Progress on epidemiological characteristics and interventions of pedestrian distraction / 中华流行病学杂志

Pedestrian distraction is one of the important risk factors of road injury. This review summarized the epidemiological characteristics, influencing factors, safety implications, and the published intervention measures. The review found that: a) the prevalence of pedestrian distraction poses a serious threat to pedestrian safety, but most epidemiological studies on pedestrian distraction focus on mobile phone use, and the incidence of pedestrian distraction varied greatly across studies using various research methods and from different countries; b) demographic characteristics, social psychology, and environment are the three main influencing factors of pedestrian distraction; c) distraction differently affected physiology, cognition, motion control, efficiency and behavior of pedestrian's street-crossing to some degrees, threatening the safety of pedestrian; d) engineering interventions and education were the most common interventions to prevent pedestrian distraction currently, but the effectiveness of most measures was not assessed rigorously. In the future, multidisciplinary and systematic epidemiological studies are recommended to design interventions purposely and evaluate the effectiveness of interventions through rigorous designs, providing scientific evidence for reducing pedestrian distraction and improving road safety of pedestrians.

Tendência temporal das internações por acidentes de trânsito na cidade de São Paulo, Brasil, 2000-2019 / Time trend in hospitalizations from motor vehicle accidents in the city of São Paulo, Brazil, 2000-2019 / Tendencia temporal de los internamientos por accidentes de tráfico en la ciudad de São Paulo, Brasil, 2000-2019

Este estudo avaliou a tendência das taxas de internação por acidentes de trânsito no Sistema Único de Saúde (SUS), de residentes no Município de São Paulo, Brasil, entre 2000 e 2019, segundo sexo, faixa etária e meio de transporte (pedestres, ciclistas, motociclistas e ocupantes de veículo). Foi ajustado um modelo de regressão segmentada com resposta binomial negativa, com pontos de inflexão para acomodar possíveis mudanças de tendência. Foram registradas 189.765 internações durante o período de estudo, a maioria de homens (80,5%) com idade entre 20 e 49 anos (71,2%). O tipo de acidente mais frequente foi com motocicleta (42,8%), seguido dos atropelamentos de pedestres (33,7%). De um modo geral, o período de 2000 a 2007 foi marcado pelo crescimento das taxas de hospitalização por acidentes de trânsito para todos os meios de transporte, em ambos os sexos e na maioria das faixas etárias. O momento em que as taxas pararam de crescer ou que eventualmente passaram a cair foi diferente para os diferentes meios de transporte. Para ocupantes de veículos e ciclistas, a tendência na maioria das faixas etárias inverteu-se para uma de queda em 2008, mas para pedestres e motociclistas, isto só ocorreu em 2012. A partir de 2015, a queda cessou em pedestres e as taxas em ciclistas voltaram a subir, na maioria das faixas etárias. Para motociclistas, as taxas voltaram a crescer em homens de 20 a 59 anos (7,2% ao ano, atingindo valores superiores a 140 por 100 mil habitantes em 2019) e em mulheres, de 15 a 39 anos (4,9% ao ano). É possível que os benefícios das medidas de segurança implementadas até agora tenham atingido seu limite, de modo que as atuais medidas de controle e prevenção devem ser revistas.

This study assessed the hospitalization rates from motor vehicle accidents in the Brazilian Unified National Health System (SUS) in residents of the city of São Paulo, Brazil, from 2000 to 2019, according to sex, age bracket, and means of transportation (pedestrians, cyclists, motorcyclists, and motor vehicle occupants). A segmented regression model with negative binomial response was adjusted with inflection points to accommodate possible changes in trends. 189,765 hospitalizations were recorded during the study period, mostly males (80.5%) and from 20 to 49 years of age (71.2%). The most frequent type of accident involved motorcyclists (42.8%), followed by run-over pedestrians (33.7%). In general, the period from 2000 to 2007 was marked by increasing hospitalization rates from motor vehicle accidents involving all means of transportation, in both sexes, and in most age brackets. The year when the rates stopped increasing (or in some cases began to drop) differed according to the means of transportation. For vehicle occupants and cyclists, the trend in most age brackets turned downward in 2008, but the same did not happen with pedestrians and motorcyclists until 2012. Starting in 2015, the decline stopped in pedestrians, and the rates in cyclists turned upward again in most age brackets. For motorcyclists, the rates turned upward again in men 20 to 59 years of age (7.2% per year, exceeding 140 per 100,000 inhabitants in 2019) and in women 15 to 39 years of age (4.9% per year). The benefits of traffic safety measures implemented thus far in Brazil may have reached their limit, so that the current control and prevention measures need to be revised.

