Factors associated with incidence and mortality by road accidents involving motorcyclists and pedestrians: a rapid systematic review / Fatores associados à incidência e mortalidade por acidentes de estrada envolvendo motociclistas e pedestres: uma revisão sistemática rápida

Introduction: traffic accidents are the third leading cause of death in the world. Vulnerable road users do not benefit from a high level of protection. As such, they face devastating consequences when involved in accidents. Objective: to analyze the incidence and mortality, and associated factors in traffic accidents among motorcyclists and pedestrians. Methods: rapid Systematic review of articles from the National Library of Medicine (PubMed), Virtual Health Library (VHL), and Web of Science databases using the descriptors Mortality, Accidents, traffic, Motorcyclists and Pedestrians. Inclusion criteria were: (1) studies involving pedestrians and motorcyclists; (2) the object of study is traffic accidents; (3) articles that studied mortality; and (4) articles published in the last ten years (2010-2019). Results: of the 206 articles found, 19 met the inclusion criteria. Factors such as increased sales of motorcycles, darkness on the roads, older pedestrians, lack of safety equipment for motorcyclists, and drug and alcohol intake contribute to the increase of the mortality rate of these individuals. Conclusion: mortality due to traffic accidents involving pedestrians and motorcyclists has increased during the analyzed period, especially among men.

Introdução: os acidentes de trânsito são a terceira causa de morte no mundo. Os usuários vulneráveis da estrada não têm um alto nível de proteção como outros tipos de vítimas. Portanto, esses indivíduos enfrentam consequências devastadoras quando envolvidos em acidentes. Objetivo: identificar a tendência da mortalidade, incidência e fatores associados aos acidentes de trânsito entre motociclistas e pedestres por meio de revisão sistemática da literatura. Método: trata-se de uma revisão sistemática das bases de indexação da National Library of Medicine (PubMed), Virtual Health Library (VHL) e Web of Science utilizando os descritores Mortality AND Accidents, Traffic AND Motorcycles AND Pedestrians. Para a seleção dos artigos, foram incluídos aqueles que obedeciam aos seguintes critérios: população que (1) inclui motociclistas e pedestres e (2) se envolveu em acidentes de trânsito; e artigos que (3) estudaram mortalidade, incidência e / ou fatores associados a acidentes de trânsito e (4) foram publicados nos últimos 10 anos.Resultados: dos 206 artigos encontrados, 19 preencheram os critérios de inclusão. Fatores como aumento da venda de motocicletas, escuridão das vias, pedestres mais velhos, falta de equipamentos de segurança para os motociclistas e ingestão de drogas e / ou álcool contribuem para o aumento da taxa de mortalidade e incidência desses indivíduos. Conclusão: a mortalidade por acidentes de trânsito com pedestres e motociclistas tem aumentado nos últimos anos, com alta prevalência de mortalidade entre os homens. A maioria dos acidentes foi devido a falhas humanas e / ou deficiências nas vias públicas.

Años potenciales de vida perdidos y análisis espacial de incidentes viales en peatones de Medellín 2015-2020 / Years of potential life lost and spatial analysis of road accidents in medellin pedestrians between 2015-2020

Resumen Objetivo: Describir los años potenciales de vida perdidos (APVP) y la distribución espacial de la mortalidad por incidente vial en peatones de Medellín durante el período 2015-2020. Métodos: Se realizó estudio descriptivo con fuente de información secundaria, se analizaron la totalidad de registros de peatones muertos en incidente vial. El cálculo de los APVP fue realizado por grupos quinquenales y eligiendo como edad límite la esperanza de vida al nacer de Colombia, estimada por el DANE para el período 2015-2020. Para conocer la distribución geográfica de las muertes se creó mapa de puntos y densidad de Kernel con clasificación estándar-cuantil. El análisis de proximidad se realizó por el método búfer de anillos múltiples, con distancias de 100, 200 y 300 metros. Resultados: En Medellín, durante los años 2015-2020, se registraron 696 muertes de peatones, 514(73,9%) hombres y 182 (26,1%) mujeres. Las comunas de mayor mortalidad fueron Candelaria con 217(31,2%) muertes y Castilla con 61(8,8%). Las lesiones más frecuentes fueron politraumatismos 401 (57,6%) y lesiones en cabeza 231 (33,2%). En total los peatones de la ciudad perdieron 14.553 APVP por incidente vial. Del total de incidentes fatales en peatones, 400 (57,5%) ocurrieron en un radio de distancia de 300 metros de un puente peatonal. Conclusión: Peatones hombres presentaron las tasas de APVP más altas del período, y son quienes más mueren en la vía. Lesiones en cabeza y cráneo son las más fatales, especialmente si son adultos mayores quienes las sufren. La pérdida de fuerza laboral y económica es alta para la ciudad, pero la social y familiar es incalculable.

