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Motor vehicle crashes

Roadway Tragedies: When Will the Madness End?

16 Jun, 17 | by Angy El-Khatib

[Angy El-Khatib] This post is from guest blogger Bethesda Yohannes. Bethesda is an intern at the Injury Prevention Center of Greater Dayton in Dayton, Ohio, United States. She is currently a second year undergradute student in the College of Education and Human Ecology at Ohio State University. 

As the journey to reduce traffic-related fatalities continues, more information is becoming available to aid in this expedition. Traffic fatalities have been present ever since the time of buggies and horse-drawn carriages. Although traffic-related casualties have occurred since the beginning of vehicle transportation, the tolerance for these accidents remains low due to the high potential for prevention. Recently, the Insurance Institute for Highway Safety (IIHS) published a report which explores the correlation between mortalities and factors such as weekends, unemployment, and technology.

The 2017 IIHS report reveals that traffic-related death rates increase during weekends and holidays. According to the IIHS, increasing death rates can be linked to risky behaviors that take place during these periods. Although roadway deaths have decreased since 1998, the pattern of deaths remains stagnant. As Charles Farmer, IIHS Vice President for Research and Statistical Services, said, “The riskiest times remain risky.” However, with proper enforcements these rates can decline. New Years Eve and [American] Independence Day are the two holidays with the highest, traffic-related fatality rates; however, when increased impaired-driving enforcement (i.e. – DUI checks) are initiated during these holidays, traffic-related fatalities went down 5% during New Years Eve and 13% during Independence Day.

Although traffic-related death patterns have remained the same, they have decreased within the last decade; this can partly be attributed to advances in technology relating to motor vehicles. Improved safety technology and newer car models have resulted in slightly reduced driver death rates. Factors, such as the size of the vehicle, are being investigated; for example, small, four-door cars were found to have the highest death rate (87 deaths per million) whereas SUVs had the lowest death rates (6 deaths per million). Crash avoidance technology and “self-driving” vehicles could, in theory, reduce crash rates. However, as Farmer points out, “Improvement in vehicle technology are important, but we also need to address old problems such as speeding and driving while impaired.”

Unfortunately, improvements in the economy do not always equate to lower death rates; the decline of unemployment rates due to a flourishing economy have been linked to the increase in traffic fatalities. This increase is not only due to an improved economy, but rather the increase of vehicle miles as more people attend work. If the U.S Bureau of Labor Statistics prediction of an annual decline of 1.7% in unemployment from 2014 to 2024 continues, it is expected that the , traffic-related death rates will reduce from 35,092 in 2015 to 34,400 by 2024. An improved economy may be related to increases in highway fatalities or accidents at the workplace, but lifestyle factors could also play a role. We know that smoking, alcohol use, obesity, and physical inactivity rise when unemployment rates fall.

The exact correlation between unemployment and traffic-related death rates are still being researched as more data about the multiple factors continues to be collected. Researchers remain puzzled about the most effective and efficient methods to prevent traffic-related deaths, but efforts continue. Partnerships with court systems, law enforcement agencies, hospitals, and other community organizations (such as Mothers Against Drunk Driving or the American Automobile Association) allow injury prevention professionals to identify high-risk individuals and make a population-level impact. Surveillance of traffic-related crashes and reports, such as the IIHS report, are necessary to better inform policy and/or community-level interventions.

 

There’s strength in numbers when it comes to injury prevention

11 May, 17 | by Bridie Scott-Parker

This week marks the Fourth UN Global Road Safety Week. As noted on the website, the focus is

on speed and what can be done to address this key risk factor for road traffic deaths and injuries.

Speed contributes to around one-third of all fatal road traffic crashes in high-income countries, and up to half in low- and middle-income countries.

Countries successfully reducing road traffic deaths have done so by prioritizing safety when managing speed. Among the proven strategies to address speed include:

  • Building or modifying roads to include features that calm traffic
  • Establishing speed limits to the function of each road
  • Enforcing speed limits
  • Installing in-vehicle technologies
  • Raising awareness about the dangers of speeding.

The Fourth UN Global Road Safety Week seeks to increase understanding of the dangers of speed and generate action on measures to address speed, thereby saving lives on the roads.

One of the ways that injury prevention researchers – such as myself – can increase their capacity for influence is working with others who also have the capacity for influence. Regular readers of the blog will recognise my repeated recommendation to connect, collaborate, and achieve; indeed I’ve often featured my perspectives regarding the many and varied benefits that arise from such actions.

