Bus Riding as Amplification Mechanism for SARS-CoV-2 Transmission, Germany, 20211

To examine the risk associated with bus riding and identify transmission chains, we investigated a COVID-19 outbreak in Germany in 2021 that involved index case-patients among bus-riding students. We used routine surveillance data, performed laboratory analyses, interviewed case-patients, and conducted a cohort study. We identified 191 case-patients, 65 (34%) of whom were elementary schoolchildren. A phylogenetically unique strain and epidemiologic analyses provided a link between air travelers and cases among bus company staff, schoolchildren, other bus passengers, and their respective household members. The attack rate among bus-riding children at 1 school was ≈4 times higher than among children not taking a bus to that school. The outbreak exemplifies how an airborne agent may be transmitted effectively through (multiple) short (<20 minutes) public transport journeys and may rapidly affect many persons.

A 17-month longitudinal surface sampling study carried out on public transport vehicles operating in England during the COVID-19 pandemic identified low levels of SARS-CoV-2 RNA contamination

AIMS

To monitor severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA contamination in vehicles operating in England during the pandemic, to better understand transmission risk of SARS-CoV-2 on public transport.

METHODS AND RESULTS

We collected 1314 surface samples between December 2020 and April 2022 on trains and buses managed by five different transport operators. The presence of SARS-CoV-2 RNA was investigated through reverse transcription polymerase chain reaction (RT-PCR). SARS-CoV-2 RNA was found on 197 (15%) of the 1314 surfaces sampled, including seat head rests, handholds, and air extract grilles, but the levels of RNA recovered on those samples (median value of 23.4, interquartile range: 14.3-35.4, N gene copies per extraction) made the presence of infectious virus at the time of sampling extremely unlikely. However, detection rates varied over time with peaks broadly coinciding with times of high community transmission, when it was more likely that people infected with SARS-CoV-2 were travelling on public transport.

CONCLUSION

During the pandemic, and as in other public spaces, low levels of SARS-CoV-2 RNA were found on surfaces associated with public transport.

[Environmental Benefits of Pollution and Carbon Reduction by Bus Fleet Electrification in Zhengzhou]

Electrification of bus fleets is an effective approach to reducing transportation-related pollution and carbon emissions. Evaluating the impact of electrification on existing bus fleets can provide valuable insights for promoting full electrification of public transportation in large cities. Utilizing the fuel life cycle method, we analyzed the CO2 and pollutant emissions of Zhengzhou's bus fleet before and after electrification and evaluated emissions under different electrification scenarios. Our results indicated that after electrification, the fuel life cycle CO2 and PM2.5 emissions increased by 32.6% and 42.6%, respectively, whereas CO, NOx, and VOC emissions decreased by 28%, 34%, and 25%, respectively. Optimizing the power generation structure is a critical factor in reducing CO2 and PM2.5 emissions during the electrification process. The best scenario for comprehensive electrification and power generation structure optimization could result in a 38.7% reduction in CO2, as well as reductions of 80.1% in CO, 84.4% in NOx, 92.2% in VOC, and 30.2% in PM2.5. Prioritizing electrification on long-distance routes is recommended during the replacement process. Additionally, replacing plug-in hybrid natural gas vehicles with pure electric vehicles has both advantages and disadvantages in terms of emission reduction. Achieving pollution reduction and carbon synergies requires advancing fleet replacement and power structure adjustments simultaneously.

Particle Number Concentration Measurements on Public Transport in Bangkok, Thailand

Traffic is a major source of particulate pollution in large cities, and particulate matter (PM) level in Bangkok often exceeds the World Health Organisation limits. While PM_2.5 and PM₁₀ are both measured in Bangkok regularly, the sub-micron range of PM, of specific interest in regard to possible adverse health effects, is very limited. In the study, particle number concentration (PNC) was measured on public transport in Bangkok. A travel route through Bangkok using the state railway, the mass rapid transport underground system, the Bangkok Mass Transit System (BTS) Skytrain and public buses on the road network, with walking routes between, was taken whilst measuring particle levels with a hand-held concentration particle counter. The route was repeated 19 times covering different seasons during either morning or evening rush hours. The highest particle concentrations were found on the state railway, followed by the bus, the BTS Skytrain and the MRT underground with measured peaks of 350,000, 330,000, 33,000 and 9000 cm^-3, respectively, though particle numbers over 100,000 cm^-3 may be an underestimation due to undercounting in the instrument. Inside each form of public transport, particle numbers would peak when stopping to collect passengers (doors opening) and decay with a half-life between 2 and 3 min. There was a weak correlation between particle concentration on bus, train and BTS and Skytrain with carbon monoxide concentration, as measured at a fixed location in the city.