Abstract Objective: To describe the Years of Potential Life Lost (YPLL), and the spatial distributions of mortality caused by road accidents in Medellin pedestrians between the periods of 2015-2020. Methods: A descriptive study with a secondary source of information was carried out, and all the records of pedestrians killed in road accidents were analyzed. The calculation of the YPLL was carried out by five-year age groups and the Life Expectancy at Birth of Colombia as the age limit estimated by DANE for the period 2015-2020 was chosen. To know the geographical distribution of the deaths, point maps, and kernel density estimation with a standard quantile classification were created. The proximity analysis was performed by the multiple ring buffer method, with distances of 100, 200 and 300 meters. Results: During the years 2015-2020, 696 pedestrian deaths were registered in Medellin, from which 514 (73.9%) were men and 182 (26.1%) were women. The neighborhoods with the highest mortality were Candelaria with a percentage of 31.2% (217 deaths), and Castilla with a percentage of 8.8% (61 deaths). The most frequent injuries were polytrauma with a total of 401 cases (57.6%), and head injuries in 231 cases (33.2%). In total, the city's pedestrians lost 14,553 YPLL due to road accidents. From the total number of fatal pedestrian accidents, 400 (57.5%) of them occurred within a 300-meter radius of a pedestrian bridge. Conclusion: Male pedestrians had the highest YPLL rates of the period, and they are the ones who die the most on the road. Head and skull injuries are the most fatal, especially if they are suffered by older adults. The loss of labor and economic power is high for the city, but the social and family loss is incalculable.

Padrão de deslocamento ativo da região metropolitana de Campinas, Brasil / Campinas metropolitan region's active commuting pattern

Analisar o padrão do deslocamento ativo da Região Metropolitana Campinas, levando em conside-ração particularidades dos residentes e suas viagens. Utilizando as bases de dados obtidas através da Pesquisa Origem e Destino da Região Metropolitana de Campinas dos anos de 2003 e 2011, foram realizadas estatísticas descritivas e temporais a partir das características dos sujeitos, municípios e via-gens. Para identificarmos diferenças adotamos o intervalo de confiança de 95% (IC 95%). Utilizamos a regressão de Poisson para verificação da correlação entre características individuais e o desfecho ser ciclista ou caminhante, adotando o valor de p < 0,05. Todos os dados foram analisados levando-se em consideração os procedimentos de amostragem para que a amostra fosse representativa. Cons-tatou-se que a frequência de ciclistas e caminhantes e suas respectivas viagens caíram. Encontramos associação positiva para ciclista ser homem e classes econômicas mais baixas, para os caminhantes houve associação positiva ser mulher e crianças/adolescentes. Quanto ao tempo de viagem, notou-se aumento na mediana para os ciclistas e queda para os caminhantes. Não encontramos nenhuma via-gem de bicicleta que faça integração com outro modo de transporte. Quanto ao porte do município, observou-se uma queda em viagens de bicicleta tanto nos municípios pequenos, médios e grandes, e os residentes de Campinas apresentaram as menores frequências

This study analyzes the active commuting pattern of the Metropolitan Region of the City of Campinas, Brazil, by considering its commuters and their features. By using the database of Pesquisa Origem e Destino (a Brazilian instrument for transportation planning) of Campinas Metropolitan Region 2003-2011, we present descriptive and temporal statistics concerning the characteristics of the region's commuters, cities, and journeys. To assess those, we adopted a confidence interval of 95% (CI 95%). We used the Poisson regression to check the correlation between individual characteristics and outcomes of being a cyclist or a pedestrian, adopting the value of p < 0.05. We took into consideration the procedures for datum obtaining to present representative samples, verifying that the number of both cyclists and pedestrians has dropped. We found pos-itive associations regarding low-income males and being a cyclist; as well as females and children/teenagers and being pedestrians. The mean length of commuting time has increased for cycling journeys and decreased for pedestrian ones. We could not find a bicycle journey that integrates with another mean of transportation. Regarding the size of a city, we observed that the number of cycling journeys has dropped in small, medium, and large municipalities; Campinas presents the lowest index

Hit-and-runs more common with pedestrians lying on the road: Analysis of a nationwide database in Japan / 中华创伤杂志(英文版)

PURPOSE@#To determine the trends with fatally or otherwise injured pedestrians lying on the road and the relationship to hit-and-run incidents in Japan.@*METHODS@#We extracted data for 2012-2016 from the records of the Institute for Traffic Accident Research and Data Analysis, Japan, a nationwide traffic accident database. All the injured and fatally injured pedestrians were selected. We examined the levels of pedestrian injury, vehicle speed immediately before the collision, whether or not the pedestrian was lying on the road, and hit-and-run incidents. Chi-square test was employed to make a statistical comparison between the two groups.@*RESULTS@#The database contained data on 286,383 pedestrian casualties and 7256 fatalities; 8.3% of fatalities (602 persons) and 0.6% of casualties (1827 persons) involved pedestrians lying on the road. The rates of fatalities and severe injuries were significantly higher for pedestrians who were lying on the road than for those who were not. Hit-and-run incidents were evident in 4.0% of casualties and 7.3% of fatalities. The rate of hit-and-run cases was also significantly higher among pedestrians who were lying on the road. Among fatally injured pedestrians not lying on the road, the rates with speeds of ≥30 km/h did not differ significantly between hit-and-run and other cases. However, when the pedestrians were lying on the road, the rate was significantly increased in hit-and-run cases.@*CONCLUSION@#This is the first report to focus on pedestrians lying on the road and being involved in hit-and-run incidents. In addition to preventing hit-and-run incidents, prevention of pedestrians lying on the road could also decrease fatalities.

