Addressing the minimum fleet problem in on-demand urban mobility.

Information and communication technologies have opened the way to new solutions for urban mobility that provide better ways to match individuals with on-demand vehicles. However, a fundamental unsolved problem is how best to size and operate a fleet of vehicles, given a certain demand for personal mobility. Previous studies1-5 either do not provide a scalable solution or require changes in human attitudes towards mobility. Here we provide a network-based solution to the following 'minimum fleet problem', given a collection of trips (specified by origin, destination and start time), of how to determine the minimum number of vehicles needed to serve all the trips without incurring any delay to the passengers. By introducing the notion of a 'vehicle-sharing network', we present an optimal computationally efficient solution to the problem, as well as a nearly optimal solution amenable to real-time implementation. We test both solutions on a dataset of 150 million taxi trips taken in the city of New York over one year 6 . The real-time implementation of the method with near-optimal service levels allows a 30 per cent reduction in fleet size compared to current taxi operation. Although constraints on driver availability and the existence of abnormal trip demands may lead to a relatively larger optimal value for the fleet size than that predicted here, the fleet size remains robust for a wide range of variations in historical trip demand. These predicted reductions in fleet size follow directly from a reorganization of taxi dispatching that could be implemented with a simple urban app; they do not assume ride sharing7-9, nor require changes to regulations, business models, or human attitudes towards mobility to become effective. Our results could become even more relevant in the years ahead as fleets of networked, self-driving cars become commonplace10-14.

Overdosing in a Motor Vehicle: Examination of Human, Geographic, and Environmental Factors.

BACKGROUND: Fentanyl, a type of opioid, in impaired driving cases increased across cities in the United States. OBJECTIVES: No empirical studies have examined motor vehicle overdoses with fentanyl use. We investigated the magnitude of the motor vehicle overdose problem in Providence, RI, and the environmental, socioeconomic, and geographic conditions associated with motor vehicle overdose occurrence. METHODS: This was a retrospective observational study of emergency medical services data on all suspected opioid overdoses between January 1, 2017, and October 31, 2020. The data contain forced-choice fields, such as age and biological sex, and an open-ended narrative in which the paramedic documented clinical and situational information. The overdoses were geocoded, allowing for the extraction of sociodemographic data from the U.S. Census Bureau's American Community Survey. Seven other data sources were included in a logistic regression to understand key risk factors and spatial patterns of motor vehicle overdoses. RESULTS: Of the 1,357 opioid overdose cases in this analysis, 15.2% were defined as motor vehicle overdoses. In adjusted models, we found a 61% increase in the odds of a motor vehicle overdose involvement for men versus women, a 16.8% decrease in the odds of a motor vehicle overdose for a one-unit increase in distance to the nearest gas station, and a 10.7% decrease in the odds of a motor vehicle overdose for a one-unit increase in distance to a buprenorphine clinic. CONCLUSION: There is a need to understand the interaction between drug use in vehicles to design interventions for decreasing driving after illicit drug use.

Proposal for nationwide registration of injuries or fatalities in wheelchair user motor vehicle passengers in Japan.

One consequence of population aging is an increase in the number of older wheelchair users. They often board the motor vehicle from the rear for moving. Recently, wheelchair user vehicle passengers have involved in motor vehicle collisions and died. A three-point seatbelt does not adequately fit most wheelchair user passengers because of the way that the wheelchair is constructed. Therefore, owing to the movement of the body immediately after the collision, the wheelchair user passengers attacked their body to the interior of the vehicle or suffered from the intrusion of the lap belt into the abdomen, subsequently suffered from severe head, chest or abdominal injuries. According to the review of all fatal motor vehicle collisions in Shiga Prefecture, Japan, which has a population of approximately 1.4 million, from 2017 to 2022, the rate of wheelchair users in fatal motor vehicle passenger increased from 3.6% in 2017 to 2019 to 7.8% in 2020 to 2022. Therefore, there is a risk that substantial numbers of wheelchair user passengers involved in motor vehicle collisions will die. However, in Japan, there are no official statistics on the involvement of wheelchair user passengers in motor vehicle collisions. Therefore, we propose a nationwide registration of injuries and fatalities in wheelchair user passengers. Investigating the mechanisms of injury in wheelchair user passengers would contribute to the development of safety measures, especially for restraint systems. Established preventive measure would contribute to the decrease of fatally or severely injured motor vehicle collision passengers.