Today, for something a little different, I am delighted to feature a blog written by my colleague, Ms Julia Carter, the Writer and Content Marketing Specialist at Youi Insurance, as she shares some thoughts regarding working with an injury prevention researcher:

 

At Youi, we know there’s a huge gap in the car insurance market. Insurers are providing cover for when things go wrong on the road, but what are we actually doing to prevent those things from happening?

Knowledge is Power

We believe we have a responsibility as insurers to help protect our customers the best we can, and not just by offering them cover for a range of insured events, but by equipping them with tools and resources that help avoid those events in the first place.

Engage an Expert

In addition to regularly writing articles about road safety and publishing them on our “On The Road” blog, we have partnered with Dr. Bridie Scott-Parker to focus on injury prevention. Dr. Bridie’s expertise perfectly complements our content mission to raise awareness for road safety. We are currently finalizing production for a new VLOG featuring Dr Bridie’s research, which we hope will engage and inspire various road users to commit to road safety.

Be Seen to be Heard

Of course sometimes the easiest way to get people to listen is to speak directly to them. That’s why we recently hosted a #SlowDownDay as part of the 4th annual United Nations Global Road Safety Week. The event encouraged our staff to take a few minutes out of their busy day to slow down, grab a snack and learn about road safety from experts in the field, including Dr. Bridie and the Queensland Fire & Emergency Services. We also invited our partners from the Sunshine Coast Animal Refuge to share some tips on preventing animal collisions, and Automotive Service Centres (ABS) discussed the importance of regular car servicing and brake check-ups to ensure safe driving.

Strength in Skills & Numbers

One thing we’ve learned since taking this more robust approach to road safety awareness is that people want to stay safe on the roads. Everyone’s been touched by a road collision in some way or another, and we all agree that we need to do our part in making the roads a safer place for everyone. That said, we have found that getting people to take the time to read or watch content about road safety requires a variety of skills. In this day and age of social media and information overload, there is so much content online that most of it just gets lost. Having someone as enthusiastic and passionate as Dr. Bridie deliver road safety education is instrumental, but we also need to host that content in the right place, boost it through the right channels, and throw all of our resources behind it to ensure the message gets across.

 

We are extremely excited about what the future of this partnership holds and its potential to bring Dr. Bridie’s research to a wider audience through a strategic content marketing approach. We encourage all businesses and individuals to seek out local road safety authorities and create similar partnerships, because when it comes to injury prevention, there is strength in numbers.

 

 

Pondering the peanutabout…..

5 Jan, 17 | by Bridie Scott-Parker

I read the StreetsBlogUSA post Study: Diagonal Intersections are Especially Dangerous for Cyclists today with great interest, for a number of reasons that I thought I would share with you.

Firstly, there is no doubt that cyclists are a vulnerable road user group, and that particular segments of road are more problematic for cyclists. The research cited in the post pertains to an Injury Prevention publication which examined, in-depth, police reports of 300 car-cyclist crashes in the New York city area , and the police templates to record crash-pertinent information across the US. Innovative research which approaches a known problem from novel perspectives helps to provide additional pieces for the jigsaw puzzle that we seek to solve, and this research was an intriguing read indeed.

Secondly, the research revealed that some road configurations appeared to increase crash risk (i.e., we want to reconfigure these roads), and that the safest option in the most problematic circumstances was to separate the motor vehicle from the vulnerable cyclist. The ‘solution’ for cyclist safety can be a highly contentious issue, particularly here in Australia in which the motor vehicle has traditionally – through necessity – dominated our vast landscape, and as health and other benefits become apparent, cycling is gaining traction. Indeed, Cadel Evans, arguably Australia’s most celebrated cyclist, has tried to bring clarity to this divisive issue; stating that

I don’t think we should separate the two, because most people who ride a bike also have a car. In the end, they’re public roads for everyone. It’s a privilege to use roads; not a right.

 We have to respect everyone who’s using them, whether they’re driving a car, bus, tractor or truck, or riding a bike or are a pedestrian. We have to respect each other’s privilege and safety.”

in response to the question “What do you say to drivers who think cyclists don’t belong on the road?

