Under-reporting bicycle accidents to police in the COST TU1101 international survey: Cross-country comparisons and associated factors.

Police crash reports are often the main source for official data in many countries. However, with the exception of fatal crashes, crashes are often underreported in a biased manner. Consequently, the countermeasures adopted according to them may be inefficient. In the case of bicycle crashes, this bias is most acute and it probably varies across countries, with some of them being more prone to reporting accidents to police than others. Assessing if this bias occurs and the size of it can be of great importance for evaluating the risks associated with bicycling. This study utilized data collected in the COST TU1101 action "Towards safer bicycling through optimization of bicycle helmets and usage". The data came from an online survey that included questions related to bicyclists' attitudes, behaviour, cycling habits, accidents, and patterns of use of helmets. The survey was filled by 8655 bicyclists from 30 different countries. After applying various exclusion factors, 7015 questionnaires filled by adult cyclists from 17 countries, each with at least 100 valid responses, remained in our sample. The results showed that across all countries, an average of only 10% of all crashes were reported to the police, with a wide range among countries: from a minimum of 0.0% (Israel) and 2.6% (Croatia) to a maximum of a 35.0% (Germany). Some factors associated with the reporting levels were type of crash, type of vehicle involved, and injury severity. No relation was found between the likelihood of reporting and the cyclist's gender, age, educational level, marital status, being a parent, use of helmet, and type of bicycle. The significant under-reporting - including injury crashes that do not lead to hospitalization - justifies the use of self-report survey data for assessment of bicycling crash patterns as they relate to (1) crash risk issues such as location, infrastructure, cyclists' characteristics, and use of helmet and (2) strategic approaches to bicycle crash prevention and injury reduction.

Motorcycle riders' perception of helmet use: complaints and dissatisfaction.

In accidents which involve two-wheeled vehicles the helmet plays a life-saving role, but very little is known about the motorcycle rider's perception of the helmet. We evaluated the relationships between having been involved in an accident and dissatisfaction with the helmet, and between the perception of motorcycle riders and the objective features of the helmet. This was a case-control study: riders of motorized two-wheelers who had been involved in accidents (accident cases) were compared against a similarly interviewed sample of riders that had not been in accidents (control cases). Information about the driver, the vehicle and the helmet was collected in all interviews. To evaluate the relationships, logistic regressions were carried out. The majority of drivers were dissatisfied with their helmets, but no evidence was found to link this dissatisfaction with having been involved in an accident. The two most common complaints related to noisiness, followed by the helmet visor. Complaints did not seem to be statistically associated with physical features of the helmet.

Exploring the effects of lifestyle, sleep factors and driving behaviors on sleep-related road risk: a study of Greek drivers.

PURPOSE: The present study explored the effect of various lifestyle patterns and sleep-related factors on the sleep-related road risk. Sleep-related factors included daytime sleepiness, drowsy driving and quality/quantify of sleep. METHODS: A sample of 1366 non-professional drivers aged 19-65 was selected from the broader Athens area of Greece, using stratified random sampling. The questionnaire solicited information on the participants' socio-demographic characteristics, driving background, lifestyle patterns, sleep quality and quantity, daytime sleepiness, drowsy driving behavior and sleep-related road risk. RESULTS: Sleep-related road risk was affected by gender, quantity of night sleep and drowsy driving behavior. Drowsy driving behavior was shown to be related to gender, daytime sleepiness, sleep quality and the lifestyle of "amusement". Daytime sleepiness was correlated with sleep quality and the lifestyles of "amusement" and "sport". Finally, sleep quality and quantity were significantly affected by the lifestyles of "amusement" and "yuppies-workaholic". CONCLUSION: The current study has identified a number of risk factors in sleep-related crash risk in the general population of drivers. By raising public awareness the health and safety community can play an important role in reducing, if not preventing, the consequences of this public health problem.

Modelling the factors related to the seatbelt use by the young drivers of Athens.

Road traffic accidents in Greece are one of the major problems of the public health sector and the first cause of death in the ages 18-24. However, there are no records available for defining the determinants of road accidents and seatbelt wearing rates. The main objective of this study is to determine and clarify the relationship between young drivers' intentions (motivation to use/non use seatbelt) and their behaviour (self-reported use). Additionally, the purpose of this study is to evaluate the seatbelt wearing rates among young drivers in relation to their trip-type. The sample consisted of 200 young Greek drivers of both sexes. The statistical analysis included factor analysis and multiple regression analysis. The seatbelt use was measured in relation with seven trip-types. Through factor analysis, a seven factor scale of seatbelt use and a four factor scale of seatbelt non use were created which included Greek young drivers' basic motivations for wearing or not wearing a seatbelt. A model, constructed by the multiple regression analysis, revealed the factors related with the seatbelt use. The factors positively related were 'imitation', 'self-protection', and 'legality'. The factor of 'discomfort' is negatively associated with the seatbelt use. Furthermore, mileage was negatively related with seatbelt use. Finally, some preliminary suggestions on how prevention strategies should be implemented in Greece are discussed.