Examining the Trends in Motor Vehicle Traffic Deaths in New York City, 1999-2020.

Monitoring and understanding the trends in motor vehicle traffic (MVT) mortality is crucial for developing effective interventions and tracking progress in reducing deaths related to MVT. This study aimed to assess the trends in MVT mortality in New York City from 1999 through 2020. Publicly available de-identifiable mortality data were abstracted from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research. MVT deaths were identified using the International Classification of Diseases Codes, 10th Revision: V02-V04 (.1, .9), V09.2, V12-V14 (.3-.9), V19 (.4-.6), V20-V28 (.3-.9), V29-V79 (.4-.9), V80 (.3-.5), V81.1, V82.1, V83-V86 (.0-.3), V87 (.0-.8), and V89.2. Age adjusted mortality rates (AAMR) were abstracted by county (Bronx; Kings; Queens; New York), age (in years) (< 25; 25-44; 45-64; ≥ 65), sex (male; female), race/ethnicity (Non-Hispanic Black; Non-Hispanic White; Asian/Pacific Islander; Hispanic), and road user type (motor vehicle occupant; motorcyclist; pedal cyclist; pedestrian). Joinpoint regression models were fitted to estimate the annual percentage change (APC) and average annual percentage change (AAPC) in AAMR during the study period. The Parametric Method was used to compute 95% confidence intervals (CI). Between 1999 and 2020, a total of 8,011 MVT deaths were recorded in New York City. Mortality rates were highest among males (age adjusted mortality rate (AAMR) = 6.4 per 100,000; 95% CI: 6.2, 6.5), Non-Hispanic Blacks (AAMR = 4.8; 95% CI: 4.6, 5.0), older adults (AAMR = 8.9; 95% CI: 8.6, 9.3), and persons from Richmond County (AAMR = 5.2; 95% CI: 4.8, 5.7). MVT death rates, overall, have declined by 3% per year (95% CI: -3.6, -2.3) from 1999 to 2020. The rates have fallen or stabilized by race/ethnicity, county of residence, road user type, and age group. In contrast, rates have increased by 18.1% per year among females and by 17.4% per year in Kings County from 2017 to 2020.The results of this study draw attention to the worsening trends in MVT mortality among females and in Kings County, New York City. Further investigation is needed to determine the underlying behavioral, social, and environmental factors contributing to this increase, such as polysubstance or alcohol abuse, psychosocial stressors, access to medical and emergency care, and compliance with traffic laws. These findings emphasize the importance of developing targeted interventions to prevent MVT deaths and ensure the health and safety of the community.

Initial impact of COVID-19's stay-at-home order on motor vehicle traffic and crash patterns in Connecticut: an interrupted time series analysis.

INTRODUCTION: Understanding how the COVID-19 pandemic has impacted our health and safety is imperative. This study sought to examine the impact of COVID-19's stay-at-home order on daily vehicle miles travelled (VMT) and MVCs in Connecticut. METHODS: Using an interrupted time series design, we analysed daily VMT and MVCs stratified by crash severity and number of vehicles involved from 1 January to 30 April 2017, 2018, 2019 and 2020. MVC data were collected from the Connecticut Crash Data Repository; daily VMT estimates were obtained from StreetLight Insight's database. We used segmented Poisson regression models, controlling for daily temperature and daily precipitation. RESULTS: The mean daily VMT significantly decreased 43% in the post stay-at-home period in 2020. While the mean daily counts of crashes decreased in 2020 after the stay-at-home order was enacted, several types of crash rates increased after accounting for the VMT reductions. Single vehicle crash rates significantly increased 2.29 times, and specifically single vehicle fatal crash rates significantly increased 4.10 times when comparing the pre-stay-at-home and post-stay-at-home periods. DISCUSSION: Despite a decrease in the number of MVCs and VMT, the crash rate of single vehicles increased post stay-at-home order enactment in Connecticut after accounting for reductions in VMT.

