Risk of Mortality in Association with Pregnancy in Women following Motor Vehicle Crashes: A Systematic Review and Meta-Analysis

The aim of the study was to provide a systematic review and meta-analysis of studies examining the association between mortality risk and motor vehicle crashes (MVCs) in pregnant women compared with nonpregnant women. We used relevant MeSH terms to identify epidemiological studies of mortality risk in relation to MVCs from PubMed, Embase, and MEDLINE databases. The Newcastle–Ottawa Scale (NOS) was used for quality assessment. For comparison of mortality from MVCs between pregnant and nonpregnant women, the pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random effects model. The eight studies selected met all inclusion criteria. These studies included 14,120 injured victims who were pregnant at the time of the incident and 207,935 victims who were not pregnant. Compared with nonpregnant women, pregnant women had a moderate but insignificant decrease in mortality risk (pooled OR = 0.68, 95% CI = 0.38–1.22, I2 = 88.71%). Subgroup analysis revealed that the pooled OR significantly increased at 1.64 (95% CI = 1.16–2.33, I2 < 0.01%) for two studies with a similar difference in the mean injury severity score (ISS) between pregnant and nonpregnant women. Future studies should further explore the risk factors associated with MVCs in pregnant women to reduce maternal mortality.

Pedestrian Safety in Compact and Mixed-Use Urban Environments: Evaluation of 5D Measures on Pedestrian Crashes

This study examined the impact of density, diversity, design, distance to transit, and destination accessibility, five measures, known as the 5Ds, that characterize the built environment, on pedestrian–vehicle crashes in Seoul, Korea. Using spatial analysis based on 500-m grid cells, this study employed negative binomial regression models on the frequencies of three specific types of pedestrian–vehicle crashes: crashes causing death, major injury, and minor injury to pedestrians. Analysis shows that compact and mixed-use urban environments represented by 5D measures have mixed effects on pedestrian safety. Trade-off effects are found between a higher risk for all types of pedestrian crashes, and a lower risk for fatal pedestrian crashes in 5D urban environments. As a design variable, a higher number of intersections is more likely to increase some types of pedestrian crashes, including fatal crashes, a finding which warrants policy attention to promote pedestrian safety near intersection areas. This study also confirms an urgent need to secure the travel safety of pedestrians near public transit stations due to the higher risk of pedestrian crashes near such facilities. Various destinations, such as retail stores, traditional markets, and hospitals, are associated with pedestrian crashes. Pedestrian safety measures should be implemented to reduce the likelihood of pedestrian crashes near major destination facilities.

Analysis of safety impact of paved shoulder width on Czech secondary roads

Traffic safety is influenced, among other factors, by characteristics of the roads, which include the width of the shoulder. Shoulder width was noted to have a large effect on crash frequency, as well as on traffic speed. In this paper, we focused on paved shoulders. Previous studies confirmed that increasing the width of the paved shoulder is associated with a decrease in crash frequency. However, wider shoulders may encourage higher driving speed, which is related to an increase of impact speed and crash severity – this issue was hypothesized, but not statistically investigated. Thus, conclusions based on crashes and speeds contradict each other, and there is no simple answer to the question of the safety impact of wide shoulders. To address this gap, we analyzed a sample of two most typical categories of Czech secondary roads, which differ only in the paved shoulder width (S9.5 roads with 0.75m-wide shoulder, and S11.5 roads with 1.75m-wide shoulder) and thus present a suitable example for studying the safety impact of paved shoulder width. We used generalized linear models of crash frequency, and multinomial logistic models of crash severity (separately for single-vehicle and multi-vehicle crashes), as well as a statistical test of differences in speed for the two road categories. The results showed that: Firstly, there were fewer crashes on S11.5 roads compared to S9.5 roads; this was true for both single-vehicle and multi-vehicle crashes. Secondly, single-vehicle crashes on S11.5 roads were more severe compared to S9.5 roads; the change of severity in multi-vehicle crashes was not statistically significant. Thirdly, driving speeds on S11.5 roads were approx. by 7 km/h higher compared to S9.5 roads. These findings support the hypothesis of an association between wider shoulders, higher speeds, and increased crash severity, especially in the case of single-vehicle crashes. As a practical solution, various speed management measures, including widening to a 2+1 road, may be recommended.

The Analysis of the Factors Influencing the Severity of Bicyclist Injury in Bicyclist-Vehicle Crashes

Transportation and technological development have for centuries strongly influenced the shaping of urbanized areas. On one hand, it undoubtedly brings many benefits to their residents. However, also has a negative impact on urban areas and their surroundings. Many transportation and technological solutions lead, for example, to increased levels of pollution, noise, excessive energy use, as well as to traffic accidents in cities. So, it is important to safe urban development and sustainability in all city aspects as well as in the area of road transport safety. Due to the long-term policy of sustainable transport development, cycling is promoted, which contributes to the increase in the number of this group of users of the transport network in road traffic for short-distance transport. On the one hand, cycling has a positive effect on bicyclists’ health and environmental conditions, however, a big problem is an increase in the number of serious injuries and fatalities among bicyclists involved in road incidents with motor vehicles. This study aims to identify factors that influence the occurrence and severity of bicyclist injury in bicyclist-vehicle crashes. It has been observed that the factors increasing the risk of serious injuries and deaths of bicyclists are: vehicle driver gender and age, driving under the influence of alcohol, exceeding the speed limit by the vehicle driver, bicyclist age, cycling under the influence of alcohol, speed of the bicyclist before the incident, vehicle type (truck), incident place (road), time of the day, incident type. The obtained results can be used for activities aimed at improving the bicyclists’ safety level in road traffic in the area of analysis.

Exploring injury severity of pedestrian-vehicle crashes at intersections: unbalanced panel mixed ordered probit model

Although the pedestrian deaths have been declining in recent years, the pedestrian-vehicle death rate in Croatia is still pretty high. This study intended to explore the injury severity of pedestrian-vehicle crashes with panel mixed ordered probit model and identify the influencing factors at intersections. To achieve this objective, the data were collected from Ministry of the Interior, Republic of Croatia from 2015 to 2018. Compared to the equivalent random-effects and random parameter ordered probit models, the proposed model showed better performance on goodness-of-fit, while capturing the impact of exogenous variables to vary among the intersections, as well as accommodating the heterogeneity issue due to unobserved effects. Results revealed that the proposed model can be considered as an alternative to deal with the heterogeneity issue and to decide the factor determinants. The results may provide beneficial insight for reducing the injury severity of pedestrian-vehicle crashes.

Motor vehicle crashes on tribal reservations: mapping and statistics

Background Motor vehicle crashes (MVC’s) in the American Indian/Alaska Native (AI/AN) communities account for 43% of unintentional injury deaths. This article introduces MVC data and geographic information system (GIS) mapping for tribal reservations. Methods Utilizing a sample of Montana Department of Transportation (DOT) data for the Flathead reservations to calculate frequencies and proportions of crash types (i.e., property damage or no-injury, injury, fatality or unknown), while also mapping these data to provide a cross-sectional snapshot of MVC’s. Results Overall, 515 MVC’s occurred for years 2016 through 2018, with no-injury, injury, and fatality accounting for 72.2%, 24.9% and 1.8% of all crashes, respectively, with the number of MVC’s ranging up to 30 per square mile. Conclusion Examining DOT data and utilizing it for visual representation of MVC’s can be used as an additional source in uncovering patterns and trends on Tribal reservations and supporting MVC prevention efforts.