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Background: Studies from Finland and Taiwan have shown that walking against traffic was beneficial for reducing pedestrian crashes and fatalities. This study examined whether such beneficial effects are consistent across various circumstances. Methods: This study aimed to investigate pedestrian fatalities in walking-against or with-traffic crashes by analysing the UK STATS19 crash data for the period between 1991 and 2020. We firstly employed Chi-square tests to examine risk factors for pedestrian injury severity. These variables were then incorporated into stepwise logistic regression models with multiple variables. We subsequently conducted joint effect analysis to investigate whether the beneficial effects of walking against traffic on injury severity vary across different situations. Results: Our data contained 44,488 pedestrian crashes, of which 16,889 and 27,599 involved pedestrians walking against and with traffic, respectively. Pedestrians involved in with-traffic crashes were more likely to sustain fatalities (adjusted odds ratio [AOR] = 1.542; confidence interval [CI] = 1.139–1.927) compared with those in walking against-traffic crashes. The detrimental effect of walking with traffic on fatalities appeared to be more pronounced in darkness-unlit conditions (AOR = 1.48; CI = 1.29–1.70), during midnight hours (00:00–06:59 am) (AOR = 1.60; CI = 1.37–1.87), in rural areas (AOR = 2.20; CI = 1.92–2.51), when pedestrians were elderly (≥ 65 years old) (AOR = 2.65, CI = 2.16–3.26), and when heavy goods vehicles were crash partners (AOR = 1.51, CI = 1.28–1.78). Conclusions: Walking against traffic was beneficial in reducing pedestrian fatalities compared with walking with traffic. Furthermore, such a beneficial effect was more pronounced in darkness-unlit conditions, at midnights (00:00–06:59 am), in rural areas, when pedestrians were elderly, and when heavy goods vehicles struck pedestrians. [ABSTRACT FROM AUTHOR]

Background: Most studies have focused on injuries sustained by intoxicated drivers themselves, but few have examined the effect of drunk driving on injury outcomes among VRUs (vulnerable road users) in developing countries. This study aims to evaluate the effect of drunk driving on fatal injuries among VRUs (pedestrians, cyclists, or motorcyclists). Methods: The data were extracted from the National Taiwan Traffic Crash Dataset from January 1, 2011, to December 31, 2019. Crashes involving one motorized vehicle and one VRU were considered. This study examines the effect of drunk driving by estimating multivariate logistic regression models of fatal injuries among VRUs after controlling for other variables. Results: Among 1,416,168 casualties, the fatality rate of VRUs involved in drunk driving was higher than that of general road users (2.1% vs. 0.6%). Drunk driving was a significant risk factor for fatal injuries among VRUs. Other risk factors for fatal injuries among VRUs included VRU age ≥ 65 years (adjusted odds ratio [AOR]: 5.24, 95% confidence interval [CI]: 5.53–6.07), a nighttime accident (AOR: 4.52, 95% CI: 4.22–4.84), and being hit by a heavy-duty vehicle (AOR: 2.83, 95% CI: 2.26–3.55). Subgroup analyses revealed a linear relationship between driver blood alcohol concentration (BAC) and the risk of fatal injury among motorcyclists. Motorcyclists exhibited the highest fatality rate when they had a BAC ≤ 0.03% (AOR: 3.54, 95% CI: 3.08–4.08). Conclusion: Drunk driving was associated with a higher risk of fatality for all VRUs. The risk of fatal injury among motorcyclists was linearly related to the BAC of the drunk drivers. Injuries were more severe for intoxicated motorcyclists, even those with BAC ≤ 0.03%, which is within the legal limit. [ABSTRACT FROM AUTHOR]

Background: Motorcycle full-coverage helmet use may reduce fatalities and head injuries.Methods: This retrospective cohort study extracted injury data from eight level-I trauma centres in Taiwan and performed a questionnaire survey to investigate injuries sustained by motorcyclists for the period between January 2015 and June 2017.Results: As many as 725 patients participated in the questionnaire survey and reported their helmet types or phone use during crashes. The results of multivariate logistic models demonstrated that nonstandard helmet (half or open-face helmet) use was associated with an increased risk of head injuries and more severe injuries (injury severity score ≥ 8). Drunk riding and phone use appeared to be two important risk factors for head injuries and increased injury severity. Anaemia was also found to be a determinant of head injuries."Conclusions: Compared to full-coverage helmets, nonstandard provide less protection against head injuries and increased injury severity among motorcyclists. [ABSTRACT FROM AUTHOR]

