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1.
J Safety Res ; 89: 41-55, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38858062

ABSTRACT

INTRODUCTION: Development and implementation of autonomous vehicle (AV) related regulations are necessary to ensure safe AV deployment and wide acceptance among all roadway users. Assessment of vulnerable roadway users' perceptions on AV regulations could inform policymakers the development of appropriate AV regulations that facilitate the safety of diverse users in a multimodal transportation system. METHOD: This research evaluated pedestrians' and bicyclists' perceptions on six AV regulations (i.e., capping AV speed limit, operating AV in manual mode in the sensitive areas, having both pilot and co-pilot while operating AVs, and three data-sharing regulations). In addition, pedestrians' and bicyclists' perceptions of testing AVs in public streets were evaluated. Statistical testing and modeling techniques were applied to accomplish the research objectives. RESULTS: Compared to the other AV regulations assessed in this research, strong support for AV-related data sharing regulations was identified. Older respondents showed higher approval of AV testing on public roadways and less support for regulating AVs. AV technology familiarity and safe road sharing perceptions with AVs resulted in lower support for AV regulations. CONCLUSIONS: Policymakers and AV technology developers could develop effective educational tools/resources to inform pedestrians and bicyclists about AV technology reliability and soften their stance, especially on AV regulations, which could delay technology development. PRACTICAL APPLICATIONS: The findings of this research could be used to develop informed AV regulations and develop policies that could improve pedestrians' and bicyclists' attitudes/perceptions on regulating AVs and promoting AV technology deployments.


Subject(s)
Bicycling , Pedestrians , Humans , Male , Adult , Female , Bicycling/legislation & jurisprudence , Middle Aged , Pedestrians/psychology , Young Adult , Accidents, Traffic/prevention & control , Adolescent , Walking , Perception , Aged , Safety/legislation & jurisprudence , Surveys and Questionnaires , Automobiles/legislation & jurisprudence
2.
Accid Anal Prev ; 204: 107620, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38823082

ABSTRACT

As autonomous driving advances, autonomous vehicles will share the road with human drivers. This requires autonomous vehicles to adhere to human traffic laws under safe conditions. Simultaneously, when confronted with dangerous situations, autonomous driving should also possess the capability to deviate from traffic laws to ensure safety. However, current autonomous vehicles primarily prioritize safety and collision avoidance in their decision-making and planning. This may lead to misunderstandings and distrust from human drivers in mixed traffic flow, and even accidents. To address this, this paper proposes a decoupled hierarchical framework for compliance safety decision-making. The framework primarily consists of two layers: the decision-making layer and the motion planning layer. In the decision-making layer, a candidate behavior set is constructed based on the scenario, and a dual layer admission assessment is utilized to filter out unsafe and non-compliant behaviors from the candidate sets. Subsequently, the optimal behavior is selected as the decision behavior according to the designed evaluation metrics. The decision-making layer ensures that the vehicle can meet lane safety requirements and comply with static traffic laws. In the motion planning layer, the surrounding vehicles and the road are modeled as safety potential fields and traffic laws potential fields. Combining the optimal decision behavior, they are incorporated into the cost function of the model predictive control to achieve compliant and safe trajectory planning. The planning layer ensures that the vehicle meets trajectory safety requirements and complies with dynamic traffic laws under safe conditions. Finally, four typical scenarios are used to evaluate the effectiveness of the proposed method. The results indicate that the proposed method can ensure compliance in safe conditions while also temporarily deviating from traffic laws in emergency situations to ensure safety.


