Journal of Local and Global Health Science - Proceedings of the 24th World International Traffic Medicine Association Congress, Qatar 2015, November 2015

Helmets save lives, yet many countries do not have laws about their quality assessment or how they should be worn. We assessed the effectiveness of helmet use in preventing injuries in such a setting. The data were extracted from a large road traffic injury surveillance study in Karachi, Pakistan. We assessed the association of wearing helmets with several injury outcomes including deaths, injury severity (via New Injury Severity Score, NISS ≥ 9) and moderate or severe injury (via Abbreviated Injury Score, AIS ≥ 2) to head, face, or other regions of the body. The data about helmet use was available for about 109,210 riders injured between January 2007 and December 2013. Only 6% of riders wore helmets, whereas this proportion was less than one percent in pillion riders and women. The rates were also lower among those aged 18 years or younger (1%) and those aged 18 to 25 years (4%). About 2% of riders died; 34% had an injury to the head region, 30% to face, 1% to chest, 5% to abdominal, 46% to extremities, and 61% to external body regions. Likelihood of dying was low among helmet users (adjusted odds ratio [aOR] = 0.37, 95% confidence interval [CI] = 0.28 to 0.50). Helmets reduced the likelihood of moderate to severe injuries to the head (aOR = 0.68, 95% CI = 0.58 to 0.80) but not to the face region (aOR = 1.37, 95%CI = 1.17 to 1.62). Helmet users also had severer injuries in other body regions except for chest injuries. Helmets prevented deaths and severe head injuries but had limited effectiveness in preventing facial injuries in this setting with poor helmet use standards. More work is needed to understand the helmet wearing and rider behaviours in helmet users in this setting.

Significant reductions in road trauma among young drivers could be achieved if they drove safer vehicles. Parents are likely to play a critical role in the access, timing of vehicle purchase, available budget, and vehicle choice for the young driver’s first vehicle. However, little attention has been directed to understanding the most effective communication strategies to encourage young drivers and their parents to purchase and use safe vehicles. This study was undertaken to examine existing strategies in Australia and provide recommendations for improving communication initiatives. A two-staged study was undertaken including in-depth consultation with representatives from key road safety stakeholders groups to identify current initiatives, and development of conceptual model to identify current and potential improvements to communication strategies. The findings of the consultation phase showed that a sporadic and un-coordinated approach was used regarding the promotion of key messages for purchase and use of safe vehicles and there was some suggestion that the communication medium, content and message style may not reach the target audience in the most effective way. Stakeholder representatives were unanimous in the argument that parents play an integral role. A conceptual framework was developed, depicting key stakeholders in Australia and the various interactions across stakeholders. This was instrumental in identifying areas where effective communicative initiatives and resources could be considered to increase the purchase and use of safe vehicles, including development of a widespread and accessible website and inclusion of vehicle safety choices in young driver education and training programs. The results of the study suggest that a National Framework that co-ordinates government and non-government activities and initiatives aimed at encouraging the purchase and usage of safer vehicles by parents and young drivers should be developed. The methodology can be applied to other countries to develop similar communication campaigns.

Speeding remains a major contributor to trauma on our roads, held to be a major factor in around one-third of fatal crashes and over 10 percent of all crashes (Bowie & Walz, 1994; Fildes & Lee, 1993). This study reviewed speed management strategies and key factors that should be considered through a comprehensive review of the literature. One of the most frequently used methods of managing travel speeds is the posted speed limit. The primary purpose of the speed limit is to advise drivers of the maximum reasonable and safe operating speed under favourable conditions, therefore considered to be a road safety measure. Further, speed limits are designed to be (i) related to crash risk, (ii) provide a reasonable basis for enforcement, (iii) fair in the context of traffic law, and (iv) accepted as reasonable by most road users. Traditional approaches to setting speed limits (e.g. engineering approach using the 85th percentile speed) are compared with an alternative view to setting speed limits: the Safe System approach. This approach requires that all aspects of the system work together for the safest possible outcome, with speed representing a critical component. The findings suggest that there are some inherent issues in traditional speed limit setting guidelines, particularly as drivers lack awareness of the true relationship between speed and road trauma, under-estimate crash and injury risk and over-estimate what is a safe speed, and that there is often a mismatch between environmental cues and speed limits. There are opportunities to review and strengthen speed management policies and practices with a view to creating environments that promote safe behaviour rather than relying on drivers/riders to decide what is a safe speed, complemented by strengthened Police enforcement and increased community knowledge and awareness of the importance of speed to road trauma.