Atropelamento de idosos em vias públicas: caracterização e evolução do evento no período de 2007 a 2017, em um município brasileiro / Overrunning of elderly people on the streets: characterization and evolution, between 2007 and 2017, in a brazilian city

Este estudo teve como objetivo caracterizar os atropelamentos de idosos nas vias públicas de Maringá (PR), no período de 2007 a 2017. Trata-se de um estudo de abordagem quantitativa do tipo transversal descritivo. Foram pesquisados dados de natureza secundária nos Relatórios de Atendimento do Socorrista - RAS, do 5º Grupamento de Bombeiros de Maringá. Das 4213 ocorrências de atropelamentos registradas, 21,78% (918 casos) envolveram idosos. Aplicando-se o teste para comparação de proporções entre os sexos, não foram identificadas evidências amostrais suficientes de diferença significativa entre ambos (p = 0,508). Em 53,81% o veículo caracterizava-se como automóvel. Verificou-se uma grande variação do número de ocorrências anuais ao longo do período avaliado. O mês de maio teve maior ocorrência (11,33%). Identificou-se uma grande quantidade de escoriações no membro superior esquerdo (33%). Verificou-se que 22,11% dos acidentes foram no centro da cidade. Conclui-se que prevalecem como vítimas de atropelamento no município de Maringá idosos jovens, sem diferenças significativas em relação ao sexo. Apesar de preocupante, o número de ocorrências de atropelamento vem se mantendo estável nos últimos anos e os automóveis são os principais veículos envolvidos.

Current essay characterizes the overrunning of elderly people on the streets of Maringá, Brazil, between 2007 and 2017, through a quality, descriptive and transversal research. Secondary data in the Attendance Reports of First-Aid Helpers from the Fire Brigade of Maringá were researched. There were 4213 hits, with 918 (21.78%) cases involving elderly people. Tests for comparing gender ratios failed to show evidences with significant difference (p=0.508). The car comprised 53.81‰ of vehicles involved, but there was a great numerical variation of yearly occurrences throughout the period, with May as peak (11.33%). Wounds in the left upper limbs (33%) were detected, whilst 22.11% of accidents occurred downtown. Results show prevalence of young elderly hit victims in Maringá without any significant gender differences. However, number of hit occurrences maintained stable during the last years, with the main involvement of cars.

Lesiones por accidentes de tránsito en una institución de salud en el municipio de Pereira entre los años 2014 2017 / Injuries from traffic accidents in a health institution in the municipality of Pereira from 2014 to 2017

Resumen Introducción: Los accidentes de tránsito se han convertido en un importante problema de salud pública debido a su alta morbimortalidad. La tendencia en lesiones y muerte por accidentes de tránsito se encuentra en niveles alarmantes en países como Colombia. Objetivo: Caracterizar epidemiológicamente las lesiones por accidentes de tránsito reportados en personas atendidas en una institución de salud en el municipio de Pereira entre 2014 y 2017. Materiales y métodos: Estudio descriptivo y transversal basado en fuentes secundarias según características sociodemográficas, epidemiológicas y clínicas de los accidentes de tránsito atendidos en una entidad de salud del municipio de Pereira, durante el período comprendido entre los años 2014 a 2017. Resultados: Se analizaron 460 casos en el periodo estudiado (64,1%) en hombres. El motociclista representó el 44,3% de las víctimas. El 64,3% sufrieron contusiones, seguido del 20,9% de fracturas, el 53% de las lesiones se presentaron en miembros superiores e inferiores. Conclusiones: Existió un incremento significativo de las lesiones ocasionadas por accidentes de tránsito, producidas por motociclistas y peatones, asociadas a la impericia del conductor y la distracción del peatón, el cual desencadenó en contusiones y fracturas y aumento de la carga de la enfermedad.

Abstract Introduction: Traffic accidents have become an important public health problem due to their high morbimortality. The trend in injury and death from road traffic accidents is at alarming levels in countries like Colombia. Objective: To characterize epidemiologically the injuries by traffic accidents reported in people who were served in a health institution in the municipality of Pereira from 2014 to 2017. Materials and methods: A descriptive and transversal study was made based on secondary sources according to sociodemographic, epidemiological and clinical characteristics of traffic accidents attended by a health entity in the municipality of Pereira from 2014 to 2017. Results: 460 cases were analyzed in the studied period, 64.1% in males. The motorcyclist represented 44.3% of the victims. 64.3% suffered bruises, followed by 20.9% of fractures. 53% of the lesions were presented in upper and lower limbs. Conclusions: There was a significant increase in injuries caused by traffic accidents caused by motorcyclists and pedestrians, associated with the driver's incompetence and the distraction of the pedestrian, which triggered in contusions, fractures and increased burden of disease.

Epidemiological profile of pedestrian-motor vehicle trauma in the metropolitan area of Guadalajara

Background: According to ENSANUT, 60% of deaths are caused by road traffic injuries and affect the most vulnerable road users such as pedestrians, cyclists, and motorcyclists. Of this percentage, 45% were pedestrians. Objective: The objective of this study was to define the epidemiological profile of pedestrian-motor vehicle trauma in the Metropolitan Area of Guadalajara. Materials and Methods: A cross-sectional study was conducted on pedestrians injured in car collisions who were referred to a third-level public hospital from 2014 to 2015. The variables comprised the municipality where the event occurred, demographic characteristics, substance abuse, medication, the use of devices while crossing the street, and severity of injury. The information was analyzed using percentages, standard deviation, and χ2 for comparison-related factors according to the injury severity, considering p < 0.05 as statistically significant. Results: The total number of injured pedestrians was 397. The municipalities with the highest number of injured pedestrians were Guadalajara (41.3%) and Zapopan (29.7%). Males were the most affected (80.4%), with most incidents affecting those in the age group of 18–39 years old (34.5%). Roughly 65% of cases occurred at night and on Fridays, Saturdays, and Sundays. The most common injuries were fractures and injuries to the extremities and head, with 27% of injured pedestrians showing severe injuries. Conclusion: Although we did not find any statistical significance, the information gathered from this study indicates a need to implement preventive strategies about vial education and the improvement of signals and protective elements on the streets to aid vehicle and pedestrian flow and control or reduce the number of injured pedestrians.

