Injury severity and mortality of adult zebra crosswalk and non-zebra crosswalk road crossing accidents: a cross-sectional analysis

PRINCIPALS Over a million people worldwide die each year from road traffic injuries and more than 10 million sustain permanent disabilities. Many of these victims are pedestrians. The present retrospective study analyzes the severity and mortality of injuries suffered by adult pedestrians, depending on whether they used a zebra crosswalk. METHODS Our retrospective data analysis covered adult patients admitted to our emergency department (ED) between 1 January 2000 and 31 December 2012 after being hit by a vehicle while crossing the road as a pedestrian. Patients were identified by using a string term. Medical, police and ambulance records were reviewed for data extraction. RESULTS A total of 347 patients were eligible for study inclusion. Two hundred and three (203; 58.5%) patients were on a zebra crosswalk and 144 (41.5%) were not. The mean ISS (injury Severity Score) was 12.1 (SD 14.7, range 1-75). The vehicles were faster in non-zebra crosswalk accidents (47.7 km/n, versus 41.4 km/h, p<0.027). The mean ISS score was higher in patients with non-zebra crosswalk accidents; 14.4 (SD 16.5, range 1-75) versus 10.5 (SD13.14, range 1-75) (p<0.019). Zebra crosswalk accidents were associated with less risk of severe injury (OR 0.61, 95% CI 0.38-0.98, p<0.042). Accidents involving a truck were associated with increased risk of severe injury (OR 3.53, 95%CI 1.21-10.26, p<0.02). CONCLUSION Accidents on zebra crosswalks are more common than those not on zebra crosswalks. The injury severity of non-zebra crosswalk accidents is significantly higher than in patients with zebra crosswalk accidents. Accidents involving large vehicles are associated with increased risk of severe injury. Further prospective studies are needed, with detailed assessment of motor vehicle types and speed.

Risk Factors for Intracranial Haemorrhage in Accidents Associated with the Shower or Bathtub

BACKGROUND There has been little research on bathroom accidents. It is unknown whether the shower or bathtub are connected with special dangers in different age groups or whether there are specific risk factors for adverse outcomes. METHODS This cross-sectional analysis included all direct admissions to the Emergency Department at the Inselspital Bern, Switzerland from 1 January 2000 to 28 February 2014 after accidents associated with the bathtub or shower. Time, age, location, mechanism and diagnosis were assessed and special risk factors were examined. Patient groups with and without intracranial bleeding were compared with the Mann-Whitney U test.The association of risk factors with intracranial bleeding was investigated using univariate analysis with Fisher's exact test or logistic regression. The effects of different variables on cerebral bleeding were analysed by multivariate logistic regression. RESULTS Two hundred and eighty (280) patients with accidents associated with the bathtub or shower were included in our study. Two hundred and thirty-five (235) patients suffered direct trauma by hitting an object (83.9%) and traumatic brain injury (TBI) was detected in 28 patients (10%). Eight (8) of the 27 patients with mild traumatic brain injuries (GCS 13-15), (29.6%) exhibited intracranial haemorrhage. All patients with intracranial haemorrhage were older than 48 years and needed in-hospital treatment. Patients with intracranial haemorrhage were significantly older and had higher haemoglobin levels than the control group with TBI but without intracranial bleeding (p<0.05 for both).In univariate analysis, we found that intracranial haemorrhage in patients with TBI was associated with direct trauma in general and with age (both p<0.05), but not with the mechanism of the fall, its location (shower or bathtub) or the gender of the patient. Multivariate logistic regression analysis identified only age as a risk factor for cerebral bleeding (p<0.05; OR 1.09 (CI 1.01;1.171)). CONCLUSION In patients with ED admissions associated with the bathtub or shower direct trauma and age are risk factors for intracranial haemorrhage. Additional effort in prevention should be considered, especially in the elderly.

