Pedestrian safety on the road to net zero: cross-sectional study of collisions with electric and hybrid-electric cars in Great Britain.

BACKGROUND: Plans to phase out fossil fuel-powered internal combustion engine (ICE) vehicles and to replace these with electric and hybrid-electric (E-HE) vehicles represent a historic step to reduce air pollution and address the climate emergency. However, there are concerns that E-HE cars are more hazardous to pedestrians, due to being quieter. We investigated and compared injury risks to pedestrians from E-HE and ICE cars in urban and rural environments. METHODS: We conducted a cross-sectional study of pedestrians injured by cars or taxis in Great Britain. We estimated casualty rates per 100 million miles of travel by E-HE and ICE vehicles. Numerators (pedestrians) were extracted from STATS19 datasets. Denominators (car travel) were estimated by multiplying average annual mileage (using National Travel Survey datasets) by numbers of vehicles. We used Poisson regression to investigate modifying effects of environments where collisions occurred. RESULTS: During 2013-2017, casualty rates per 100 million miles were 5.16 (95% CI 4.92 to 5.42) for E-HE vehicles and 2.40 (95%CI 2.38 to 2.41) for ICE vehicles, indicating that collisions were twice as likely (RR 2.15; 95% CI 2.05 to 2.26) with E-HE vehicles. Poisson regression found no evidence that E-HE vehicles were more dangerous in rural environments (RR 0.91; 95% CI 0.74 to 1.11); but strong evidence that E-HE vehicles were three times more dangerous than ICE vehicles in urban environments (RR 2.97; 95% CI 2.41 to 3.7). Sensitivity analyses of missing data support main findings. CONCLUSION: E-HE cars pose greater risk to pedestrians than ICE cars in urban environments. This risk must be mitigated as governments phase out petrol and diesel cars.

Use of face masks and other personal preventive measures by Hajj pilgrims and their impact on health problems during the Hajj.

BACKGROUND: The Hajj is one of the world's largest pilgrimage and gathers millions of Muslims from different nationalities every year. Communicable diseases have been reported frequently, during and following the Hajj, and these have been linked to individual behavioural measures. This study aimed to measure the effect of personal preventive measures, such as face mask use, hand hygiene and others, adopted by pilgrims in reducing the acquisition of infectious diseases. METHODS: We conducted a cross-sectional study at the Hajj terminal in King Abdulaziz International Airport in Jeddah, Saudi Arabia. Pilgrims were approached in the airport lounges after the 2017 Hajj season and prior to the departure of their flights from Jeddah to their home countries. An electronic data collection tool ('Open Data Kit') was used to gather survey data in regards to health problems and preventive measures during the Hajj. RESULTS: A total of 2973 Hajj pilgrims were surveyed. In all, 38.7% reported symptoms of upper respiratory tract infections (URTIs) and 5.4% reported symptoms of travel diarrhoea. Compliance with face mask use was 50.2%. Changing a face mask every 4 h was found to be significantly associated with lower prevalence of URTIs [adjusted odds ratio 0.56 (95% confidence interval 0.34-0.92), P = 0.02]. There was no statistical difference between overall face mask use and URTI acquisition. The main sources of food, eating raw vegetables/food, frequency of hand washing or use of hand sanitizers were not found to be significantly associated with reported travellers' diarrhoea. Unlicensed barbers were used by 12% of pilgrims and 9.2% of pilgrims reported using blades that were reused by other pilgrims. CONCLUSION: Preventive measures are the most effective way to prevent infections. Pilgrims can benefit from face masks by changing them frequently. There is still limited information on the effect of the use of face mask in decreasing the risk of URTI in mass gatherings.

Factorial trial found mixed evidence of effects of pre-notification and pleading on response to Web-based survey.

OBJECTIVES: To evaluate the effectiveness of pre-notification and pleading invitations in Web surveys by embedding a randomized controlled trial (RCT) in a Web-based survey. STUDY DESIGN AND SETTING: E-mail addresses of 569 authors of published maternal health research were randomized in a 2×2 factorial trial of a pre-notification vs. no pre-notification e-mail and a pleading vs. a non-pleading invitation e-mail. The primary outcome was completed response rate, and the secondary outcome was submitted response rate (which included complete and partial responses). RESULTS: Pleading invitations resulted in 5.0% more completed questionnaires, although this difference did not reach statistical significance [odds ratio (OR) 1.23; 95% confidence interval (CI): 0.86, 1.74; P=0.25]. Pre-notification did not increase the completion rate (OR 1.04; 95% CI 0.73, 1.48; P=0.83). Response was higher among authors who had published in 2006 or later (OR 2.07; 95% CI: 1.43, 2.98; P=0.001). There was some evidence that pre-notification was more effective in increasing submissions from authors with recent publications (P=0.04). CONCLUSION: The use of a "pleading" tone to e-mail invitations may increase response to a Web-based survey. Authors of recently published research are more likely to respond to a Web-based survey.

Deaths of cyclists in London: trends from 1992 to 2006.

BACKGROUND: Cycling is an increasingly important mode of transport for environmental and health reasons. Cycling fatalities in London were previously investigated in 1994 using routinely collected data. Since then, there have been shifts in the modes of transport used, and in transport policies. We sought to replicate the previous work using data on cyclist deaths in London between 1992 and 2006, specifically investigating whether heavy goods vehicles continued to pose a threat. METHODS: Observational study based on analysis of time series of police road casualties data, 1992 to 2006, in London, UK. The main outcome measures were cyclists killed in road traffic collisions. Poisson regression and chi-squared test for homogeneity were used to assess time effects. Travel flow data was then used to estimate annual fatality rates per 100,000 cyclists per kilometre. RESULTS: From 1992 to 2006 there was a mean of 16 cycling fatalities per year (range 8-21). 146 deaths (60%) were in inner London and 96 in outer London. There was no evidence for a decline over time (p = 0.7) other than a pronounced dip in 2004 when there were 8 fatalities. Freight vehicles were involved in 103 of 242 (43%) of all incidents and the vehicle was making a left turn in over half of these (53%). The fatality rate ranged from 20.5 deaths in 1992 to 11.1 deaths in 2006 per 100,000 estimated cyclists per kilometre (rate ratio 0.54, 95% confidence interval 0.28 to 1.03). CONCLUSIONS: There is little evidence fatality rates have fallen. Freight vehicles over 3.5 tonnes continue to present a disproportionate threat; they should be removed from urban roads and more appropriate means of delivery of essential goods found.