COVID-19 lockdown and fatal motor vehicle collisions due to speed-related traffic violations in Japan: a time-series study.

Between March and May 2020, Japan experienced a lockdown due to the COVID-19 crisis. Empty roads possibly triggered speed-related traffic violations that caused fatal motor vehicle collisions (MVCs). Using police data on the monthly number of fatal MVCs between January 2010 and February 2020 in which motor vehicle drivers were at fault, we forecasted the numbers of fatal MVCs due to the speed-related violations during the lockdown and compared these with those observed. We also compared the observed to forecasted using the ratio of the number of speed-related fatal MVCs to that of non-speed related fatal MVCs. The observed numbers of speed-related fatal MVCs were within the 95% CIs of the forecasted numbers. The observed ratio was higher than the forecasted ratio in April (p=0.016). In the second month of the lockdown, drivers were more likely to commit speed-related violations that caused fatal MVCs than before the lockdown.

Forgotten children in parked vehicles: a review of Italian fatalities.

In recent years, Italy has reported the deaths of children who have died of hyperthermia after having been left inadvertently in a car seat. Although very rare, these preventable deaths have dramatic and long-lasting consequences for families, communities and public opinion. The aim of the paper is to review the available data on the deaths of children in vehicles by heatstroke in Italy and to discuss how to promote strategies aimed at avoiding these preventable fatalities. We carried out a search using the website research tool for the five most widely read Italian newspapers and an internet search on Google and Yahoo's Italian websites, to identify lethal cases of children left unintentionally in a parked motor vehicle. We identified eight deaths, occurring between 1998 and 2017 in Italy. All incidents occurred in the period between May and July when the mean daily external temperature was between 16 and 27.5 °C. Five girls and three boys between 11 and 24 months in age were involved, and in all cases the caregiver concerned was a parent. The Public Health community must vigorously promote research by auto manufacturers to develop technological solutions such as visual and audio warning systems aimed at reducing the possibility that a child be inadvertently left inside a parked vehicle.

Vehicle inspection policy and emission analysis in Kuwait.

Technical vehicle inspection centers are widespread in Kuwait. All vehicles should pass the test every 2 years if not older than 6 years or every 1 year for other vehicles. This study provided an insight into the data collected from test centers and the emission test utilized in Kuwait. Data were collected from test centers in the six Kuwaiti governorates. European standards were selected as limits for emission violations. Independent variables included the place of vehicle manufacture, vehicle's age, and odometer reading. A multinomial logit model was used to identify the significant predictors and determine the correlation between dependent and independent variables. Artificial neural network was employed to compare prediction estimates of neural network and multinomial logit. The findings showed that the place of vehicle's manufacture, vehicle's age, and odometer reading were significant regarding violating emission standards of carbon monoxide (CO). Asian vehicles, vehicles with more than 150,000 km mileage, and vehicles older than 15 years had a higher probability of failing the CO test compared to the place of manufacture. In contrast, the odometer reading was the only significant indicator for vehicles that have failed the hydrocarbons test, especially for vehicles with 150,000 km odometer reading. The findings of this study can reduce air-pollution, time, and money by targeting the most polluting vehicles; thus, more efficient test can be performed.

Genetic Programming Hyper-Heuristics with Vehicle Collaboration for Uncertain Capacitated Arc Routing Problems.

