Narelle Haworth

Bike Share: A Synthesis of the Literature

This paper begins by providing an overview of bike share programs, followed by a critical examination of the growing body of literature on these programs. This synthesis of previous works, both peer-reviewed and gray, includes an identification of the current gaps in knowledge related to the impacts of bike sharing programs. This synthesis represents a critically needed evaluation of the current state of global bike share research, in order to better understand, and maximize the effectiveness of current and future programs. Several consistent themes have emerged within the growing body of research on bike share programs. Firstly, the importance bike share members place on convenience and value for money appears paramount in their motivation to sign up and use these programs. Secondly, and somewhat counter intuitively, scheme members are more likely to own and use private bicycles than nonmembers. Thirdly, users demonstrate a greater reluctance to wear helmets than private bicycle riders and helmets have acted as a deterrent in jurisdictions in which helmets are mandatory. Finally, and perhaps most importantly from a sustainable transport perspective, the majority of scheme users are substituting from sustainable modes of transport rather than the car.

Powered two wheelers in a changing world-challenges and opportunities.

Powered two wheelers (PTWs) come in diverse forms and are used for a range of purposes in very different parts of the world. In many parts of the world, the forms and uses of PTWs are changing, influenced by social, economic and demographic changes. Most of the challenges associated with PTWs relate to safety, while the majority of the opportunities relate to mobility. The challenges for improving safety relate to the PTW user, other road users, the road environment, the vehicle, data and research, and socio-political dimensions. The relative importance of particular challenges varies between developed and developing countries, and among developing countries according to whether PTWs are largely used for recreation or for transport. PTWs present a range of psychological, transport, economic and environmental opportunities to individuals and societies. The fun and excitement of riding PTWs is a major motivator for their purchase and use for recreational purposes, both off-road and on-road. The transport and economic advantages to the individual also need to be considered. At a societal level, research has examined the potential for increasing PTW volumes to reduce fossil fuel use and traffic congestion in busy cities. The future of PTWs may differ greatly between countries and environmental and technological changes are leading to an evolution in the form of PTWs to encompass new modes of personal transportation.

Motorcycle protective clothing: protection from injury or just the weather?

BACKGROUND Apart from helmets, little is known about the effectiveness of motorcycle protective clothing in reducing injuries in crashes. The study aimed to quantify the association between usage of motorcycle clothing and injury in crashes. METHODS AND FINDINGS Cross-sectional analytic study. Crashed motorcyclists (n=212, 71% of identified eligible cases) were recruited through hospitals and motorcycle repair services. Data was obtained through structured face-to-face interviews. The main outcome was hospitalization and motorcycle crash-related injury. Poisson regression was used to estimate relative risk (RR) and 95% confidence intervals for injury adjusting for potential confounders. RESULTS Motorcyclists were significantly less likely to be admitted to hospital if they crashed wearing motorcycle jackets (RR=0.79, 95% CI: 0.69-0.91), pants (RR=0.49, 95% CI: 0.25-0.94), or gloves (RR=0.41, 95% CI: 0.26-0.66). When garments included fitted body armour there was a significantly reduced risk of injury to the upper body (RR=0.77, 95% CI: 0.66-0.89), hands and wrists (RR=0.55, 95% CI: 0.38-0.81), legs (RR=0.60, 95% CI: 0.40-0.90), feet and ankles (RR=0.54, 95% CI: 0.35-0.83). Non-motorcycle boots were also associated with a reduced risk of injury compared to shoes or joggers (RR=0.46, 95% CI: 0.28-0.75). No association between use of body armour and risk of fracture injuries was detected. A substantial proportion of motorcycle designed gloves (25.7%), jackets (29.7%) and pants (28.1%) were assessed to have failed due to material damage in the crash. CONCLUSIONS Motorcycle protective clothing is associated with reduced risk and severity of crash related injury and hospitalization, particularly when fitted with body armour. The proportion of clothing items that failed under crash conditions indicates a need for improved quality control. While mandating usage of protective clothing is not recommended, consideration could be given to providing incentives for usage of protective clothing, such as tax exemptions for safety gear, health insurance premium reductions and rebates.

Rear seat safer: Seating position, restraint use and injuries in children in traffic crashes in Victoria, Australia

Car crashes are a major cause of death and serious injury to children but most analyses of risk are based on US data. The Australian context is different in at least three ways: (1) the proportion of passenger-side airbags, a potential risk to children in front seats, is much lower; (2) unlike in the US, Australian airbags are designed to work with restrained passengers; (3) restraint use for children 0-12 years is high (>90%). Official data drawn from Victorian crash records (n=30,631) were used to calculate relative risks of death or serious injury for children (0-3 years, 4-7 years; 8-12 years) traveling in passenger cars during 1993-1998 and 1999-2004. Over 90% were reportedly wearing a restraint, and 20% were traveling in the front seat. For children under 4 years traveling in the front seat, the relative risk of death was twice as great as when traveling in the rear, and that of serious injury was 60% greater. The relative risk of death whilst traveling in the front seat was almost four times greater for children aged under 1 year. We suggest that serious consideration should be given to mandating rear seating for children, particularly those aged 4 and under.