Mortalidade de pedestres em acidentes de trânsito no Brasil: análise de tendência temporal, 1996-2015 / Mortalidad de peatones en accidentes de tránsito en Brasil: análisis de tendencia temporal, 1996-2015 / Pedestrian mortality in road traffic accidents in Brazil: time trend analysis, 1996-2015

Objetivo: analisar a tendência do coeficiente de mortalidade dos acidentes de trânsito envolvendo pedestres, por sexo, faixa etária e macrorregião no Brasil, entre 1996 e 2015. Métodos: estudo ecológico de série temporal, com dados de mortalidade do Sistema de Informações sobre Mortalidade (SIM) do Ministério da Saúde; utilizaram-se regressões generalizadas lineares de Prais-Winstein para o cálculo da variação percentual anual. Resultados: óbitos de pedestres corresponderam a 26,5% das mortes por acidentes de trânsito; a mortalidade entre pedestres diminuiu 63,2% no país, com variação do coeficiente padronizado, de 8,9 para 3,3 para cada 100 mil habitantes, ressaltando-se que as regiões Norte e Nordeste apresentaram uma diminuição mais lenta em relação à média nacional; os atropelamentos são significativamente maiores entre homens e idosos. Conclusão: apesar de a mortalidade entre pedestres estar diminuindo em todas as regiões, os números atuais ainda representam uma grande parcela da mortalidade no trânsito.

Objetivo: analizar la tendencia de la tasa de mortalidad de los accidentes de tránsito involucrando peatones, por sexo, grupo de edad y macrorregión en Brasil, entre 1996 y 2015. Métodos: estudio ecológico de serie temporal, con datos de mortalidad del Sistema de Informaciones sobre Mortalidad (SIM) del Ministerio de Salud; se utilizaron regresiones generalizadas lineales de Prais-Winstein para el cálculo de la variación porcentual anual. Resultados: las muertes de peatones correspondieron al 26,5% de las muertes por accidentes de tránsito; la mortalidad entre peatones disminuyó un 63,2% en el país, con variación de la tasa estandarizada, de 8,9 para 3,3 por cada 100 mil habitantes, destacando que las regiones Norte y Nordeste presentaron una disminución más lenta en relación al promedio nacional; los atropellamientos son significativamente mayores entre hombres y ancianos. Conclusión: a pesar de que la mortalidad entre peatones está disminuyendo en todas las regiones, las cifras actuales todavía representan una gran parte de la mortalidad en el tránsito.

Objective: to analyze the mortality coefficient trend for road traffic accidents involving pedestrians in Brazil, by sex, age range and macro-region, between 1996 and 2015. Methods: this was an ecological time series study using data from the Ministry of Health's Mortality Information System (SIM); Prais-Winstein generalized linear regression was used to calculate annual percentage change. Results: pedestrian deaths corresponded to 26.5% of deaths due to road traffic accidents; mortality among pedestrians decreased 63.2% in the country as a whole, with the standardized coefficient varying between 8.9 to 3.3 per 100,000 inhabitants, although the decrease in the country's North and the Northeast regions was slower than the national average; being run over was significantly higher among men and the elderly. Conclusion: although mortality among pedestrians is decreasing in all regions of the country, current figures still account for a large part of road traffic mortality.

Propuesta de un índice de seguridad de cruces peatonales para la Ciudad de México / Proposed Pedestrian Crosswalk Safety Rating for Mexico City / Proposta de um índice de segurança de travessia de pedestres para a Cidade do México

RESUMEN Objetivo Proponer un índice de seguridad de cruces peatonales (ISCP) sobre vialidades primarias en Ciudad de México para calificar los cruceros peatonales semaforizados, y contrastar el ISCP con hechos de tránsito para probar, en forma empírica, si hay alguna asociación entre la calidad de los cruceros y la siniestralidad. Métodos Identificación de los criterios del índice mediante una revisión del estado del arte, ponderación de los criterios para generar el ISCP mediante el método de análisis multicriterio, diseño de una muestra aleatoria estratificada de cruces peatonales (n = 490) y su evaluación. Resultados Relativo a la evaluación de los cruceros mediante el ISCP, destaca que 91,3% de los cruces evaluados en Ciudad de México no cuentan con las condiciones óptimas para resguardar la seguridad de los peatones, con el macrocriterio "Accesibilidad" como el peor calificado. En lo referente al modelaje, resalta que tanto la mezcla de usos del suelo como la distancia de cruce son las variables explicativas más importantes para predecir hechos de tránsito. Conclusiones El análisis mostró con relativo éxito la relación entre algunas de las variables (criterios) que conforman el ISCP con los hechos de tránsito. En muchos casos, esto muestra coherencia teórica. En otros, abre preguntas de investigación.

