Exposure to traffic and risk of hospitalization due to injuries.
ABSTRACT Research on the risk of motor vehicle injuries and their relationship with the amount of travel has been only partially analyzed. The few individual exposure assessments are related to very specific subsets of the driving and traveling populations. This study analyzes the relationship between kilometers traveled and hospitalization due to motor vehicle injuries. Twelve thousand three hundred and sixty nine Spanish university graduates from the Seguimiento Universidad de Navarra multipurpose cohort study were evaluated. They had not been hospitalized due to motor vehicle injuries at baseline and were followed up to eight years. Biannual questionnaires allowed for self-reporting of kilometers traveled in motor vehicles, together with incidence of hospitalization. Covariates in the Cox regression models included age and gender and baseline use of safety belt while driving, driving a vehicle with driver-side airbag, driving a motorcycle, and drinking and driving. There were 49,766 participant-years with an average yearly travel of 7,828 km per person-year. Thirty-six subjects reported a first hospitalization event during this time. The adjusted hazard ratio per additional kilometer traveled was 1.00005 (95% confidence interval 1.000013 to 1.000086). Even the smallest of reductions in the amount of kilometers traveled (from an average of 3,250 km per year to 1,000) has a statistically significant protective effect on the likelihood of sustaining hospitalization due to motor vehicle injury (aHR 0.9, 95% CI 0.78 to 0.98). In light of current policies aimed to reduce motorized traffic due to environmental concerns, it may be appropriate to consider the additional health benefit related to reductions in injuries.
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ABSTRACT: OBJECTIVE: Pedestrians account for a third of the 1.2 million traffic fatalities annually worldwide, and men are overrepresented. We examined the factors that contribute to this male-female discrepancy: walking exposure (kilometres walked per person-year), vehicle-pedestrian collision risk (number of collisions per kilometres walked) and vehicle-pedestrian collision case fatality rate (number of deaths per collision). DESIGN: The decomposition method quantifies the relative contributions (RCs) of individual factors to death rate ratios among groups. The male-female ratio of pedestrian death rates can be expressed as the product of three component ratios: walking exposure, collision risk and case fatality rate. Data sources included the 2008-2009 US Fatality Analysis Reporting System, General Estimates System, National Household Travel Survey and population estimates. SETTING: USA. PARTICIPANTS: Pedestrians aged 5 years and older. MAIN OUTCOME MEASURES: Death rate per person-year, kilometres walked per person-year, collisions per kilometres walked and deaths per collision by sex. RESULTS: The pedestrian death rate per person-year for men was 2.3 times that for women. This ratio of male to female rates can be expressed as the product of three component ratios: 0.995 for walking exposure, 1.191 for collision risk and 1.976 for case fatality rate. The RCs of these components were 1%, 20% and 79%, respectively. CONCLUSIONS: The majority of the male-female discrepancy in 2008-2009 pedestrian deaths in the US is attributed to a higher fatality per collision rate among male pedestrians.Injury Prevention 11/2012; 19(4). DOI:10.1136/injuryprev-2012-040594 · 1.94 Impact Factor
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ABSTRACT: Objectives: While self-report methods to collect exposure information have large practical advantages in many research contexts, little research has specifically investigated the reliability and validity of motorcyclists' self-reported exposure. The present study aimed to examine the reliability and validity of different self-report exposure measures and to provide recommendations on best practice self-report riding exposure questions. Methods: The reliability and validity of different self-report exposure measures were examined amongst novice motorcyclists through t-tests, Bland Altman plots, coefficients of variation, and correlations. Results: The most valid and reliable data was provided when riding exposure was asked for the current average week rather than earlier and longer periods, and in units of time rather than distance or number of trips. The greater reliability of riding exposure found amongst commuting and rural riders compared to recreational and metropolitan riders respectively and at the second interview compared to the first suggests that factors such as riding purposes, geographical locations, and riding experience can contribute to measurement error. Conclusions: If self-reported odometer readings are used, questions on whether the respondents share their own bike or ride more than one bike, and a built-in process to ensure respondents report the exact odometer reading on their bike are recommended. It is recommended that self-report riding exposure questions ask about the hours of riding for the current average week, and data on riding purposes, locations, and experience are also collected.Traffic Injury Prevention 03/2014; 15(5):491-500. DOI:10.1080/15389588.2013.837576 · 1.29 Impact Factor