Around schools, increases in walking and cycling help to reduce traffic congestion and improve the road safety and neighborhood navigation skills of children. Physical activity and independent mobility may also have a positive effect on children’s behavioural and cognitive development. Child pedestrians, however, are a vulnerable road user groups, experiencing an increased crash and injury risk relative to older pedestrians, constituting a substantial proportion of all pedestrian fatalities and serious injuries, with children below the age of 10 years of age shown to have four to 11 times greater risk of collision compared to other pedestrians, and they frequently occur around schools. In fact, vehicle collisions involving children pedestrians are considered as the most serious health risk facing children in developed worlds. School safety evaluations were conducted involving four components: i) site visits providing physical assessments of current road conditions, ii) consultation with key groups including school principals and Local Council representatives, iii) desk-top review of available behavioural and training programs, iv) workshops to develop recommendations for appropriate and sustainable conceptual solutions. Using a number of case studies, the findings suggest that evidence-based and consultative selection of initiatives can be effective in encouraging walking and cycling while providing a safer environment around schools. This can be achieved through implementation of multi-faceted initiatives including engineering treatments to enhance the safety of the physical environment around the school and on popular routes to school, as well as sustainable educational/training programs for both students and parents. Evidence-based safety assessments are useful to develop a Safe System environment around schools. A combination of improvements to road design and operation, especially vehicle speed reductions and separation of vehicles and pedestrians, and behavioural programs to improved education and training, along with enhanced supervision can achieve sustainable reductions in child pedestrian trauma around schools.

The Department of Transport (DoT) in Abu Dhabi has recognised that while minibuses play a key role in transporting people within the United Arab Emirates, levels of fatal and serious injury among minibus occupants in crashes are high. As a first step toward addressing this problem, the DoT commissioned a benchmarking study to gain an understanding of the state of the minibus fleet, focusing on fundamental vehicle safety aspects, as well as fitment rates of safety features such as airbags and stability control systems. Furthermore, the in-service condition of vehicles was also assessed. Data was collected from 566 minibuses in Abu Dhabi and Dubai, comprising more than 80 separate data points characterising the presence, nature and condition of each vehicle. An innovative system was developed to combine these variables to yield a weighted safety score that allowed them to be grouped into categories for later input into a benefit cost analysis of a replacement program. A star rating system was used for the categorisation process because it allows for good discrimination between safety levels while remaining easy to comprehend. The results of the benchmarking study showed that despite the fleet being quite uniform by make and model, there was considerable variation among individual vehicles in terms of seat belt fitment rates and rear passenger compartment seat mounting integrity in particular. Many vehicles in current operation are deficient both in terms of primary and secondary safety, compounded by inconsistent fitment of passenger seat belts. This in-depth survey has provided significant additional information unavailable from registration data and provides a valuable insight into the state of minibus safety in the UAE. The data acquired will be used to conduct a benefit cost analysis targeted at determining the optimal means for implementing significant improvements to the minibus fleet.