Due to its direct relevance to post-disaster operations, meter reading and civil refuse collection, the Uncertain Capacitated Arc Routing Problem (UCARP) is an important optimisation problem. Stochastic models are critical to study as they more accurately represent the real world than their deterministic counterparts. Although there have been extensive studies in solving routing problems under uncertainty, very few have considered UCARP, and none consider collaboration between vehicles to handle the negative effects of uncertainty. This article proposes a novel Solution Construction Procedure (SCP) that generates solutions to UCARP within a collaborative, multi-vehicle framework. It consists of two types of collaborative activities: one when a vehicle unexpectedly expends capacity (route failure), and the other during the refill process. Then, we propose a Genetic Programming Hyper-Heuristic (GPHH) algorithm to evolve the routing policy used within the collaborative framework. The experimental studies show that the new heuristic with vehicle collaboration and GP-evolved routing policy significantly outperforms the compared state-of-the-art algorithms on commonly studied test problems. This is shown to be especially true on instances with larger numbers of tasks and vehicles. This clearly shows the advantage of vehicle collaboration in handling the uncertain environment, and the effectiveness of the newly proposed algorithm.

Prevalence of use of safety devices on motorized vehicles in Italy. A multicentric road side observational study.

OBJECTIVES: to give an overview of the use of safety devices in motorized vehicles in Italy in the years 2015-2017. DESIGN: road side observational study. SETTING AND PARTICIPANTS: a sample of 232,283 road users in 28 cities across the Italian territory with a resident population of more than 10 million inhabitants (17% of the Italian population) was considered. MAIN OUTCOME MEASURES: the use of seat belts (front and rear), child restraints, and motorcycle helmets were monitored. For each city, the survey was carried out in urban, sub-urban, and extra-urban areas. Data were aggregated by three geographic areas: North, Centre, and South. Data for front seat belts was also provided for drivers and passengers separately. RESULTS: the use of front seat belts shows a dramatic geographical trend ranging from 82.6% (North) to 36.3% (South). Drivers use seat belts more frequently than passengers (63.3% vs 57.4%). The same North-South trend shows the use of rear seat belts (from 19.0% to 3.3%) and child restraints (from 59.9% to 16.6%). Helmet use was high everywhere in Italy (more than 94%). CONCLUSIONS: despite the use of safety devices, which has been mandatory for many years, compliance seems to depend on the voluntary behaviour of drivers and passengers influenced by socioeconomical and cultural patterns. The use of rear seat belts and child restraints is still far from an acceptable level, as well as the use of front seat belts in the South and in the Centre. The increased use of safety devices would have significant public health and traffic safety implications, as a potential of 327 deaths/year could be saved.

HIV Risk profile and its socio-demographic correlates among long-distance truckers in West Bengal, India: Evidence from national HIV sentinel surveillance 2017.

BACKGROUND: Long-distance truckers (LDTs) belong to a special sentinel group with potentially high risk of acquisition of HIV owing to their high mobility, sociodemographic vulnerability, and high-risk behaviors. OBJECTIVE: The objective is to estimate the prevalence of HIV and identifies its sociodemographic correlates among a representative population of LDTs in West Bengal, India. METHODS: Between May and July 2017, HIV Sentinel Surveillance (HSS) was conducted in West Bengal by the National AIDS Control Organization. A total of 749 LDTs were recruited for the study, were interviewed, and tested for HIV. Descriptive and logistic regression analysis of socio-demographics, sexual risk behavior, and HIV serostatus were performed using SAS 9.3.2. RESULTS: The prevalence of HIV among LDT was 1.2% (95% confidence interval [CI] = 0.4-2.0). Mean age was 32.8 years (standard deviation 8.5), 77.1% were currently married, 89.9% were literate, 85.7% visited HSS site for collecting condoms or seeking medical care and treatment, 53.1% were rural residents, 86.7% had sex at least once with a female partner other than wife in the past 6 months, 2.7% had sex with a male partner and 1.7% injected drugs for recreational purpose. Higher age (odds ratio [OR] = 1.1 [95% CI = 1.0-1.1]), literate (OR = 0.3 [95% CI = 0.1-0.9]), visiting HSS sites for collecting condoms or seeking medical care and treatment (adjusted OR [AOR] = 0.2 [95% CI = 0.1-0.6]), rural residence (OR = 0.2 [95% CI = 0.1-0.3]) and duration of stay in home (AOR = 1.3 [95% CI = 1.1-1.5]) were found to be significant predictors of having sex with a female partner other than wife. CONCLUSION: High HIV burden calls for urgency in the implementation of targeted intervention to minimize HIV risk among LDTs in West Bengal to fight against HIV/AIDS.