Este estudio evaluó la tendencia de las tasas de internamiento por accidentes de tránsito en el Sistema Único de Salud, de residentes en el Municipio de São Paulo, Brasil, entre 2000 y 2019, según sexo, franja de edad y medio de transporte (peatones, ciclistas, motociclistas y ocupantes de vehículo). Fue ajustado a un modelo de regresión segmentada con respuesta binomial negativa, con puntos de inflexión para acomodar posibles cambios de tendencia. Se registraron 189.765 internamientos durante el período de estudio, la mayoría de hombres (80,5%) con edad entre 20 y 49 años (71,2%). El tipo de accidente más frecuente fue con motocicleta (42,8%), seguido de atropellamientos de peatones (33,7%). De modo general, el período de 2000 a 2007 estuvo marcado por el crecimiento de las tasas de hospitalización por accidentes de tránsito para todos los medios de transporte, en ambos sexos, y en la mayoría de las franjas de edad. El momento en el que las tasas pararon de crecer, o que eventualmente pasaron a caer, fue diferente para los diferentes medios de transporte. En el caso de ocupantes de vehículos y ciclistas, la tendencia en la mayoría de las franjas de edad se invirtió hacia una caída en 2008, pero en peatones y motociclistas, esto solo ocurrió en 2012. A partir de 2015, la caída cesó en peatones y las tasas en ciclistas volvieron a subir, en la mayoría de las franjas de edad. Para los motociclistas, las tasas volvieron a crecer en hombres de 20 a 59 años (7,2% al año, alcanzando valores superiores a 140 por 100 mil habitantes en 2019) y en mujeres, de 15 a 39 años (4,9% al año). Es posible que los beneficios de las medidas de seguridad implementadas hasta ahora hayan alcanzado su límite, de modo que las actuales medidas de control y prevención deben ser revisadas.

Promoção de comportamento seguro no trânsito: relato de uma intervenção / Promoting safe behavior in traffic: an intervention report / Promoción de comportamiento seguro en el tránsito: relato de una intervención

Este artigo objetiva relatar uma intervenção em Psicologia do Trânsito, visando conscientizar jovens estudantes sobre aspectos importantes do trânsito que estão envolvidos no cotidiano. O projeto "Meu Primeiro Certificado UFPR" foi elaborado como projeto piloto para implementação durante a Feira de Profissões da Universidade Federal do Paraná, desenvolvendo quatro temáticas: o pedestre e uso do celular; cinto de segurança; mobilidade com a bicicleta; e entrar no carro com motorista alcoolizado. Estandes com os temas foram montados em pontos estrategicamente distribuídos na feira. Ao entrar na feira, os estudantes recebiam um material já no primeiro estande; ao visitarem os outros quatro estandes, recebiam carimbos de presença em cada um; e, ao final da feira, o estudante recebia um certificado mediante a apresentação do cartão carimbado. Ao todo, o projeto alcançou diretamente 2674 estudantes de Ensino Médio, 68,7% adolescentes mulheres. Os participantes tinham entre 14 e 19 anos (M = 16,59). Do total de jovens, 72,3% estudam em escola pública. Concluiu-se que a aplicação do piloto foi relevante, uma vez que houve grande alcance do público-alvo, que demonstrou interesse em visitar os estandes e dialogar sobre as temáticas apresentadas. O projeto foi bem avaliado pelos participantes, a maioria (75%) classificando-o como excelente.(AU)

This article aims to report a Traffic Psychology intervention that sought to raise awareness about important traffic features involved in everyday life among young students. Developed to be implemented in the Career Expo at the Universidade Federal do Paraná, the pilot project Meu Primeiro Certificado UFPR (My first UFPR Certificate) consisted of four stands strategically positioned along the expo, each approaching one of the following themes: pedestrian's use of mobile phone, seat belt, bicycle use, and travelling with a drunk driver. The students received the material to participate in the activity upon entering the expo; for each visited stand, they received a stamp and, after completing the four stands, they received a certificate. The project was offered to 2674 high school students (68.7% female; 72.3% of whom studied in public schools) aged between 14 and 19 years (M = 16.59); among these, 924 visited all stands and received the certificate. The intervention program was relevant due to its wide reach, as a considerable amount of students showed interest in visiting the stands and talking about the presented topics, with 75% of them rating the project as excellent.(AU)