Assessment of SARS-CoV-2 airborne infection transmission risk in public buses

Public transport environments are thought to play a key role in the spread of SARS-CoV-2 worldwide. Indeed, high crowding indexes (i.e. high numbers of people relative to the vehicle size), inadequate clean air supply, and frequent extended exposure durations make transport environments potential hotspots for transmission of respiratory infections. During the COVID-19 pandemic, generic mitigation measures (e.g. physical distancing) have been applied without also considering the airborne transmission route. This is due to the lack of quantified data about airborne contagion risk in transport environments.

In this study, we apply a novel combination of close proximity and room-scale risk assessment approaches for people sharing public transport environments to predict their contagion risk due to SARS-CoV-2 respiratory infection. In particular, the individual infection risk of susceptible subjects and the transmissibility of SARS-CoV-2 (expressed through the reproduction number) are evaluated for two types of buses, differing in terms of exposure time and crowding index: urban and long-distance buses. Infection risk and reproduction number are calculated for different scenarios as a function of the ventilation rates (both measured and estimated according to standards), crowding indexes, and travel times. The results show that for urban buses, the close proximity contribution significantly affects the maximum occupancy to maintain a reproductive number of <1. In particular, full occupancy of the bus would be permitted only for an infected subject breathing, whereas for an infected subject speaking, masking would be required. For long-distance buses, full occupancy of the bus can be maintained only if specific mitigation solutions are simultaneously applied. For example, for an infected person speaking for 1 h, appropriate filtration of the recirculated air and simultaneous use of FFP2 masks would permit full occupancy of the bus for a period of almost 8 h. Otherwise, a high percentage of immunized persons (>80%) would be needed.

Seatbelt use among bus passengers in Ghana: observed versus self-reported measures

Many road traffic injuries in low- and middle-income countries (LMICs) are to bus passengers. We sought to determine the availability, functionality, and observed vs. self-reported use of seatbelts in large intercity buses in Ghana. We observed seatbelt use for 1,184 passengers in 35 large intercity buses. We interviewed a separate group of 633 bus passengers. All buses observed had seatbelts and most (92.6%) were functional. A little over a fifth (21.6%) of passengers were observed to wear seatbelts. However, 34.5% of passengers in the self-reported survey indicated always wearing seatbelts when riding in buses. Passengers on 5 buses out of the 35 observed where the driver verbally prompted them to wear seatbelts were more likely (57.8%) to wear seatbelts than on the other buses (15.3%, p = 0.001). Comparing the self-reported survey with observations, passengers tended to overinflate seatbelt use by a factor of 1.6. This study provides useful information for efforts to increase and monitor seatbelt use among large intercity bus passengers in LMICs.Supplemental data for this article is available online at.

Mining groups of factors influencing bus/minibus crash severities on poor pavement condition roads considering different lighting status

OBJECTIVE

This study employs a data mining approach to discover hidden groups of crash-risk factors leading to each bus/minibus crash severity level on pothole-ridden/poor roads categorized under different lighting conditions namely daylight, night with streetlights turned on, and night with streetlights turned off/no streetlights.

METHODS

The bus/minibus data employed contained 2,832 crashes observed on poor roads between 2011 and 2015, with variables such as the weather, driver, vehicle, roadway, and temporal characteristics. The data was grouped into three based on lighting condition, and the association rule data mining approach was applied.

RESULTS

Overall, most rules pointing to fatal crashes included the hit-pedestrian variable, and these crashes were more frequent on straight/flat roads at night. While median presence was highly associated with severe bus/minibus crashes on dark-and-unlighted roads, median absence was correlated with severe crashes on dark-but-lighted roads. On-street parking was identified as a leading contributor to property-damage-only crashes in daylight conditions.

CONCLUSIONS

The study proposed relevant countermeasures to provide practical guidance to safety engineers regarding the mitigation of bus/minibus crashes in Ghana.

An Analysis of the Reliability of a Bus Safety Structure on Carrying Out the Numerical and Experimental Tests

In the paper, the reliability of a spatial tubular structure of a bus safety frame formed of different steel profiles is discussed. A methodology for the bus safety structure modeling is presented herein by applying numerical methods that enable us to simulate virtually a test for assessing bus rollover crashworthiness according to the United Nations Economic Commission for Europe (UNECE) Regulation No. 66, and also to assess and ensure the reliability and safety of the structure under operating conditions. The simulation has been performed by applying the mixed method of kinematical analysis and finite elements. In the course of the calculations, physical and geometrical non-linearity of materials was assessed. In addition, an experimental rollover test according to UNECE Regulation No. 66 was performed in this work, striving to verify the provided methodology for modeling by applying numerical methods. For the experiment, an identical safety structure and a rollover stand (identical to the one used in modeling) were used. The rollover test was shot by a Phantom v711 high-speed camera. In the paper, the results of kinematical and dynamic analysis from applying the finite element method and the ones of the experimental test, as well as their comparisons, are provided. It is assessed whether the developed safety structure model is reliable and suitable for use.

