Effects of mobile Internet use on college student pedestrian injury risk

Background

College-age individuals have the highest incidence of pedestrian injuries of any age cohort. One factor that might contribute to elevated pedestrian injuries among this age group is injuries incurred while crossing streets distracted by mobile devices.

Objectives

Examine whether young adult pedestrian safety is compromised while crossing a virtual pedestrian street while distracted using the Internet on a mobile “smartphone.”

Method

A within-subjects design was implemented with 92 young adults. Participants crossed a virtual pedestrian street 20 times, half the time while undistracted and half while completing an email-driven “scavenger hunt” to answer mundane questions using mobile Internet on their cell phones. Six measures of pedestrian behavior were assessed during crossings. Participants also reported typical patterns of street crossing and mobile Internet use.

Results

Participants reported using mobile Internet with great frequency in daily life, including while walking across streets. In the virtual street environment, pedestrian behavior was greatly altered and generally more risky when participants were distracted by Internet use. While distracted, participants waited longer to cross the street (F = 42.37), missed more safe opportunities to cross (F = 42.63), took longer to initiate crossing when a safe gap was available (F = 53.03), looked left and right less often (F = 124.68), spent more time looking away from the road (F = 1959.78), and were more likely to be hit or almost hit by an oncoming vehicle (F = 29.54; all ps < 0.01). Results were retained after controlling for randomized order; participant gender, age, and ethnicity; and both pedestrian habits and mobile Internet experience.

Conclusion

Pedestrian behavior was influenced, and generally considerably riskier, when participants were simultaneously using mobile Internet and crossing the street than when crossing the street with no distraction. This finding reinforces the need for increased awareness concerning the risks of distracted pedestrian behavior.     

Relations between temperamental fear and risky pedestrian behavior

Objective

Child pedestrian injury poses a significant global public health challenge. This study examines relations between temperamental fear and children’s risky pedestrian behavior, utilizing mediation analytic strategies to study underlying mechanisms of the hypothesized relation.

Methods

As part of a larger study, 240 seven- and eight-year-old children completed 30 crossings in a virtual reality (VR) pedestrian environment. Three pedestrian behaviors were considered: start gap (lag after a traffic gap appears before child initiates crossing into the gap), time to contact (TTC; gap between avatar and the lead oncoming vehicle), and hits (collisions with vehicles in simulated crossings). Temperamental fear was measured by parent report.

Results

Fearful children were more likely to be struck by virtual vehicles, and the relation between fear and risky pedestrian behaviors was mediated by start gap and TTC. Specifically, children who were temperamentally more fearful were more likely to hesitate before initiating crossing, which led to shorter gaps between themselves and the oncoming vehicle, hence causing them to be more likely to be hit by virtual vehicles. Gender interacted with fear, such that fearful girls were most likely to be hit.

Conclusions

Both temperamental fear and gender influenced the risk of child pedestrian injuries. Delayed entry into traffic and shorter gaps between children and oncoming vehicles may underlie this relation. Future research should explore how these factors might influence the effectiveness of prevention programs.     

Hazard perception test for pedestrians

Research Goal

This research was aimed to construct and develop a unique system for training of pedestrians – children, adults and older persons – to cross streets safely and especially to detect successfully on-road hazards as pedestrians. For this purpose, an interactive computerized program has been inspired by the format of the popular HPT (hazard perception test) for drivers.

Methods

The HPTP (hazard perception test for pedestrians) includes 10 pairs of video clips that were filmed in various locations but had a similar hazardous element. The clips presented potentially dangerous crossing scenarios such as a vehicle merging from the right side of the road from the perspective of the pedestrian who is trying to cross the street. The participants were asked to press the spacebar key every time they identified an approaching hazard. The participants were instructed to use the arrow keys for moving the viewing panel to the left or to the right in order to enlarge the field of view accordingly. Totally, 359 participants took part. Adults, children, and elders were assigned to two practice groups and three control groups in a 3 (age groups) × 5 (experimental groups) design. One practice group underwent pretest, practice, discussion and posttest, the second experimental group through pretest, practice and posttest, one control group that underwent posttest only, the second control group underwent pretest, discussion and posttest and the third control group underwent both pretest and posttest.