Overloading among crash-involved vehicles in China: identification of factors associated with overloading and crash severity.

OBJECTIVE: Motor vehicle overloading is correlated with the possibility of road crash occurrence and severity. Although overloading of motor vehicles is pervasive in developing nations, few empirical analyses have been performed on factors that might influence the occurrence of overloading. This study aims to address this shortcoming by seeking evidence from several years of crash data from Guangdong province, China. METHODS: Data on overloading and other factors are extracted for crash-involved vehicles from traffic crash records for 2006-2010 provided by the Traffic Management Bureau in Guangdong province. Logistic regression is applied to identify risk factors for overloading in crash-involved vehicles and within these crashes to identify factors contributing to greater crash severity. Driver, vehicle, road and environmental characteristics and violation types are considered in the regression models. In addition to the basic logistic models, association analysis is employed to identify the potential interactions among different risk factors during fitting the logistic models of overloading and severity. RESULTS: Crash-involved vehicles driven by males from rural households and in an unsafe condition are more likely to be overloaded and to be involved in higher severity overloaded vehicle crashes. If overloaded vehicles speed, the risk of severe traffic crash casualties increases. Young drivers (aged under 25 years) in mountainous areas are more likely to be involved in higher severity overloaded vehicle crashes. CONCLUSIONS: This study identifies several factors associated with overloading in crash-involved vehicles and with higher severity overloading crashes and provides an important reference for future research on those specific risk factors.

Overweight and Obesity Among School Bus Drivers in Rural Arkansas.

INTRODUCTION: Obesity is a major public health concern. Compared with other occupational groups, transportation workers, such as school bus drivers, have higher rates of obesity. However, little is known about the body weight and related health behaviors of these drivers, and opportunities for intervention are undetermined. METHODS: We collected multilevel data from school bus drivers working from 4 school bus garages in Little Rock, Arkansas, and their work environment from January through July of 2017. Data on weight, height, sociodemographic characteristics, work factors, weight-related behaviors, and psychosocial variables were collected from 45 drivers. Analyses explored associations between body mass index (BMI; weight in kg/ height in m2) and sociodemographic characteristics, work factors, weight-related behaviors, and psychosocial variables. Two focus groups with a total of 20 drivers explored drivers' perspectives about healthy weight. Observational data at the bus and garage levels were collected through 2 "ride-alongs" and an environmental scan. RESULTS: Drivers in our sample were predominately overweight or obese (91.1%), and most did not meet dietary or physical activity guidelines. Drivers who were currently dieting had higher BMIs (36.4; standard deviation [SD], 8.2) than drivers who were not dieting (28.5; SD, 7.7); drivers who reported eating less to lose weight had higher BMIs (38.1; SD, 8.5) than those who did not report eating less (29.5; SD, 6.0). Drivers who did not meet physical activity recommendations had higher BMIs (36.5; SD, 9.8) than those who met recommendations (30.9; SD, 4.8). Structural barriers and work stress were significant barriers to achieving a healthy weight. Resources for healthful eating and physical activity were limited in the garage. CONCLUSION: Our study provides preliminary data on the prevalence, risk factors, and perceptions of overweight and obesity among school bus drivers. Study data on drivers' body weight, health-related behaviors, and psychosocial characteristics could serve as a basis for worksite interventions to improve drivers' health.

Road traffic safety: An analysis of the cross-effects of economic, road and population factors.