Controlling the speed of vehicles on various roads and streets is crucial in order to maintain the safety of people and to prevent any possibility of injury or death. One technique that is widely used in Qatar to force road users to reduce their vehicles’ speed is the installation of speed humps and tables. In this study, an evaluation of speed humps and tables in selected areas of Qatar was conducted, since they vary in shape and size and many complaints are raised about their inverse effect on driving safety. The aim of this study was to observe the condition of these traffic calming measures in Qatar. The condition of speed humps and tables was investigated by classifying them based on their dimensions, and verifying if they were constructed according to Ashghal’s standards. The following areas were selected for the study: Qatar University, Male Campus (fully covered) and three neighborhoods: Al-Aziziya, Al-Mura and Al-Waab (partially covered). Two parameters were taken into consideration, height and length of both speed humps and tables. Measurements were taken through site visits to each area, recording dimensions of each speed hump and table using measuring tools as well as taking photographic pictures for reference. The results show considerable variation in height and length dimensions of speed humps and tables. By comparing these results with Ashghal’s standards, it was found that for speed humps, few matched the standard specification for height, but almost none matched the standard for length. None of the speed tables met the standard for both height and length dimensions. The study concludes most of the speed humps and tables in the areas covered in the study do not meet Ashghal’s standard specification for height and length dimensions and re-construction according to standards is recommended.

Since 2010, Sweden presents suicides in road traffic separately from fatalities caused by accidents. The aim with this study was to assess the number of road traffic suicides by studying the fatality from three angles; the vehicle, the road and the road user. The main focus was to develop and perform a psychosocial examination of the road user. First, a method was developed for classification of road fatalities to determine if they were caused by accident or suicide and criteria was developed for selection of cases that are to undergo the classification process. The examination of the road user was performed in cooperating with accident investigators at the Transport Administration, the police, relatives, witnesses, as well as with information from autopsy reports, and case records from earlier medical service. During 2012, an investigator in behavioural science, experienced from counselling at hospitals conducted the examinations. The suspected suicides were classified by an expert group of five persons with knowledge in forensic medicine, psychology and traffic safety using the classification system. First, the classification was made without the psychosocial examination. A second classification was performed with the additional psychosocial information. Forty-nine cases were studied. In 2012, twenty-two (7%) cases were classified as suicides without the psychosocial information and thirty-six (11%) with all information included. The unclear cases were reduced from 20 to 8. From 2013 and forward the classifications were made only once with all information. In 2012-2014, 89 (10%) fatalities were classified as suicides. Year 2010-2011, when the classifications were made without additional psychosocial information, 6% of the fatalities were classified as suicides [Skyltfondsprojekt;TRV2011-13351]. By including psychosocial factors in the classification of suspected suicides the number of unclear cases were reduced. In order to work with suicide prevention the size and the pattern of the problem must be known.

Not all fatalities in road traffic are accidents; some are suicides. Since 2010, Sweden have been presenting suicides in road traffic separately from fatalities caused by accidents. To carry out this task a method has been developed for classification of road traffic fatalities in order to determine if the fatality was caused by accident or suicide. A five-grade classification scale was developed. Grade one indicated a clear suicide and grade five a clear accident. The definition of grade one was suicide with a clear statement of the suicidal intent. Grade two indicated an almost certain suicide but the intention was based primarily on the course of event and psychosocial information of the road user. Grade three indicated that the information was not sufficient to determine whether the fatality was the result of a suicide or an accident and grade four indicated an almost certain accident. Fatalities in grade one and two are classified as suicides. Criteria for cases that are to undergo the classification process include to examine the traffic event together with knowledge of background factors, for example prior suicide attempts, indirect suicidal communication, knowledge of ongoing depression etc. From 2012, the classification has been performed with additional information from a psychosocial examination. From 2010 to 2014, a total of 128 fatalities have been classified as suicides, 46 as grade one and 82 as grade two. From 2012 to 2014, when the psychosocial information was included in the analysis, 10% of all fatalities were classified as suicides. Analysis of gender, age, collision types, influence of alcohol, use of seatbelt, time etc., has been performed. The method can be used to determine which fatalities in road traffic are caused by suicide or accident. The method can be used on all modes of transport.