Este artículo tiene como objetivo relatar una intervención en Psicología del Tránsito con el fin de concientizar a jóvenes estudiantes sobre los aspectos importantes de esta involucrados en el día a día. El proyecto Meu Primeiro Certificado UFPR ("Mi Primer Certificado UFPR") se elaboró como un proyecto piloto y fue desarrollado durante la Feria de Profesiones de la Universidade Federal do Paraná, teniendo en cuenta cuatro temáticas: el peatón y uso del celular; el cinturón de seguridad; la movilidad con la bicicleta y el manejo del coche con conductor alcohólico. Los estudiantes recibían el material en el primero de los stands, junto con un sello de presencia por cada visita a los cuatro stands, y obtenían el certificado al final de la feria mediante la presentación de la tarjeta sellada. En total, el proyecto llegó directamente a 2.674 estudiantes de la secundaria, siendo el 68,7% mujeres. Los participantes tenían edades entre los 14 y los 19 años (media = 16,59). Del total de jóvenes, el 72,3% estudiaban en escuelas públicas. Se concluye que la aplicación piloto se mostró relevante debido al gran alcance dentro del público objetivo, que durante la aplicación se mostró interesado por la visita a los stands y el diálogo con respecto a las temáticas presentadas. En cuanto al nivel de satisfacción, el 75% de los participantes clasificaron el proyecto como excelente.(AU)

Voluntary and mandatory use of face mask by pedestrians in Guatemala City during the COVID-19 pandemic / Uso voluntario y obligatorio de mascarilla por peatones en la ciudad de Guatemaladurante la pandemia de COVID-19

The COVID-19 pandemic has currently affected more than 200 countries and caused around four million cases. Face masks are recommended for preventing the contagion. The Guatemalan government issued a decree for the mandatory use of face masks in public places. In order to find out the frequency of voluntary and mandatory use of face masks by Guatemalans we conducted a case study divided in two episodes (pre and post mandatory use decree) by driving a 27.8 km car transect through 11 of the 22 zones of Guatemala City and observing the use of face mask by pedestrians walking on the sides of the transect. Pedestrians were visually classified by age category (children [< 12 years], juveniles [12-21 years], adults [21-65 years] and elders [> 65 years]) and gender. During the pre-decree observation, we registered 476 individuals using a face masks and 674 not using or using them improperly. During the post-decree observation, we registered 797 individuals using face masks and 211 not using or using them improperly. In general, the frequency of face mask use was higher in the post-decree sample. Males used face masks less frequently than females, especially the elders and especially before the use became mandatory. Although the mandatory use decree managed to increase the frequency of the use of the face mask, there is a portion of the population that is not using it or that is using it improperly, so this should be considered by the health authorities who are dealing with the COVID-19 pandemic.

a pandemia de COVID-19 ha afectado actualmente a más de 200 países y causado alrededor de cuatro millones de casos. Se recomienda el uso de mascarillas faciales para prevenir el contagio. El gobierno de Guatemala emitió el decreto 6-2020 para el uso obligatorio de mascarilla en lugares públicos. Para determinar la frecuencia del uso voluntario y obligatorio de la mascarilla por parte de los guatemaltecos, se realizó un estudio de caso dividido en dos episodios (pre-decreto y post-decreto), recorriendo un transecto de 27.8 km en 11 de las 22 zonas de la ciudad de Guatemala y observando el uso de mascarilla por los peatones que caminaban a los lados del transecto. Los peatones se clasificaron visualmente por categoría de edad (niños [< 12 años], jóvenes [12-21 años], adultos [21-65 años] y adultos mayores [> 65 años]) y sexo. Durante el recorrido pre-decreto, observamos 476 personas usando mascarilla y 674 que no la utilizaban o la utilizaban incorrectamente. Durante el recorrido post-decreto, observamos 797 personas utilizando mascarilla y 211 que no la utilizaban o la utilizaban incorrectamente. En general, la frecuencia de uso de la mascarilla aumentó, luego de publicado el decreto. Los hombres usan mascarilla en menor proporción que las mujeres, sobre todo antes de publicarse el decreto. Aunque el decreto de uso obligatorio logró aumentar la frecuencia de uso de la mascarilla, todavía hay una parte de la población que no la está utilizando o que la está utilizando de manera incorrecta por lo que esto debe ser considerado por las autoridades de salud que están lidiando con la pandemia.

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.