The bikeshare program in Taipei City and New Taipei City, called U-bike, was launched in August 2012 and has more than 7500 bicycles operating out of 769 stations. Research has suggested that bicycle helmet use is a means of reducing morbidity and mortality among bike users. Helmets, however, are not available for rent when a U-bike is rented. The current research conducted an observational study to examine the prevalence of helmet non-use by users of the bikeshare program, electric bicycles, racing bicycles, and personal bicycles in Taipei City and New Taipei City. Trained observers using compact video cameras collected helmet non-use data during various times of the day and on different days of the week. Observers collected data on cyclist attributes, bicycle types, and helmet use at several selected locations within Taipei City and New Taipei City. U-bike users were found to be the least likely to wear helmets. Other noteworthy findings include that violations such as phone use, red-light violations, and travelling at ≥25 km/h were associated with riding without a helmet. Male users of racing bikes tended not to wear helmets, while female users of other bicycle types were less likely to use a helmet. Carrying passengers by users of electric bikes and personal bikes was a determinant of helmet non-use. This paper concludes with a discussion and recommendations for future research. [ABSTRACT FROM AUTHOR]

The paper investigates the effects of phone use (talking, texting, and listening to music) on the street-crossing behaviours of pedestrians and their inattentional blindness in Taiwan. Recent handsets with touchscreens, as well as more advanced features including multimedia, and mobile applications (apps), exacerbate problems relating to cognitive distraction and reduced situation awareness. A controlled field study using video cameras was conducted for observing pedestrians’ crossing behaviours (e.g. crossing time, sudden stops, looking both ways before crossing, and disobeying traffic signals). Pedestrians were classified into two groups: experimental group (talking, texting, and listening to music) and control group (no phone use). Pedestrians’ inattentional blindness was examined by evaluating whether they saw and heard an unusual object (i.e. a clown) nearby. The results indicate that the proportions of unsafe crossing behaviours (e.g. sudden stops, disobeying traffic signals, and not looking both ways before crossing) were higher among distracted individuals and more pronounced among those using instant-messaging apps. These instant-message app users were the least likely to see the clown, and music listeners were the least likely to hear the horn that the clown was honking. Contributing factors to unsafe behaviours include being a student, having a phone screen of 5 inches or larger, and having unlimited 3G Internet access. Texting message via apps was the leading factor on unsafe crossing behaviours of pedestrians and their inattentional blindness. [ABSTRACT FROM PUBLISHER]

This paper examines pedestrian anatomical injuries and crash characteristics in back-to-traffic and facing-traffic crashes. Pedestrian crashes involving pedestrians walking along streets (i.e. with their backs to traffic or facing traffic) have been overlooked in literature. Although this is not the most frequent type of crash, the crash consequence to pedestrians is a safety concern. Combining Taiwan A1A2 police-reported accident data and data from the National Health Insurance Database from years 2003-2013, this paper examines anatomical injuries and crash characteristics in back-to-traffic and facing-traffic crashes. There were a total of 830 and 2267 pedestrian casualties in back-to-traffic and facing-traffic crashes respectively. The injuries sustained by pedestrians and crash characteristics of these two crash types were compared with those of other crossing types of crashes (nearside crash, nearside dart-out crash, offside crash, and offside dart-out crash). Odds of various injuries to body regions were estimated using logistic regressions. Key findings include that the percentage of fatalities in back-to-traffic crashes is the highest; logistic models reveal that pedestrians in back-to-traffic crashes sustained more head, neck, and spinal injuries than did pedestrians in other crash types, and unlit darkness and non-built-up roadways were associated with an increased risk of pedestrian head injuries. Several crash features (e.g. unlit darkness, overtaking manoeuvres, phone use by pedestrians and drivers, and intoxicated drivers) are more frequently evident in back-to-traffic crashes than in other types of crashes. The current research suggests that in terms of crash consequence, facing traffic is safer than back to traffic. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