Bilateral Accidents with Intrinsically Interdependent Costs of Precaution

The standard economic model of bilateral precaution postulates an interdependency between the care taken by injurers and victims that operates through the effects of each on the expected accident loss. This paper considers situations in which each party's precaution affects not only expected accident loss, but also directly affects the other party's cost of taking precaution. Generalizing the economic model of tort law in this way allows for a more complete analysis of when standard tort rules can and cannot induce optimal precaution. When this additional externality is introduced into a model of unilateral harm (where all accident losses are borne by the victim), none of the standard tort liability rules induces socially optimal behavior by both parties. Moreover, under a contributory negligence rule, the only equilibrium is in mixed strategies; this gives rise to the possibility of litigation in equilibrium. A 'tort-like' liability rule that induces socially optimal behavior by both parties is then characterized; this involves a payment by victims to non-negligent injurers whenever an accident occurs. The model is then extended to consider the case of bilateral harm (where both parties suffer accident losses). It is shown that, as long as both parties can sue to recover their accident losses, all negligence-based tort rules lead to socially optimal behavior by both parties.

Dietrich de Freiberg, Oeuvres choisies, vol. I : Substances, quidités et accidents, textes latins traduits et annotés par Catherine König-Pralong, avec la collaboration de Ruedi Imbach, Introduction de Kurt Flasch, Paris, Vrin, 2008 (Bibliothèque des textes philosophiques), 222 p. ; ISBN 978-2-71116-1983-2

Fil: Ocampo, Fernanda.

The interurban DRAG-Spain model: the main factors of influence on road accidents in Spain

This paper presents the results of applying DRAG methodology to the identification of the main factors of influence on the number of injury and fatal accidents occurring on Spain’s interurban network. Nineteen independent variables have been included in the model grouped together under ten categories: exposure, infrastructure, weather, drivers, economic variables, vehicle stock, surveillance, speed and legislative measures. Highly interesting conclusions can be reached from the results on the basis of the different effects of a single variable on each of the accident types according to severity. The greatest influence revealed by the results is exposure, which together with inexperienced drivers, speed and an ageing vehicle stock, have a negative effect, while the increased surveillance on roads, the improvement in the technological features of vehicles and the proportion of high capacity networks have a positive effect, since the results obtained show a significant drop in accidents.

The influence of economic incentives linked to road safety indicators on accidents: The case of toll concessions in Spain

The goal of this paper is to evaluate whether the incentives incorporated in toll highway concession contracts in order to encourage private operators to adopt measures to reduce accidents are actually effective at improving safety. To this end, we implemented negative binomial regression models using information about highway characteristics and accident data from toll highway concessions in Spain from 2007 to 2009. Our results show that even though road safety is highly influenced by variables that are not managed by the contractor, such as the annual average daily traffic (AADT), the percentage of heavy vehicles on the highway, number of lanes, number of intersections and average speed; the implementation of these incentives has a positive influence on the reduction of accidents and injuries. Consequently, this measure seems to be an effective way of improving safety performance in road networks.

Safety and operability of small fishing vessels: study of a series of stability-related accidents

The intact stability of five small Spanish fishing vessels with ages between 3 and 8 years old which sunk in stability related accidents between 2004 and 2007 is compared to the stability of the fishing vessels which were retired from service to build those. The seakeeping performance of both sets of vessels is also compared. The differences found between the results obtained by the two methods have been analyzed. The suitability of seakeeping methods to assess stability performance is discussed.

Fishing effort control regulations influence on stability, safety and operability of small fishing vessels: study of a series of stability related accidents occurred in Spain between 2004 and 2007