ABSTRACT Objective Propose a pedestrian crosswalk safety rating (PCSR) for primary roads in Mexico City in order to rate crosswalk safety at intersections with a traffic light and then compare the PCSR with traffic accidents so as to empirically determine any association between the quality of the crosswalk and the traffic accident rate. Methods Identify criteria for the rating system through a state-of-the art review; weight the criteria to create a rating system through multicriterion analysis; design a stratified random sample of crosswalks (n = 490); and evaluate the data set. Results Through the PCSR, 91.3% of the crosswalks evaluated in Mexico City were found not to offer the conditions required to protect pedestrian safety; the "access" macro-criterion received the worst scores. The modelling shows that mixed land use and the length of the crosswalk are the most important variables in predicting traffic accidents. Conclusions The analysis was relatively successful in showing the relationship between some variables (criteria) of the PCSR and traffic accidents. In many cases, this shows theoretical coherence; in others, research questions are raised.

RESUMO Objetivo Propor um índice de segurança de travessia de pedestres (ISTP) para as principais vias públicas na Cidade do México para classificar as travessias de pedestres semaforizadas e comparar o ISTP com os dados de trânsito para comprovar empiricamente se existe associação entre a qualidade dos locais de travessia e a taxa de acidentes. Métodos Foram identificados os critérios do índice com uma revisão do conhecimento atual e os critérios para gerar o ISTP foram ponderados com uso do método de análise de decisão multicritério e delineamento e avaliação de uma amostra aleatória estratificada de travessias de pedestres (n = 490). Resultados Com respeito à avaliação das travessias com o uso do ISTP, verificou-se que 91,3% das travessias avaliadas na Cidade do México não têm condições ideais para resguardar a segurança dos pedestres, com o macrocritério "acessibilidade" com a pior qualificação. Quanto à modelagem, observou-se que a mescla de usos do solo e a distância da travessia são as variáveis explicativas mais importantes para predizer a ocorrência de acidentes de trânsito. Conclusões A análise demonstrou com relativo sucesso a relação entre algumas variáveis (critérios) que compõem o ISTP e acidentes de trânsito. Houve uma coerência teórica em muitos casos, porém em outros suscitou dúvidas a serem investigadas.

Relationship between age and injury severity in traffic accidents involving elderly pedestrians

OBJECTIVE: This study aimed to examine whether injury severity differs with respect to age among elderly pedestrians involved in traffic accidents and identify factors affecting injury severity.METHODS: Using emergency department-based injury in-depth surveillance data, we analyzed the data of patients aged ≥60 years who were victims of pedestrian traffic accidents during 2011 to 2016. The pedestrians’ ages were divided into 5-year age strata beginning at 60 years. In a multivariate analysis, injury severity was classified as severe to critical or mild to moderate.RESULTS: The analysis included 10,449 patients. All age groups had a female predominance, and accidents most frequently occurred during the early morning. Multivariate analyses revealed that compared to the 60 to 64 years group, the odds ratios for incurring a severe injury were 1.18 (95% confidence interval [CI], 1.02 to 1.37) for the 65 to 69 years group, 1.42 (95% CI, 1.23 to 1.64) for the 70 to 74 years group, 1.70 (95% CI, 1.45 to 1.98) for the 75 to 79 years group, and 1.83 (95% CI, 1.56 to 2.15) for the ≥80 years group.CONCLUSION: In this study of emergency department-based data, we found that injury severity increased with age among elderly victims of traffic accidents. Furthermore, injury severity varied with respect to sex, time and location of the accident, and type of vehicle involved. Therefore, measures intended to reduce and prevent traffic accidents involving elderly pedestrians should consider these findings.

Incidence of pedestrian traffic injury in são paulo, brazil, in 2016 / Incidência de atropelamentos em são paulo, brasil, em 2016

ABSTRACT Objective: Globally, more than 1.2 million people die from traffic accidents each year. In order to reduce the rate of traffic accidents and their subsequent social consequences in Sao Paulo, Brazil, the aim of this study was to characterize pedestrian victims of traffic accidents and occurrences. Methods: This is a cross-sectional, quantitative, descriptive and retrospective epidemiological study of 2723 pedestrians injured in traffic accidents during 2016 in Sao Paulo. Results: Of the total sample, 37.3% participants were female and 62.7% male; incidence was highest in the 10-19 year old age group (19.9%) and lower limb injuries were most frequent (28.6%). Of the cases attended in urgent health care units, 75.6% progressed to hospital discharge. Accidents were more frequent in the afternoon (44.6%), and most commonly involved cars (47.2%). Conclusions: This study showed the importance of making detailed records of traffic accidents to guide the government in intensive education efforts to develop a healthy society and respect for traffic regulations, to promote urban improvements involving signage and pavement, and to maintain pre-hospital and hospital care teams in strategic locations to minimize the time elapsed between the accident and care provided to the victim. Level of Evidence II; Retrospective study.