Subject(s)
Accidents, Traffic , Automobile Driving , Decision Making , Safety , Humans , Automobile Driving/legislation & jurisprudence , Accidents, Traffic/prevention & control , Accidents, Traffic/legislation & jurisprudence , Safety/legislation & jurisprudence , Automation , Automobiles/legislation & jurisprudence , Models, Theoretical
4.
OTJR (Thorofare N J) ; 44(4): 543-553, 2024 10.
Article in English | MEDLINE | ID: mdl-38389336

ABSTRACT

This article addresses a critically important topic for the occupational therapy (OT) profession and driver rehabilitation specialists (DRS), related to the introduction and deployment of personal and public automated vehicles (AVs); and discusses the current and corresponding changing roles for these professionals. Within this commentary, we provide an overview of the relevant literature on AV regulations, policy, and legislation in North America, the various levels of AV technology, and inclusive and universal design principles to consider in AV deployment for people with disabilities. The role of the OT practitioner and DRS is described within the context of the person-environment-occupation-performance model, and within the guidelines of the Association for Driver Rehabilitation Specialists and the American Occupational Therapy Association. The article concludes with considerations for an extended clinical agenda, a new research agenda, and a call for action to OT practitioners and DRS, as well as to educators, certification bodies, professional organizations, and collaborators.


Automated Vehicles: Future Initiatives for Occupational Therapy Practitioners and Driver Rehabilitation SpecialistsThis article discusses a critical practice and scientific area for occupational therapy (OT) practitioners and driver rehabilitation specialists (DRS), namely the deployment of automated vehicles (AVs) in North America and its effect on the OT profession. The article situates driving, including driving AVs, within the context of a credible OT model, discusses the current and changing roles of the OT practitioner and DRS, stipulates the rules and regulations for AVs in North America, expounds on the different levels of AV technology and potential implications, requirements for accessible AVs for people with disabilities, and highlights guidelines from professional organizations pertaining driving as a practice area. The article concludes by suggesting new directions for clinical practice and research, and it calls on OT practitioners, DRS, educators, certification organizations, and collaborators to take action.


Subject(s)
Automation , Automobile Driving , Occupational Therapy , Humans , Automation/legislation & jurisprudence , Automobile Driving/legislation & jurisprudence , Automobiles/legislation & jurisprudence , Disabled Persons/legislation & jurisprudence , Disabled Persons/rehabilitation , Equipment Design , Occupational Therapy/methods , Professional Role
6.
Rev. bras. oftalmol ; 81: e0034, 2022. tab, graf
Article in English | LILACS | ID: biblio-1376787

ABSTRACT

ABSTRACT Objective: To measure visual acuity in high contrast and low contrast sensitivities in different grades of visible light transmission films in three different positions (front, lateral and rear windows). Methods: Forty-four healthy volunteers between 30-75 y-o, with BCVA better than 0,5, were tested in the 5 following vehicles with different grades of visible light transmission films. Vehicle 1: 75% in the front and 70% in the lateral and rear windows; Vehicle 2: 70% in the front and lateral windows and 28% in the rear; Vehicle 3: 70% in the front, 28% in the lateral and 15% rear; Vehicle 4: 35% in all 3 windows; Vehicle 5: 50% in the front, 20% in the lateral and 15% in the rear. Descriptive statistics were used and the average of the 3 measurements of VA was considered. Wilcoxon Test was applied to compare the average visual acuity in each vehicle and position. P value<0.05 was considered statistically significant. Results: According to the Brazilian Traffic Regulations for driving in categories C/D/E, when low contrast was tested in the front window, all visible light transmissions were borderline, in the lateral window they were all outside the limit, while in the rear window for both low and high contrast, all visible light transmissions tested were outside the limit and also borderline for driving in categories A/B, with the exception of the vehicle with visible light transmission of 35%. Conclusion: Visual acuity is affected, especially in the rear window, by the use of automotive films. The study is an alert that window films is a possible cause of accidents and may contribute to the revision of traffic regulations worldwide.