Thirdly, the innovative solution of the peanutabout helps speak to ideas beyond the cyclist themselves – this is consistent with systems thinking which argues that safety (in this case, cyclist safety) emerges from a complex web of actions and interactions among a breadth of stakeholders who play a role in the larger safety system (e.g., in the case of my own research interests, an application of systems thinking in the young driver road safety). Given we are more than half way through the Decade of Action for Road Safety, and in the case of Australia, our road toll returned to an upward trajectory in 2016 after many years of a downward trajectory, such innovative thinking is critical.

Fourthly, the researchers noted that the templates used by police to record crash-pertinent information did not provide adequate details regarding the crash circumstances. Unfortunately this is not an uncommon problem, and again one that I have come across in my own research endeavours. If we are to effectively prevent injury, we need as much contextual and other information regarding the incident contributing to the injury.

Fifthly, while the peanutabout appears to be an ideal solution to the critical issues identified for the area noted, I am mindful that drivers do not always ‘cope well’ with complex infrastructure such as roundabouts. As a researcher within the realm of young driver road safety, and the mother of teen with the learner licence which requires full supervision whenever she is behind the wheel, Learner drivers often tell me that they ‘freak out’ when they come to a roundabout, and it is not actually round! According to Learners, roundabouts must be round, while oval roundabouts and others shaped as a parallelogram should be called something different. Hmmmm, on reflection, maybe Learners will be okay with a ‘peanutabout’…..

Finally, I paused to reflect on the safety implications for motorcyclists – another vulnerable road user group. While traversing a roundabout on his Harley Davidson last year, a colleague was driven over by a driver behind the wheel of 4WD, texting, who reported that she had checked the roundabout for vehicles before entering, and that she did not see – or hear – my colleague already on the roundabout (and thus he had right of way) until her front right tyre was on top of his leg and his motorbike. Thankfully he has managed to retain his leg, however he has had multiple operations, requires additional surgery, and will be scarred for life and never walk without support again. My colleague is the first to acknowledge that motorcyclists sometimes deliberately place themselves in danger through their riding behaviours – himself included – however we both eagerly await any intervention that will increase motorcycle safety when traversing complex infrastructure such as roundabouts.

Meet Graham and Almost Impossible Cancer Spaghetti: The intersection between injury prevention and the arts

22 Nov, 16 | by Sheree Bekker

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“The artist is distinguished from all other responsible actors in society — the politicians, legislators, educators, and scientists — by the fact that he is his own test tube, his own laboratory, working according to very rigorous rules, however unstated these may be, and cannot allow any consideration to supersede his responsibility to reveal all that he can possibly discover concerning the mystery of the human being.

Society must accept some things as real; but he must always know that visible reality hides a deeper one, and that all our action and achievement rest on things unseen. A society must assume that it is stable, but the artist must know, and he must let us know, that there is nothing stable under heaven. One cannot possibly build a school, teach a child, or drive a car without taking some things for granted.

The artist cannot and must not take anything for granted, but must drive to the heart of every answer and expose the question the answer hides”

 ~ James Baldwin*

Meet Graham

Over this past weekend I met Graham: the only person designed to survive on our roads. Graham is a remarkable sculpture. He has been designed with the bodily features that humans would need if we were to withstand motor vehicle crashes:

As much as we like to think we’re invincible, we’re not. But what if we were to change? What if our bodies were built to survive a low impact crash? What might we look like? The result of these questions is Graham, a reminder of just how vulnerable our bodies really are.

The piece forms part of the Towards Zero campaign – a vision for a future free of deaths and serious injuries on Australian roads:

In a shift from its traditional road safety campaigns, the Transport Accident Commission has collaborated with a leading trauma surgeon, a crash investigation expert and a world-renowned Melbourne artist to produce ‘Graham’, an interactive lifelike sculpture demonstrating human vulnerability.

Meeting Graham over the weekend was a revelation. As an injury prevention researcher, it is always exciting to be able to view and interact with innovative campaigns that take knowledge translation to the next level. This installation makes use of Google Tango, an immersive augmented reality technology, to allow the viewer to learn more about Graham’s unique features (such as his ribcage – my favourite feature – think airbags rather than armour). The campaign also features a school curriculum, and the ability to Meet Graham online – where one can view the sculpture in 360 degrees, as well as see videos from the surgeon, researcher, and artist.