Assessing sleepiness and sleep disorders in Australian long-distance commercial vehicle drivers: self-report versus an "at home" monitoring device

STUDY OBJECTIVES As obstructive sleep apnea (OSA) is associated with a higher risk of motor vehicle crashes, there is increasing regulatory interest in the identification of commercial motor vehicle (CMV) drivers with this condition. This study aimed to determine the relationship between subjective versus objective assessment of OSA in CMV drivers. DESIGN Cross-sectional survey. SETTINGS Heavy vehicle truck stops located across the road network of 2 large Australian states. PARTICIPANTS A random sample of long distance commercial vehicle drivers (n = 517). INTERVENTIONS None. MEASUREMENTS AND RESULTS Drivers were interviewed regarding their driving experience, personal health, shift schedules, payments, and various questions on sleep and tiredness in order to describe their sleep health across a range of variables. In addition, home recordings using a flow monitor were used during one night of sleep. Only 4.4% of drivers reported a previous diagnosis of sleep apnea, while our at home diagnostic test found a further 41% of long-distance heavy vehicle drivers likely to have sleep apnea. The multivariable apnea prediction index, based on self-report measures, showed poor agreement with the home-monitor detected sleep apnea (AUC 0.58, 95%CI = 0.49-0.62), and only 12% of drivers reported daytime sleepiness (Epworth Sleepiness Scale score > 10). Thirty-six percent of drivers were overweight and a further 50% obese; 49% of drivers were cigarette smokers. CONCLUSIONS Sleep apnea remains a significant and unrecognized problem in CMV drivers, who we found to have multiple health risks. Objective testing for this sleep disorder needs to be considered, as symptom reports and self-identification appear insufficient to accurately identify those at risk.

Comparison of Risk Taking in Moped and Motorcycle Crashes

Risk taking in motorcycling includes deliberately not following road rules (including excessive speeding and performing stunts), unlicensed riding, riding while impaired by drugs and alcohol, and riding without a helmet. Motor scooters and mopeds, however, are less capable of extreme speeds and stunts and may therefore attract riders with safer attitudes and behaviors. Their use for commuting may also limit opportunities for risk taking. Some European studies have reported higher crash risks for mopeds and scooters than for other motorcycles, but others disagree. This study aims to examine the role of risk taking in moped crashes compared with motorcycle crashes by presenting the results of analyses of police-reported crashes in Queensland, Australia, focusing on markers for risk taking such as vehicle most at fault, alcohol involvement, excessive speed, nonuse of helmets, and unlicensed riding. Risk taking in terms of alcohol involvement and excessive speed was more common in single- than in multivehicle crashes. Alcohol involvement was associated with excessive speed, nonuse of helmets, and unlicensed riding. There were few differences in risk-taking behaviors between moped and motorcycle riders. Excessive speed was less common in moped crashes, but this finding may reflect vehicle performance limitations as much as a decision not to speed.

Comparison of moped, scooter and motorcycle crash risk and crash severity.

The increased popularity of mopeds and motor scooters in Australia and elsewhere in the last decade has contributed substantially to the greater use of powered two-wheelers (PTWs) as a whole. As the exposure of mopeds and scooters has increased, so too has the number of reported crashes involving those PTW types, but there is currently little research comparing the safety of mopeds and, particularly, larger scooters with motorcycles. This study compared the crash risk and crash severity of motorcycles, mopeds and larger scooters in Queensland, Australia. Comprehensive data cleansing was undertaken to separate motorcycles, mopeds and larger scooters in police-reported crash data covering the five years to 30 June 2008. The crash rates of motorcycles (including larger scooters) and mopeds in terms of registered vehicles were similar over this period, although the moped crash rate showed a stronger downward trend. However, the crash rates in terms of distance travelled were nearly four times higher for mopeds than for motorcycles (including larger scooters). More comprehensive distance travelled data is needed to confirm these findings. The overall severity of moped and scooter crashes was significantly lower than motorcycle crashes but an ordered probit regression model showed that crash severity outcomes related to differences in crash characteristics and circumstances, rather than differences between PTW types per se. Greater motorcycle crash severity was associated with higher (>80km/h) speed zones, horizontal curves, weekend, single vehicle and nighttime crashes. Moped crashes were more severe at night and in speed zones of 90km/h or more. Larger scooter crashes were more severe in 70km/h zones (than 60km/h zones) but not in higher speed zones, and less severe on weekends than on weekdays. The findings can be used to inform potential crash and injury countermeasures tailored to users of different PTW types.