How Does the Location of Transfer Affect Travellers and Their Choice of Travel Mode?-A Smart Spatial Analysis Approach

This study explores the relationship between the spatial distribution of relative transfer location (i.e., the location of the transfer point in relation to the trip origin and destination points) and the attractiveness of the transit service using smart card data. Transfer is an essential component of the transit trip that allows people to reach more destinations, but it is also the main factor that deters the smartness of the public transit. The literature quantifies the inconvenience of transfer in terms of extra travel time or cost incurred during transfer. Unlike this conventional approach, the new “transfer location” variable is formulated by mapping the spatial distribution of relative transfer locations on a homogeneous geocoordinate system. The clustering of transfer points is then quantified using grid-based hierarchical clustering. The transfer location factor is formulated as a new explanatory variable for mode choice modelling. This new variable is found to be statistically significant, and no correlation is observed with other explanatory variables, including transit travel time. These results imply that smart transit users may perceive the travel direction (to transfer) as important, in addition to the travel time factor, which would influence their mode choice. Travellers may disfavour even adjacent transfer locations depending on their relative location. The findings of this study will contribute to improving the understanding of transit user behaviour and impact of the smartness of transfer, assist smart transport planning and designing of new transit routes and services to enhance the transfer performance.

Ramps remain a barrier to safe wheelchair user transit bus ingress/egress

Background: Wheelchair users (WCUs) often rely on ramps for access to transit buses. Previous studies indicate WCUs have difficulty using ramps for bus ingress/egress and many transportation-related incidents occur on ramps. However, experiences of WCU ramp usage during ingress/egress have not been fully described.Methods: Cross-sectional, internet-based survey of WCUs who ride transit buses was conducted. The participants were queried on frequency of bus usage, difficulty and incidents involving ramps, and factors contributing to difficulty and incidents. Wheelchair characteristics, primary condition, and whether participants received travel training were also captured. Chi-square was used to describe relationships between wheelchair type and frequency of difficulties and incidents, and odd ratios were used to determine likelihood of the incidents.Results: The majority (55.7%) of 384 participants reported using public transportation ≥ 1 per week. Seventy-eight percent of WCUs had ≥ 1 ramp incident over the past 3 years, with an increased likelihood of incidents occurring during ingress (OR = 1.53; CI 1.21-1.86). Of those who had an incident, 22% were injured or had damage to their wheelchair. Over 60% of those who had an incident identified steep ramp slope as being the contributing factor. Steep ramp slope, exterior ramp thresholds and wet surfaces were the most common contributing factors to difficulty using ramps.Conclusion: This is the first large-scale US study enabling WCUs to describe their experiences using transit bus ramps. Despite ADA guidelines, steep ramps remain the primary factor contributing to incidents and difficulty when using ramps to access transit buses.Implications for rehabilitationThe discrepancy between ADA maximum allowable ramp slopes for the built environment and transit buses may require an increased level of effort that is a barrier to transportation accessibility for some wheelchair users.Wheelchair users who access transit buses should be made aware of, and trained, to navigate ramp configurations found in the environment.We suggest rehabilitation therapists provide skills training specific to navigating transit bus ramp slopes that may be steeper and narrower than building ramps.

Evaluation for Fatigue and Accident Risk of Korean Commercial Bus Drivers

Many Korean bus drivers work long hours, which causes fatigue and increased risk of accidents during driving. Their fatigue due to long working hours may cause a significant accident accompanied by injuries of the general population. The present study aimed to evaluate the fatigue and accident risk in Korean commercial bus drivers. The subjects were 16 city and express bus drivers with various work schedules: 2 shifts (2 shifts in a day), WR (duty-off), W2R (duty-duty-off), and W4R2 (duty-duty-duty-duty-off-off). We measured the subjects' heart rate in their workplace during their work and calculated relative heart rate (RHR) and maximum acceptable work time (MAWT), the maximum amount of time for which workers can sustain their workload without physical fatigue. Fatigue and risk index, which is a tool for assessing the risk from fatigue in the safety critical workers, was calculated using the subjects' work schedule. RHR ranged from 9.7 to 21.8% and MAWT was shorter than each subject's actual work hours. Fatigue (45.2-54.4) and risk indices (1.8) were high in WR schedule, which were higher than recommended value (30-35 for fatigue index and < 1.6 for risk index). According to these findings, Korean bus drivers worked long hours beyond their physical abilities, and the fatigue and risk indices were high, especially in WR schedule. It is necessary to prepare the policies to reduce the fatigue and accident risk in the Korean bus drivers including regulation for bus drivers' driving time restriction.