Entre los años 2004 y 2007 se hundieron por problemas de estabilidad cinco pesqueros españoles de pequeña eslora, de características parecidas, de relativamente poca edad, que habían sido construidos en un intervalo de pocos años. La mayoría de los tripulantes de esos pesqueros fallecieron o desaparecieron en esos accidentes. Este conjunto de accidentes tuvo bastante repercusión social y mediática. Entre ingenieros navales y marinos del sector de la pesca se relacionó estos accidentes con los condicionantes a los diseños de los pesqueros impuestos por la normativa de control de esfuerzo pesquero. Los accidentes fueron investigados y publicados sus correspondientes informes; en ellos no se exploró esta supuesta relación. Esta tesis pretende investigar la relación entre esos accidentes y los cambios de la normativa de esfuerzo pesquero. En la introducción se expone la normativa de control de esfuerzo pesquero analizada, se presentan datos sobre la estructura de la flota pesquera en España y su accidentalidad, y se detallan los criterios de estabilidad manejados durante el trabajo, explicando su relación con la seguridad de los pesqueros. Seguidamente se realiza un análisis estadístico de la siniestralidad en el sector de la pesca para establecer si el conjunto de accidentes estudiados supone una anomalía, o si por el contrario el conjunto de estos accidentes no es relevante desde el punto de vista estadístico. Se analiza la siniestralidad a partir de diversas bases de datos de buques pesqueros en España y se concluye que el conjunto de accidentes estudiados supone una anomalía estadística, ya que la probabilidad de ocurrencia de los cinco sucesos es muy baja considerando la frecuencia estimada de pérdidas de buques por estabilidad en el subsector de la flota pesquera en el que se encuadran los cinco buques perdidos. A continuación el trabajo se centra en la comparación de los buques accidentados con los buques pesqueros dados de baja para construir aquellos, según exige la normativa de control de esfuerzo pesquero; a estos últimos buques nos referiremos como “predecesores” de los buques accidentados. Se comparan las dimensiones principales de cada buque y de su predecesor, resultando que los buques accidentados comparten características de diseño comunes que son sensiblemente diferentes en los buques predecesores, y enlazando dichas características de diseño con los requisitos de la nueva normativa de control del esfuerzo pesquero bajo la que se construyeron estos barcos. Ello permite establecer una relación entre los accidentes y el mencionado cambio normativo. A continuación se compara el margen con que se cumplían los criterios reglamentarios de estabilidad entre los buques accidentados y los predecesores, encontrándose que en cuatro de los cinco casos los predecesores cumplían los criterios de estabilidad con mayor holgura que los buques accidentados. Los resultados obtenidos en este punto permiten establecer una relación entre el cambio de normativa de esfuerzo pesquero y la estabilidad de los buques. Los cinco buques accidentados cumplían con los criterios reglamentarios de estabilidad en vigor, lo que cuestiona la relación entre esos criterios y la seguridad. Por ello se extiende la comparativa entre pesqueros a dos nuevos campos relacionados con la estabilidad y la seguridad delos buques: • Movimientos a bordo (operatividad del buque), y • Criterios de estabilidad en condiciones meteorológicas adversas El estudio de la operatividad muestra que los buques accidentados tenían, en general, una mayor operatividad que sus predecesores, contrariamente a lo que sucedía con el cumplimiento de los criterios reglamentarios de estabilidad. Por último, se comprueba el desempeño de los diez buques en dos criterios específicos de estabilidad en caso de mal tiempo: el criterio IMO de viento y balance intenso, y un criterio de estabilidad de nueva generación, incluyendo la contribución original del autor de considerar agua en cubierta. Las tendencias observadas en estas dos comparativas son opuestas, lo que permite cuestionar la validez del último criterio sin un control exhaustivo de los parámetros de su formulación, poniendo de manifiesto la necesidad de más investigaciones sobre ese criterio antes de su adopción para uso regulatorio. El conjunto de estos resultados permite obtener una serie de conclusiones en la comparativa entre ambos conjuntos de buques pesqueros. Si bien los resultados de este trabajo no muestran que la aprobación de la nueva normativa de esfuerzo pesquero haya significado una merma general de seguridad en sectores enteros de la flota pesquera, sí se concluye que permitió que algunos diseños de buques pesqueros, posiblemente en busca de la mayor eficiencia compatible con dicha normativa, quedaran con una estabilidad precaria, poniendo de manifiesto que la relación entre seguridad y criterios de estabilidad no es unívoca, y la necesidad de que éstos evolucionen y se adapten a los nuevos diseños de buques pesqueros