The aim of this study was to determine the incidence pattern of the burden severe traumatic brain injuries (TBIs) among young children in Qatar and to suggest practical prevention policies that can be implemented in Qatar. This is a retrospective study that included all pediatric cases of severe TBI during the period from January 2002 to December 2008. The study was conducted among children aged 14 years or less at the Children Rehabilitation Unit, Pediatric Department, Hamad General Hospital. The Glasgow Coma Scale (GCS) was used to assess severity of TBIs. This study was based on 65 children suffering from severe traumatic brain injury, of which 12 of them died within the first month of admission in pediatric intensive care unit. The predominant gender was male (73.8%), of which non-Qataris form 50.8%. Predominant mechanisms of injury were road traffic accident (84.6%), then injuries due to falls (10.8%), followed by sports and recreation injuries. Among our patients 43.1% had spasticity, 33.8% experienced posttraumatic epilepsy. Better outcomes were observed after severe TBI among older children. The current study revealed that 24.6% had communication disorder, 26.2% had poor cognition, 24.6% had hemiplegia, 18.5% had abnormal behavior and 15.4% had a vegetative state. All the patients (98.5%) required physiotherapy and occupational therapy, 50.8% of them required speech therapy and swallowing assessment. Further, 47.7% required braces either ankle foot orthosis or hands splints; also, 16.9% required behavior therapy and we have used Botox injection in only 6.2% of the spastic patients. Finally, the incidence of TBIs from road traffic crashes and injuries in Qatar are increasing significantly compared to other developing and developed countries. In conclusion, the present study findings provided an overview of TBI in Qatar and mostly related to the road traffic crashes and injuries.

An increasing part of the global population holds a driver’s license. Thus, a greater variety of prerequisites regarding the fitness to drive will occur, increasing the demand for assessing fitness to drive. However, today, there is a lack of internationally agreed upon methods for assessing the fitness to drive. Specifically, there is a need to develop methods to assess cognitive abilities required for driving safely (Hird, Vetivelu, Saposnik, & Schweizer, 2014; Vrkljan, Myers, Crizzle, Blanchard, & Marshall, 2013). The aim of the present project was to develop an objective and scientifically valid method for assessing cognitive aspects of the fitness to drive in a few targeted groups. The aim was to design and implement a mini-simulator for assessing fitness to drive. The target groups included stroke, mild cognitive impairment, ageing and ADHD. A mini-simulator as well as test scenarios for the assessment of cognitive aspects of fitness to drive was designed (see figure 1). A literature review was undertaken regarding previous research on assessing fitness to drive in the targeted groups. The features of the focused diagnosis were studied regarding underlying cognitive impairment with bearing on driving ability. Each scenario of the simulator drive was designed to enable assessment of these cognitive abilities. Examples of diagnose features that were included were risk taking, distraction, impulsivity, inattention, cognitive flexibility, overconfidence, reaction time, responsiveness, neglect, divided attention and memory. A fixed based mini-simulator was built (Figure 1). To assess the cognitive features mentioned, a road stretch was designed. The road included rural road, highway and urban road. The speed limits varied as well as the landscape surrounding the road. Along the road, different, more or less critical situations, were staged enabling assessment of the targeted cognitive abilities. The mini-simulator met the expectations regarding a good implementation of the simulated scenarios. Future research include validation of the mini-simulator and the scenarios. References Hird, M. A., Vetivelu, A., Saposnik, G., Schweizer, T. A. (2014). Cognitive, On-road, and simulator-based Driving Assessment after Stroke. Journal of Stroke and Cerebrovascular Diseases, 23(10), 2654-2670. Doi.org/10.1016/j.jstrokecerebrovasdis.2014.06.010 Vrkljan, B. H., Myers, A. M., Crizzle, A. M., Blanchard, R. A., & Marshall, S. C. (2013). Evaluating medically at-risk drivers: A survey of assessment practices in Canada. Canadian Journal of Occupational Therapy, 80(5), 295-303. Doi: 10.1177/0008417413511788