RESUMO Objetivo: Medir a acuidade visual em alto e baixo contraste nas diversas graduações de transparência de filmes em três janelas de veículos: frontal, lateral e traseira. Métodos: Foram avaliados 44 voluntários saudáveis entre 30 e 75 anos, com acuidade visual melhor corrigida acima de 0,5, em cinco veículos, sendo: veículo 1, com 75% de transparência frontal e 70% na lateral e traseira; veículo 2, com 70% na frontal e na lateral e 28% na traseira; veículo 3, com 70% na frontal, 28% na lateral e 15% na traseira; veículo 4, com 35% nas três janelas; e veículo 5, com 50% na frontal, 20% na lateral e 15% na traseira. Foi realizada estatística descritiva utilizando a média de três medidas consecutivas, com teste de Wilcoxon para comparar a média de acuidade visual em cada janela, e foi considerado estatisticamente significativo quando valor de p<0,05. Resultados: Todas as transparências testadas nos vidros reduziram a acuidade visual em situação de baixo contraste para níveis limítrofes na janela frontal e níveis ilegais na lateral para conduzir veículos nas categorias C/D/E. Na janela traseira, tanto em alto quanto em baixo contraste, todas as transparências mostraram redução da acuidade visual para níveis ilegais para categorias C/D/E e limítrofes para as categorias A/B, exceto na transparência de 35%. Conclusão: A acuidade visual é reduzida pelo uso dos filmes automotivos, especialmente na janela traseira. Condutores de veículos com filmes devem ser alertados pelo risco aumentado de acidentes. Esse dado científico propõe revisões nas regulações de tráfego mundiais.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Automobile Driving/legislation & jurisprudence , Automobiles/legislation & jurisprudence , Automobiles/standards , Contrast Sensitivity , Visual Acuity , Space Perception , Vision Tests , Lighting , Accidents, Traffic , Cross-Sectional Studies , Color , Glass , Light
7.
N Z Med J ; 133(1520): 99-103, 2020 08 21.
Article in English | MEDLINE | ID: mdl-32994598

ABSTRACT

In this viewpoint we briefly review the evidence for smoke-free car legislation. We find that this legislation has been consistently associated with reduced secondhand exposure in cars with children/youth in all nine jurisdictions studied. Despite this, there are various aspects of this intervention that warrant further study-especially determining its impact on reducing tobacco-related ethnic inequalities. So we argue that the New Zealand Ministry of Health should invest in a thorough evaluation of this important upcoming public health intervention. This could both help the country in further refining the design of the law (if necessary) and would also be a valuable contribution to advancing the knowledge base for international tobacco control.


Subject(s)
Automobiles/legislation & jurisprudence , Environmental Exposure/prevention & control , Smoke-Free Policy/legislation & jurisprudence , Tobacco Smoke Pollution/legislation & jurisprudence , Adolescent , Automobiles/standards , Child , Environmental Exposure/adverse effects , Ethnicity/statistics & numerical data , Humans , New Zealand/epidemiology , Public Health/economics , Public Health/legislation & jurisprudence , Socioeconomic Factors , Nicotiana/adverse effects , Tobacco Smoke Pollution/adverse effects , Tobacco Smoke Pollution/prevention & control
8.
Thorax ; 75(4): 345-347, 2020 04.
Article in English | MEDLINE | ID: mdl-31988266

ABSTRACT

England banned smoking in cars carrying children in 2015 and Scotland in 2016. We used survey data from 3 years for both countries (NEngland=3483-6920, NScotland=232-319) to assess effects of the English ban using logistic regression within a difference-in-differences framework. Among children aged 13-15 years, self-reported levels of regular exposure to smoke in cars for Scotland were 3.4% in 2012, 2.2% in 2014 and 1.3% in 2016 and for England 6.3%, 5.9% and 1.6%. The ban in England was associated with a -4.1% (95% CI -4.9% to -3.3%) absolute reduction (72% relative reduction) in exposure to tobacco smoke among children.