para continuar garantizando su seguridad. También se concluye que la estabilidad es un aspecto transversal del diseño de los buques, por lo que cualquier reforma normativa que afecte al diseño de los pesqueros o su forma de operar debería estar sujeta a evaluación por parte de las autoridades responsables de la seguridad marítima con carácter previo a su aprobación. ABSTRACT Between 2004 and 2007 five small Spanish fishing vessels sank in stability related accidents. These vessels had similar characteristics, had relatively short age, and had been built in a period of a few years. Most crewmembers of these five vessels died or disappeared in those accidents. This set of accidents had significant social and media impact. Among naval architects and seamen of the fishing sector these accidents were related to the design constraints imposed by the fishing control effort regulations. The accidents were investigated and the official reports issued; this alleged relationship was not explored. This thesis aims to investigate the relationship between those accidents and changes in fishing effort control regulations. In the introduction, the fishing effort control regulation is exposed, data of the Spanish fishing fleet structure and its accident rates are presented, and stability criteria dealt with in this work are explained, detailing its relationship with fishing vessel safety. A statistical analysis of the accident rates in the fishing sector in Spain is performed afterwards. The objective is determining whether the set of accidents studied constitute an anomaly or, on the contrary, they are not statistically relevant. Fishing vessels accident rates is analyzed from several fishing vessel databases in Spain. It is concluded that the set of studied accidents is statistically relevant, as the probability of occurrence of the five happenings is extremely low, considering the loss rates in the subsector of the Spanish fishing fleet where the studied vessels are fitted within. From this point the thesis focuses in comparing the vessels lost and the vessels that were decommissioned to build them as required by the fishing effort control regulation; these vessels will be referred to as “predecessors” of the sunk vessels. The main dimensions between each lost vessel and her predecessor are compared, leading to the conclusion that the lost vessels share design characteristics which are sensibly different from the predecessors, and linking these design characteristics with the requirements imposed by the new fishing control effort regulations. This allows establishing a relationship between the accidents and this regulation change. Then the margin in fulfilling the regulatory stability criteria among the vessels is compared, resulting, in four of the five cases, that predecessors meet the stability criteria with greater clearance than the sunk vessels. The results obtained at this point would establish a relationship between the change of fishing effort control regulation and the stability of vessels. The five lost vessels complied with the stability criteria in force, so the relation between these criteria and safety is put in question. Consequently, the comparison among vessels is extended to other fields related to safety and stability: • Motions onboard (operability), and • Specific stability criteria in rough weather The operability study shows that the lost vessels had in general greater operability than their predecessors, just the opposite as when comparing stability criteria. Finally, performance under specific rough weather stability criteria is checked. The criteria studied are the IMO Weather Criterion, and one of the 2nd generation stability criteria under development by IMO considering in this last case the presence of water on deck, which is an original contribution by the author. The observed trends in these two cases are opposite, allowing to put into question the last criterion validity without an exhaustive control of its formulation parameters; indicating that further research might be necessary before using it for regulatory purposes. The analysis of this set of results leads to some conclusions when comparing both groups of fishing vessels. While the results obtained are not conclusive in the sense that the entry into force of a new fishing effort control in 1998 caused a generalized safety reduction in whole sectors of the Spanish fishing fleet, it can be concluded that it opened the door for some vessel designs resulting with precarious stability. This evidences that the relation between safety and stability criteria is not univocal, so stability criteria needs to evolve for adapting to new fishing vessels designs so their safety is still guaranteed. It is also concluded that stability is a transversal aspect to ship design and operability, implying that any legislative reform affecting ship design or operating modes should be subjected to assessing by the authorities responsible for marine safety before being adopted.