Findings

The most important finding was that children and adults who underwent practice received higher scores in the posttest compared to the pretest. Also, children who underwent practice increased their use of the arrow keys in the posttest compared to the pretest. Across conditions men scored higher than women on the HPTP, and used the keys more often. Age differences were found, with adults scoring being the highest, followed by children and the older persons.     

Discrepancies between knowledge and practice of childhood motor vehicle occupant safety in Nova Scotia—A population-based study

Objectives

To determine discrepancies between knowledge and practice of childhood motor vehicle restraints (CMVRs) and vehicle seating position amongst parents within the province of Nova Scotia.

Design

Random telephone survey.

Setting

The Canadian province of Nova Scotia.

Subjects

Four hundred and twenty-six households with at least one child under the age of 12 years, totaling 723 children.

Main outcome measures

The proportion of parents whose children who should be in a specific stage of CMVR and sitting in the rear seat of the vehicle, and who demonstrate correct knowledge of that restraint system and seating position, yet do not use that restraint system/seating position for their child (demonstrate practice discrepant from their knowledge).

Results

Awareness of what restraint system to use is good (>80%). However, knowledge of when it is safe to graduate to the next stage is low (30–55%), most marked for when to use a seatbelt alone. Awareness of the importance of sitting in the rear seat of a vehicle was universal. Discrepancies between knowledge and practice were most marked with booster seats and rear-seating of older children. Factors influencing incorrect practice (prematurely graduated to a higher-level restraint system than what is appropriate for age and weight) included lower household income, caregiver education level, and knowledge of when to graduate from forward-facing car seats and booster seats. Incorrect practice was also more commonly observed amongst children of weight and/or age approaching (but not yet reaching) recommended graduation parameters of the appropriate CMVR.

Conclusions

Discrepancies between knowledge and practice are evident through all stages of CMVRs, but most marked with booster seats. The roles of lower socioeconomic status and gaps in CMVR legislation, in influencing discrepant practice, must be acknowledged and suggest the need for targeted education concurrent with development of comprehensive all-stages CMVR policies.     

Inexperience and risky decisions of young adolescents,as pedestrians and cyclists,in interactions with lorries,and the effects of competency versus awareness education

Background

Road injuries are a prime cause of death in early adolescence. Often road safety education (RSE) is used to target risky road behaviour in this age group. These RSE programmes are frequently based on the assumption that deliberate risk taking rather than lack of competency underlies risk behaviour. This study tested the competency of 10–13 year olds, by examining their decisions – as pedestrians and cyclists – in dealing with blind spot areas around lorries. Also, the effects of an awareness programme and a competency programme on these decisions were evaluated.

Method

Table-top models were used, representing seven scenarios that differed in complexity: one basic scenario to test the identification of blind spot areas, and 6 traffic scenarios to test behaviour in traffic situations of low or high task complexity. Using a quasi-experimental design (pre-test and post-test reference group design without randomization), the programme effects were assessed by requiring participants (n = 62) to show, for each table-top traffic scenario, how they would act if they were in that traffic situation.

Results

On the basic scenario, at pre-test 42% of the youngsters identified all blind spots correctly, but only 27% showed safe behaviour in simple scenarios and 5% in complex scenarios. The competency programme yielded improved performance on the basic scenario but not on the traffic scenarios, whereas the awareness programme did not result in any improvements. The correlation between improvements on the basic scenarios and the traffic scenarios was not significant.

Conclusions

Young adolescents have not yet mastered the necessary skills for safe performance in simple and complex traffic situations, thus underlining the need for effective prevention programmes. RSE may improve the understanding of blind spot areas but this does not ‘automatically’ transfer to performance in traffic situations. Implications for the design of RSE are discussed.     