[Hybrid Electric Bus SCR System Operation and NOx Emission Characteristics Based on Remote Communication Technology]

The selective catalytic reduction system (SCR) is an essential method to reduce NO_x emissions from heavy-duty diesel engine-powered vehicles, which include conventional diesel buses and diesel-electric hybrid buses. Using wireless remote communication technology, the SCR system status and NOx emissions were reviewed for ten fully-operational hybrid buses from Hangzhou China in this research. Under the internal combustion engine mode, the main factors studied were vehicle speed, engine operation conditions and environment temperature, impact on the SCR catalyst outlet temperature and NO_x concentration and dosing rate of the urea injector of the SCR system. The research result shows that (32.4±4)% of the operational time of the hybrid buses with SCR system was spent in internal combustion engine mode, and under (26.9±11)% of the operation time of this mode, the SCR system did not dose urea. The average NOx emission reduction rate of the SCR system, when operating normally with hybrid buses, is about 59%. The main reasons for the high NO_x emission of the diesel-electric hybrid buses in operation condition are poor satisfaction of the requirements of the SCR system control strategy and the SCR catalyst's low temperature conversion efficiency. Whenever the speed of the hybrid buses was above 40 km·h^-1, the SCR catalyst outlet temperatures were higher than the 230℃, and the NO_x emission concentrations were significantly reduced, as the urea injector working proportion and urea quantity increased. In the winter, the SCR catalyst outlet temperature and urea injection quantity dropped with the reduced environment temperature, which led to increased NO_x emissions.

Analysis of Provincial Mortalities Among Bus/Minibus Users Over Twelve Years, East Azerbaijan, Iran

Objective: The aim of this study was to investigate the epidemiological features of bus/minibus users' road traffic injury mortalities during 2006-2017, in the East Azerbaijan province of Iran. Methods: All 245 bus/minibus users' mortalities, registered in the forensic medicine database, were analyzed by STATA 13 statistical software package. Results: The majority of victims (mean age: 41.5±18.6 years) were men (70%), adults (79.18%), illiterate (22.4%) and self-employed (25.3%). Passersby and police played an almost null role in transporting victims since 2014. A decreasing trend of bus/minibus users' fatalities was observed over the study time. Head-neck-face trauma was more common among those who died prior to hospitalization. Rollover was significantly prevalent among bus users and falling among minibus users. Lorries, vans, and trailers as crash counterpart vehicles caused 59% of deceases, excluding the cases when no other vehicle was engaged. Victims were more likely to die at the hospital when crashes happened in the city's inner roads (OR: 4.17; 95%CI:1.7-9.9). The elderly were 2.78 times more likely to die at the hospital when compared to the other age groups (95%CI: 1.23-6.26). Conclusions: To identify a target group for interventions on traffic-related knowledge, attitude and behaviors, male adults, illiterate and self-employed bus/minibus users could be of priority. Type vehicles involved in the crash should be considered as an important factor affect on crash fatalities. Further investigations are needed in this regard in the future.

Health Risks Associated with Occupational Exposure to Ambient Air Pollution in Commercial Drivers: A Systematic Review

Ambient air pollution is a major global health problem and commercial drivers are particularly exposed to it. As no systematic assessment of the health risks associated with occupational exposure to ambient air pollution in this population had yet been carried out, we conducted a systematic review using a protocol-driven strategy. Papers published from inception to April 20, 2018 in MEDLINE, EMBASE, CINAHL, African journals online, the Cochrane library, ISRCTN WHO ICTRP, and the Web of Science and Scopus databases were screened for inclusion by two independent reviewers. Original articles with at least an available abstract in English or French were included. The initial search retrieved 1454 published articles of which 20 articles were included. Three studies reported a significant difference in white blood cells (10⁶/L) among commercial motorcyclists compared to rural inhabitants (5.041 ± 1.209 vs. 5.900 ± 1.213, p = 0.001), an increased risk of lung cancer (RR = 1.6, 95%CI 1.5–1.8) in bus drivers and an increased standardized mortality ratio (SMR) in bus drivers from Hodgkin’s lymphoma (SMR 2.17, 95%CI 1.19–3.87) compared to white-collar workers. Other studies also found that drivers had more oxidative DNA damage and chromosome breaks. Four papers failed to demonstrate that the drivers were more exposed to air pollution than the controls. Three other studies also reported no significant difference in lung function parameters and respiratory symptoms. The genetic polymorphisms of detoxifying enzymes were also not homogeneously distributed compared to the controls. There is some evidence that occupational exposure to ambient air pollution among commercial drivers is associated with adverse health outcomes, but the existing literature is limited, with few studies on small sample size, methodological weaknesses, and contradictory findings—thus, further research is recommended.