Almost Impossible Cancer Spaghetti

In an innovative move, The BMJ is working with interactive data visualisation designerWill Stahl-Timmins, to present medical research findings in more visually appealing ways. His infographic development process, as detailed in the blog post Almost Impossible Cancer Spaghetti, is a fascinating study in attention to detail – something that communication and information designers are skilled at.

front

The knowledge translation gap

We know that a 17 year gap exists between research and its translation. The field of injury prevention – as an area of public health research – has a long and successful history with educational, media, and social marketing campaigns aimed at reducing this gap. In the quest for more rapid distribution of knowledge, many journals have moved toward open access publishing. Researchers are increasingly working to present research findings in more useful formats, including developing consensus statements, guidelines, and posters, as well as in more engaging formats such as apps, or – in the latest craze – designing their own infographics.

A pertinent question must be raised here: when does the pursuit of knowledge translation through formatting information in new and colourful ways tip over into the realm of creating “too much information” – merely adding to the sea of white noise rather than effectively increasing knowing and influencing behaviour change? We know that viral does not necessarily equal effective, and the problem remains that even if people do know about scientific evidence, they fail to use it anyway.

The intersection between injury prevention and the arts

In the age of viral marketing, art – to my mind – has a different quality, with new and exciting possibilities for better injury prevention knowledge and knowledge translation. Art provides the visual language for the kind of aesthetic knowing that is currently lacking in the ways in which we approach research and knowledge translation in this field. The arts are situated in the liminal space which moves us towards a different kind of embodied knowledge. Perhaps it is because art speaks to the unseen, in the words of James Baldwin.

Is there space in our field for fine art, design, sculpture, craft, poetry, spoken word, performance art, dance, music, photography, film-making? Should there be? What can we learn from other fields of research that do make use of arts-based methods? What can we learn from art itself?

This is not to say that researchers should necessarily be creating art and designing visual information themselves. We need to leave art to the artists, and design to the designers**. But perhaps we do need to collaborate with, and commission, artists and designers (and pay them!) to convey our messages in new and exciting ways – as the above two examples show. Further, the possibilities of arts-based research methods hold possibilities for the generation of different kinds of knowledge in our field, thereby enriching our understanding of injury and its prevention. A recent webinar from artist and academic Dr Mandy Archibald – on the intersection between the arts, research and knowledge translation – sheds light on this practice.

The examples of Meet Graham and the Almost Impossible Cancer Spaghetti have left me wholly inspired as to the possibilities of the art and science of injury prevention research and knowledge translation.

The science of injury prevention is ripe for collaboration with the arts.

I am curious as to other similar initiatives that sit at the intersection of injury prevention and art – please do share links in the comments section below.

*Of course, this was written at a time before the recognition of the importance of gender-neutral language

**Of course, all humans are creative and should all be making art – this statement refers solely to using art for knowledge translation purposes as part of specific research/advocacy projects

 

Fatality Free Friday | Road Safety | Australia

27 May, 16 | by Sheree Bekker

Fatality Free Friday is an initiative that started in Australia in 2007, and the campaign has continued to expand its operation and is now recognised as Australia’s only national community based road safety program.

Road safety is a complex issue but we believe that if drivers consciously think about road safety and safe driving for just one Friday in the year, that day’s toll – statistically about 5.3* deaths – could be reduced to zero.

That’s our aim. Not a single road death in Australia for just one day. Just one Fatality Free Friday.

We believe that if drivers are asked to actively concentrate on road safety and safe driving for just one day in the year, they’ll drive safer for the next few days too and, over time, change their outlook completely, consciously thinking about safety each and every day they get behind the wheel.

*DataSource: Australian Transport Safety Bureau

(From Fatality Free Friday)

Drivers can take the pledge to drive safely here.

On advocacy: championing young driver safety

2 May, 16 | by Sheree Bekker

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[SB] In this post, public health consultant Dr Sarah J Jones (follow her on Twitter @GDLSarahJones), an advocate for better safety for young drivers and all
who share the roads with them, shares her experiences on her efforts to advocate for Graduated Driver Licencing in the UK
. In her previous role, Sarah was an injury epidemiologist at Cardiff University, researching a range of injury prevention topics and completing a PhD on Child Pedestrian Injuries and Deprivation, a study that included analysis of the links between traffic calming distribution, deprivation and narrowing inequalities. 