Subject(s)
Automobiles/legislation & jurisprudence , Child Welfare , Smoke-Free Policy/legislation & jurisprudence , Smoking Prevention/legislation & jurisprudence , Surveys and Questionnaires , Tobacco Smoke Pollution/prevention & control , Adolescent , Child , England , Female , Humans , Male , Scotland , Tobacco Smoke Pollution/adverse effects
9.
N Z Med J ; 133(1508): 118-122, 2020 01 17.
Article in English | MEDLINE | ID: mdl-31945048

ABSTRACT

This viewpoint welcomes the recent announcement of the Government of Aotearoa/New Zealand to ban smoking in cars with children. However, it notes that the thorny issue of enforcement and punishment remains. Internationally there is a deficit on research on this issue. The experiences of the UK and Ireland are examined, where there was little or no enforcement of such laws, as well as a comparison with the State of Victoria in Australia, where the law was more robustly enforced. This viewpoint argues that enforcement is an important element in safeguarding the health and wellbeing of children.


Subject(s)
Automobiles/legislation & jurisprudence , Child Welfare/legislation & jurisprudence , Smoke-Free Policy/legislation & jurisprudence , Tobacco Smoking/legislation & jurisprudence , Adult , Child , Child Welfare/ethics , Humans , Law Enforcement/methods , New Zealand/epidemiology , Tobacco Smoking/adverse effects
10.
Nat Hum Behav ; 4(2): 134-143, 2020 02.
Article in English | MEDLINE | ID: mdl-31659321

ABSTRACT

When an automated car harms someone, who is blamed by those who hear about it? Here we asked human participants to consider hypothetical cases in which a pedestrian was killed by a car operated under shared control of a primary and a secondary driver and to indicate how blame should be allocated. We find that when only one driver makes an error, that driver is blamed more regardless of whether that driver is a machine or a human. However, when both drivers make errors in cases of human-machine shared-control vehicles, the blame attributed to the machine is reduced. This finding portends a public under-reaction to the malfunctioning artificial intelligence components of automated cars and therefore has a direct policy implication: allowing the de facto standards for shared-control vehicles to be established in courts by the jury system could fail to properly regulate the safety of those vehicles; instead, a top-down scheme (through federal laws) may be called for.


Subject(s)
Accidents, Traffic , Automation , Automobile Driving , Automobiles , Man-Machine Systems , Safety , Social Perception , Accidents, Traffic/legislation & jurisprudence , Adult , Automation/ethics , Automation/legislation & jurisprudence , Automobile Driving/legislation & jurisprudence , Automobiles/ethics , Automobiles/legislation & jurisprudence , Humans , Pedestrians/legislation & jurisprudence , Safety/legislation & jurisprudence
11.
J Expo Sci Environ Epidemiol ; 30(4): 629-640, 2020 07.
Article in English | MEDLINE | ID: mdl-31142812

ABSTRACT

Air pollution from motor vehicle traffic remains a significant threat to public health. Using taxi inspection and trip data, we assessed changes in New York City's taxi fleet following Clean Air Taxi legislation enacted in 2005-2006. Inspection and trip data between 2004 and 2015 were used to assess changes in New York's taxi fleet and to estimate and spatially apportion annual taxi-related exhaust emissions of nitric oxide (NO) and total particulate matter (PMT). These emissions changes were used to predict reductions in NO and fine particulate matter (PM2.5) concentrations estimates using data from the New York City Community Air Survey (NYCCAS) in 2009-2015. Efficiency trends among other for-hire vehicles and spatial variation in traffic intensity were also considered. The city fuel efficiency of the medallion taxi fleet increased from 15.7 MPG to 33.1 MPG, and corresponding NO and PMT exhaust emissions estimates declined by 82 and 49%, respectively. These emissions reductions were associated with changes in NYCCAS-modeled NO and PM2.5 concentrations (p < 0.001). New York's clean air taxi legislation was effective at increasing fuel efficiency of the medallion taxi fleet, and reductions in estimated taxi emissions were associated with decreases in NO and PM2.5 concentrations.