Siniestros de tránsito de las personas mayores en Chile entre los años 2008 y 2017: estudio descriptivo / Road traffic accidents of the elderly in Chile between the years 2008-2017: a register-based descriptive study

OBJETIVO: Determinar si las personas mayores tienen mayor tasa de sufrir siniestros de tránsito, de fallecer o de lesionarse en estos, en comparación con personas adultas en Chile entre los años 2008 y 2017. MÉTODO: Se utilizaron las bases de datos de la Comisión Nacional de Seguridad de Tránsito de los últimos 10 años y los datos de habitantes según las proyecciones realizadas por el Instituto Nacional de Estadística. Se calcularon las medidas de efecto e intervalos de confianza del 95%. RESULTADOS: Las personas mayores en Chile tuvieron 0,5 veces la tasa de sufrir un siniestro de tránsito; 0,6 veces la tasa de lesionar y 1,3 veces la tasa de fallecer en un siniestro de tránsito que presentan las personas adultas. Antofagasta y Arica fueron las regiones con menor y mayor ocurrencia de fallecimientos de personas mayores. Las principales causas de siniestro fueron la imprudencia del conductor y peatón, las que a su vez presentaron 1,6 y 2,6 veces la tasa de fallecimiento en personas adultas. De los principales tipos de siniestros, sólo en los atropellos las personas mayores tuvieron mayor ocurrencia de muerte (razón de tasas 2,4). CONCLUSIONES: Confirma la mayor vulnerabilidad a fallecer en un siniestro de tránsito de las personas mayores. Se aprecian grandes diferencias a través de las diversas regiones del país. Las futuras investigaciones deben abordar las características de los usuarios, las estrategias que podrían ayudar a estos a tener una mejor interacción y promover la salud con foco en la seguridad vial en las personas mayores.

OBJECTIVE: To determine if older adults in Chile have higher rates of traffic incidents, resulting in death or injury when compared to younger adults between 2008 and 2017. METHODS: The databases of the National Traffic Safety Commission of the last ten years and the data of inhabitants according to the projections made by the National Statistics Institute were used. Effect measures and 95% confidence intervals were calculated. RESULTS: The elderly in Chile had 0.5 times the rate of suffering a traffic accident, 0.6 times the rate of injury, and 1.3 times the rate of dying in a traffic accident when compared against non-elderly adults. Antofagasta and Arica were the regions with the lowest and highest occurrence of death for older adults, respectively. The leading causes of traffic accidents were the imprudence of the driver and pedestrian, which presented 1.6 and 2.6 times the death rate when compared against non-elderly adults. Of the main types of traffic accidents, only when the pedestrian was hit by a vehicle, the elderly had a higher occurrence of death (rate ratio 2.4). CONCLUSIONS: Older adults presented a greater vulnerability to death by traffic accidents. Substantial differences are seen across different regions. Future research should address the characteristics of the users, the strategies that could help them to have better interaction, and promote health with a focus on road safety for older people.

Reconstruction of Vehicle-pedestrian Collision Road Traffic Accidents Based on PC-Crash Software / 法医学杂志

Objective To discuss the application value of vehicle-pedestrian collision road traffic accidents reconstruction based on PC-Crash software in forensic identification. Methods A case of vehicle-pedestrian collision was chosen based on a tachograph, then PC-Crash software was applied to construct a vehicle-pedestrian collision model, and reconstruct the vehicle-pedestrian collision road traffic accident. Finally, the process of vehicle-pedestrian collision was reproduced. Results In accident reconstruction, when the car speed was lower than 50km/h, the landing point of the pedestrian after collision was in the front of the car. When the car speed was higher than 50 km/h, after collision, the pedestrian flipped towards the car roof and landed behind the car. With the increase of vehicle speed, throwing distance of the pedestrian increased continuously. When the vehicle collision speed reached 60 km/h, the experimental results in this case were basically consistent with the actual situation of the case. Head acceleration of the pedestrian was at the maximum （1 655.70 m/s2） at 0.080 s. Chest acceleration of the pedestrian increased from 597.63 m/s2 to the peak 675.52 m/s2 at 0.055-0.060 s. Tibia acceleration of the pedestrian increased from 759.26 m/s2 to the first peak 1 367.06 m/s2, then reached the maximum speed （1 718.19 m/s2） at 1.225 s. Conclusion The process of vehicle-pedestrian collision road traffic accidents can be reconstructed based on PC-Crash software under a situation of limited conditions, and can further clarify the speed of the vehicle, the location and degree of human body injury as well as the mechanism of damage of the pedestrian in the accident. Therefore, PC-Crash software has a certain practical value in forensic identification of road traffic accidents.

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.