The impact of young drivers' lifestyle on their road traffic accident risk in greater Athens area.

Young drivers (18-24) both in Greece and elsewhere appear to have high rates of road traffic accidents. Many factors contribute to the creation of these high road traffic accidents rates. It has been suggested that lifestyle is an important one. The main objective of this study is to find out and clarify the (potential) relationship between young drivers' lifestyle and the road traffic accident risk they face. Moreover, to examine if all the youngsters have the same elevated risk on the road or not. The sample consisted of 241 young Greek drivers of both sexes. The statistical analysis included factor analysis and logistic regression analysis. Through the principal component analysis a ten factor scale was created which included the basic lifestyle traits of young Greek drivers. The logistic regression analysis showed that the young drivers whose dominant lifestyle trait is alcohol consumption or drive without destination have high accident risk, while these whose dominant lifestyle trait is culture, face low accident risk. Furthermore, young drivers who are religious in one way or another seem to have low accident risk. Finally, some preliminary observations on how health promotion should be put into practice are discussed.

Stigmatization, discrimination and fear of AIDS in Greece: implications for health policy.

A prospective health-education research project about AIDS knowledge and attitudes towards AIDS was conducted in Athens and nine adjacent municipalities in west Attica, Greece. Socioeconomic and demographic data, AIDS knowledge, and attitudinal information were collected from 1552 respondents and analysed treating the attitudes of stigmatization, discrimination and fear towards AIDS as the dependent variable. Statistically significant correlations were found between each of the three attitudinal variables and the independent ones; specifically, age, place of residence, marital status and level of AIDS knowledge. Our working hypothesis--that the higher the level of AIDS knowledge, the lower the level of discrimination and stigmatization--was supported by our data. The relationship between AIDS knowledge and fear was less clear. Fear probably inhibits a rational approach to screening for HIV, and more empirical research is needed about fear and its interaction with stigmatizing and discriminatory attitudes and behaviours. Such research should be aimed at identifying population groups 'at risk' of expressing high levels of negative social attitudes about AIDS so that educational programmes can be appropriately designed.

Blood donor behaviour in Greece: implications for health policy.

Blood donation behaviour was studied in 809 residents of the Greater Athens area to identify socio-economic and attitudinal factors and level of knowledge about blood donation related to donor behaviour. The sample was randomly selected and consisted of men and women aged 18-65, the legally defined age for donation. According to stepwise regression analysis, blood donation (40.8% of the study population) was found to be correlated with gender, place of birth, occupation and knowledge about donation. Donors were more likely to be men than women; students and military recruits than professionals and scientists; and those with higher knowledge scores regarding donation. In our factor analysis of the social attitudes related to blood donation, three factors emerged as important regarding donation: health-related incentives for the donor, structural incentives (organization of blood donation education and management of facilities) and the creation of social and economic incentives. With respect to the affective measures those who expressed feelings of guilt when presented with hypothetical, emotionally charged situations dramatizing the need for donor blood were more likely to be donors. The results of the data are discussed within a larger socio-cultural context and suggestions for health policy are made.

Knowledge and attitudes about AIDS of residents of greater Athens.

A prospective research project on health education about AIDS is being conducted in the Greater Athens area. In the first phase of the project, information was collected concerning the knowledge and attitudes about AIDS of a sample of the population. The results indicated that, in general, the population was moderately well informed about AIDS. The population groups who were best informed were the females, those with a higher level of education and a longer period of urban residence, and those in the occupational category merchants/sales personnel. Three attitudinal categories were identified which could be characterized as discrimination, stigmatization and fear of those affected by AIDS. These attitudes were linked respectively to: (1) approval of the enforcement of special measures, (2) stigmatizing of persons, behaviours and districts and (3) fear that AIDS comprises a major social threat. The attitudes expressed by restrictive measures towards those affected and stigmatization were associated with a low level of knowledge about most aspects of AIDS. Health education programmes directed at the population in the districts studied should take into account the findings of this study.

Breast self-examination. Knowledge and behavior of Greek female health care professionals working in primary health care centers.

A comparative correlational study was conducted to examine the knowledge and frequency of breast self-examination (BSE) by Greek health care professionals. A total of 268 women working in primary health care centers constituted the sample. The women were 22-64 years of age. Subjects reported low levels of knowledge about BSE and facts related to breast cancer. Multiple regression analysis showed significant relationships between level of knowledge and profession, number of years of health-related education, and frequency of BSE. The sample's frequency of practice of BSE was limited. Only 34.7% of the participants claimed to practice BSE on a monthly basis. Multiple regression analysis revealed statistically significant correlations between BSE behavior and marital status, professional experience with breast cancer, and level of knowledge. The level of knowledge of the participants is considered to be inadequate, taking into account that they work in settings where primary health care is offered. Courses of preventive medicine and health education should be incorporated in medical and nursing curricula.