Subject(s)
Air Pollution/legislation & jurisprudence , Automobiles/legislation & jurisprudence , Vehicle Emissions/legislation & jurisprudence , Air , Air Pollutants/analysis , Air Pollution/analysis , Environmental Monitoring , Humans , Motor Vehicles , New York City , Nitric Oxide , Particulate Matter/analysis , Public Health , Vehicle Emissions/analysis
13.
Appl Ergon ; 81: 102904, 2019 Nov.
Article in English | MEDLINE | ID: mdl-31422264

ABSTRACT

To date, vehicle manufacturers have largely been left to their own initiatives when it comes to the design, development and implementation of automated driving features. Whilst this has enabled developments within the field to accelerate at a rapid pace, we are also now beginning to see the negative aspects of automated design (e.g., driver complacency, automation misuse and ethical dilemmas). It is therefore becoming increasingly important to identify systemic aspects that can address some of these Human Factors challenges. This paper applies the principles of the Risk Management Framework to explore the wider systemic issues associated with automated driving in the United Kingdom through the novel application of network metrics. The authors propose a number of recommendations targeted at each level of the Risk Management Framework that seek to shift the power of influence away from vehicle manufacturers and back into the hands of governing bodies.


Subject(s)
Automation/ethics , Automobiles/ethics , Ergonomics/ethics , Risk Management/ethics , Systems Analysis , Automobile Driving/legislation & jurisprudence , Automobile Driving/psychology , Automobiles/legislation & jurisprudence , Humans , Risk Management/legislation & jurisprudence , Social Networking , United Kingdom
14.
PLoS One ; 14(8): e0221213, 2019.
Article in English | MEDLINE | ID: mdl-31437260

ABSTRACT

Intelligent Transport System (ITS) uses the IEEE 802.11P standard for the wireless communication among vehicles. A wireless ad hoc network of vehicles is established to improve road safety, comfort, security, and traffic efficiency. Wireless communication in ITS leads to many security and privacy challenges. Security and privacy of ITS are important issues that demand incorporation of confidentiality, privacy, authentication, integrity, non-repudiation, and restrictive obscurity. In order to ensure the privacy of vehicles during communication, it is required that the real identity of vehicles should not be revealed. There must be robust and efficient security and privacy mechanisms for the establishment of a reliable and trustworthy network. Therefore, we propose Advanced Strong Pseudonym based Authentication (ASPA), which is a distributed framework to handle the security and privacy issues of vehicle communications in ITS. ASPA only allows vehicles with valid pseudonyms to communicate in ITS. Pseudonyms are assigned to vehicles in a secure manner. The pseudonym mappings of vehicles are stored at different locations to avoid any chance of vehicle pseudonyms certificates linkability. In addition, the most recent communication pseudonyms of a malicious vehicle are revoked and are stored in the Certificate Revocation List (CRL) that results in small size of the CRL. Therefore, the CRL size does not increase exponentially. The distributed framework of ASPA guarantees, the vehicles privacy preservation in the real identities mapping and revocation phase. The empirical results prove that ASPA is robust and efficient with low computational cost, overhead ratio, average latency, and an increased delivery ratio.


Subject(s)
Accidents, Traffic/prevention & control , Anonyms and Pseudonyms , Transportation/ethics , Wireless Technology/ethics , Automobiles/legislation & jurisprudence , Computer Security , Humans , Privacy
15.
PLoS One ; 14(4): e0215152, 2019.
Article in English | MEDLINE | ID: mdl-30973920