Pedestrian crossing situations: Quantification of comfort boundaries to guide intervention timing

Introduction

Technical systems that warn or brake for vehicle–pedestrian encounters reduce injuries more effectively the earlier an intervention is initiated. However, premature intervention can irritate drivers, leading to system deactivation and, consequently, no injury reduction whatsoever. It has been proposed that no intervention should be initiated as long as attentive drivers are within their comfort zones. This study aims at quantifying driver comfort boundaries for pedestrian crossing situations to offer guidance for the appropriate timing of interventions.

Methods

Sixty two volunteers drove through an intersection on a test track at 30 and 50 km/h. A pedestrian dummy was launched from behind an obstruction towards the driving path of the approaching car. Brake onset indicated discomfort. Time to collision (TTC), longitudinal and lateral distance were measured at brake onset.

Results

TTC was independent of driving speed ranging from 2.1 to 4.3 s with a median of 3.2 s. Longitudinal distance ranged from 19 to 48 meters with an apparent difference between driving speeds. Lateral distances differed slightly, but significantly between driving speeds. The median was 3.1 m (3.2 m for 30 km/h and 2.9 m for 50 km/h) and values ranged from 1.9 to 4.1 m. Lateral distance in seconds ranged from 1.9 to 4.3 s with a median value of 3.1 s (3.2 s for 30 km/h and 3.0 s for 50 km/h).

Discussion

TTC was independent of driving speed, trial order and volunteer age. It might be considered suitable to intervene in situations where, for example, 90% of drivers have exceeded their comfort boundary, i.e. when drivers have already initiated braking. This percentile value translates to intervention at a TTC of 2.5 s (95% confidence 2.4–2.7 s). The study was limited to Swedish nationals, fully aware drivers, and two driving speeds, but did not investigate behavioural changes due to system interaction.

Conclusion

This study showed that TTC at brake onset was a suitable measure for the quantification of driver comfort boundaries in pedestrian crossing situations. All drivers applied their brakes prior to 2.1 s TTC.     

Can we improve clinical prediction of at-risk older drivers?

Objectives

To conduct a pilot study to evaluate the predictive value of the Montreal Cognitive Assessment test (MoCA) and a brief test of multiple object tracking (MOT) relative to other tests of cognition and attention in identifying at-risk older drivers, and to determine which combination of tests provided the best overall prediction.

Methods

Forty-seven currently licensed drivers (58–95 years), primarily from a clinical driving evaluation program, participated. Their performance was measured on: (1) a screening test battery, comprising MoCA, MOT, Mini-Mental State Examination (MMSE), Trail-Making Test, visual acuity, contrast sensitivity, and Useful Field of View (UFOV) and (2) a standardized road test.

Results

Eighteen participants were rated at-risk on the road test. UFOV subtest 2 was the best single predictor with an area under the curve (AUC) of .84. Neither MoCA nor MOT was a better predictor of the at-risk outcome than either MMSE or UFOV, respectively. The best four-test combination (MMSE, UFOV subtest 2, visual acuity and contrast sensitivity) was able to identify at-risk drivers with 95% specificity and 80% sensitivity (.91 AUC).

Conclusions

Although the best four-test combination was much better than a single test in identifying at-risk drivers, there is still much work to do in this field to establish test batteries that have both high sensitivity and specificity.     

A few seconds to have an accident,a long time to recover: Consequences for road accident victims from the ESPARR cohort 2 years after the accident

Objective

The aim of the present study was to describe the consequences of a road accident in adults, taking account of the type of road user, and to determine predictive factors for consequences at 2 years.

Design

Prospective follow-up study.

