Risk mitigation at train stations: underlying causes of slips, trips, and falls for passengers with reduced mobility.

Slips, trips, and falls (STFs) occur frequently at train stations and on trains, and result in passengers injuries. STFs underlying causes focussing on passengers with reduced mobility (PRM) were investigated. Mixed methods combining observation and retrospective interviews were used. Thirty-seven participants between 24 and 87 years of age completed the protocol. They navigated between three selected stations while wearing the Tobii eye tracker. In retrospective interviews, they were asked to explain their actions in selected video segments. The research identified the dominant risky locations and risk-taking behaviour in risky locations. For example: (i) risky locations were the vicinity of obstacles, (ii) risky behaviour was not looking at the gap between the platform and train. The dominant risky locations and behaviours could be considered as underlying causes of slips, trips, and falls for PRMs. They can be applied during planning and design of rail infrastructure to predict and mitigate STFs.Practitioner summary: A significant number of slips, trips, and falls (STFs) occurs at railway stations, and often result in personal injury. This research identified the dominant risky locations and behaviour as underlying causes of STFs for people with reduced mobility (PRMs). The recommendations presented could be implemented to mitigate such risk.

Safe trip: Factors contributing to slip, trip and fall risk at train stations.

Public transport systems are vital services in urban environments. The design of these complex socio-technical systems is continuously evolving to accommodate larger populations, and their adaptation is essential in supporting the successful and sustainable development of cities and regions. An essential part of this adaptation includes working to increase passenger safety and to minimise their risk of injury. With this focus, key objectives of the current study were to identify the causes of slip, trip and fall (STF) incidents attributable to the rail user and to train and station characteristics. An investigation of historical STF records of 1247 train and station incidents in two Australian jurisdictions was conducted. Various contributing factors to STF events were identified, including locations such as stairs, ramps, escalators, the train's entry and exit step, doorway areas, and passenger running or rushing. A mixed-method field study was then conducted at three train stations and on trains. To further investigate the contributing factors, participants (N = 40) wore an eye tracker as they navigated the stations and trains. The research illustrates that their continuous search for information, and a disconnect between the information needed and the information provided, might be a cause of passenger distraction and an increase in their risky behaviour. Therefore, we suggest that improvements in information design to reduce the high visual workload for passengers might also reduce the incidence of STFs.

Effectiveness of the black spot programs in Western Australia.

This study evaluates the effectiveness of the Black Spot Programs in Western Australia. Reduction in crash rate at the treated locations and the economic benefits of these treatments were assessed. The results showed that the programs have been effective overall, reducing all reported crash rate by 15%. The estimated crash cost savings were 50.8 million Australian dollars, of which 89% could be attributed to the reduction in casualty crashes. This led to net savings to the community of 40.4 million Australian dollars ($35.1 million attributable to casualty crashes) after subtracting the capital costs of treating sites, maintenance and operating costs. The benefit cost ratio across all treatment sites was 4.9. Evaluation of the treatments has identified some effective treatment types and others without any significant change in either the rate or cost of crashes. The latter could be due to insufficient number of sites that received the treatment, the post-treatment period being relatively short, or the treatments genuinely had little impact on road safety. Findings of this study provide objective information for the development of effective strategies on road safety investment.

Fragility and crash over-representation among older drivers in Western Australia.

This study assessed age-related and gender differences in the relative contribution of fragility and crash over-representation to serious injuries per crash-involved driver in Western Australia. Police-reported crashes for the period 1998-2003 were extracted from the Western Australian Road Injury Database. For each passenger vehicle driver age and gender group, serious injuries per crash-involved driver and driver involvements in crashes per 100 million vehicle-kilometre travelled (VKT) were calculated as the respective measure of fragility and crash over-representation. Results from the decomposition method of analysis showed that older drivers over the age of 70 sustained serious injury rates more than twice as high as those of the 30-59-year-old drivers. Fragility increased with age, contributing between 47% and 95% for drivers above 65 years, but crash over-representation was the dominant factor for male drivers above 80 years. In contrast, fragility contributed little to the excess injury risk of younger drivers under the age of 30. The importance of fragility as a contributing factor to the inflated serious injury risk per vehicle-kilometre travelled for older drivers suggested that road safety initiatives should be directed towards the protection of vehicle occupants as well as screening for their driving ability.

Estimating crashes involving heavy vehicles in Western Australia, 1999-2000: a capture-recapture method.