Providing safe roads around schools is a challenge faced by all communities. Children’s behaviour is unpredictable and their safety is of particular concern in an area where there is often a mix of vulnerable road users and motor vehicles. In 2011, Ashghal commissioned a major road safety contract to conduct road safety assessments at 200 schools throughout Qatar. The results have since been collated into a comprehensive school safety improvements program and Ashghal is now constructing safe and convenient school zones for all road users throughout Qatar, based on the principles of a Safe System. The Qatar National Road Safety Strategy (2013-2022) has a vision of “a safe road transport system that protects all road users from death and serious injury” and adopts the Safe System as the guiding principle for building safe roads. The Safe System acknowledges that people make mistakes and that there is a limit to human injury tolerance. For example, a pedestrian hit at 30km/h is likely to survive (OECD, 2008). Whereas, a pedestrian hit at 60km/h is likely to be killed. Schools in Qatar are being treated with standard traffic engineering measures in a way that aims to achieve a Safe System 30km/h environment. Schools that have been completed show tremendous success and the benefits are being directly felt by parents, teachers, children and key stakeholders. Survey results show that vehicle speeds within school zones are successfully lowered to Safe System limits and that these speed reductions are being achieved over a 24 hour period without the need for Police enforcement. The improvements carried out to date have been well received and are seen as a positive step towards Qatar’s ambitious road safety vision. Site observations and speed surveys undertaken to date support the proposition of developing Safe System schools in Qatar. References: Qatar National Road Safety Strategy (2013-2022) Marsh, F. Principles of road design under a Safe System. ITS & Road Safety Conference, 22-23 September 2014, Doha, Qatar. OECD (Organization for Economic Cooperation and Development), 2008. Towards Zero, Ambitious Road Safety Targets and the Safe System Approach, In International Transport Forum, OECD Transport Research Centre, Paris. UN (United Nations), 2011. Global Plan for the Decade of Action for Road Safety 2011-2020, UN Road Safety Collaboration, Geneva.

Road traffic accidents are an emerging public health problem. The deaths due to road traffic injuries represent only a small fraction of the total waste of human and social resources. Road traffic injuries leading to disabilities are often neglected part of the problem. In the year of 2010, it was reported 2721 have died and 26487 have sustained injuries due to road traffic accidents. Sri Lanka being a middle income country, the information on disability following road traffic injuries is scarce. Therefore, a descriptive cross sectional study was conducted to describe the functional disability of road traffic injury patients. A descriptive cross sectional study was conducted among 881road traffic injury patients admitted to the National Hospital of Sri Lanka. The functional disability of activities of daily living was assessed on admission and after three months of hospital discharge using validated Sinhala version of 10 item- Barthel Index. The total score of the index was 0 to 20 and score of less than 19 was considered as functional disability. Injury severity was measured using Injury Severity Score (ISS) based in Abbreviated Injury Severity Scale (AIS). There were 793 (90.1%) males and 88 (9.9%) females. Of them 551 (56.9%) had sustained injuries to one AIS body regions, 322 (36.5%) and 58 (6.6%) had sustained injuries to two and three or more than three AIS body region respectively. The mean (±SD) total score of Barthel Index on admission and three months after discharge were 12.8(±4.4) and 18.2(± 2.9) respectively. Functional disability was observed in 91.1% of the injured at admission and 33.9% at three months after hospital discharge (p=0.00). At three months after the injury significant increase proportion of functional disability was observed with increase number of body regions injured (p=0.000) and with increase injury severity (p=0.000). Functional disability of road traffic injury patients on admission had reduced to 33.9% at three months after discharge from the hospital. One third of the study population was having functional disability at three months of the hospital discharge is note worthy to take actions.