Methods

The cohort was composed of 1168 victims of road traffic accidents, aged ≥16 years. Two years after the accident, 912 victims completed a self-administered questionnaire. Weighted logistic regression models were implemented to compare casualties still reporting impact related to the accident versus those reporting no residual impact. Five outcomes were analysed: unrecovered health status, impact on occupation or studies, on familial or affective life, on leisure or sport activities and but also the financial difficulties related to the accident.

Results

46.1% of respondents were motorised four-wheel users, 29.6% motorised two-wheel (including quad) users, 13.3% pedestrians (including inline skate and push scooter users) and 11.1% cyclists. 53.3% reported unrecovered health status, 32.0% persisting impact on occupation or studies, 25.2% on familial or affective life, 46.9% on leisure or sport activities and 20.2% still had accident-related financial difficulties. Type of user, adjusted on age and gender, was linked to unrecovered health status and to impact on leisure or sport activities. When global severity (as measured by NISS) was integrated in the previous model, type of user was also associated with impact on occupation or studies. Type of user was further associated with impact on occupation or studies and on leisure or sport activities when global severity and the sociodemographic data obtained at inclusion were taken into account. It was not, however, related to any of the outcomes studied here, when the models focused on the injured body region. Finally, type of road user did not seem, on the various predictive models, to be related to financial difficulties due to the accident or to impact on familial or affective life.

Conclusions

Overall, victims were affected by their accident even 2 years after it occurred. The severity of lesions induced by the accident was the main predictive factor. However, considering lesion as intermediary factors between the accident and the recovery status at 2 year post-accident, impact on health status was lower for cyclists than M4W users or M2W users.     

Distraction and driving: Results from a case–control responsibility study of traffic crash injured drivers interviewed at the emergency room

Background

Use of cellular phones has been shown to be associated with crashes but many external distractions remain to be studied.

Objective

To assess the risk associated with diversion of attention due to unexpected events or secondary tasks at the wheel.

Design

Responsibility case–control study.

Setting

Adult emergency department of the Bordeaux University Hospital (France) from April 2010 to August 2011.

Participants

955 injured drivers presenting as a result of motor vehicle crash.

Main outcome measures

The main outcome variable was responsibility for the crash. Exposures were external distraction, alcohol use, psychotropic medicine use, and sleep deprivation. Potential confounders were sociodemographic and crash characteristics.

Results

Beyond classical risk factor found to be associated with responsibility, results showed that distracting events inside the vehicle (picking up an object), distraction due to driver activity (smoking) and distracting events occurring outside were associated with an increased probability of being at fault. These distraction-related factors accounted for 8% of injurious road crashes.

Limitations

Retrospective responsibility self-assessment.

Conclusions

Diverted attention may carry more risk than expected. Our results are supporting recent research efforts to detect periods of driving vulnerability related to inattention.     

The effects of driver identity on driving safety in a retrospective feedback system

Background

Retrospective feedback that provides detailed information on a driver's performance in critical driving situations at the end of a trip enhances his/her driving behaviors and safe driving habits. Although this has been demonstrated by a previous study, retrospective feedback can be further improved and applied to non-critical driving situations, which is needed for transportation safety.

Objectives

To propose a new retrospective feedback system that uses driver identity (i.e., a driver's name) and to experimentally study its effects on measures of driving performance and safety in a driving simulator.

Method

We conducted a behavioral experimental study with 30 participants. “Feedback type” was a between-subject variable with three conditions: no feedback (control group), feedback without driver identity, and feedback with driver identity. We measured multiple aspects of participants’ driving behavior. To control for potential confounds, factors that were significantly correlated with driving behavior (e.g., age and driving experience) were all entered as covariates into a multivariate analysis of variance. To examine the effects of speeding on collision severity in driving simulation studies, we also developed a new index – momentum of potential collision – with a set of equations.

Results

Subjects who used a feedback system with driver identity had the fewest speeding violations and central-line crossings, spent the least amount of time speeding and crossing the central line, had the lowest speeding and central-line crossing magnitude, ran the fewest red lights, and had the smallest momentum of potential collision compared to the groups with feedback without driver identity and without feedback (control group).

