeita do uso de álcool foi relatada por 15,16% dos entrevistados. Comparados aos ciclistas, mais motociclistas julgaram que houve imprudência/negligência no acidente. Equipamentos de segurança não foram usados por 8,58% dos motociclistas e 95,45% dos ciclistas. São necessárias medidas de educação dirigida aos motociclistas e fiscalização que priorizem o período noturno e os finais de semana.

Understanding adolescent development: implications for driving safety

PROBLEM

The implementation of Graduated Driver Licensing (GDL) programs has significantly improved the crash and fatality rates of novice teen drivers, but these rates remain unacceptably high.

METHOD

A review of adolescent development research was undertaken to identify potential areas of improvement.

RESULTS

Research support for GDL was found to be strong, particularly regarding early acquisition of expertise in driving safety (beyond driving skill), and to limitations that reduce opportunities for distraction. GDL regimes are highly variable, and no US jurisdictions have implemented optimal regimes.

SUMMARY

Expanding and improving GDL to enhance acquisition of expertise and self-regulation are indicated for implementation and for applied research. Driver training that effectively incorporates safety goals along with driving skill is another target.

IMPACT ON INDUSTRY

The insurance industry will benefit from further GDL enhancements. Benefits may accrue to improved driver training, improved simulation devices during training, and automated safety feedback instrumentation.