Driving is a visually demanding task (Kotecha, Spratt and Viswanathan, 2008). Does individuals with visual deficits fulfill the “Fitness to drive” criteria? The developed simulator based method presented below was driven by the purpose to be able to discriminate between individuals with and without visual deficits. (Owsley, Wood, and McGwin, 2015). An advanced driving simulator was used to develop a simulated driving task, which also included a choice reaction test performed while driving on a rural road. Twenty-four drivers with various visual field impairments were compared to 55 drivers without visual defects. Two types of traffic signs positioned 5, 10, and 15 degrees (left, right) horizontally were used as stimuli. The test included both single and double stimuli. Drivers reacted by pressing buttons attached to the drivers fingers. It was found that the visually impaired drivers reacted 23% slower (1.46s vs. 1.19s) and had 14% less correct number of hits (74% vs. 84%) for single stimuli trials. Reaction time for double stimuli trials was 15% longer (1,68s vs. 1.46s) and hit rate was 27% less (69% vs. 88%). When the results from a secondary trial for drivers visual impairments were compared the normal sighted drivers’ first try the differences decreased but were still statistical significant. For single stimuli 17% slower, 5% less correct and for double stimuli 5% slower and 13% less correct hits. It was concluded that the developed test was useful in order to detect performance differences between drivers with visual impairments compared to drivers with an unimpaired visual field. However, the test should be completed with other performance assessment of more naturalistic critical traffic situations in order to be used as an instrument to measure “Fitness to drive”. Furthermore, the analysis needs to be complemented with an analysis which consider diagnosis and cognitive status.

Backgrounds: Pre-hospital emergency call is a crucial index to indicate emergency disease spectrum. For Beijing, which has changed greatly in economy and population, analyzing the trend of the emergency disease spectrum can greatly contribute to formulate the pre-hospital emergency planning. Methods: In this 10-year retrospective study, pre-hospital emergency records of Beijing Emergency Medical Center from 2003 to 2012 were collected. Medical Priority Dispatch System was used to classify the call demands. Linear regression models were constructed to examine the changing trends. Results: 2,410,575 cases were collected, and 2,278,415 of them were analyzed in this study. The results showed that: 1. In the past decade, the number of pre-hospital emergency call demands soared from 150,656 to 309,297 (204.6%, 2012/ 2003, p<0.001). 2. The top five call demands based on the rank of proportion were trauma related demands(25.4%, including falls（5.0%）, traffic/ transportation incidents(7.2%) and traumatic injuries(13.1%)), sick person(17.7%), heart problems(11.4%), unconscious/fainting（10.0%） and breathing problems（8.1%）Also, they were the top five fastest growing call demands. Conclusion: Compared with the growth of population (145.4%, 2012/2003), pre-hospital emergency calls increased much more, which shows a growing desire on ambulance service. Different from developed countries, the proportion of trauma related cases was constantly in the top rank and continuously increasing, much higher than that in San Francisco (15.7%), which could be resulted from accelerated city construction and rapid augment of vehicle quantity(244.8%, 2012/ 2003). Based on the changes and trends of pre-hospital emergency disease spectrum, it is encouraged to provide specific training program for emergency medical service staff and improve related medical devices. Note: Beijing emergency medical center is the only pre-hospital emergency system of Beijing government

Objective: This study aims to evaluate the effects of standardization processes in improving severe trauma treatments in China. Methods: This study was conducted in 12 hospitals located in 12 geographically and industrially different cities in China. A standard process on severe trauma rescue was established as a general rule for staff training and patient treatment. A regional network (system) efficiently integrating pre-hospital rescue, emergency room treatments, and hospital specialist treatments was built under the rule for information sharing and improving severe trauma treatments. Treatment outcomes were compared between before and one year after the implementation of standardization processes. Results: The outcomes of a total of 74,615 and 12051 cases of severe trauma were collected from 12 hospitals before the implementation of standardization processes. Implementation of the standardization processes led to efficient cooperation and information sharing of different treatmen services. The emergency response time, pre-hospital transit time, emergency rescue time, consultation call time, and mortality rate of patients were 24.24±4.32、45.69±3.89、6.38±1.05、17.53±0.72 minutes, and 33.82±3.87%, n=441,respectively before the Implementation of the standardization and significantly reduced to 10.11±3.21、22.39±4.32、3.26±0.89、3.45±0.45 minutes, and20.49±3.11 %, seperatly, n=495, (P<0.05) after that. Conclusion: Staff training and standardization processes can significantly improve the treatment efficiency of severe trauma based on current personnel and organizations of severe trauma treatments in China.