Conclusions

The new retrospective feedback system with driver identity has the potential to enhance a person's driving safety (e.g., speeding, central-line crossing, momentum of potential collision), which is an indication of the valence of one's name in a feedback system design.     

Impairment of a speed management strategy in young drivers under high cognitive workload

Background

A training method known as Episodic training has shown promise in reducing speeding behavior in young drivers (Prabhakharan and Molesworth, 2011). The present study aimed to investigate how cognitive resources are utilized to implement this behavioral change.

Method

60 participants were randomly divided into four groups and completed a simulated training drive in Week 1 followed by a 10 km simulated test drive in Week 2. As part of the test drive, two groups were asked to complete a secondary task (mental arithmetic task) in addition to the test drive.

Results

The results indicated that implementing a speed management strategy elicited by Episodic training was successful in isolation, but came at a cognitive trade-off when performed in conjunction with a secondary task.

Conclusion

From an applied perspective, these results suggest driver training programmes should compartmentalize driver training in order to reduce the cognitive load experienced by trainee drivers, and hence facilitate in driver skill acquisition.     

Hostility,driving anger,and dangerous driving: The emerging role of hemispheric preference

Background

Various studies have implicated psychosocial variables (e.g., hostility) in risk of dangerous driving and traffic accidents. However, whether these variables are related to more basic neurobiological factors, and whether such associations have implications for the modification of psychosocial risk factors in the context of driving, have not been examined in depth. This study examined the relationship between hemispheric preference (HP), hostility and self-reported dangerous driving, and the ability to affect driving anger via hemisphere activating cognitive exercises (HACE).

Methods

In Study 1, 254 Turkish students completed questionnaires of hostility, HP and driving behavior. In Study 2, we conducted a “proof of concept” experimental study, and tested effects of left, right and neutral HACE on driving anger, by exposing N = 650 Turkish students to written scenarios including either logical (left hemisphere), visuo-spatial (right hemisphere) or “mild doses” of both types of contents (control).

Results

In Study 1, left-HP was associated with higher hostility and with more dangerous driving, and hostility mediated the relationship between L-HP and reported driving behavior. In Study 2, only right-HACE led to immediate significant reductions in self-reported driving anger.

Conclusions

Left-HP is related to hostility and to dangerous driving, and it may be possible to partly reduce driving anger by right-HACE. Future studies must replicate these findings with objective measures, more enduring interventions and longer follow-ups.     

Risk of vehicle-pedestrian and vehicle-bicyclist collisions among children with disabilities

Objectives

To examine the potential association between disability and risk of vehicle-pedestrian and vehicle-bicyclist collisions among children.

Methods

Data from the 2002 National Transportation Availability and Use Survey for Persons with Disabilities (NTAUSPD) were analyzed.

Results

Among 5019 persons who completed the survey, there were a total of 687 children between 5-17 years of age, including 299 respondents with and 388 without disabilities. After controlling for potential confounding variables, children with disabilities were more than five times more likely to have been hit by a motor vehicle as a pedestrian or bicyclist than children without disabilities (adjusted OR = 5.53, 95% confidence interval (CI): 1.43-21.41). For all children, regardless of their disability status, children who reported having some difficulty with traffic had a significantly higher risk of collisions (adjusted OR = 50.71, 95% CI: 7.35-349.86). The most commonly reported traffic difficulties for all children with and without disabilities were “Too few or missing sidewalks/paths,” “Do not know when it's safe to cross,” and “Insensitive/unaware drivers.”

Conclusions

Existing effective transportation safety interventions should be effective in reducing the risk of vehicle-pedestrian and vehicle-bicyclist collisions in children with disabilities. Future research and safety interventions should focus on how to promote the use of existing effective transportation safety interventions among children with disabilities and their families.     