PURPOSE: Through the study of economic, traffic and population data related to road traffic accidents from 2004 to 2016, this paper analyzed the impact of various factors on road traffic casualties in China, and provided theoretical basis and suggestions for the road traffic safety management in China. METHODS: Based on three aspects (economy, road, population) with five factors (gross domestic product (GDP), traffic investment, new vehicle ownership, new road mileage and newly increased population), this paper collected the relevant data of road traffic accidents in 31 provinces and cities in China, from 2004 to 2016. A panel model was established to carry out empirical analysis. RESULTS: All factors have a significant impact on the number of road traffic accident casualties. When other factors remain unchanged, the number of road traffic casualties decreased by an average of 0.19 for every 100 million CNY increased in GDP. For every 100 million CNY increased in traffic investment, the number of road traffic casualties is reduced by an average of 13.93, indicating that economic development can improve road traffic safety to a certain extent. On the contrary, the growth in road mileage, new motor vehicles and population has increased the number of road traffic casualties. For every 10, 000 km of new road mileage, the number of traffic accident casualties has increased by 284.04. For every 10,000 newborns, the number of road traffic casualties increased by 7.33; as the number of new motor vehicles increases by 10,000, the number of road traffic casualties increased by an average of 21.77. CONCLUSION: The increase of GDP and traffic investment can significantly reduce the number of road traffic casualties in China, which shows that economic development is essential to improve road traffic safety. The numbers of new road mileage, newly increased population and the new motor vehicles are positively correlated with the number of traffic accident casualties in traffic accidents, which reflects the existing problems in road design, distribution of road resources, and traffic management in China. Therefore, it is necessary to improve the economic and road related aspects to improve road traffic safety.

Left-turning vehicle-pedestrian conflicts at signalized intersections with traffic lights: Benefit or harm? A two-stage study.

PURPOSE: Vehicle-pedestrian conflicts are common at road intersections when traffic lights change. However, the impact of traffic light on transportation safety and efficiency remains poorly understood. METHODS: A two-stage study was used to survey the proportion of intersections with conflicting traffic lights and the related transportation efficiency and safety were evaluated as well. First, a cross-sectional study estimated the proportion of signalized intersections with conflicting left-turning vehicle-pedestrian traffic lights in Changsha city, China. Second, a natural experiment compared transportation efficiency and safety between intersections with and without conflicting left-turning vehicle-pedestrian traffic lights. Risky conflicts, where motor vehicles violated laws and failed to yield to pedestrians in crosswalk were used as a surrogate for transportation safety. The number of motor vehicles and pedestrians passing through the intersections per second and per meter were used to estimate transportation efficiency. Data were collected and analyzed in 2015 (from March to December). A search of online news from domestic media sources was also conducted to collect pedestrian injury data occurring at the intersections. RESULTS: About one-fourth (57/216) intersections had conflicting left-turning traffic lights (95% CI: 20.5%, 32.3%). Risky vehicle-pedestrian conflicts were more frequently observed at intersections with conflicting lights compared to those without (incidence rate ratio (IRR) = 3.13; pedestrians: IRR = 4.02), after adjusting for type of day (weekday vs. weekend), the time period of observation, and motor vehicles traffic flow. Intersections without conflicting vehicle-pedestrian traffic lights had similar transportation efficiency to those with conflicting lights after controlling for covariates (p > 0.05). The systematic review of news media reports yielded 10 left-turning vehicle-pedestrian crash events between 2011 and 2017, involving 11 moderate or severe pedestrian injuries and 3 fatal pedestrian injuries. CONCLUSION: Over one-fourth of road intersections in Changsha city, China have conflicting left-turning traffic lights. Conflicting traffic lights cannot improve transportation efficiency, but increase risky conflicts between vehicles and pedestrians.

Road-induced fragmentation and the environmental value of roadless areas in a partly protected landscape in Central Iran.