Left-turning vehicle-pedestrian conflicts at signalized intersections with traffic lights: Benefit or harm? A two-stage study / 中华创伤杂志(英文版)

PURPOSE@#Vehicle-pedestrian conflicts are common at road intersections when traffic lights change. However, the impact of traffic light on transportation safety and efficiency remains poorly understood.@*METHODS@#A two-stage study was used to survey the proportion of intersections with conflicting traffic lights and the related transportation efficiency and safety were evaluated as well. First, a cross-sectional study estimated the proportion of signalized intersections with conflicting left-turning vehicle-pedestrian traffic lights in Changsha city, China. Second, a natural experiment compared transportation efficiency and safety between intersections with and without conflicting left-turning vehicle-pedestrian traffic lights. Risky conflicts, where motor vehicles violated laws and failed to yield to pedestrians in crosswalk were used as a surrogate for transportation safety. The number of motor vehicles and pedestrians passing through the intersections per second and per meter were used to estimate transportation efficiency. Data were collected and analyzed in 2015 (from March to December). A search of online news from domestic media sources was also conducted to collect pedestrian injury data occurring at the intersections.@*RESULTS@#About one-fourth (57/216) intersections had conflicting left-turning traffic lights (95% CI: 20.5%, 32.3%). Risky vehicle-pedestrian conflicts were more frequently observed at intersections with conflicting lights compared to those without (incidence rate ratio (IRR) = 3.13; pedestrians: IRR = 4.02), after adjusting for type of day (weekday vs. weekend), the time period of observation, and motor vehicles traffic flow. Intersections without conflicting vehicle-pedestrian traffic lights had similar transportation efficiency to those with conflicting lights after controlling for covariates (p > 0.05). The systematic review of news media reports yielded 10 left-turning vehicle-pedestrian crash events between 2011 and 2017, involving 11 moderate or severe pedestrian injuries and 3 fatal pedestrian injuries.@*CONCLUSION@#Over one-fourth of road intersections in Changsha city, China have conflicting left-turning traffic lights. Conflicting traffic lights cannot improve transportation efficiency, but increase risky conflicts between vehicles and pedestrians.

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.

Impacto do Código de Trânsito Brasileiro e da Lei Seca na mortalidade por acidentes de trânsito / Impact of the Brazilian Traffic Code and the Law Against Drinking and Driving on mortality from motor vehicle accidents / Impacto del Código de Tráfico Brasileño y la Ley Seca en la mortalidad por accidentes de tráfico

Resumo: O objetivo foi analisar o impacto do Código de Trânsito Brasileiro (CTB) e da Lei Seca na mortalidade por acidentes de trânsito no Estado do Paraná, Brasil, no período de 1980 a 2014. Estudo ecológico de séries temporais das taxas de mortalidade por acidentes de trânsito de residentes de 15 a 49 anos por sexo, idade e categorias das vítimas, com dados do Sistema de Informações sobre Mortalidade. O estudo da tendência foi realizado por meio do modelo de regressão linear segmentada e pelo procedimento iterativo de Cochrane-Orcutt. O pressuposto de independência dos resíduos foi verificado por correlogramas e teste de Box-Pierce. Em todo o período, as maiores taxas de mortalidade foram observadas para sexo masculino, motociclistas e faixa etária de 20 a 29 anos de idade. Após a implantação do CTB, houve redução de 9,69 óbitos, por ano, para todas as categorias de acidentes de trânsito (p < 0,001), de 6,90 para pedestres (p = 0,001) e de 1,96 para ocupantes de veículo (p < 0,001). Quanto à faixa de etária, o maior impacto na mortalidade foi observado de 15 a 19 anos para pedestres (p < 0,001) e entre 20 a 29 anos para todas as categorias (p < 0,001). Após a Lei Seca, os dados apresentaram variabilidade e as tendências não foram significativas. Entretanto, houve diminuição da mortalidade para a categoria geral e pedestre. Para as categorias de motociclista e veículo, houve estabilização das taxas. Os resultados mostram impacto nas taxas de mortalidade por acidentes de trânsito após a implantação do CTB e da Lei Seca, com posterior aumento destas. Evidencia-se a demanda por efetividade na fiscalização das leis e avanço nas políticas públicas para que não haja retrocesso no já realizado.

Abstract: The objective was to analyze the impact of the Brazilian Traffic Code and the Law Against Drinking and Driving on mortality from traffic accidents in the State of Paraná, Brazil, from 1980 to 2014. This was an ecological time series study on mortality from traffic accidents in residents 15 to 49 years of age, stratified by the sex, age, and categories of victims, with data from the Mortality Information System. The time trend study used a segmented linear regression model and the Cochrane-Orcutt iterative procedure. The assumption of independence of residuals was verified by correlograms and the Box-Pierce test. The highest mortality rates during the period were in males 20 to 29 years of age. After enactment of the Brazilian Traffic Code, there was a decrease of 9.69 deaths/100,000 inhabitants per year for all categories of traffic accidents (p < 0.001), 6.90 for pedestrians (p = 0.001), and 1.96 for vehicle occupants (p < 0.001). As for age bracket, the greatest impact on mortality was in pedestrians 15 to 19 years of age (p < 0.001) and all victims 20 to 29 years of age (p < 0.001). Following enactment of the Drinking and Driving Law, the data displayed variability and the trends were not significant. However, there was a decrease in overall and pedestrian mortality. The rates for motorcyclists and vehicle occupants stabilized. The results showed an impact on traffic accident mortality after enactment of the new Brazilian Traffic Code and Drinking and Driving Law, followed by an increase in the rates. The study evidenced the need for more effective enforcement and progress with public policies in order to avoid a reversal of the gains achieved.