Trends in head injuries associated with mandatory bicycle helmet legislation targeting children and adolescents

Background

Bicycling related head injuries (HIs) can be severe. Helmet use reduces head injury risk; however, there are few controlled studies of the effect of helmet legislation. We conducted this study to investigate changes in HIs after bicycle helmet legislation targeting those <18 in Alberta, Canada in 2002.

Methods

Bicyclist and pedestrian (control) HI rates and HIs as a proportion of all injuries were compared for the three years (1999–2001) before and four years (2003–2006) after bicycle helmet legislation in three age groups (children: <13, adolescents: 13–17, and adults: 18+).

Results

There were 41,270 ED visits and 2782 hospitalizations for bicyclists and 9836 ED visits and 2029 hospitalizations for pedestrians (excluding the legislation year 2002). The rate of ED HIs declined for child bicyclists and child pedestrians, while the rate of non-HIs declined in adult bicyclists and child pedestrians. The rate of hospitalized HIs declined in child bicyclists and all ages of pedestrians while non-HI rates declined for child and adult pedestrians. Non-HI rates for adolescent and adult bicyclists increased. After adjusting for sex and location, the proportion of ED bicycle HIs declined by 9% (APR = 0.91; 95% CI: 0.86, 0.95) in children, was unchanged among adolescents and increased in adults (APR = 1.08; 95% CI: 1.01, 1.15). The proportion of bicycle HI related hospitalizations decreased by 30% (APR = 0.70; 95% CI: 0.55, 0.90) in children, 36% (APR = 0.64; 95% CI: 0.49, 0.84) in adolescents and 24% (APR = 0.76; 95% CI: 0.63, 0.91) in adults. There were no observed changes in the proportion of pedestrian HIs resulting in ED visits or hospitalizations.

Interpretation

Our data indicate significant declines in the proportion of child bicyclist ED HIs and child, adolescent and adult bicyclist HI hospitalizations. This is in contrast to no significant trends in the proportion of ED or hospitalized HIs among pedestrians and the unexpected increases in the proportion of ED HIs for adult bicyclists. Comparing bicyclist and pedestrian trends in the proportion of child and adolescent HIs suggests a bicycle helmet legislation effect.     

Antecedents and consequences of pediatric dog-bite injuries and their developmental trends: 101 cases in rural China

Objective

Study the contextual antecedents and consequences of pediatric dog bites in rural China.

Methods

A total of 101 caregivers from rural Anhui Province, China, whose children had suffered dog-bite injuries in the past year, participated in a structured interview about the circumstances, antecedents and consequences of their child's injury.

Results

Contextual circumstances identified frequently included outside-home environment and presence of peers but not adult supervisors. Frequent antecedents were dogs’ initiation of the encounter, children walking to/from school, and dogs unleashed. Consequences to children identified frequently were rabies vaccines, restricted activity, and fear of dogs. Developmental trends emerged, with bite circumstances differing by children's ages.

Conclusions

These results offer data on common antecedents and consequences of pediatric dog bites in rural China, a necessary prerequisite for development of empirically supported prevention programs in a vulnerable population.     

Exploring the impact of a dedicated streetcar right-of-way on pedestrian motor vehicle collisions: A quasi experimental design

Background and Objectives

The frequency of pedestrian collisions is strongly influenced by the built environment, including road width, street connectivity and public transit design. In 2010, 2159 pedestrian collisions were reported in the City of Toronto, Canada with 20 fatalities. Previous studies have reported that streetcars operating in mixed traffic pose safety risks to pedestrians; however, few studies evaluate the effects on pedestrian-motor vehicle collisions (PMVC). The objective of this study was to examine changes in the rate and spatial patterning of PMVC, pre to post right-of-way (ROW) installation of the St. Clair Avenue West streetcar in the City of Toronto, Canada.