Conveyance Contact Investigation for Imported Middle East Respiratory Syndrome Cases, United States, May 2014

In 2014, the Centers for Disease Control and Prevention conducted conveyance contact investigations for 2 Middle East respiratory syndrome cases imported into the United States, comprising all passengers and crew on 4 international and domestic flights and 1 bus. Of 655 contacts, 78% were interviewed; 33% had serologic testing. No secondary cases were identified.

Understanding parents' concerns about their children with autism taking public school transportation in Los Angeles County

There are a number of recent US news media reports of children and youth with autism becoming lost, injured, or even dying while taking public school transportation, yet research on this problem is scarce. This ethnographic study examines the experiences of 14 parents whose children with autism take public school transportation in Los Angeles County. We present two case studies of children with autism being "lost" while in transit from school to home on the bus to (1) describe how the situation was experienced, responded to, and managed by the parents; (2) consider three interrelated themes that emerged from interviews with 14 parents, related to children's safety, independence, and participation, across multiple contexts and analytic levels; and (3) discuss the findings in relation to US news media reports of incidents involving children with autism on school buses to identify specific weaknesses in school transportation infrastructure, particularly in the context of privatization, that create conditions in which children with autism can "fall through the cracks" in potentially life-threatening ways. We argue that there is a critical need to address transportation accessibility for individuals on the autism spectrum to ensure their safety and support their independence and community participation.

An accidental decapitation resulting from head protruding out of bus

Decapitation is the separation of the head from the neck. Accidental decapitation is rare, and very few cases are cited in the literature. In this case, the victim was asleep during an overnight trip with her head sticking out of the window, and she was decapitated by a truck travelling in the opposite direction. Lack of security grilles on windows, high-speed driving, narrow roads and night travel were contributing factors. This case is presented for its rarity and pattern of injuries during the fatal mishap and to consider possible preventive measures.

Prevalence of and factors associated with distraction among public transit bus drivers

OBJECTIVE

Recent research has suggested that driver distraction is a major cause of driving performance impairment and motor vehicle collisions. Research on the topic has focused on passenger vehicles, with studies suggesting that drivers may be distracted nearly 33 percent of the time spent driving. To date, no study has examined the prevalence of distraction specifically among public transit bus drivers.

METHODS

Over a 3-month period, trained investigators observed and recorded distraction behaviors of bus drivers. Distraction prevalence was compared by route characteristics (e.g., geographic area, travel speed) using chi-square test. A general estimating equation logistic regression was used to estimate P values for distraction prevalence by driver demographics.

RESULTS

Overall, there was a 39 percent prevalence of distraction. The most prevalent distractions were due to interactions with another passenger. Distractions were more prevalent among drivers <30 years of age or ≥ 50 years of age, on city streets or highways (relative to residential streets), and when there were more than 20 passengers. Distractions were the least prevalent in suburban areas, with the highest prevalence observed in city centers and rural areas.

CONCLUSIONS

Driver distraction is a common problem for public transit bus drivers, mainly due to other passengers. Drivers should be educated on the hazards of distracted driving and on ways to avoid distraction.

Active or passive journeys and low back pain in adolescents

The objective of this cross-sectional study was to study associations between low back pain (LBP) and modes of transport to school and leisure activities among adolescents. The study population included all adolescents in eighth and ninth grade in two geographic areas in eastern Norway. Eighty-eight adolescents participated (mean age 14.7 years), making the response rate 84%. Data concerning active (walking/bicycling) and passive (bus/car) journeys were obtained from lists and maps from local authorities, and from the pupils, using a questionnaire that also included LBP, activities and wellbeing. Distance walked/bicycled to school was slightly shorter among those reporting LBP in bivariate analyses. Walking/bicycling more than 8 km weekly to regular activities was inversely associated with LBP in multivariate analysis (OR 0.3; 95% confidence interval 0.1-1.0). No associations were found between passive journeys and LBP. The results raise the question for future research of whether lack of active transport may be one cause behind the increase in juvenile LBP.