Resumen: El objetivo fue analizar el impacto del Código de Tráfico Brasileño (CTB) y la Ley Seca en la mortalidad por accidentes de tráfico, en el Estado de Paraná, Brasil, durante el período de 1980 a 2014. Se trata de un estudio ecológico de series temporales sobre las tasas de mortalidad por accidentes de tráfico, de residentes de 15 a 49 años, por sexo, edad y categorías de las víctimas, con datos del Sistema de Informaciones sobre Mortalidad. El estudio de la tendencia se realizó mediante un modelo de regresión lineal segmentada y por el procedimiento interactivo de Cochrane-Orcutt. El presupuesto de independencia de los residuos se verificó mediante correlogramas y el test de Box-Pierce. Durante todo el período, las mayores tasas de mortalidad se observaron para el sexo masculino, motociclistas y una franja de edad de 20 a 29 años de edad. Tras la implantación del CTB, hubo una reducción de 9,69 óbitos por año, en todas las categorías de accidentes de tráfico (p < 0,001), de 6,90 en peatones (p = 0,001) y de 1,96 en ocupantes de vehículo (p < 0,001). En cuanto a la franja de edad, el mayor impacto en la mortalidad se observó desde los 15 a los 19 años en peatones (p < 0,001) y entre 20 a 29 años en todas las categorías (p < 0,001). Tras la Ley Seca, los datos presentaron variabilidad y las tendencias no fueron significativas. No obstante, hubo una disminución de la mortalidad en la categoría general y peatones. En las categorías de motociclista y vehículo, hubo una estabilización de las tasas. Los resultados muestran impacto en las tasas de mortalidad por accidentes de tráfico, tras la implantación del CTB y la Ley Seca, con un posterior aumento de las mismas. Se evidencia una demanda de efectividad en la fiscalización de las leyes y el avance en las políticas públicas para que no haya retroceso en lo ya realizado.

Road traffic accidents in children: the 'what', 'how' and 'why'

<p><b>INTRODUCTION</b>Road traffic accidents (RTAs) in Singapore involving children were evaluated, with particular focus on the epidemiology, surrounding circumstances and outcomes of these accidents. Key factors associated with worse prognosis were identified. We proposed some measures that may be implemented to reduce the frequency and severity of such accidents.</p><p><b>METHODS</b>This was a retrospective study of RTAs involving children aged 0-16 years who presented to the Children's Emergency at KK Women's and Children's Hospital, Singapore, from January 2011 to June 2014. Data was obtained from the National Trauma Registry and analysed in tiers based on the Injury Severity Score (ISS).</p><p><b>RESULTS</b>A total of 1,243 accidents were reviewed. RTA victims included motor vehicle passengers (60.4%), pedestrians (28.5%), cyclists (9.9%) and motorcycle pillion riders (1.2%). The disposition of emergency department (ED) patients was consistent with RTA severity. For serious RTAs, pedestrians accounted for 63.6% and 57.7% of Tier 1 (ISS > 15) and Tier 2 (ISS 9-15) presentations, respectively. Overall use of restraints was worryingly low (36.7%). Not restraining increased the risk of serious RTAs by 8.4 times. Young age, high ISS and low Glasgow Coma Scale score predicted a longer duration of intensive care unit stay.</p><p><b>CONCLUSION</b>The importance of restraints for motor vehicle passengers or helmets for motorcycle pillion riders and cyclists in reducing morbidity requires emphasis. Suggestions for future prevention and intervention include road safety education, regulation of protective restraints, use of speed enforcement devices and creation of transport policies that minimise kerbside parking.</p>

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.

