Pre-injury alcohol use and road traffic injury among patients at Mulago National Referral Hospital, Kampala, Uganda: Cross-sectional study

Background: Uganda has a high rate of road traffic injuries (RTI). Alcohol use increases traffic injury risk and severity through impairment of road-use skills and hazard perception. Few studies have examined this problem in Uganda. We therefore assessed the prevalence and determinants of pre-injury alcohol use among road traffic injured patients at Mulago National Referral Hospital, Kampala Uganda. Methods: We enrolled 330 eligible adult RTI patients consecutively in a crosssectional study, at the emergency department in Mulago National Referral Hospital from March-May, 2016. We assessed pre-injury alcohol use using BACtrack professional Breathalyzer, alcohol intoxication assessment tool and alcohol use selfreport covering the period of 6 hours before the injury. We assessed injury severity using Glasgow Coma Scale and Kampala Trauma Score. We estimated prevalence ratios [PR] using modified Poisson regression. Results: Prevalence of pre-injury alcohol use among injured patients was 29.7%. Pedestrians (44%) had the greatest percentage of alcohol use when compared to other road users. Pre-injury alcohol use was associated with mortality at the Emergency Department, PR: 2.33 [1.39 – 3.9]. Conclusion and recommendations: Pre-injury alcohol use is high among pedestrians and yet prevention efforts target mostly motorists. Pre-injury alcohol use also resulted into increased mortality at Emergency Department. We recommend prevention efforts to not only target motorists but also pedestrians.

Bicycle-Friendly Roundabouts: A Case-Study

Roundabouts constrain speeds and impact angles for vehicles as they approach. Therefore, they are considered to be a ‘Safe System’ solution for intersections. Though roundabouts are a positive road safety treatment for cars they do not show as dramatic a reduction in road trauma for bicyclists. New Zealand crash data for 2001-2011, found almost 28% of injury crashes at roundabouts involve cyclists, while at priority-controlled intersections and signalised intersections the proportions are 8% and 5.5% respectively. VicRoads specifies technical guidance in relation to road safety treatments at roundabouts specifically targeted for the protection of cyclists and pedestrians. In 2018 this guidance was used to design and build two cycle-friendly protected roundabouts in Moray St, South Melbourne, as part of the Metro Tunnel Project. The project upgraded the Moray Street bicycle path to provide cyclists with a safe path in the north-south route and raised pedestrian crossings at all branches of the roundabout during Metro Tunnel works on St Kilda Road. Safe System Solutions Pty Ltd evaluated the performance and found a moderate utilisation rate of cyclists on the dedicated bicycle lanes and a high utilisation rate of pedestrians using raised crossings. The evaluation also found no significant issues with near-crashes for bicycle-and-pedestrian and bicycle-and-vehicle interaction. There were no significant problems with vehicle drivers using the protected roundabout. However, it was noted that when pedestrians are crossing at the raised crossings then vehicles would sometimes stop in the middle of the roundabout thus blocking traffic.

The effect of sanctions on Victorian speeding drivers

Speeding is a major contributor to deaths and serious injuries in Australia. To assist in speed countermeasure development, VicRoads commissioned an examination of speeding offenders’ characteristics, re-offence and casualty crashes during and after periods of licence sanctions. These analyses aimed to determine the effects of the following sanctions: licence bans; the increase in speeding ban periods and demerit points for higher level speeding offences; additional demerit point bans for high-range offenders in addition to a 12-month speeding ban; and the good behaviour bond available as an alternative to the licence ban after reaching the demerit point threshold. The study had several positive findings, for example licence bans from speeding offences reduced speeding re-offending and casualty crashes; and there were lower re-offence rates for those who elected to take the good behaviour bond when reaching the demerit point limit.

Simulators, driver education and disadvantaged groups: A scoping review

This paper examines simulators to deliver driver education programs for two very different populations (a) those who have specific impairments or intellectual disabilities and (b) those who may suffer disadvantage associated with their ethnicity. To do this we addressed two research questions (a) What role, if any, can simulation play as an education and/or training intervention for individuals disadvantaged because of individually-orientated concerns such as intellectual impairment or ADHD? (b) What role, if any, can simulation play as an education and/or training intervention for those who are disadvantaged because of their indigenous ethnicity? Technological developments have enabled the incorporation of driving simulators into driver education programs. A review of major databases using keywords identified 2,420 records. After duplicates were removed and screening occurred, thirteen studies were included in the review. The disadvantaged populations for the driver education initiatives that incorporated a simulator were very specific (e.g. intellectual disabilities) with no interventions for those disadvantaged because of ethnicity. A second search identified six papers that discussed interventions for indigenous populations. None of these interventions had a simulator component. The review highlights the need for high quality empirical research in the area of simulators, driver education and disadvantaged groups in order to inform policy development within this area. While there are some preliminary results indicating potential benefits, there is limited research evidence for an initiative of this type making it difficult to develop evidence based policy and practice. Therefore, when these types of initiatives are introduced, they need to be evaluated.

Novice drivers’ experiences of parental encouragement with road rules in Queensland: Scope for a third party policing approach?