[SJJ] It all began in 2008. I was in the final stages of Public Health Registrar Training when my supervisor told me to “go somewhere and do something”. My interests in road traffic crash prevention lead me first to Dot Begg at Otago, Dunedin and then on to Erin Cassell at Monash, Melbourne. The main objective, as well as a fascinating insight into how pandemic flu and other public health issues were being dealt with (I travelled the week after the 2009 swine flu pandemic first emerged), was an estimate of the effect that Graduated Driver Licensing (GDL) could have if implemented in the UK.

Back home, I presented what I had done, sat back, exceptionally pleased with myself, after all the case was now made, and awaited the “pat on the back” from my supervisor. “Nice” he said. “Now get it implemented”. “How” I lamely asked. “I don’t know. Work it out” was the response.

I’m still trying to work it out. Seven years on I have talked to a lot of people. I’ve given presentations to vaguely interested lay people in village halls, as well as to Members of Parliament. I have written articles for newspapers, magazines and peer reviewed journals. I have given newspaper, television and radio interviews, some live, and have participated in “phone-ins”.

Yet, we still do not have GDL in the UK. So, in seven years, I have achieved nothing.

I think people are more generally aware of GDL than when I started talking, but that may be completely unrelated to anything I have done. I am still looking for the guide on “How to bring about legislative change”, but there does not seem to be one. I have learned a lot about the policy process in the UK and about how reluctant people are to change their viewpoint, even in the face of overwhelming evidence to the contrary.

I always knew that the pace of Public Health change was painfully slow, but even with that knowledge continuing to advocate for change is difficult and often demoralising. It’s little wonder that we have become locked into a cycle of quick fixes (action that is just a proxy for effective action) to match political cycles that can then be quietly sidelined when they do not have the effect that was intended.

After 8 years in research / academia, my move into service based public health was my “translational research”. I am coming to believe that advocacy is the most important, but most overlooked area of both public health and injury prevention, partly because it is so difficult to measure the effect of what is being done. How we support people to become effective advocates is likely to be key to effective intervention prevention in the future.

[SB] I too have written on the vital importance of advocacy: here and here. As researchers, it is important to remember that we do not always need to disseminate purely our most up-to-date research results, or even the most innovative interventions; sometimes our work life’s work is bigger than that. Sometimes we need to advocate for the very heart that lies at our work: simple, credible information and resources that can make a difference in even one person’s life.

Botswana reflections: on learning the ABCs

15 Oct, 15 | by Sheree Bekker

I am currently in Botswana: a landlocked southern-African country of roughly two million people. I grew up here, and it is a place that I consider one of the most beautiful in the world (particularly the Okavango Delta – a bucket list destination for wildlife). The country and its people were beautifully portrayed in this music video from Nico and Vinz (take note Taylor Swift).

Although Botswana is amongst the most economically and politically stable countries in Africa, the need for public health improvements (as with other countries) remains a priority.

The top ten causes of death in Botswana, according to the Centers for Disease Control and Prevention (2010) are:

  1. HIV
  2. Cancer
  3. Stroke
  4. Tuberculosis
  5. Ischemic Heart Disease
  6. Diarrheal Disease
  7. Diabetes
  8. Road Injuries
  9. Lower Respiratory Infections
  10. Malaria

It is no surprise that HIV remains at number one on this list, in 2014 the prevalence of HIV in adults aged 15 to 49 was 25.2% – second in the world only to Swaziland.

The ubiquitous presence of the HIV epidemic can still be seen in the faded remains of the educational messaging that was painted on every available public wall in the 1990s and early 2000s.

SANYO DIGITAL CAMERA

SANYO DIGITAL CAMERA

Indeed, I so clearly remember that we learned our ABCs at school in Botswana, the letters themselves certainly, but almost more importantly the potentially life-saving versions too: A) Abstain, B) Be wise, C) Condomise. To this day, condoms are widely and freely available (useful, except when the HIV awareness ribbons are stapled to – through – the condoms themselves).

Botswana has generated what is often referred to as a ‘stunning achievement‘ in its multi-faceted response to the HIV epidemic. This success means that the government can now allocate resources to start to address other public health concerns.

Number eight on the above list, road injuries, is now seeing an uptick in prevention initiatives. A 2012 abstract published in Injury PreventionCharacteristics of casualty crashes in the Republic of Botswana: identifying evidence-based prevention opportunities showed that:

Fatality rates increased by 383% (per 10 000 vehicles) from 1975–1998, with recent estimates indicating a 50% higher fatality rate per population than the global average.