• National Taiwan Traffic Crash Dataset for the period from 2011 to 2015 were used in this study. • Alcohol-involved and un-helmeted riders were approximately 18 times more likely to sustain fatal injuries than sober and helmeted riders. • The other risk factors of motorcyclist fatalities include head-on crashes and approach-turn motorcycle crashes. Alcohol-involved riders tend to engage in other risk-taking behaviours such as un-helmeted riding which could further increases injury severity. The combined effect of alcohol-involved and un-helmeted riding on fatal injuries is rarely investigated. This study investigated the interaction effect between blood alcohol concentration and helmet use on fatal injuries. This study used the National Taiwan Traffic Crash Dataset for the period from 2011 to 2015. Data on road crashes involving a motorcycle and an automobile were extracted and analysed. Multiple logistic regression models were used to calculate the adjusted odds ratio (AOR). We calculated an interaction effect for blood alcohol concentration and helmet use based on STROBE guidelines. There were a total of 669,292 motorcyclist casualties; among these casualties, 3459 (0.5 %) motorcyclists sustained fatal injuries. Alcohol-involved riders were 9.47 times (AOR = 9.47; 95 % CI = 8.75–10.25) more likely than sober ones to sustain fatal injuries. Alcohol-involved and un-helmeted riders were approximately 18 times (AOR = 18.1; CI: 15.9–20.4) more likely to sustain fatal injuries than sober and helmeted riders. Riders involved in head-on crashes and approach-turn motorcycle crashes had an increased probability of sustaining fatal injuries by 240 % (AOR = 3.4; 95 % CI = 2.91–4.09) and 132 % (AOR = 2.3; 95 % CI = 2.016–2.67), respectively. This study found that alcohol-involved riding acts synergistically with un-helmeted riding to increase motorcyclist injury severity. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association between drunk riding, unhelmeted riding, unlicensed riding, and running-off-road (ROR) crashes. Multiple logistic regression was used to calculate the adjusted odds ratio (AOR) by using the National Taiwan Traffic Crash Dataset for 2011-2016. The results revealed that unhelmeted riding was associated with 138% (AOR = 2.38; CI (confidence interval) = 2.34-2.42) and 47% (AOR = 1.47; CI = 1.45-1.49) higher risks of drunk riding and unlicensed riding, respectively. The risk of unhelmeted riding increased with blood alcohol concentrations (BACs), and riders with the minimum BAC (0.031-0.05%) had nearly five times (AOR = 4.99; CI = 4.74-5.26) higher odds of unlicensed riding compared with those of riders with a negative BAC. Unhelmeted riding, drunk riding, and unlicensed riding were associated with 1.21 times (AOR = 1.21; CI = 1.13-1.30), 2.38 times (AOR = 2.38; CI = 2.20-2.57), and 1.13 times (AOR = 1.13; CI = 1.06-1.21) higher odds of ROR crashes, respectively. The three risky riding behaviours (i.e., unhelmeted riding, drunk riding, and unlicensed riding) were significantly related to ROR crashes. The risk of unhelmeted riding and ROR crashes increased with BACs.

Although past studies have identified predictors related to child injuries with developmental disorders, national-level research in Asia is limited. The objective of this study was to explore the risk factors for child injuries with developmental disorders in Taiwan using a national-level integrated database for the period between 2004-2015 (The Maternal and Child Health Database, National Health Insurance Research Database, Census Registry, and Indigenous Household Registration). Children younger than 12 years old who had records of visiting the ER or being hospitalized due to injury or without injury were included in this study. A 1:1 nested case-control study (injury vs. noninjury) to examine the risk factors for child injury with developmental disorder was performed. A total of 2,167,930 children were enrolled. The risk factors were associated with repeated ER visits or hospitalization: being indigenous (adjusted odds ratio [AOR]: 1.51; CI: 1.45-1.57); having a developmental disorder (AOR: 1.74; CI: 1.70-1.78); and having parents with illicit drug use (AOR: 1.48; CI: 1.32-1.66), alcohol abuse (AOR: 1.21; CI: 1.07-1.37), or a history of mental illness (AOR: 1.43; CI: 1.41-1.46). Being indigenous, having developmental disorders, and having parents with history of illicit drug use, alcohol abuse, or mental illness were predictors related to injuries in children.

Background: Studies have suggested that trauma centre-related risk factors, such as distance to the nearest trauma hospital, are strong predictors of fatal injuries among motorists. Few studies have used a national dataset to study the effect of trauma centre-related risk factors on fatal injuries among motorists and motorcyclists in a country where traffic is dominated by motorcycles. This study investigated the effect of distance from the nearest trauma hospital on fatal injuries from two-vehicle crashes in Taiwan from 2017 to 2019., Methods: A crash dataset and hospital location dataset were combined. The crash dataset was extracted from the National Taiwan Traffic Crash Dataset from 1 January 2017 through 31 December 2019. The primary exposure in this study was distance to the nearest trauma hospital. This study performed a multiple logistic regression to calculate the adjusted odds ratios (AORs) for fatal injuries., Results: The multivariate logistic regression models indicated that motorcyclists involved in crashes located ≥5 km from the nearest trauma hospital and in Eastern Taiwan were approximately five times more likely to sustain fatal injuries (AOR = 5.26; 95% CI: 3.69-7.49)., Conclusions: Distance to, level of, and region of the nearest trauma centre are critical risk factors for fatal injuries among motorcyclists but not motorists. To reduce the mortality rate of trauma cases among motorcyclists, interventions should focus on improving access to trauma hospitals.