ABSTRACT

Direct road mortality and the barrier effect of roads are typically identified as one of the greatest threats to wildlife. In addition, collisions with large mammals are also a threat to human safety and represent an economic cost to society. We documented and explored the effects of animal-vehicle crashes on human safety in São Paulo State, Brazil. We estimated the costs of these crashes to society, and we summarized the legal perspectives. On average, the Military Highway Police of São Paulo reported 2,611 animal-vehicle crashes per year (3.3% of total crashes), and 18.5% of these resulted in human injuries or fatalities. The total annual cost to society was estimated at R$ 56,550,642 (US $ 25,144,794). The average cost for an animal-vehicle crash, regardless of whether human injuries and fatalities occurred, was R$ 21,656 (US $ 9,629). The Brazilian legal system overwhelmingly (91.7% of the cases) holds the road administrator liable for animal-vehicle collisions, both with wild and domestic species. On average, road administrators spent R$ 2,463,380 (US $ 1,005,051) per year compensating victims. The logical conclusion is that the Brazilian legal system expects road administrators to keep animals, both wild and domestic species, off the road. We suggest an improved coordination between the laws that relate to animal-vehicle collisions and human safety, and the process for environmental licenses that focusses on reducing collisions with wildlife and providing habitat connectivity. In addition, we suggest better management practices, raising awareness and social change with regard to abandoned domesticated animals including horses, cattle, and dogs. This should ultimately result in a road system with improved human safety, reduced unnatural mortality for both domestic and wild animal species, safe crossing opportunities for wildlife, and reduced monetary costs to society.


Subject(s)
Accidents, Traffic/economics , Accidents, Traffic/legislation & jurisprudence , Animals, Wild/injuries , Automobiles/statistics & numerical data , Safety/standards , Wounds and Injuries/economics , Wounds and Injuries/prevention & control , Accidents, Traffic/prevention & control , Accidents, Traffic/statistics & numerical data , Animals , Automobiles/legislation & jurisprudence , Built Environment , Humans , Risk Factors
16.
Accid Anal Prev ; 115: 143-150, 2018 Jun.
Article in English | MEDLINE | ID: mdl-29571012

ABSTRACT

Subsystem impactor tests are the main approaches for evaluation of safety performance of vehicle front design for pedestrian protection in legislative regulations. However, the main aspects of vehicle safety for pedestrians are shape and stiffness, and though it is clear that subsystem impact tests encourage lower vehicle front stiffness, it is unclear whether they promote improved vehicle front shapes for pedestrian protection. The purpose of this paper is therefore to investigate the effects of European pedestrian safety regulations on passenger car front shape and pedestrian injury risk using recent German In-Depth Accident Study (GIDAS) pedestrian collision data and numerical simulations. Firstly, a sample of 579 pedestrian collision cases involving 190 different car models between 2000-2015 extracted from the GIDAS was used to compare front-end shapes of passenger cars manufactured before and after the legislative pedestrian safety regulations were introduced in Europe. The focus was on changes in passenger car front shape and differences in pedestrian AIS2+ (Abbreviated Injury Scale at least level 2) leg, pelvis/femur and head injury risk observed in collisions. Multi-body simulations were also used to assess changes in vehicle aggressivity due to the observed changes in vehicle shape. The results show that newer passenger cars tend to have a flatter and wider bumper, higher bonnet leading edge, shorter and steeper bonnet and a shallower windscreen. Both the collision data and the numerical simulations indicate that newer passenger car front bumper designs are significantly safer for pedestrians' legs. However, the results also show that the higher bonnet leading edge in newer passenger cars is poor for pedestrian pelvis/femur protection, even though newer cars show an obviously lower AIS2+ injury risk to younger pedestrians in collisions. Newer cars have a lower AIS2+ head injury risk for pedestrians in collisions, but the numerical analysis indicate that this is not likely due to shape changes in passenger car fronts. Overall, the introduction of pedestrian safety regulations has resulted in reductions in pedestrian injury risk, but further benefits would accrue from tests which promote a lower bonnet leading edge. The influence of vehicle shape on pedestrian head injury risk remains unclear.