RESUMO Objetivo: Mundialmente, mais de 1,2 milhão de pessoas morrem por ano vítimas de acidentes de trânsito. Visando a redução das taxas de acidentes de trânsito e suas consequências sociais em São Paulo, Brasil, o objetivo deste estudo foi caracterizar as vítimas de acidentes e ocorrências de trânsito. Métodos: Este é um estudo epidemiológico transversal, quantitativo, descritivo e retrospectivo de 2.723 pedestres vítimas de acidentes de trânsito durante 2016 em São Paulo. Resultados: Do total da amostra, 37,3% participantes eram mulheres e 62,7% homens; a incidência foi maior no grupo de 10 a 19 anos (19,9%) sendo as lesões de membros inferiores as mais frequentes (28,6%). Dos casos encaminhados às unidades de pronto atendimento, 75,6% evoluíram para alta hospitalar. Os acidentes foram mais frequentes no período da tarde (44,6%) e a maioria associada a automóveis (47,2%). Conclusões: O estudo mostrou a importância de realizar o registro detalhado de acidentes de trânsito para orientar os governantes para a educação intensiva da população visando o desenvolvimento de uma sociedade sadia e o respeito às leis de trânsito, promover melhorias urbanas quanto à sinalização e ao pavimento das vias e para manter equipes de atendimento pré-hospitalar e hospitalar em locais estratégicos para minimizar o intervalo de tempo entre o acidente e o atendimento das vítimas. Nível de Evidência II; Estudo retrospectivo.

Association between Time of Injury and Injury Severity after Pediatric Pedestrian Injury

PURPOSE: Pedestrian injury is one of the most frequent injury mechanism in pediatrics. This study aimed to measure the association between time of pedestrian injury and injury severity among pediatric patients. METHODS: We used the Emergency Department based Injury In-depth Surveillance (EDIIS) database from 23 emergency departments between 2013 and 2016. All pediatric (≤15 years old) patients with pedestrian injury were eligible, excluding cases with unknown outcomes. Primary and secondary endpoints was severe injury. We calculated adjusted odds ratios (AORs) of time of injury (8 am to 2 pm, 2 pm to 8 pm, 8 pm to 8 am) to investigate out-comes while adjusting for potential confounders. RESULTS: Among 6,748 eligible patients, 4,184 (62.0%) suffered pedestrian injury at 2 pm to 8 pm, 1,566 (23.2%) at 8 am to 2 pm, and 998 (14.8%) at 8 pm to 8 am. Among them, 52 (0.8%) had case-fatalities, 572 (8.5%) had severe injuries, and 1,246 (18.5%) were admitted to hospital. In terms of severe injury, the 8 am to 2 pm group (10.5%) had higher proportions of severe injury compared to the 2 pm to 8 pm (8.0%; AOR {95% confidence interval [CI]}, 0.73 [0.60 to 0.89]) and 8 pm to 8 am (7.2%; AOR [95% CI], 0.65 [0.49 to 0.88]) groups. CONCLUSION: Pediatric pedestrian injury was frequent at 2 pm to 8 pm and was more severe at 8 am to 2 pm. Public health efforts to decrease pediatric pedestrian injury are needed to reduce health burden.

Prospective Study on Road Traffic Accident Cases in Sub-urban Region of Chennai, Tamil Nadu State

The present study consists of 100 road traffic injury cases admitted in our tertiary health care centre. In the present study, males victims (84 cases, 84%) outnumbered the females victims (16 cases, 16%) with an approximate male female ratio of 5:1. Four wheelers and two wheelers involving mainly pedestrians were the most common cause for fatal head injury seen in 66 cases, 66%. Multiple abrasions were the most commonly seen external injury, seen in 68 cases, 68%. Skull bone fracture was seen in 40 cases, 40%. Temporal and parietal bones were common site of fracture seen in 41 cases, 41%.The mean survival period was 73.42 hours, range being 6 hours to 600 hours.

Burden of traffic accidents among pedestrians of Fars province, southern Iran; estimate of years of life lost in a sample of Iranian population from 2009 to 2013 / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Traffic injuries are among the leading causes of mortality and morbidity worldwide. Pedestrians have been considered as a high-risk group among road users, especially in middle- or low-income communities. This study attempted to determine the burden of pedestrians' fatalities in Fars, the southern province of Iran using years of life lost (YLL) approach.</p><p><b>METHODS</b>The data used in this study were retrieved from Fars Forensic Medicine Organization database on pedestrian traffic accidents. The YLL from 2009 to 2013 was estimated using the method presented by World Health organization. Some epidemiological characteristics of pedestrians' fatalities were analyzed by SPSS.</p><p><b>RESULTS</b>Although YLL among 1000 male pedestrians decreased from 2.5 in 2009 to 1.5 in 2013, it increased from 0.9 to 2.1 among 1000 females during the same period. Higher proportion of death was found in female, illiterate, and married pedestrians (p < 0.001). In addition, mortality was higher in pedestrians living the cities, during daytime, at home, and in hospitals (p < 0.001).</p><p><b>CONCLUSION</b>Consistent with the global trends, burden of pedestrian accidents in Fars was also exceptionally high. Considering the national and cultural aspects of different countries, improving the safety of pedestrians demands a multi-dimensional approach with interventional factors concerning policies, rules, pedestrians, motor vehicles and environmental conditions taken into consideration.</p>

Errores humanos autorreferenciados por los peatones del sistema vial de la ciudad de Bahía Blanca, Argentina: estudio descriptivo observacional / Human mistakes sel-referred by pedestrians in the city of Bahía Blanca, Argentina: descriptive, observational study