The Global Burden of Disease 2010 Study showed that alcohol use was the leading risk factor for disease burden in Botswana. A 30% tax on alcohol (reduced from the initial plan for a 70% tax) was subsequently introduced. A second 2012 abstract in Injury PreventionComparing fatal alcohol-related road traffic crashes in Botswana pre- and post-passage of a national alcohol levy showed:

A large percentage of fatal alcohol-related crashes (FARCs) occurred on weekends (49%), among males (78%), and among 25–34 year-olds (35%).

Comparing changes pre- and post-levy, we found that there was a statistically significant change in FARCs per 10 000 registered vehicles (rate pre-levy=10.4; 95% CI 9.1 to 11.8 vs rate post-levy=8.3; 95% CI 7.3 to 9.3; p=0.01). However, rates per 100 000 population remained stable pre- and post-levy (rate pre-levy: 6.9; 95% CI 6.0 to 7.7 vs rate post-levy: 7.5; 95% CI 6.6 to 8.4; p=0.29).

Alcohol is, obviously, only one element of the highly complex issue that is road safety in Botswana. Road safety issues that I notice here daily include: lack of seatbelt use, unrestrained children, unroadworthy vehicles, animals on roads, speeding, negligent driving, potholes, and overcrowded vehicles. It is encouraging to see work being done on the ground to improve safety (police spot licence checks for example), however it will take time and a multifaceted, focused, local strategy similar to that seen in the HIV response for any great strides to be made. Encouragingly, we know that research and policy have had positive impacts in similar countries around the world. Interestingly, Botswana’s current road safety initiatives do not seem to be as creative as the robots in the Democratic Republic of Congo.

Whilst there is much to achieve in Botswana on the issue of road safety, the success of the HIV campaign means that Botswana can be proud of its initiatives to prevent injury to and illness in its citizens and visitors alike.

 

*Please note that I am not a researcher in the area of HIV or road safety, and this blog is largely based on my personal observations and knowledge. I welcome comments and insights from people who are – either below, or on our Twitter or Facebook.

The door zone: looking out for cyclist safety

17 Sep, 15 | by Sheree Bekker

lookforbikers

Bicycling related injuries are a complex problem. Take for example injuries related to “dooring” – in which a car driver or passenger opens a car door into the path of a cyclist, causing the cyclist to hit the door or veer into the path of oncoming traffic – which are becoming all-the-more common in our cities. Real video examples of this risk can be seen here and here.

Multiple factors contribute for the occurrence of “dooring” events, including those related to the behavior of road users, the infrastructure, traffic regulations, policies, and even recommendations based on bicycling safety research.

It has been suggested that the lack of awareness among car users can be in part explained by the limited efforts of city administrators to change the attitudes and social norms via increased penalties for “dooring” bikers and stronger campaigns promoting looking for bikers on the road.

In Injury Prevention Global News Highlights from 2014, Barry Pless wrote:

“A column in the New York Times, “Is it OK to kill cyclists?”, was prompted by the observation that “motorists in America generally receive no punishment for crashing into or killing cyclists, even when the ‘accident’ is transparently their fault.” In the Netherlands, the opposite is true: “if a motor vehicle hits a cyclist, … it is always assumed to have been the driver’s fault… ” because “the law treats pedestrians and cyclists as weaker participants in traffic…” The result is far fewer injuries to cyclists: 12 per billion km cycled in the Netherlands versus 58–109 in the USA.

Editor’s comment: Bicyclists need better protection. I am tired of complaints about how some cyclists behave. Their foolish behaviour mostly leads to harming themselves. In contrast, the far more dangerous car and truck drivers tend to be tolerated. Until there is equal condemnation for driver infractions, I suggest we cut bicyclists some slack. An example: recently, coroners reports were issued following three bicyclist deaths in Montreal. In the last year, 92 bicyclists were doored; 58 were taken to hospital and 2 died. The fine for dooring is US$30! Alongside a public awareness campaign reminding drivers that dooring is illegal, one coroner recommended charges of criminal negligence and a substantial increase in fines. “Motorists (must) accept that cyclists … are not obligated to restrict themselves to bike lanes.” It is time now for the balance in North America to swing in the direction of the Netherlands.” [emphasis ours] 

Another contributing factor to “dooring” is unsafe infrastructure. For example, even if bike lanes might be associated with overall risk reduction on average, they become a problem when built near to car parking spots, as open car doors usually block most of bike lane areas giving bikers no options to avoid crashes.

