Major trauma and urban cyclists: physiological status and injury profile

Research on urban path selection of construction vehicles based on bi-objective optimization

With the implementation of urban central rail transit and old city reconstruction projects, construction vehicles frequently enter and depart the urban area. And because of its large volume and other characteristics, it increases the risk probability and severity of urban traffic accidents. This study takes the transportation path selection of construction vehicles as the breakthrough point, weighs the transportation efficiency and safety of construction vehicles, establishes a bi-objective optimization model, involving constraints such as height limit, weight limit, speed limit, direction limit and traffic limit and uses genetic algorithm to solve it. Finally, through case analysis, the user preference is adjusted to conduct functional test and description of the model. The results indicate that the model has the function of transportation vehicle path optimization. In the meantime, compared with the safest route, the time-consuming of the optimal route decreases by 16% and the risk increases by 7.4%, while the time-consuming of it increases by 5% and the risk decreases by 15.4% compared with the shortest route. Moreover, the corresponding coefficients of time-consuming and safety preference can reach about 0.65, and the relevant stakeholders have high acceptance of the route. Further improvement of construction vehicle management mechanism based on path optimization is one of the limited ways to effectively improve the current situation of construction vehicle management.

Cycling related major trauma in Ireland

INTRODUCTION

Cycling as a means of transport or recreational activity is increasing in popularity in Ireland. However, increasing numbers of cyclists may lead to an increased number of bicycle collisions and fatalities. The Road Safety Authority is the statutory body for road safety in Ireland but uses police data alone to collate cycling collision statistics. This may lead to an underestimation of cycling injuries in Ireland. Using hospital statistics may provide a greater understanding of cycling trauma in Ireland.

OBJECTIVE

The present study examines cycling related trauma in Ireland using the Major Trauma Audit (MTA) data collected via the Trauma and Research Network (TARN) from hospitals in Ireland for the period 2014 to 2016. The database was interrogated for demographics, mechanism of injury, injury characteristics and patient outcomes.

RESULTS

There were 410 cycling collisions recorded in the TARN database which represented 4.4% of trauma captured by TARN for the study period. Of this cohort 79% were male compared with 58% in the overall (TARN) trauma cohort (p < 0.001) and the median (IQR) age was 43.8 years (31.0, 55.7) which is younger than the median (IQR) of 58.9 (36.2, 76.0) years for the overall trauma cohort (p < 0.001). Cycling collisions had a median (IQR) injury severity score (ISS) of 10 (9, 20) which was higher than the overall trauma cohort ISS of 9 (9, 17). Of the mechanisms observed for cycling trauma, 31.7% (n = 130) had a collision with a motor vehicle. Of those who did not wear a helmet, 52.2% (n = 47) sustained a head injury compared with 27.5% (n = 44) in the group who were wearing a helmet (p < 0.001).

CONCLUSION

The TARN data presented in this paper builds a more complete overview of the burden of cycling collisions in Ireland. Particular points of focus are that serious cycling injuries occur in a predominantly male population, and that only around 30% of cases are recorded as involving a motor vehicle, with the majority having an unknown mechanism of injury. There was an association between helmets and head injuries in this study, but there are likely other contributing factors such as mechanism of injury, velocity or cycling infrastructure. Using hospital data such as the MTA provides valuable information on the injuries sustained by cyclists, but more prospective studies to capture injury mechanism and contributing factors are needed.

The Impacts of Climate Change on Road Traffic Accidents in Saudi Arabia

The potential costs of road traffic accidents (RTAs) to society are immense. Yet, no study has attempted to examine the impact of climate change on RTAs in Saudi Arabia, though RTA-leading deaths are very high, and the occurrence of climatic events is very frequent. Therefore, this study aims to assess the impact of climate change on RTAs in Saudi Arabia and to recommend some climate change mitigation and adaptation policies to make roads safe for all. This study employed annual data from 13 regions of Saudi Arabia, from 2003 to 2013. The data were analyzed on the basis of panel regression models—fixed effect, random effect, and the pooled ordinary least square. The findings show that temperature, rainfall, sandstorms, and number of vehicles were statistically and significantly responsible for RTAs in Saudi Arabia in the study period. This study also found that RTAs both inside and outside cities significantly caused injuries, but only RTAs inside cities significantly caused death. Furthermore, the death from RTAs injuries was found to be statistically significant only for motor vehicle accidents. The findings will assist policymakers in taking the right courses of action to mitigate the negative impacts of climate change through understanding climate influence on RTAs.

Looking forward to safer HGVs: The impact of mirrors on driver reaction times

Heavy Goods Vehicle (HGV) collisions are responsible for a disproportionate number of urban vulnerable road user casualties (VRU - cyclists and pedestrians). Blind-spots to the front and side of HGVs can make it difficult (sometimes impossible) to detect close proximity VRUs and may be the cause of some collisions. The current solution to this problem is to provide additional mirrors that can allow the driver to see into the blind-spots. However, keeping track of many mirrors requires frequent off-road glances which can be difficult to execute during demanding driving situations. One suggestion is that driving safety could be improved by redesigning cabs in order to reduce/remove blind-spot regions, with the aim of reducing the need for mirrors, and increasing detection rates (and thereby reducing collisions). To examine whether mirrors delay driver responses we created a series of simulated driving tasks and tested regular car drivers and expert HGV drivers. First we measured baseline reaction times to objects appearing when not driving ('Parked'). Participants then repeated the task whilst driving through a simulated town (primary driving tasks were steering, braking, and following directional signs): driving slowed reaction times to objects visible in mirrors but not to objects visible through the front windscreen. In a second experiment cognitive load was increased, this slowed RTs overall but did not alter the pattern of responses across windows and mirrors. Crucially, we demonstrate that the distribution of mirror RTs can be captured simply by the mirror's spatial position (eccentricity). These findings provide robust evidence that drivers are slower reacting to objects only visible in eccentric mirrors compared to direct viewing through the front windscreen.

Head injury patterns in helmeted and non-helmeted cyclists admitted to a London Major Trauma Centre with serious head injury

BACKGROUND

Cycle use across London and the UK has increased considerably over the last 10 years. With this there has been an increased interest in cycle safety and injury prevention. Head injuries are an important cause of mortality and morbidity in cyclists. This study aimed to ascertain the frequency of different head injury types in cyclists and whether wearing a bicycle helmet affords protection against specific types of head injury.

METHODS

A retrospective observational study of all cyclists older than 16 years admitted to a London Major Trauma Centre between 1st January 2011 and 31st December 2015 was completed. A cohort of patients who had serious head injury was identified (n = 129). Of these, data on helmet use was available for 97. Comparison was made between type of injury frequency in helmeted and non-helmeted cyclists within this group of patients who suffered serious head injury.

RESULTS

Helmet use was shown to be protective against intracranial injury in general (OR 0.2, CI 0.07-0.55, p = 0.002). A protective effect against subdural haematoma was demonstrated (OR 0.14, CI 0.03-0.72, p = 0.02). Wearing a helmet was also protective against skull fractures (OR 0.12, CI 0.04-0.39, p<0.0001) but not any other specific extracranial injuries. This suggests that bicycle helmets are protective against those injuries caused by direct impact to the head. Further research is required to clarify their role against injuries caused by shearing forces.

CONCLUSIONS

In a largely urban environment, the use of cycle helmets appears to be protective for certain types of serious intra and extracranial head injuries. This may help to inform future helmet design.