Introducción: los peatones representan el 22% del total mundial de fallecimientos por colisiones viales. Constituyen la población más vulnerable del sistema vial. Objetivo: describir los tipos de errores humanos autorreferenciados por los peatones que circularon en el sistema vial de la ciudad de Bahía Blanca durante el período septiembre del 2014 a abril del 2015. Metodología: estudio descriptivo observacional de corte transversal. Muestra por conveniencia. Se confeccionó una encuesta estructurada en base al Driver Behaviour Questionnaire en la versión traducida al español. Se validó mediante el método Delphi. Se analizó con software stadístico SPSS. Resultados: el 46,5% refiere no mirar a ambos lados de la calle antes de cruzar. El 22,3% refiere no ver cuando está saliendo un auto de un garaje y debe frenar bruscamente. El 32,2% refiere cruzar la calle hablando por teléfono celular y no darse cuenta si viene un vehículo. El 89,2% refiere cruzar a la vereda de enfrente por la mitad de la calle. El 69,7% refiere cruzar la calle aunque el semáforo peatonal esté en rojo. Conclusiones: las conductas que se observan en el estudio demuestran la inobservancia de las normas por parte de los peatones. Muchas de dichas conductas son condiciones que podrían generar una colisión con lesiones graves. El foco de la intervención debería orientarse al control más estricto de los peatones cuando circulan por el sistema vial.

Abstract Introduction: pedestrians represent 22% of the global number of deaths due to car accidents. They are the most vulnerable population of the road system. Objective: to describe the kinds of human mistakes self-referred by pedestrians who circulate in the road system of the city of Bahía Blanca during the September 2014- April 2015 period of time. Methodology: observational descriptive, cross-sectional study. Convenience sample. A survey was prepared based on the “Driver Behavior Questionnaire” (Spanish versión). It was validated by the Delphi method and analysed with With SPSS predictive analytics software. Results: 46.5 % declare no to look both ways before crossing the street. 22.3% state they do not see when a car is coming out of a garage and obliges it to stop abruptly. 32.2% declare to cross the street while using the cellphone and not realizing whether a vehicle is approaching. 89.2% admit they cross in the middle of the street. 69.7% affirm they cross the street on a red light. Conclusions: behaviors observed in the study demonstrate failure to observe the norms by pedestrians. Many of the above mentioned behaviors could result in collisions and cause serious lesions. Interventions should focus on stricter controls to pedestrians when they circulate in the road system.

Resumo Introdução: os pedestres são 22% do total mundial de falecimentos por colisões viárias. É a população mais vulnerável do sistema viário. Objetivo: descrever os erros humanos auto-relatados pelos pedestres que circulam no sistema viário da cidade de Bahía Blanca durante o período setembro de 2014 - abril de 2015. Metodologia: estudo descritivo observacional transversal. Amostragem por conveniência. Um questionário estruturado foi elaborado baseado na versão em espanhol do “Driver Behaviour Questionnaire”. Foi validado utilizando o método Delphi e analisado usando o software estatístico SPSS. Resultados: 46,5 % afirma não olhar para os dois lados da rua antes de atravessar. 22,3% afirma não ver quando um auto sai de uma garagem e tem que frear bruscamente. 32,2% afirma atravessar a rua conversando pelo celular e não perceber a aproximação de um veículo. 89,2% afirma atravessar a rua na metade do quarteirão. 69,7% afirma atravessar a rua mesmo quando o semáforo para pedestres está vermelho. Conclusões: as condutas observadas no estudo mostram que os pedestres não respeitam as normas. Muitas dessas condutas podem causar colisões com lesões graves. A intervenção deveria focar-se em um controle mais rigoroso dos pedestres quando circulam pelo sistema viário.

Atendimento de urgência e emergência a pedestres lesionados no trânsito brasileiro / Urgent and emergency care for pedestrians injured in Brazilian traffic

Resumo O objetivo do artigo foi descrever o perfil epidemiológico de pedestres que sofreram lesões no trânsito, atendidos em unidades de urgência e emergência participantes do VIVA Inquérito de 2014 e a caracterização desses eventos e de suas consequências para essas vítimas. Trata-se de um estudo transversal realizado no período de setembro a novembro de 2014 em 24 capitais brasileiras e no Distrito Federal. Foram analisadas variáveis que caracterizam a vítima, o acidente e sua gravidade e a evolução do caso. Foram calculadas frequências simples e relativas. Realizou-se análise bivariada segundo sexo e faixa etária. Para verificar a independência entre as variáveis, empregou-se o teste de Rao-Scott, com um nível de significância de 5%. Os resultados mostram que 34,3% dos atendimentos foi de indivíduos na faixa etária de 20 a 39 anos, 54,2% de pessoas de cor parda, 35,9% de indivíduos com até 4 anos de escolaridade. Os atropelamentos ocorreram principalmente à noite (33,6%) e à tarde (31,3%). Em todos os grupos etários a maior parte dos casos evoluiu para a alta, mas 41,6% dos idosos (60 anos ou mais) necessitaram de internação hospitalar. Destaca-se a necessidade de investimentos públicos priorizando a circulação de pedestres no planejamento do trânsito e da infraestrutura das vias.