Video-based assessment of pedestrian behavior: development and testing of methods / Estudio de comportamiento peatonal basado en video: desarrollo y prueba de los métodos

ABSTRACT Objective The aim of this paper is to develop a computer algorithm that analyzes pedestrian behavior at an urban site in Bogota, Colombia, considering that the assessment of pedestrian behavior is a road safety priority. Methods Pedestrians were video-taped as they crossed a selected road. An algorithm was developed in order to record, from these videos, pedestrian and vehicle positions and speeds. This information made possible the identification of hazardous behaviors, which were compared through visual assessments. Results 429 pedestrians crossed the selected road at an average distance of 4.5 meters from vehicles that moved at an average speed of 21 km/h. With a maximum difference of 19 % with respect to visual assessments, the algorithm estimated that 58.5 % pedestrians crossed through non-designated locations; 62.2 % crossed near moving vehicles, and that 41.2 % ran while they were crossing the road. Conclusions Video-based analysis can be used to assess pedestrians' behavior. Future research work should focus on improving both the accuracy and the number of safety parameters of the algorithm.(AU)

RESUMEN Objetivo La medición del comportamiento de peatones es una prioridad de la seguridad vial. Por lo anterior, se desarrolló un algoritmo para analizar el comportamiento de los peatones en una zona urbana de Bogotá, Colombia. Métodos Los peatones fueron filmados mientras cruzaban la calle. Mediante el algoritmo se midieron las posiciones y velocidades de peatones y vehículos en los videos. Se identificaron los comportamientos riesgosos y se compararon visualmente. Resultados 429 peatones cruzaron la vía a una distancia promedio de 4.5 metros de los vehículos (velocidad promedio 21 km/h). El algoritmo estimó, con una diferencia máxima de 19 % con respecto a lo observado, que 58.5 % de los peatones cruzaron por zonas incorrectas, 62.2 % cruzaron cerca de vehículos en movimiento y 41.2 % corrieron al cruzar. Conclusiones El análisis basado en video puede utilizarse para medir el comportamiento de los peatones. Los trabajos sobre el tema que se realicen en el futuro deben enfocarse en mejorar la precisión y los parámetros de seguridad del algoritmo.(AU)

Años potenciales de vida perdidos por incidentes viales de motociclistas, Medellín, 20092012: un analisis espacial por sitio de la ocurrencia / Potential years of life lost due to road incidents of motorcyclists, Medellin, 2009-2012: a spatial analysis of the occurrencesite

Introducción. La accidentalidad de motociclistas es una problemática de salud pública de Medellín, que afecta inequitativamente a la población. Objetivo. Describir los años potenciales de vida perdidos (APVP) por accidentes de motociclistas en Medellín entre 2009 y 2012. Métodos. Se realizó un estudio descriptivo con fuente de información secundaria ajustada con el método de Preston y Coale, y OPS de distribución proporcional; en el cálculo de los APVP se empleó como valor de referencia la proyección anual de la esperanza de vida al nacer de Colombia 2009-2014 y para el análisis geográfico se empleó el método cuantil de clasificación, la densidad de Kernel y la simbología por cantidades y atributos múltiples. Resultados. El 79,4% de los muertos en incidentes viales fueron hombres, el 50% tenía 40 años o menos (RQ= 35 años); los peatones (45,6%) y los motociclistas (31,7%) fueron los usuarios más vulnerables de la vía. Los motociclistas hombres entre los 15 y 29 años tuvieron la mayor pérdida de años potenciales de vida, al igual que los accidentados en los barrios Caribe, San Cristóbal, Guayabal y Castilla; la mayor frecuencia de motociclistas muertos se observó en tramos de la autopista norte, la autopista sur, la carrera 65, la avenida regional y la avenida guayabal. Conclusión. En Medellín los motociclistas jóvenes de sexo masculino presentan las tasas de APVP más altas del periodo, lo que implica mayores costos sociales y económicos para la ciudad. La accidentalidad fatal más alta de este grupo de interés se presenta en las vías principales de la ciudad aledañas al río Medellín

Introduction. Motorcycle accidents is a public health problem of Medellin, which affects unfairly the population. Objective. To describe the potential years of life lost (YPLL) motorcycle accident in Medellin between 2009 and 2012. Methods: A descriptive study was conducted with secondary information source adjusted with the Preston and Coale method; in the calculation of YPLL, the annual projection of life expectancy at birth of Colombia 2009-2014 was used as reference value, and for the geographic analysis the “Quantile” classification method, Kernel density and symbology amounts and multiple attributes were used. Results: 79.4% of those killed in road accidents were men, 50% were 40 years old or less; pedestrians (45.6%) and motorcyclists (31.7%) were the most vulnerable road users. Motorcyclists men between 15 and 29 years of age had the highest amount of potential years of life lost, in the same way, the road accidents in Caribe, San Cristóbal, Guayabal and Castilla neighborhoods; the increased frequency of motorcyclists killed was observed in sections of the highway north, the south highway, running 65 regional and Guayabal Avenue. Conclusion: In Medellin young male motorcyclists have YPLL rates highest in the period, which implies greater social and economic costs for the city. The highest fatal accident rate of this interest group is presented on the main roads of the city along the Medellin River