This study assessed the effect of road development on vegetation fragmentation in and around a protected area network in western Isfahan Province, Central Iran. As the first study in Iran, an attempt was also made using the weighted linear combination-informed ecological value index of roadless area (EVIRA), to evaluate the environmental value of roadless areas based on a set of ecological and anthropogenic factors. Toward these aims, a Landsat 8-OLI image was processed to delineate land use/cover of the region. Road-induced fragmentation was then estimated by comparing the results of a small set of landscape metrics (DIVISION, SPLIT, MESH, LPI, and NP) measured from the original and road-included LULC map. The results showed road-induced increasing DIVISION (by 4.8-85.9%) and SPLIT (by 0.01-23.1%) and decreasing MESH (by 2.7-14%), LPI (by 1.3-32.4%), and NP (by 6-97.8%) values within all protected areas and across the entire study area, indicating a significant rise in landscape fragmentation and habitat loss. Roadless patch area and Thiessen connectivity stood out as the most salient criteria in determining environmentally valuable roadless areas. The results of EVIRA showed that the study region comprises some valuable but unprotected roadless areas which should be protected against road development or any kind of destructive human activities by laying out conservation plans or their inclusion to the current protected area network.

Traveling by Bus Instead of Car on Urban Major Roads: Safety Benefits for Vehicle Occupants, Pedestrians, and Cyclists.

Some studies have estimated fatality and injury rates for bus occupants, but data was aggregated at the country level and made no distinction between bus types. Also, injured pedestrians and cyclists, as a result of bus travel, were overlooked. We compared injury rates for car and city bus occupants on specific urban major roads, as well as the cyclist and pedestrian injuries associated with car and bus travel. We selected ten bus routes along major urban arterials (in Montreal, Canada). Passenger-kilometers traveled were estimated from vehicle counts at intersections (2002-2010) and from bus passenger counts (2008). Police accident reports (2001-2010) provided injury data for all modes. Injury rates associated with car and bus travel were calculated for vehicle occupants, pedestrians, and cyclists. Injury rate ratios were also computed. The safety benefits of bus travel, defined as the number of vehicle occupant, cyclist, and pedestrian injuries saved, were estimated for each route. Overall, for all ten routes, the ratio between car and bus occupant injury rates is 3.7 (95% CI [3.4, 4.0]). The rates of pedestrian and cyclist injuries per hundred million passenger-kilometers are also significantly greater for car travel than that for bus travel: 4.1 (95% CI [3.5, 4.9]) times greater for pedestrian injuries; 5.3 (95% CI [3.8, 7.6]) times greater for cyclist injuries. Similar results were observed for fatally and severely injured vehicle occupants, cyclists, and pedestrians. At the route level, the safety benefits of bus travel increase with the difference in injury rate associated with car and bus travel but also with the amount of passenger-kilometers by bus. Results show that city bus is a safer mode than car, for vehicle occupants but also for cyclists and pedestrians traveling along these bus routes. The safety benefits of bus travel greatly vary across urban routes; this spatial variation is most likely linked to environmental factors. Understanding the safety benefits of public transit for specific transport routes is likely to provide valuable information for mobilizing city and transportation planners.

Effectiveness of child restraints and booster legislation in Israel.

INTRODUCTION: 96 countries in the world have enacted child restraints and booster legislation (CRBL). Yet, findings regarding the effectiveness of CRBLs are mixed. The current study is the first to examine the association between Israel's CRBL, implemented in November 2004, and the traffic injury and fatality rates among children aged 0-9 years. We extend on previous studies by accounting for risk exposure and by comparing populations of children affected by the legislation to those who were not. METHODS: We used an interrupted time series design of kilometre driven-based traffic injury rates for children aged 0-4 years and children aged 5-9 years using childred aged 10-14 years as a comparison group. We estimated the effects of Israel's CRBL using monthly injury and fatality count data from the Israeli Central Bureau of Statistics. The sample includes all child vehicle occupants injured and killed in crashes in Israel between January 2003 and December 2011. RESULTS: Children aged 0-4 years experienced a 5.17% yearly reduction in traffic injury rate (incidence rate ratio (IRR): 0.94(95% CI 0.92 to 0.96); p=0.000), and the injury rate for children aged 5-9 years was associated with a 4.10% yearly reduction (IRR: 0.95(95% CI 0.93 to 0.98); p=0.001). The comprehensive CRBL implemented in Israel was associated with a 6.3% (95% CI -7.2% to5.5%; p=0.001) reduction in traffic injuries and fatalities for children aged 0-9 years. CONCLUSION: This is the first study comparing traffic injury rates per kilometre driven for motor vehicle-occupant children before and after the implementation of the CRBL in Israel.