Poisson dynamic models. An application to interurban accidents in Spain

In this study we apply count data models to four integer–valued time series related to accidentality in Spanish roads applying both the frequentist and Bayesian approaches. The time series are: number of fatalities, number of fatal accidents, number of killed or seriously injured (KSI) and number of accidents with KSI. The model structure is Poisson regression with first order autoregressive errors. The purpose of the paper is first to sort out the explanatory variables by relevance and second to carry out a prediction exercise for validation.

Evaluación teórico experimental de la influencia de espumas de relleno metálicas como elementos de absorción de energía en perfiles tubulares de pequeño espesor. Su aplicación a vehículos para el transporte colectivo de personas

Los accidentes con implicación de autocares en los que se producen vuelcos ponen de manifiesto la especial agresividad de los mismos, como lo confirman las estadísticas. Como medida para mejorar la seguridad de los Vehículos de Grandes Dimensiones para el Transporte de Pasajeros (V.G.D.T.P.) frente a vuelco fue aprobado por las Naciones Unidas el Reglamento Nº 66 de Ginebra. Este reglamento establece los requisitos mínimos que las estructuras de los vehículos de grandes dimensiones deben cumplir con respecto a vuelco. El reglamento 66 ha supuesto un paso adelante muy importante en relación con la seguridad de los autocares, puesto que especifica por primera vez requerimientos estructurales a este tipo de vehículos, y en general ha supuesto una mejora del vehículo . Por otro lado, a consecuencia de la obligatoriedad de instalación de cinturones de seguridad, existe una unión entre pasajeros y vehículo, pero como no se trata de una unión rígida, hay que contemplar el porcentaje de la masa de los ocupantes que influye en la absorción de energía de la estructura. Además la retención de los ocupantes con cinturones de seguridad influye en la energía a absorber por la estructura del vehículo en dos aspectos, por un lado aumenta la masa del vehículo y en el otro se incrementa la altura el centro de gravedad. Esta situación a conducido a elaborar por parte de las Naciones Unidas la revisión 01 del Reglamento 66, en el que se considera que el 50 % de la masa total de los pasajeros posee una unión rígida con la estructura del vehículo, y por lo tanto debe ser tenida en cuenta si el vehículo posee sistemas de retención. En la situación actual, con limitaciones de peso del vehículo y peso por eje, los elementos de confort, seguridad y espacio para maleteros contribuyen a aumentar el peso del vehículo. Esto unido a la dificultad de introducción de cambios radicales en la concepción actual de fabricación de este tipo de vehículos por suponer unas pérdidas importantes para los fabricantes existentes, tanto en su conocimiento del producto como en su metodología de proceso, conlleva la necesidad cada vez más agobiante de analizar y evaluar otras alternativas estructurales que sin suponer grandes revoluciones a los productos actualmente en fabricación los complementen permitiendo adaptarse a los nuevos requerimientos en seguridad. Recientes desarrollos en la relación costo-beneficio de los procesos para la producción de materiales celulares metálicos de baja densidad, tales como las espumas metálicas, los posiciona como una alternativa de especial interés para la aplicación como elementos de absorción de energía para reforzar estructuras. El relleno con espumas metálicas puede ser más eficiente en términos de optimización de peso comparado con el aumento de espesor de los perfiles estructurales, dado que la absorción de energía se produce en una fracción relativamente pequeña de los perfiles, en las denominadas rótulas plásticas. La aplicación de espumas de relleno metálicas en estructuras de vehículos se está empezando a emplear en determinadas zonas de los vehículos de turismo, siendo totalmente novedosa cualquier intento de aplicación en estructuras de autobuses y autocares. Conforme a lo expuesto, y con el objeto de resolver estos problemas, se ha elaborado el presente trabajo de tesis doctoral, cuyos objetivos son: -Desarrollar un modelo matemático, que permita simular el ensayo de vuelco, considerando la influencia de los ocupantes retenidos con cinturones de seguridad para evaluar su influencia en la absorción de energía de la estructura. -Validar el modelo matemático de vuelco de la estructura mediante ensayos de secciones representativas de la estructura del vehículo y mediante el ensayo de un vehículo completo. -Realizar un estudio de las propiedades de las espumas metálicas que permitan incorporarlas como elemento de absorción de energía en el relleno de componentes de la superestructura de autobuses y autocares. -Desarrollar un modelo matemático para evaluar el aporte del relleno de espuma metálica en la absorción de energía ante solicitaciones por flexión estática y