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This study aims to describe patterns of injury mechanism among patients treated at a tertiary trauma center in Mumbai to identify opportunities for targeted injury prevention strategies. Data were collected from an institutional trauma registry, and all patients presenting with life- or limb-threatening injuries over a 16- month period were included. Univariate and bivariate analyses were performed for demographic characteristics, injury mechanisms, and clinical outcomes. A total of 1,115 patients were treated during the study period, and the in-hospital mortality rate was 32% in this severely injured cohort. More than one half of patients were suffered transportation injuries (58%). Of victims of transportation injuries, 45% were victims of railway injuries and 28% were pedestrians struck by motor vehicles. Mortality was highest among victims of railway injuries (42%) and pedestrians struck by automobiles (38%). Although injury prevention is a major public health concern worldwide, it is important to understand local patterns of injury to guide targeted prevention strategies. This study highlights the utility of trauma registries in collecting crucial injury surveillance data. In this context, a focus on pedestrian safety and railway injury prevention is warranted.

Although roundabouts have been used at many locations around the world, the safety of roundabouts under different conditions has not been fully understood. In this study, 17 roundabouts in five cities in Arizona were evaluated, out of which 11 are single lane and six are double lane. Most of the intersections of single-lane roundabouts were controlled by two-way stop signs before roundabout conversion, whereas most of the intersections of double-lane roundabouts were controlled by traffic signals. Accident data were collected and broken down into five categories: damage without injury, minor injury, nonincapacitating injury, incapacitating injury, and fatality. Equal number of years were used before and after the roundabout conversion at each location. The average rates of accidents, damages without injury, injuries and fatalities per year and per million vehicles were evaluated. It was found that single-lane roundabouts reduced the accident rate, whereas double-lane roundabouts increased the accident rate. The results also showed that single- and double-lane roundabout conversions reduced the severity levels of accidents. Considering accident rate and severity level, warrants need to be developed for roundabout conversion and number of roundabout lanes under different traffic conditions. [ABSTRACT FROM AUTHOR]

Guardrails have commonly been installed to prevent errant vehicles from impacting roadside hazards. However, guardrail impacts have contributed to numerous serious injuries and fatalities. Plus, guardrails are generally impacted more often because they are installed closer to the edge of travel way and are much longer than the shielded hazard itself. Thus, to reduce the frequency of guardrail crashes, an optimized length should be determined. The American Association of State Highway and Transportation Officials (AASHTO)Roadside Design Guide(RDG) has suggested guardrail runout lengths which are dependent on posted speed limit and traffic volumes. Crash data analyses and simulation using the recently-updated Roadside Safety Analysis Program (RSAPv3) was conducted to evaluate the guardrail length-of-need (LON) associated with the lowest crash cost (i.e., cost associated with injuries and property damage) and maximum cost-effectiveness for freeways. Crash data involving Kansas guardrail systems, which were compliant with recommendations provided in the 2006 AASHTORDGand occurring on freeways with divided medians, were collected and analyzed. The frequency, rate, and risk of shielded hazard crashes were extremely low. RSAPv3 analyses indicated that there was an economic and safety benefit to reducing the installed LON as well as utilizing different runout lengths for left- and right-side departures for divided roadways. [ABSTRACT FROM AUTHOR]

Safety on low-volume rural roads is drawing attention due to the high fatality and severe injury rates in comparison with high-volume roads and the increasing awareness of sustainable rural development among policy makers. This study analyzes the risk factors associated with crash severity on low-volume rural roads, including crash characteristics, driver attributes and behavior, vehicle type, road features, environmental conditions, distance from the nearest hospital, and zone rurality degree. The data consist of a set of crashes occurred on low-volume rural roads in Denmark between 2007 and 2011. The crashes were identified by map-matching the crash location to the geographic information system representing the national transport network and extracting the relevant crashes based on annual average traffic volumes. Injury severity was modeled by estimating a generalized ordered logit model due to its advantage in accommodating the ordered-response nature of severity while relaxing the proportional odds assumption. Model estimates and pseudoelasticities show that aggravated crash injury severity is significantly associated with (1) alcohol and failure to wear seatbelts, (2) involvement of vulnerable road users (i.e., pedestrians, cyclists and motorcyclists), (3) involvement of heavy vehicles, (4) speed limits of 80–90 km/h, (5) longer distance to the nearest hospital, and (6) peripheral rural regions. [ABSTRACT FROM PUBLISHER]