Abstract This paper aimed to describe the epidemiological profile of pedestrians injured in traffic accidents treated at urgent and emergency facilities participating in the 2014VIVA Survey and the characterization of these events and consequences for these victims. This is a cross-sectional study conducted in the period from September to November 2014 in 24 Brazilian state capitals and the Federal District. We analyzed variables that characterize the victim, the accident and its severity and case outcome. We calculated simple and relative frequencies and performed a bivariate analysis by gender and age group. We used the Rao-Scott test with a 5% significance level in order to verify the independence of variables. Results show that 34.3% of attendances were for individuals aged 20–39 years, 54.2% had brown skin and 35.9% of individuals had up to 4 years of schooling. Run-overs occurred mainly at night (33.6%) and in the afternoon (31.3%). Most cases resulted in discharge in all age groups, but 41.6% of the elderly (60 years and over) required hospitalization. We stress the need for public investment, prioritizing pedestrian circulation in traffic and road infrastructure planning.

Desarrollo de un Cuestionario Breve para la Medición del Comportamiento Arriesgado en Peatones Adolescentes / Development of a Brief Questionnaire to Measure Risky Behavior in Adolescent Pedestrians / Desenvolvimento de um Questionário Breve para a Medição do Comportamento Arriscado em Pedestres Adolescentes

El objetivo del presente estudio fue la creación de un cuestionario autoinformado breve para valorar los comportamientos arriesgados en peatones. Para ello se contó con una muestra de 351 personas que completaron los 13 ítems iniciales del instrumento y que llevaron a cabo una tarea de percepción de riesgo a modo de medida de validez. El análisis factorial confirmatorio verificó el ajuste satisfactorio del modelo final de 8 ítems en un único factor, que alcanzó una consistencia interna satisfactoria (α=.75). Posteriormente los análisis evidenciaron la validez convergente y discriminante del cuestionario, con base en las correlaciones obtenidas con las medidas de percepción de riesgo administradas.

The objective of the present study is the creation of a brief self-reporting questionnaire to assess risky behaviors among pedestrians. For this purpose, a sample of 351 people completed the initial 13 items on the instrument and performed a task of risk perception as a measure of validity. The confirmatory factor analysis verified a satisfactory fit of the final 8-item model for a single factor, which reached a satisfactory internal consistency (α=.75). Subsequently, the analysis showed the convergent and discriminant validity of the questionnaire based on correlations obtained with the administered measures of risk perception.

O objetivo do presente estudo foi a criação de um questionário autorrelatado breve para avaliar os comportamentos arriscados em pedestres. Para isso, contou-se com uma amostra de 351 pessoas que completaram os 13 itens do instrumento e que realizaram uma tarefa de percepção de risco como modo de medida de validez. A análise fatorial confirmatória verificou o ajuste satisfatório do modelo final de 8 itens num único fator, que alcançou uma consistência interna satisfatória (α=.75). Posteriormente, as análises evidenciaram a validez convergente e discriminante do questionário, com base nas correlações obtidas com as medidas de percepção de risco administradas.

A Postmortem Study of Pedestrian Injuries to Find out Risk Factors And Preventive Measures.

Objectives: Present study is a little effort to understand factors responsible for pedestrians accidents, to determine risk factors, sources and causes of mortality involved in pedestrians accidents, to reach a conclusion regarding prevention of pedestrians accidents and reducing pedestrians mortality. Materials and Method: Present study is a retrospective study based on an analysis of 156 autopsies on cases of pedestrian accidents at Sheth V.S. General Hospital, Ahmadabad during two consecutive years from May 2008 to April 2010. Result: Following risk factors are identified from this study- old age, heavy motor vehicles, city life, morning hours of the day etc. Pedestrians are the most vulnerable to vehicular injuries and victims of road traffic accidents. There is less awareness in pedestrians as well as in drivers of vehicles regarding road traffic accidents and its consequences.

Pattern of road traffic accidents in Imphal.

In recent years the incidence of Road Traffic Accidents is increasing at an alarming rate throughout the world posing itself as a major epidemiological as well as medico-legal problem. In a study of 205 cases of Road Traffic Accidents brought to the mortuary of Regional Institute of Medical sciences, Imphal during September 2007 to August 2009, it was noted that males (75.13 %) outnumbered the females (24.87%). Majority of the victims were in the age group of 21 - 30 years (24.89%). It was also noted that majority of the accidents happened in the National Highways (59.51%) and pedestrians were the commonest victims (37.56%). Trucks were the most frequent offending vehicles (34.63%) followed by Buses (22.94%) The commonest cause of death was due to shock and haemorrhage (34.64%). large number of human lives can be saved if trauma centres are established along the National Highways equipped with well trained medical personnel and complete infrastructure of emergency care.

Profile of fatal road traffic accidents in Rajkot city.

Road traffic injuries are recognized as a major health problem in developing countries accounting for the maximum morbidity and mortality following trauma. The present prospective study was conducted at the Department of Forensic Medicine, P.D.U. Medical College and Associated Hospital, Rajkot from January 2008 to December 2008. The objective of this study was to analyze the trend of fatal road traffic accidents and to find out the measures for the prevention of their causative factors. During that period out of 2159 autopsies, 298 cases of Road Traffic Accidents were selected for the present study which accounts 13.8% deaths. Our study shows that 99(33.22%) victims were male of middle age group (21-30 years), male: female ratio was 10.5:1. 114(38.26%) cases were observed during working hours between 12.01 p.m. to 6.00 p.m. 101(33.89%) victims were pedestrians, followed by occupants of heavy four wheelers, two wheelers and three wheelers. Head injury in 161(54.03%) followed by hemorrhagic shock in 51(17.11%) were main causes of death. 141(47.32%) victims were died within one hour after accident.