Effectiveness of motorcycle protective clothing: Riders’ health outcomes in the six months following a crash

BACKGROUND Little is known about the contribution of protective clothing worn in motorcycle crashes to subsequent health-related outcomes, impairment and quality of life. METHODS A prospective cohort of 212 adult motorcyclists were recruited following presentations to hospitals or crash repair services in a defined geographic area in Australia between June 2008 and July 2009. Data was obtained from participant interviews and medical records at baseline, then by mailed survey two and six months post-crash (n=146, 69%). The exposure factor was usage of protective clothing classified as full protection (motorcycle jacket and pants), partial protection (motorcycle jacket) and unprotected (neither). Outcomes of interest included general health status (Short Form SF-36), disability (Health Assessment Questionnaire) treatment and recovery progress, quality of life and return to work in the six months post-crash. Odds ratios (OR) were estimated for categorical outcomes using multiple logistic regression to assess differences in outcomes associated with levels of protection adjusted for potential confounders including age, sex, occupation, speed and type of impact. Non-parametric procedures were used for data that was not normally distributed. RESULTS Compared to unprotected riders, both fully and partially protected riders had fewer days in hospital and reported less pain immediately post-crash; at two months both protection groups were less likely to have disabilities or reductions in physical function. By six months there were no significant differences in disability or physical function between groups, but both protection groups were more likely to be fully recovered and returned to pre-crash work than unprotected riders. Fully protected riders achieved better outcomes than either partially or unprotected riders on most measures. There were few significant differences between the full and partial protection groups although the latter showed greater impairment in physical health two months post-crash. CONCLUSIONS We found strong associations between use of protective clothing and mitigation of the consequences of injury in terms of post-crash health and well-being. Given this evidence it seems likely that the use of protective clothing will confer significant benefits to riders in the event of a crash.

Motor Scooters and Mopeds: Are Increasing Sales Translating into Increasing Crashes?

Little is known about the crash involvement of scooters and mopeds and whether they are safer than other motorcycles. Difficulties in defining motor scooters and mopeds and identifying them in crash and other databases have hindered research. This paper reviews recent research and analyzes the nature and extent of moped and motorcycle crashes in the State of Queensland, Australia. Analyses of merged crash and registration data found that the number of moped crashes increased from 25 in 2001 to 97 in 2005. Most crashes resulted in hospitalization (43%) or medical treatment (38%) and occurred between 6 a.m. and 6 p.m. on weekdays in low-speed areas. Overall, 50.8% of crashes occurred at intersections and 32.3% were single-vehicle crashes. The most common crash types were collisions between vehicles traveling in the same direction (24.8%), loss of control on a straight road (23.1%), and collisions between the moped and another vehicle on an adjacent approach to an intersection (18.2%). The ratio of motorcycle to moped crashes was about 19:1, but moped crashes increased at a greater rate during 2001–2005 (260% versus 71%). The distributions of crash severity were similar. Moped crashes more often involved loss of control on a straight road (23.1% versus 12.7%), while motorcycle crashes more often involved loss of control on a curve (13.6% versus 5.0%). Moped riders in crashes were much more likely than motorcycle riders to be female (37.9% versus 7.2%) and younger and hold an interstate (10.8% versus 1.3%) or overseas (7.8% versus 0.7%) license. The interpretation of these data and their implications for licensing and other countermeasures are discussed.

The heavy vehicle study: a case-control study investigating risk factors for crash in long distance heavy vehicle drivers in Australia.

BackgroundHeavy vehicle transportation continues to grow internationally; yet crash rates are high, and the risk of injury and death extends to all road users. The work environment for the heavy vehicle driver poses many challenges; conditions such as scheduling and payment are proposed risk factors for crash, yet the precise measure of these needs quantifying. Other risk factors such as sleep disorders including obstructive sleep apnoea have been shown to increase crash risk in motor vehicle drivers however the risk of heavy vehicle crash from this and related health conditions needs detailed investigation.Methods and DesignThe proposed case control study will recruit 1034 long distance heavy vehicle drivers: 517 who have crashed and 517 who have not. All participants will be interviewed at length, regarding their driving and crash history, typical workloads, scheduling and payment, trip history over several days, sleep patterns, health, and substance use. All participants will have administered a nasal flow monitor for the detection of obstructive sleep apnoea.DiscussionSignificant attention has been paid to the enforcement of legislation aiming to deter problems such as excess loading, speeding and substance use; however, there is inconclusive evidence as to the direction and strength of associations of many other postulated risk factors for heavy vehicle crashes. The influence of factors such as remuneration and scheduling on crash risk is unclear; so too the association between sleep apnoea and the risk of heavy vehicle driver crash. Contributory factors such as sleep quality and quantity, body mass and health status will be investigated. Quantifying the measure of effect of these factors on the heavy vehicle driver will inform policy development that aims toward safer driving practices and reduction in heavy vehicle crash; protecting the lives of many on the road network.