Impact of passenger engagement through road safety bus stickers in public service vehicles on road traffic crashes in Zambia: a randomized controlled trial.

BACKGROUND: Road Traffic Crashes (RTCs) are the third highest cause of death in Zambia, claiming about 2000 lives annually, with pedestrians and cyclists being the most vulnerable. Human error accounts for 87.3% of RTCs. Minibus and big bus public service vehicles (PSVs) are among the common vehicle types involved in these crashes. Given the alarmingly high rate of road traffic crashes involving PSV minibuses and big buses within Zambia, there is a need to mitigate this through innovative solutions. In other settings, it has been shown that stickers in PSVs encouraging passengers to speak out against reckless driving can reduce RTCs, but it is unclear whether such an intervention could work in Zambia. Based on this evidence, the Zambia Road Transport and Safety Agency (RTSA) has developed a road safety bus sticker campaign for PSVs and before national scale-up, RTSA is interested in evidence of the impact of these stickers. METHODS: This evaluation will be a stratified two-arm randomized controlled trial with a one-to-one ratio. The sample will be stratified by vehicle type, thus creating a two-arm trial for minibuses and a separate two-arm trial for big buses. The sample will include 2110 minibuses and 300 big buses from four towns in Zambia. The primary outcome of interest will be the difference in the rate of RTCs over a 14-month period (7-months before the intervention and 7 months after) between buses with and without the new RTSA road safety bus stickers. DISCUSSION: This study will provide evidence on the impact of the Zambian sticker program on road traffic crashes as implemented through minibuses and big buses, that can help inform the scale up of a national 'Zambia road safety bus sticker campaign'. TRIAL REGISTRATION: PACT-R, PACTR201711002758216 . Registered 13 November 2017-Retrospectively registered.

Ecological study of road traffic injuries in the eastern Mediterranean region: country economic level, road user category and gender perspectives.

BACKGROUND: The Eastern Mediterranean region has the second highest number of road traffic injury mortality rates after the African region based on 2013 data, with road traffic injuries accounting for 27% of the total injury mortality in the region. Globally the number of road traffic deaths has plateaued despite an increase in motorization, but it is uncertain whether this applies to the Region. This study investigated the regional trends in both road traffic injury mortality and morbidity and examined country-based differences considering on income level, categories of road users, and gender distribution. METHODS: Register-based ecological study linking data from Global Burden of Disease Study with the United Nations Statistics Division for population and World Bank definition for country income level. Road traffic injury mortality rates and disability-adjusted life years were compiled for all ages at country level in 1995, 2005, 2015 and combined for a regional average (n = 22) and a global average (n = 122). The data were stratified by country economic level, road user category and gender. RESULTS: Road traffic injury mortality rates in the Region were higher than the global average for all three reference years but suggest a downward trend. In 2015 mortality rates were more than twice as high in low and high income countries compared to global income averages and motor vehicle occupants had a 3-fold greater mortality than the global average. Severe injuries decreased by more than half for high/middle income countries but remained high for low income countries; three times higher for males than females. CONCLUSION: Despite a potential downward trend, inequalities in road traffic injury mortality and morbidity burden remain high in the Eastern Mediterranean region. Action needs to be intensified and targeted to implement and enforce safety measures that prevent and mitigate severe motor vehicle crashes in high income countries especially and invest in efforts to promote public, active transport for vulnerable road users in the resource poor countries of the Region.