A 2014 commentary in Injury PreventionUnsuitability of the epidemiological approach to bicycle transportation injuries and traffic engineering problems, argued that problems such as the ‘door zone’ are also unwittingly created through the application of unsuitable methodologies in an attempt to solve complex problems:

“bicycle lanes have through systematic review received epidemiological approval. In cities around the world, these lanes, whether curbside of parked cars (therefore being cycle tracks) or roadside (ordinary bicycle lanes), typically run in the door zones. They are thus an obvious hazard. What is the common remedy offered, by epidemiologists and governments? Hypervigilance and luck, to be provoked by reducing turnover or putting the conflict on the passenger and curb side, large fines, stickers reminding drivers to watch out, advice to open the door with the opposite hand or for riders to look through vehicle windows for occupants’ heads, or even for occupants to open vehicle doors inch by inch”

It is true that bicycling safety is a complex problem. Indeed, complexity, by nature, increases the unpredictability of effects.  Likely, solutions to the “dooring” problem and others alike, would require embracing this complexity in scientific research and policy development, and also the work of of multidisciplinary teams, including engineers, road users, epidemiologists, sociologists, etc., that can study and rethink bicycling safety from different angles.

Two examples of strategies that are working to address this complexity are Vision Zero and Fatality Free Friday. Both bring together a diverse range of stakeholders – such as local traffic planners and engineers, police officers, policymakers, and public health professionals – to work towards safer mobility.

In the words of Leah Shahum, director of Vision Zero:

traditionally, traffic planners and engineers, police officers, policymakers, and public health professionals have not collaborated in meaningful, cross-disciplinary ways to meet shared goals (partly because they literally did not have shared goals for safe streets).  Vision Zero acknowledges that there are many factors that contribute to safe mobility infrastructure, enforcement, individual behavior/education, and policies — and all must be coordinated with a safety-first approach.”

Injury prevention, at its core, remains a complex endeavour and one in which the strengths of multidisciplinary teams and different fields of research must be harnessed for full effectiveness. 

~ Julian Santaella and Sheree Bekker

“Drive Your Bike, Don’t Just Ride It”

21 Aug, 15 | by Angy El-Khatib

Last week, I wrote a short blog highlighting a publication in this month’s issue of Injury Prevention which stressed the need to gather “better” data as a step towards improving future bicycle safety endeavors.

This week, I am absolutely delighted to introduce a guest blog by someone who is equally passionate and enthusiastic about data as he is about bicycle safety – my mentor and inspiration, Dr. Christiaan Abildso (follow him on Twitter at @walkbikemgw)! He is an assistant professor in the Department of Social and Behavioral Sciences at WVU School of Public Health. His main areas of research include health promotion program evaluation and the social ecological determinants of physical activity, including policy and the built environment. Recently, he presented “The Burden of Pedestrian- and Cyclist-Motor Vehicle Crashes (PCMCVs) and Costs in West Virginia: 2000-06” as a part of the 2014 WVU Injury Control Research Center’s webinar series (you can watch it here).

Christiaan rode his bike to the 2015 MPH and PhD graduation ceremony while wearing his academic dress.

Christiaan rode his bike to the 2015 WVU MPH and PhD graduation ceremony while wearing his academic garb.

Christiaan has two very notorious and very utlized catchphrases; the first is “I love data!” and the second is “Change the world!” which he very well does by engaging in the community. He served as the Chairperson for the Morgantown Pedestrian Safety Board from 2008 to 2014, has been an Ex-officio Member of the Morgantown Municipal Bicycle Board since 2012, and is a current member of both the West Virginia Connecting Communities and the Morgantown Traffic Commission.

Since this month’s blogging topic was to be focused on bike safety, I asked Christiaan to write a guest blog about his own experience as he transitioned from a novice cyclist to a trained traffic rider.


 

“Drive Your Bike, Don’t Just Ride It”
By guest blogger: Christiaan Abildso

My first taste of freedom was experienced on a teal-green Peugeot in the mid-1980s in suburban Washington DC. With each passing summer and my super cool 5-speed, I was given more and more leeway by my parents to “ride to John’s house,” then to Tom’s house, then to the community pool and parks. As a young lad in pre-helmet days I had a great time riding on and off sidewalks, and on wide streets mostly of 25 mph speed limit. It was suburban America in a Levitt town in the summer. I was safe.

