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IntroductionParamedics are frequently exposed to acute and/or chronic environmental, operational and patient-related factors that increase their risk of physical and psychological injury. However, there has been wide variation in reported paramedic injury rates. This systematic review aims to synthesise the evidence to examine the incidence and nature of occupational injury among paramedics.MethodsThis systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO 2020: CRD42020164556). A systematic search of four electronic databases was conducted for the years 2004–2019. Peer-reviewed studies examining the incidence and proportions of paramedic occupational injury within civilian emergency medical services (EMS) were included. Injury types, mechanisms, contributing factors and incidence of injury were synthesised narratively.ResultsTwelve studies met the inclusion criteria. The incidence of injury ranged from 29.7 to 345.6 injuries per 1000 workers per year. Sprains and strains were the most reported injury types, and the trunk and upper limbs were the main sites. Body motion was the most frequently reported mechanism of injury, accounting for 35%–55% of all injuries. Female paramedics had a proportionally higher rate of injury compared with male paramedics. Paramedics aged 25–34 years accounted for the majority of fatal (mean 34.0%) and non-fatal (mean 51.7%) injuries.ConclusionThis review highlights the increased risk of occupational injury among paramedics and provides further insight into their overall injury profile.

BackgroundThe Victorian Safe Systemapproach to road safety slowly evolved from a combination of the Swedish Vision Zerophilosophy and the Sustainable Safety model developed by the Dutch. The Safe Systemapproach reframes the way in which road safety is viewed and managed.MethodsThis paper presents a case study of the institutional change required to underpin the transformation to a holistic approach to planning and managing road safety in Victoria, Australia.ResultsThe adoption and implementation of a Safe Systemapproach require strong institutional leadership and close cooperation among all the key agencies involved, and Victoria was fortunate in that it had a long history of strong interagency mechanisms in place. However, the challenges in the implementation of the Safe Systemstrategy in Victoria are generally neither technical nor scientific; they are predominantly social and political. While many governments purport to develop strategies based on Safe Systemthinking, on-the-ground action still very much depends on what politicians perceive to be publicly acceptable, and Victoria is no exception.ConclusionsThis is a case study of the complexity of institutional change and is presented in the hope that the lessons may prove useful for others seeking to adopt more holistic planning and management of road safety. There is still much work to be done in Victoria, but the institutional cultural shift has taken root. Ongoing efforts must be continued to achieve alert and compliant road users; however, major underpinning benefits will be achieved through focusing on road network safety improvements (achieving forgiving infrastructure, such as wire rope barriers) in conjunction with reviews of posted speed limits (to be set in response to the level of protection offered by the road infrastructure) and by the progressive introduction into the fleet of modern vehicle safety features.

Due to aging infrastructure, increasing demand and limited capacity, unplanned failures of urban rail systems have become a major concern for cities worldwide. A key feature of unplanned rail disruption (URD) is the often chaotic and crowded conditions which arise. Passengers are placed in a situation of uncertainty and must often find their own way to react. Because rail staff are busy coordinating responses, little is known of how passengers actually behave during a URD; what alternative modes are used when passengers leave stations?. In addition, apart from often ‘colourful’ complaints, it is often unclear what passengers think of operator responses; what are passengers priorities for responding to URD's? This research aims to understand passenger behaviours, perceptions and priority interventions in response to unplanned urban passenger rail disruptions. It reports on a major survey of rider responses undertaken for users of the Metropolitan heavy rail system in Melbourne, Australia.

Crime on public transport is a major concern for society and authorities, and many security measures have been adopted in public transport facilities, like stations, to reduce crime and improve the perception of passenger safety. However, a scale to measure the design quality of public transport facilities on the basis of crime prevention through environmental design (CPTED) principles has not yet been developed. This paper presents the results of a research program to develop a unified measure of the overall design quality of train stations in terms of the main elements of CPTED: surveillance, access control or target hardening (deterring access to potential targets; a term used in the security industry), maintenance, territoriality, and activity support. In this study, a scale has been developed and applied to four stations in suburban Melbourne, Victoria, Australia. The scores illustrate the overall station design quality and highlight elements of the stations that could be improved to enhance safety. Areas for future research and implications for practice are explored.

Highway safety is a complex issue that requires the combined skills of many different types of professionals, including engineers, public administrators, first responders, and public health officials. Although the United States and Australia are culturally similar countries with high levels of motor vehicle use, for historical reasons Australia has typically reached road safety milestones earlier than the United States has. Although a few American universities offer classes on road safety, current U.S. offerings predominantly consist of professional development short courses (often with a programmatic focus). In addition to professional development courses, some undergraduate and postgraduate courses in Australian universities offer electives on the principles of road safety engineering and methods for influencing road user behavior. This coursework can be viewed as part of a wider effort to implement scientifically validated methods and the safe system approach recommended by the International Transport Forum of the Organisation for Economic Co-operation and Development. Deeper integration of highway safety principles into the undergraduate curriculum could assist both countries’ students in developing the leadership skills necessary to achieve higher levels of safety performance.

Crime on public transport is a major concern for society and authorities, and many security measures have been adopted in public transport facilities, like stations, to reduce crime and improve the perception of passenger safety. However, a scale to measure the design quality of public transport facilities on the basis of crime prevention through environmental design (CPTED) principles has not yet been developed. This paper presents the results of a research program to develop a unified measure of the overall design quality of train stations in terms of the main elements of CPTED: surveillance, access control or target hardening (deterring access to potential targets; a term used in the security industry), maintenance, territoriality, and activity support. In this study, a scale has been developed and applied to four stations in suburban Melbourne, Victoria, Australia. The scores illustrate the overall station design quality and highlight elements of the stations that could be improved to enhance safety. Areas for future research and implications for practice are explored.

Highway safety is a complex issue that requires the combined skills of many different types of professionals, including engineers, public administrators, first responders, and public health officials. Although the United States and Australia are culturally similar countries with high levels of motor vehicle use, for historical reasons Australia has typically reached road safety milestones earlier than the United States has. Although a few American universities offer classes on road safety, current U.S. offerings predominantly consist of professional development short courses (often with a programmatic focus). In addition to professional development courses, some undergraduate and postgraduate courses in Australian universities offer electives on the principles of road safety engineering and methods for influencing road user behavior. This coursework can be viewed as part of a wider effort to implement scientifically validated methods and the safe system approach recommended by the International Transport Forum of the Organisation for Economic Co-operation and Development. Deeper integration of highway safety principles into the undergraduate curriculum could assist both countries’ students in developing the leadership skills necessary to achieve higher levels of safety performance.