dinámica en componentes de la superestructura de autobuses o autocares. -Realizar un programa de ensayos a flexión estáticos y dinámicos para validar el modelo matemático del aporte del relleno de espuma metálica sobre componentes de la superestructura de autobuses y autocares. . -Incorporar al modelo matemático de vuelco de la estructura, los resultados obtenidos sobre componentes con relleno de espuma metálica, para evaluar el aporte en la absorción de energía. -Validar el modelo de vuelco de la estructura del autobús o autocar con relleno de espuma metálica, mediante ensayos de secciones de carrocería. ABSTRACT Accidents involving buses in which rollovers occur reveal the special aggressiveness thereof, as the statistics prove. As a measure to improve the safety of large vehicles for the transport of passengers to rollover, Regulation 66 of Geneva was approved by the United Nations. This regulation establishes the minimum requirements that structures of large vehicles must comply with respect to rollovers. The regulation 66 has been a major step forward in relation to the safety of coaches, since it specifies structural requirements to such vehicles and has been an improvement for the vehicle. In turn, as a result of compulsory installation of safety belts, there is contact between passengers and vehicle, but as it is not a rigid connection we must contemplate the percentage of the mass of the occupants that impacts on the energy absorption of the structure. Thus, the passengers’ restraining modifies the energy to absorb by the vehicle in two different aspects: On the one hand, it increases the vehicle weight and on the other the height of the center of gravity. This circumstance has taken the United Nations to elaborate Revision 01 of Regulation 66, in which it is considered that the 50 percent of passengers’ mass has a rigid joint together with the vehicle structure and, therefore, the passengers’ mass mentioned above should be highly considered if the vehicle has seat belts. In the present situation, in which limitations in vehicle weight and weight in axles are stricter, elements of comfort, safety and space for baggage are contributing to increase the weight of the vehicle. This coupled with the difficulty of introducing radical changes in the current conception of manufacturing such vehicles pose significant losses for existing manufacturers, both in product knowledge and process methodology, entails the overwhelming need to analyze and evaluate other structural alternatives without assuming relevant modifications on the products manufactured currently allowing them to adapt to the new safety requirements. Recent developments in cost-benefit processes for the production of metallic foams of low density, such as metal foams, place them as an alternative of special interest to be used as energy absorbers to strengthen structures. The filling with metal foams can be more efficient in terms of weight optimization compared with increasing thickness of the structural beams, since the energy absorption occurs in a relatively small fraction of the beams, called plastic hinges. The application of metal filling foams in vehicle structures is beginning to be used in certain areas of passenger cars, being an innovative opportunity in structures for application in buses and coaches. According to the mentioned before, and in order to come forward with a solution, this doctoral thesis has been prepared and its objectives are: - Develop a mathematical model to simulate the rollover test, considering the influence of the occupants held with seat belts to assess their influence on energy absorption structure. - Validate the mathematical model of the structure rollover by testing representative sections of the vehicle structure and by testing a complete vehicle. - Conduct a study of the properties of metal foams as possible incorporation of energy absorbing element in the filler component of the superstructure of buses and coaches. - Elaborate a mathematical model to assess the contribution of the metal foam filling in absorbing energy for static and dynamic bending loads on the components of buses or coaches superstructure. - Conduct a static and dynamic bending test program to validate the mathematical model of contribution of metal foam filling on components of the superstructure of buses and coaches bending. - To incorporate into the mathematical model of structure rollover, the results obtained on components filled with metal foam, to evaluate the contribution to the energy absorption. - Validate the rollover model structure of the bus or coach filled with metal foam through tests of bay sections. The objectives in this thesis have been achieved successfully. The contribution calculation model with metal foam filling in the vehicle structure has revealed that the filling with metal foam is more efficient than increasing thickness of the beams, as demonstrated in the experimental validation of bay sections.