As I grew up I rode less or not at all until I got back into bicycle commuting about 6 years ago when I became a father, gas prices were high, and I didn’t have time to go to a gym. I began to experience that freedom yet again. However, I was now riding in a more urban environment with more traffic, narrower lanes, no bike lanes or separate infrastructure, and less kindness toward me as a cyclist – let’s face it, kids on bikes get more leeway to mess up than mid-thirties cyclists! One day, I moved from the end of 5 cars at a red light in the left lane in a three lane, one-way downtown road to the middle lane to be at the front of the traffic. I did this to jump the traffic and move back over in front of the left lane traffic to make a turn. As I jumped back to the left lane, a kind gentleman driving by leaned his Livestrong band covered left wrist and wagged a finger at me, saying “you should know better. You’re gonna get killed.”

This statement made me think, what did I do wrong? That moment began my evolution from thinking like a “bike rider” to thinking like a “bike driver.” I began seeking the opinion of Frank Gmeindl – a League of American Bicyclists certified League Cycling Instructor (LCI) in Morgantown, WV, and uber-experienced rider with tens of thousands of miles of experience. He offered to ride behind me one day giving only these instructions (as I recall them): 1) ride like a vehicle, 2) be predictable, 3) be seen, and 4) take the lane. Following the ride – during which, in retrospect, I did a bunch of things that put me in harm’s way (like riding as far to the edge of the road as possible) – Frank patiently offered these same four suggestions, then took the lead. His few suggestions have, without a doubt, saved my life.

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Christiaan playing the “hipster” and picking up his Community Supported Agriculture (CSAs) on his bike.

I continued to seek out information, eventually taking the Safer City Cycling class offered by Frank and another local LCI. I have ridden thousands of miles over the past few years with the advice of Frank and others in my head. I now am confident enough in my abilities to ride in almost any condition on nearly any road without fear. Over the years I have evolved to be very calm in traffic and now help others when I see them riding in a way that puts them (or me as “one of those pesky bikers”) at risk of injury. I honed in on one statement I heard or read a few years back that summarizes how to operate a bicycle: “Drive your bike, don’t just ride it.” That neatly summarizes Frank’s four key lessons, and I often use that with others when they say I’m crazy for riding all the time and on almost any road. I also make an offer to them, as Frank did, to go for a ride to help.

To my fellow cyclists, when in traffic. Remember, we are traffic. We are adults. Vehicle drivers don’t want to hit us.

My advice when in traffic: Be seen. Be predictable. Take the lane. Drive your bike like you would a car…and, give a hand of thanks when a vehicle driver treats you well. It will make driving a bike safer for all of us.

 

 

Follow Dr. Christiaan Abildso at @walkbikemgw!

Concern for prehospital care/ambulance services

10 Aug, 15 | by jmagoola

I spent last week travelling in Adjumani district (located in Northern Uganda) as part of an exercise in improving the quality of immunization data through support supervision and mentor-ship. This required us as a team to visit as many of the health facilities in the district as possible. Due to the limited sources of our country, we had to make do with one of the hospital ambulances as a means of transport. In between ferrying us from one health facility to another, the driver would get calls to go pick up emergency cases that required urgent transportation to hospital.

In this scenario, all the ambulance is manned by only a driver (no paramedic, no nurse) whose role is to pick you up and drop you at the nearest health facility. One of 2 ambulanes currently used by the district to transport patients during emergencies.No triage, no first aid, no prehospital care until arrival. This could contribute to the trauma mortality rates, which are already higher in rural areas before victims reach the hospital. It is known that travel time is a predictor of the outcome of an injury and as such many fatal injuries or their severity may be reduced by adequate prehospital trauma care. A previous study in Uganda found that fewer than 5% of injured patients are transported by ambulance to hospital  most of which ambulances are privately run and expensive. In neighboring Tanzania, a study evaluating access to prehospital care found there was no prehospital care in the region.

The interior of the ambulance, lacking paramedic supplies for first aid.

The interior of the ambulance, lacking paramedic supplies for first aid.

This highlights a major need to prioritize the development of prehospital trauma care if we are to address the issue of injuries. In addition, while the presence of an ambulance will reduce the travel time to hospital and thus increase the chance of survival, the ambulances themselves should be equipped with materials to offer some basic first aid during the course of transportation. They key policy and clinical practice questions we should ask ourselves should include; how equipped are the ambulances?; what should be the minimum standards a vehicle should attain before it is designated as an ambulance?

 

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