Clinical Features and Outcomes of Bilateral Decompression Surgery for Immediate Contralateral Hematoma after Craniectomy Following Acute Subdural Hematoma / 대한신경손상학회지

OBJECTIVE: Immediate contralateral epidural hematoma (EDH) and traumatic intracerebral hematoma (T-ICH) after craniectomy for traumatic subdural hematoma (SDH) are rare but devastating post-operative complications. Their clinical features and outcomes are not well studied. In this report, we present the clinical features and outcomes of immediate contralateral acute hematoma cases requiring a second operation. METHODS: This study includes 10 cases of immediate contralateral EDH and T-ICH following bilateral craniectomy for the evacuation of traumatic SDH and contralateral hematoma between 2004 and 2015. Their medical records and radiographic findings were reviewed and analyzed retrospectively. RESULTS: Ten of the 528 patients (1.89%) who underwent craniectomy for the evacuation of traumatic SDH developed post-operative EDH (n=5), T-ICH (n=5). The trauma was caused by a fall in 5 patients and by a traffic accident in 5 patients. The patients who suffered trauma due to pedestrian accidents died. Seven patients had a low admission Glasgow Coma Scale (GCS; GCS≤8) score in the preoperative state (average admission GCS, 7.7; average discharge GCS, 3.4; and average discharge Glasgow Outcome Scale, 2.0). Severe intra-operative brain swelling was noted in all patients, while skull fracture was observed in 8. Multiple associated injuries and medication for heart disease were characteristic of patients who died. CONCLUSION: The prognosis of delayed contralateral hematoma was very poor. Multiple associated injuries, past medical history and traffic accidents, especially pedestrians were seemed to be associated with higher mortality rates. Finally, contralateral skull fractures can indicate high risk of delayed contralateral acute intracranial hematoma.

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.

Transport accident mortality in Chile: trends from 2000 to 2012 / A mortalidade por acidentes de transporte em Chile: tendências de 2000 a 2012

Abstract The aim of this study is to describe the trends of transport accident mortality in Chile from 2000 to 2012 by year, geographic distribution, gender, age group, and type of accident. Population-based study. Data for transport accident mortality in Chile between 2000 and 2012 were used. The crude and adjusted per region transport accident mortality rates were calculated per 100,000 inhabitants. The annual percentage change (APC) of the rates and relative risks (RR) were calculated. The average transport accident mortality rate (TAMR) in Chile (2000-2012) was 12.2. The rates were greater in men (19.7) than in women (4.8), with a RR of 4.1. The rates were higher in the country's southern zone (15.9), increasing in recent years in the southern zone, with a significant positive APC in the northern and central zones. The Maule region had the highest rate (21.1), although Coquimbo was the region with the most significant APC (2.2%). The highest rate (20.3) was verified in the 25-40 age group. The highest rate (14.3) was recorded in 2008. The most frequent type of accident was pedestrian. In general the APC trends of the rates are increasing significantly. This, added to rapid annual automotive growth, will only exacerbate mortality due to transport accidents.

Resumo O objetivo deste estudo é descrever as tendências da mortalidade por acidente em transporte no Chile, entre 2000-2012, por ano, distribuição geográfica, gênero, idade e tipo de acidente. Estudo populacional. Foram usados dados de mortalidade por acidentes de transporte entre 2000-2012. Taxas brutas e ajustadas de mortalidade por acidentes no transporte por região foram calculadas por 100.000 habitantes. A variação percentual anual (APC) da taxa e os riscos relativos (RR) foram calculados. A taxa média de mortalidade por acidentes no transporte (TAMR) no Chile (2000-2012) foi de 12,2. As taxas dos homens (19.7) foram maiores que as das mulheres (4.8), com RR de 4.1. As taxas foram mais elevadas no sul do país (15.9), apresentando crescimento nos últimos anos, com uma APC significativa e positiva nas áreas norte e central. A região de Maule teve a maior taxa (21.1), embora a de Coquimbo tenha apresentado APC (2.2%) significativa. A taxa mais elevada (20.3) foi verificada no grupo de 25-40 anos. Em 2008 foi registrada a taxa mais elevada (14.3). O tipo mais frequente de acidente é o que envolve pedestres. Em geral, a APC tende a apresentar crescimento significativo. Isto, somado a um rápido crescimento automotivo anual, só irá agravar a mortalidade por acidentes de transporte.