Occupant injury severity from lateral collisions: a literature review.

PROBLEM: Side impacts are a serious automotive injury problem; they represent about 30% of all fatalities for passenger vehicle occupants. This literature review focuses on occupant injuries resulting from real lateral collisions. It emphasizes the interaction between injury patterns and crash factors, taking into account type of injuries and their severity. It highlights what is known on the subject and suggests further studies. METHOD: We reviewed papers identified by searches in two electronic databases for the 1996-2009 publication period, and in specific journals and conference proceedings. RESULTS: Studies on the Primary Direction of Force (PDOF) have revealed that fatal crashes occur most frequently when the PDOF is at 3 or 9 o'clock. The risk of serious injury is two to three times higher for the near-side occupant than for the far-side occupant. Head injuries predominate in oblique impacts and thoracic injuries in perpendicular ones. A few results are also reported on side airbag protection. CONCLUSIONS: This literature review presents an overall picture of the injuries caused by lateral collisions, though each of the papers or articles examined focuses mostly on some particular aspect of the problem. The incidence of specific injuries depends on the data source used. Very few population-based analyses of lateral collision injuries were found. IMPACT ON INDUSTRY: New studies are needed to evaluate new protective devices (e.g., lateral airbags, inflatable curtains). Without interfering with their care duties, Emergency Medical Technicians could be systematically trained to observe the collision's specific characteristics and to report all their relevant observations to the emergency physicians to increase the likelihood of prompt diagnosis and proper care.

The role of driver education in the licensing process in Quebec.

PROBLEM: In many jurisdictions, driver education (DE) graduates, compared to non-graduates, are granted a time-discount that allows them to drive unsupervised several months earlier, despite little evidence of a safety benefit and consistent evidence of increased crash risk. Confounding factors may be threatening the validity of DE evaluations. A theoretical framework called the "licensing process" (LP) is proposed to identify and explore potential confounding factors in DE evaluations. METHOD: Prospective study data on a cohort of 1804 novice drivers 16 to 19 years of age of both sexes are analyzed in relation to the LP framework. These data derive from two sources that were linked together: an extensive questionnaire on learning methods, risk-taking, and lifestyles, and government records on exam performance, violations, and crashes. RESULTS: Violation and crash records are not associated with DE attendance. DE attendance is associated with younger ages, greater financial support from family, and fewer hours of supervised driving practice with a learner's permit. For both sexes, more hours of supervised driving practice with a learner's permit is associated with increased crash risk. Most participants, particularly males under 19 years of age, attended DE partly or entirely to save time or money; these motivations are associated with higher violation and crash rates. DISCUSSION: DE evaluations need to identify and control for potential confounding factors. Research is needed to understand the associations between increased crash risk and potential confounding factors like motivation to attend DE and hours of supervised driving practice.

Wireless telephones and the risk of road crashes.

In light of the rapidly increasing development of the cell phone market, the use of such equipment while driving raises the question of whether it is associated with an increased accident risk; and if so, what is its magnitude. This research is an epidemiological study on two large cohorts, namely users and non-users of cell phones, with the objective of verifying whether an association exists between cell phone use and road crashes, separating those with injuries. The Société de l'Assurance Automobile du Québec (SAAQ) mailed a questionnaire and letter of consent to 175000 licence holders for passenger vehicles. The questionnaire asked about exposure to risk, driving habits, opinions about activities likely to be detrimental to driving and accidents within the last 24 months. For cell phone users, questions pertaining to the use of the telephone were added. We received 36078 completed questionnaires, with a signed letter of consent. Four wireless phone companies provided the files on cell phone activity, and the SAAQ the files for 4 years of drivers' records and police reports. The three data sources were merged using an anonymized identification number. The statistical methods include logistic-normal regression models to estimate the strength of the links between the explanatory variables and crashes. The relative risk of all accidents and of accidents with injuries is higher for users of cell phones than for non-users. The relative risks (RR) for injury collisions and also for all collisions is 38% higher for men and women cell phone users. These risks diminish to 1.1 for men and 1.2 for women if other variables, such as the kilometres driven and driving habits are incorporated into the models. Similar results hold for several sub-groups. The most significant finding is a dose-response relationship between the frequency of cell phone use, and crash risks. The adjusted relative risks for heavy users are at least two compared to those making minimal use of cell phones; the latter show similar collision rates as do the non-users.

Organisation of truck-driver training for the transportation of dangerous goods in Europe and North America.

In Canada, as in several other countries, truck drivers involved in the transportation of dangerous goods must be trained. However, given the many differences in vehicles, substances transported and driving conditions, international guidelines are very open-ended. This article outlines the domestic training requirements in Canada, the United States, The Netherlands and Sweden, and examines the manner in which the training is provided. In both Canada and the United States, the responsibility for assuring a driver is adequately trained rests with the employer. It is the employer who determines the duration and content of any training program. In addition, the assessment of a driver is also an employer responsibility. In practice, possibility in light of liability issues, many employers use commercial training firms. However, generally speaking there is no national or regional accreditation program for such commercial firms. In Europe, where training is conducted in response to the European Agreement concerning the International Carriage of Dangerous Goods by Road, training and testing must receive national accreditation, although the specific details of such accreditation are not spelled out. Sweden places its emphasis on careful accreditation of those providing training, while in The Netherlands more importance is placed on examinations to be used to test the results of the training. The intent of this article is to show that the same goal in four different countries has resulted in four different schemes, each of which appears to be accepted in the country of use. A comparison of safety achieved in the transportation of dangerous goods in each country is beyond the scope of this article. International evaluation studies would be necessary to draw scientifically-based conclusions on the effectiveness of truck-driver training systems for the safe transportation of dangerous goods.