Methods

A quasi-experimental design was used to evaluate changes in PMVC rate, following implementation of a streetcar ROW. Collision data were extracted from all police-reported PMVC, complied and verified by the City of Toronto, from January 1, 2000 to December 31, 2011. A zero-inflated Poisson regression analysis estimated the change in PMVC, pre to post ROW. Age and injury severity were also examined. Changes in the spatial pattern of collisions were examined by applying the G function to describe the proportion of collision events that shared a nearest neighbor distance less than or equal to a threshold distance.

Results

A total of 23,607 PMVC occurred on roadways during the study period; 441 occurring on St. Clair Ave, 153 during the period of analysis. There was a 48% decrease in the rate of collisions on St. Clair [Incidence rate ratio (IRR) = 0.52, 95% CI: 0.37–0.74], post ROW installation. There were also decreases noted for children (IRR = 0.13, 95% CI: 0.04–0.44), adults (IRR = 0.61, 95% CI: 0.38–0.97), and minor injuries (IRR = 0.56, 95% CI: 0.40–0.80). Spatial analyses indicated increased dispersion of collision events across each redeveloped route segment following the changes in ROW design.

Conclusions/Implications

Construction of a raised ROW operating on St. Clair Ave. was associated with a reduction in the rate of collisions. Differences in pre- and post collision spatial structure indicated changes in collision locations. Results from this study suggest that a streetcar ROW may be a safer alternative for pedestrians compared to a mixed traffic streetcar route and should be considered by city planners where appropriate to the street environment.     

Risky driving behavior among university students and staff in the Sultanate of Oman

Background

There is a well developed literature on research investigating the relationship between various driving behaviors and road crash involvement. However, this research has predominantly been conducted in developed economies dominated by western types of cultural environments. To date no research has been published that has empirically investigated this relationship within the context of the emerging economies such as Oman.

Objective

The present study aims to investigate driving behavior as indexed in the driving behavior questionnaire (DBQ) among a group of Omani university students and staff.

Methods

A convenience non-probability self-selection sampling approach was utilized with Omani university students and staff.

Results

A total of 1003 Omani students (n = 632) and staff (n = 371) participated in the survey. Factor analysis of the BDQ revealed four main factors that were errors, speeding violation, lapses and aggressive violation. In the multivariate logistic backward regression analysis, the following factors were identified as significant predictors of being involved in causing at least one crash: driving experience, history of offenses and two DBQ components, i.e., errors and aggressive violation.

Conclusion

This study indicates that errors and aggressive violation of the traffic regulations as well as history of having traffic offenses are major risk factors for road traffic crashes among the sample. While previous international research has demonstrated that speeding is a primary cause of crashing, in the current context, the results indicate that an array of factors is associated with crashes. Further research using more rigorous methodology is warranted to inform the development of road safety countermeasures in Oman that improves overall Traffic Safety Culture.     

A systematic review on the influence of pre-existing disability on sustaining injury

Objective

To systematically review studies measuring the influence of pre-existing disability on the risk of sustaining an injury.

Design

Systematic review.

Data sources

Electronic databases searched included Medline (Pubmed), ProQuest, Ovid and EMBASE.

Inclusion criteria

Studies (1990–2010) in international peer-reviewed journals were identified with main inclusion criteria being that the study assessed involvement of injury sustained by persons with and without pre-existing disability.

Methods

Studies were collated by design and methods, and evaluation of results.

Results

Twenty-two studies met the inclusion criteria of our review. All studies found that persons with disabilities were at a significantly higher risk of sustaining injuries than those without. Persons with disability had a 30–450% increased odds (odds ratio 1.3–5.5) of sustaining injury compared to persons without disability. Among persons with pre-existing disability, the high risk groups of sustaining an injury are children and elderly.

Conclusions

People with disabilities experience a higher risk to sustain an injury in comparison to the healthy population. There is a high need for large epidemiological studies of injury among persons with disability, to better address these unique risk profiles in order to prevent additional disability or secondary conditions.