This study explored whether a third party policing approach is appropriate for increasing young driver compliance with graduated driver licensing restrictions. Focus groups (n = 3) and semi-structured interviews (n = 24) were conducted with young drivers from Brisbane, Queensland, Australia. Participants (n = 39 in total) were aged 17 to 19 years and held a Provisional 1 or 2 licence. Many young drivers appreciated the involvement of their parents in their novice driving period and reported that parents provided practical support and planning strategies. There is potential for the use of a third party policing intervention to improve compliance amongst young drivers.

Community participation in road safety policy development and strategy planning

Public participation in Western Australian (WA) government policy development and strategy setting is not governed by a particular best practice model. The WA Service Priority Review Working Together One Public Sector Delivering for WA, released 2017, identified the need to build a public sector focussed on community needs and to develop a whole of government citizen engagement strategy for WA, including co-designing. The Road Safety Commission (Commission) employs a diverse range of public participation and engagement initiatives. An initial step in preparing for development and introduction of a whole of government strategy review of the nature of public participation initiatives of the Commission. The review method was an analysis of five initiatives that provide reasonable representation of the Commission’s public participation and engagement activities. For the purposes of this review, the International Association for Public Participation spectrum of public participation has been used to classify the activities. This paper presents a summation of the review to date, communicating the current status and potential future direction of the Commission. Further work is required by the Commission.

Safety solutions on mixed use urban arterial roads

Urban arterials and intersections account for a large proportion of high severity crashes in Australia and New Zealand, particularly involving vulnerable road users. Safety gains appear to be slower in these ‘mixed use’ environments than in other areas. Austroads commissioned research to help identify solutions that might be applied on mixed use arterial roads to improve safety through the provision of Safe System infrastructure. The project involved assessment of six case studies around Australia and New Zealand. Concept designs were developed for each of the routes based on analysis of safety issues and the likely safety benefits were assessed. This paper presents information on the safety solutions identified, as well as the broader issues that need to be considered when addressing safety on mixed use urban arterial roads.

For whom didn’t it click? A study of the non-use of seat belts in motor vehicle fatalities in New Zealand

There is an increased risk of death or serious injury for occupants who did not wear a seat belt in a crash. In New Zealand, between 2006 and 2016, the non-use of seat belts accounted for 19-30% of the overall motor vehicle road deaths, and this figure shows no sign of decreasing. It is important to better understand the contextual factors associated with crashes where seat belts are not worn, so that more relevant and effective road safety interventions can be designed and implemented. The aim of this research was to determine the profiles for seat belt non-users who were killed in motor vehicle crashes in New Zealand between 2011 and 2015. An in-depth analysis of 200 fatalities where seat belts were not worn (186 crash cases) was carried out following a Safe System framework, using NZ Police reports. Following this, a Multiple Correspondence Analysis (MCA) developed five profiles of vehicle occupants who were killed in crashes where seat belts were not worn. While the stereotypical ‘young risky’ males were an important group, a range of other people and contexts emerged: ‘driving for work’; ‘elderly and retired’; ‘overseas passengers’; and ‘people driving in rural settings’. This has implications for tailored road safety interventions, as a variety of motivations and influences are likely to be at play, depending on the people involved.

Contemporary Guidance on Management of Road Safety Audits

Although there is good awareness of road safety audit as a proactive technique for identifying and mitigating road safety related risks throughout Australasia and internationally, local practices in procuring, managing and conducting audits can vary between jurisdictions. This paper provides an overview of recent policy developments and practical guidance in managing road safety audits in Australia and New Zealand. Based on the update (Austroads 2019) of Austroads Guide to Road Safety Part 6 (AGRS), the guidance aims at maximizing alignment with Safe System principles by integrating them into the audit process. This is achieved through improved awareness of practitioners new to the principles and concepts (especially project clients and project managers) and promoting the conduct of audits to realise their harm minimisation benefits.

The frequency and nature of aggressive acts on Australian roads

To understand the current prevalence of aggressive acts on Australian roads, a large cross-sectional survey was conducted inviting drivers from all Australian jurisdictions to participate. A stratified sampling procedure was undertaken to ensure the age and gender distributions were representative of each jurisdiction. Participants were asked to report the frequency of aggressive driving behaviours as well as speeding, drink-driving and mobile phone usage while driving. Recent crash history was also obtained. The sample consisted of 2,916 drivers (males = 45%) with an average age of 42 (±16) years. Minor aggressive behaviours such as expressing annoyance to other drivers and sounding the horn in anger were reported by the majority of the sample (60% and 70% respectively). More extreme behaviour such as chasing another driver when angry was less common, however still reported by 18% of the overall sample. Aggressive driving behaviours were more common in younger, male drivers with 36% of drivers aged 22 to 39 reporting extreme aggression. Associations were found between aggressive driving with crash involvement and other forms of risky driving behaviour. The results show that aggressive driving is a problem on Australian roads. Further research is warranted to explore where aggressive driving fits within an overall risky driving pattern of behaviour, what attitudes drivers hold toward aggressive driving, and how to target the reduction of these behaviours.