Age-based variability in the association between restraint use and injury type and severity in multi-occupant crashes.

PURPOSE: Previous studies have shown older adults receive relatively less protection from seat belts against fatal injuries, however it is unknown how seat belt protection against severe and torso injury changes with age. We estimated age-based variability in seat belt protection against fatal injuries, injuries with maximum abbreviated injury scale greater than two (MAIS 3+), and torso injuries. METHODS: We leveraged the Crash Outcome Data Evaluation System to analyze binary indicators of fatal, MAIS 3+, and torso injuries. Using a matched cohort design and conditional Poisson regression, we estimated age-based relative risks (RR) of the outcomes associated with seat belt use. RESULTS: Our results suggested that seat belts were highly protective against fatal injuries for all ages. For ages 16-30, seat belt use was associated with 66% lower risk of MAIS3+ injury (RR 0.34, 95% CI 0.30, 0.38) for occupants of the same vehicle, whereas for ages 75 and older, seat belt use was associated with 38% lower risk of MAIS3+ injury (RR 0.62; 95% CI 0.45, 0.86) for occupants in the same vehicle. The association between restraint use and torso injury also attenuated with age. CONCLUSIONS: In multi-occupant crashes, seat belts were highly protective against fatal and MAIS3+ injury, however seat belt protection against MAIS3+ and torso injury attenuated with age.

Motor vehicle-related electric scooter injuries in the US: A descriptive analysis of NEISS data.

INTRODUCTION: The introduction of scooter-share programs across the United States has led to an increased incidence of electronic scooter (e-scooter) injuries presenting to emergency departments (EDs). As legislation begins to push scooters from the sidewalk to the street, injuries resulting from collisions between e-scooters and motor vehicles are an important, but poorly characterized consideration. This study leverages data from a national injury surveillance system to characterize e-scooter versus motor vehicle collisions resulting in ED presentation. METHODS: This study utilizes data from the National Electronic Injury Surveillance System (NEISS). NEISS was queried for e-scooter-related injuries from January 1st, 2015 through December 31st, 2019. Injuries were characterized as motor vehicle-related (MV-involved) or non-motor-vehicle-related (MV-uninvolved) based on a manual review by the study investigators. Weighted tabular analyses were used to characterize both types of e-scooter injuries across demographic, diagnostic, and event-related factors. RESULTS: Over the study period an estimated 60,554 (95% CI: 37,525-84,594) injuries were treated in US EDs. Approximately 19% of these injuries involved motor vehicles. Those sustaining MV-involved injuries were significantly younger (p = 0.01), with a higher proportion of males injured (p = 0.01). Additionally, when compared to MV-uninvolved injuries, a significantly higher proportion of those with MV-involved injuries were admitted to the hospital for treatment (8.8% vs. 14.6%, p < 0.01). MV-involved injuries occurred primarily in the street (96.3%), while MV-uninvolved injuries were split across streets (44.0%), at one's home (~20%), and on public property (~20%) (p < 0.01). CONCLUSIONS: Electric scooter injuries involving a motor vehicle differed from those that did not across several key categories. As e-scooters and motor vehicles start to share the road more frequently, greater consideration should be made regarding how these two modes of transportation interact with each other. The promotion of thoughtful e-scooter legislation and infrastructure changes could help promote safer travel.

Demographic and policy-based differences in behaviors and attitudes towards driving after marijuana use: an analysis of the 2013-2017 Traffic Safety Culture Index.

OBJECTIVE: Marijuana policies in the United States have become more permissive, motivating research on demographic and policy-based differences in behaviors and attitudes towards driving after marijuana use. The Traffic Safety Culture Index is an annual survey with national scope and multiple measures relevant to driving after marijuana use. We tabulated responses to questions about driving after marijuana use from the Traffic Safety Culture Index based on demographic factors, recreational and medical marijuana policies, and per-se marijuana laws. RESULTS: Male, younger, lower-income, and lower-education respondents self-reported driving after marijuana use more than their demographic counterparts, more often reported such behavior to be personally acceptable, and exhibited lower support per-se laws. Drivers in states that legalized medical marijuana self-reported driving after marijuana use slightly more than drivers in states where both medical and recreational were illegal. Support for per-se laws was higher among those in states that legalized recreational marijuana and in states with per-se laws. Demographic differences in our outcomes were consistent and cohesive. On the other hand, we found no predominant pattern suggesting that those in states with liberal marijuana policies were more tolerant of driving after marijuana use.

Suicide Attempts in Association With Traditional and Electronic Bullying Among Heterosexual and Sexual Minority U.S. High School Students.

PURPOSE: The aim of this study was to compare the association between bullying (traditional, electronic, and both) and suicide attempt in heterosexual and lesbian, gay, or bisexual (LGB) U.S. high school students. METHODS: Data were obtained from 2015-2017 National Youth Risk Behavior Survey. RESULTS: Nearly 25% of students reported experiencing bullying. Approximately 5.9% of heterosexual and 25.7% of LGB students attempted suicide. Heterosexual students who experienced either traditional or electronic bullying had a higher risk of attempting suicide (1.54 [95% confidence interval 1.19-1.98] and 1.64 [1.23-2.19], respectively). The associations were similar but weaker among LGB students (1.49 [1.08-2.04] and 1.43 [.90-2.27], respectively). Students who experienced both forms of bullying had the highest prevalence of suicide attempt, but the interaction was not statistically significant. CONCLUSIONS: LGB students had higher rates of both suicide attempts and experiencing bullying. Traditional and electronic bullying are not synergistic in the risk of attempting suicide, although each form increases that risk.

Self-reported driving after marijuana use in association with medical and recreational marijuana policies.

BACKGROUND: A common concern surrounding increasingly permissive marijuana policies in the US is that they will lead to more dangerous behavior, including driving after marijuana use. Although there is considerable research on the effects of marijuana policies on behaviours, few studies have examined self-reported driving after marijuana use. In this study, we use data from the Traffic Safety Culture Index (TSCI) to model self-reported past-year driving after marijuana use in association with medical and recreational marijuana policies. METHODS: We analysed individual responses to annual administrations of TSCI from years 2013-2017 using a multiple logistic regression model. Our outcome variable was self-reported past-year driving after marijuana use (at least once vs. never), and our primary explanatory variable was the respondents' state medical marijuana (MM) and recreational marijuana (RM) policy. Additional explanatory variables include policies that specify thresholds for marijuana-intoxicated driving, year, and demographic factors. RESULTS: Drivers in states that legalized MM but not RM had marginally higher odds of self-reporting driving after marijuana use compared to drivers in states where both RM and MM were illegal (adjusted OR 1.29; 95% CI 0.98, 1.70; p = 0.075). However, we found little evidence that drivers in states that legalized both RM and MM had higher odds of driving after marijuana use compared to drivers in states where both RM and MM were illegal (adjusted OR 1.06; 95% CI 0.71, 1.56; p = 0.784). Per-se or THC threshold laws were associated with lower self-reported driving after marijuana use (adjusted OR 0.74; 95% CI 0.57, 0.95; p = 0.018). CONCLUSION: Although we found some evidence of an association between MM legalization and self-reported driving after marijuana use, our results provide only mixed support for the hypothesis that permissive marijuana policies are associated with higher odds of self-reported driving after marijuana use.