Subject(s)
Accidents, Traffic , Automobiles/legislation & jurisprudence , Engineering , Pedestrians , Walking/injuries , Wounds and Injuries/prevention & control , Abbreviated Injury Scale , Craniocerebral Trauma/etiology , Craniocerebral Trauma/prevention & control , Equipment Design , Europe , Femur/injuries , Germany , Head , Humans , Leg , Pelvis/injuries , Risk Assessment , Safety , Wounds and Injuries/etiology
17.
PLoS One ; 13(3): e0193777, 2018.
Article in English | MEDLINE | ID: mdl-29561860

ABSTRACT

Hybrid electric vehicles (HEVs) could be a good short term option to help achieve global targets regarding road transport greenhouse gas emissions. Several common and country-specific public policies based on price or tax rebates are established in order to encourage the adoption of HEVs. The present research empirically assesses market preferences for HEVs in Spain, looking at the role of subsidies. An interactive internet-based survey was conducted in a representative sample (N = 1,200) of Spanish drivers. Drivers are willing to pay an extra amount of €1,645 for a HEV model compared to a conventional vehicle, premium which is well below the price markup for these cars. Therefore, current levels of economic subsidies applied in isolation to promote these types of vehicles may have a quite limited effect in extending their use. Overall, it is found that drivers have clear misconceptions about HEVs, which affect their purchasing choices and perceptions. Therefore, a policy mix of various incentives (including informational campaigns) may be required in order to stimulate the demand for HEVs.


Subject(s)
Automobiles/economics , Electrical Equipment and Supplies/economics , Adult , Automobiles/legislation & jurisprudence , Comprehension , Environmental Policy/economics , Female , Humans , Male , Middle Aged , Models, Theoretical , Spain , Surveys and Questionnaires
18.
Injury ; 49(2): 208-212, 2018 Feb.
Article in English | MEDLINE | ID: mdl-29153449

ABSTRACT

AIMS: To investigate the changing epidemiology of open fractures in vehicle occupants, pedestrians, motorcyclists and cyclists. MATERIALS AND METHODS: Data on all non-spinal open fractures admitted to the Royal Infirmary of Edinburgh after a road traffic accident between 1988 and 2010 were collected and analysed to provide information about the changing epidemiology in different patient groups. Demographic information was collected on all patients with the severity of injury being analysed with the Injury Severity Score (ISS), Musculoskeletal Index (MSI) and the number of open fractures. The severity of the open fractures was analysed using the Gustilo classification. The 23-year study period was divided into four shorter periods and the results were compared. RESULTS: There were 696 patients treated in 23 years. Analysis showed that the incidence of RTA open fractures initially fell in both males and females and continued to fall in females during the 23 years. In males it levelled off about 2000. The age of the female patients also fell during the study period but it did not change in males. The only patient group to show an increased incidence of open fractures were cyclists. In vehicle occupants the incidence fell throughout the study period but it levelled off in pedestrians and motorcyclists. There was no difference in the severity of injury in any group during the study period. The most severe open fractures were those of the distal femur and femoral diaphysis although open tibial diaphyseal fractures were the most common fracture in all patient groups. CONCLUSIONS: Improved car design and road safety legislation has resulted in a reduction in the incidence of open fractures in vehicle occupants, pedestrians and motorcyclists. The most obvious group to have benefitted from this are older female pedestrians. The only group to show an increase in age during the study period were male motorcyclists.


Subject(s)
Accident Prevention/trends , Accidents, Traffic/statistics & numerical data , Fractures, Open/epidemiology , Hospitalization/statistics & numerical data , Pedestrians , Safety Management/legislation & jurisprudence , Accident Prevention/statistics & numerical data , Accidents, Traffic/prevention & control , Accidents, Traffic/trends , Adolescent , Adult , Age Distribution , Automobiles/legislation & jurisprudence , Bicycling/legislation & jurisprudence , Female , Hospitalization/trends , Humans , Incidence , Injury Severity Score , Male , Middle Aged , Motorcycles/legislation & jurisprudence , Pedestrians/statistics & numerical data , Retrospective Studies , Sex Distribution , United Kingdom/epidemiology , Walking/legislation & jurisprudence , Young Adult
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