A two-sample exploratory study of police and hospital records was undertaken to estimate the number of fatalities and serious injuries for heavy vehicle drivers involved in a crash in Western Australia. The capture-recapture method was used to assess differences and similarities in characteristics of heavy vehicle drivers from both sources. Each heavy vehicle driver involved in a crash from the police report was matched against the heavy vehicle driver's hospitalisation record from the Hospital Morbidity Data System, with surname, initials, date of birth, gender, date of crash, road user type and vehicle type as matching fields. The estimated number of fatalities and serious injuries to heavy vehicle drivers from 1st July 1999 to 31st December 2000 was 5 and 59, respectively, which was 25 and 31% higher based on the capture-recapture methodology than the aggregated (non-overlapping) total officially reported to the police and hospitals. No significant age difference (p>0.05) was found for drivers involved in a heavy vehicle crash between the two sources (37 years versus 40 year of age). However, female heavy vehicle drivers were over-represented in the hospital records (11%) compared to the police records (1%). The capture-recapture approach is useful for evaluating the completeness of data sources and identifying biases within datasets. The underestimation of heavy vehicle drivers seriously injured and killed has important implications for heavy vehicle safety management and resource allocation in Western Australia.

Health conditions of heavy vehicle drivers involved in a crash in Western Australia: a retrospective study using linked data.

ISSUE ADDRESSED: This retrospective study investigated the health conditions of a cohort of heavy vehicle drivers involved in a crash in Western Australia. METHODS: Hospital separation records of heavy vehicle drivers admitted to hospital as a result of a road crash between 1 January 1988 and 31 December 2000 in Western Australia were analysed. Heavy vehicle drivers involved in a crash were first identified using the Western Australian Road Injury Database before linking to their hospital records. All hospital admissions for each driver admitted to hospital for a crash at least once during the study period were subsequently retrieved from the Health Services Linked Database. RESULTS: There were 146 heavy vehicle drivers in the cohort. A total of 964 distinct in-patient episodes (the collection of all hospital admissions for a single event) were recorded for these drivers, with a minimum of one and a maximum of 84 hospital in-patient episodes per driver. The mean number of in-patient episodes for each driver was seven (SD=8.44), including an in-patient episode for a heavy vehicle crash. CONCLUSION: The evidence presented for the cohort of heavy vehicle drivers hospitalised as a result of road crash confirms that these drivers are characterised with health conditions such as musculoskeletal problems and digestive disorders.

Health system costs of falls of older adults in Western Australia.

The aim of this study was to determine the health system costs associated with falls in older adults who had attended an emergency department (ED) in Western Australia. The data relating to the ED presentations and hospital admissions were obtained from population-based hospital administrative records for 2001-2002. The type of other health services (eg, outpatient, medical, community, ancillary and residential care), the quantity, and their cost were estimated from the literature. In adults aged 65 years and above, there were 18 706 ED presentations and 6222 hospital admissions for fall-related injuries. The estimated cost of falls to the health system was $86.4 million, with more than half of this attributable to hospital inpatient treatment. Assuming the current rate of falls remains constant for each age group and gender, the projected health system costs of falls in older adults will increase to $181 million in 2021 (expressed in 2001-02 Australian dollars). The economic burden to the health services imposed by falls in older adults is substantial, and a long-term strategic approach to falls prevention needs to be adopted. Policy in this area should be targeted at both reducing the current rate of falls through preventing injury in people from high-risk groups and reducing the future rate of falls through reducing population risk.

A cohort study of drink-driving motor vehicle crashes and alcohol-related diseases.

OBJECTIVES: To elicit whether drivers involved in alcohol-related motor vehicle crashes are more likely to have future alcohol-related hospital admissions. METHOD: A population-based cohort study of 3,286 drivers involved in a motor vehicle crash between 1988 and 1992 were followed over an eight to 13-year period. RESULTS: The findings from the study suggest a twofold increased risk associated with an alcohol-related motor vehicle crash and future alcohol-related hospital admission. The average time between an alcohol-related motor vehicle crash and future alcohol-related hospital admission was 12 years. Men and indigenous Australian drivers were more likely to have a future alcohol-related hospital admission. CONCLUSION: It is evident from this study that drink-driving resulting in a motor vehicle crash and hospitalisation could be considered an indicator of a less overt problem of alcohol dependency. IMPLICATIONS: It is important that penalties for drink-driving go beyond merely punitive action and provide rehabilitation.