This research considers a Bayesian analysis of crash data in an attempt to predict, from a group of potential collision hotspot sites, which of these sites could benefit from treatment with a road safety scheme. Intrinsic to the analysis is the identification of trend and site-specific regression to the mean (RTM) effects. As in a standard retrospective before-after study to evaluate the effectiveness of a change in e.g. the geometric design of an intersection, observed collision rates are adjusted using values from a suitable crash prediction model (CPM). In any year, collision rates, which are unusually high/low will be suitably depressed/inflated according to the posterior distributions for collision rates at each site, hence giving a more realistic summary of safety in that year. Where site characteristic information (e.g. annual figures for average speed or traffic flow) for use in the CPM is limited, standard techniques from time series analysis are employed to exploit any time dependent (autoregressive) structure observed in historical collision rates at each site. The Bayesian posterior predictive distribution is then used to predict collision rates at each site in future years, having adjusted for trend, RTM and any autoregression in collision rates at each site. This equips road safety practitioners with the necessary methodology to identify, and possibly treat, such locations before these collisions occur and this has the potential to help, inform, and direct, investment in future road safety schemes. In this research, crash data from the United Kingdom and Germany were analysed, and results have shown that this methodology is transferable between regions. The methodology is currently being implemented into a prototype software application to be tested by local road safety practitioners later in the year in the UK.

Road traffic injuries (RTI) are the leading cause of death in Qatar with one in eight deaths from all causes due to RTIs. Furthermore, motor vehicle crashes (MVC) are becoming a growing public health problem and the use of seatbelt is universally low throughout the nation. The aim of our study was to investigate and highlight potential socio-demographic risk factors that contribute to seatbelt non-compliance. A prospective cross-sectional survey of all adults admitted with orthopaedic injuries following a MVC was conducted. A physician-administered questionnaire was used to interview all patients. Univariate and multivariate logistic regression analysis was carried out to examine the association of various risk factors and seatbelt compliance. One hundred and seventy one patients were interviewed over a twelve-month period. Of the 171 patients, 103 patients (60%) (92 males, 11 females) were not wearing a seatbelt compared to 68 patients (59 males, 8 females) wearing a seatbelt. The mean age of the non-compliant patients was 32.8 years compared to 33.8 years of the compliant patients. Seatbelt compliance was associated with gender (OR: 11.3), nationality (ORs: 7.6 and 1.9), position in the car (OR: 14.2), education of the patient (ORs: 25.9 and 30.5), time of the injury (OR: 3.3), marital status (OR: 6.5), awareness of seatbelt campaign (OR: 5.9) and owner of a vehicle (OR: 11.2). The majority of non-compliant patients were single males from a Middle Eastern background that we involved in a MVC during the weekend. The majority of patients admitted with orthopaedic injuries following MVCs were not wearing seatbelts. The majority of non-compliant patients were driving 4WD vehicles and had crashes on main roads. A further national seatbelt campaign is required to promote the importance of seatbelt compliance amongst young male drivers with more stringent traffic penalties.

Hearing loss (HL) is one of the most frequent sensory deficit in humans (Stevens et al., 2013), which might reduce traffic safety. The prevalence of age-related HL is increasing (Roth et al., 2001), and as a consequence the number of road users with HL will also increase. The effects of HL on traffic safety have been investigated and the use of tactile support systems has been evaluated both in a driving simulator and in real traffic. Tactile support was used to alert the driver during the simulator drive and to facilitate navigation with a GPS during the drive in real traffic. Differences related to HL in terms of driving behavior were bound to driving condition and occurred when complexity of driving task increased. There was also an effect of HL on visual behavior, indicated in the simulator and confirmed in the field study, suggesting that drivers with HL have a more active visual behavior with more frequent glances in the rear view mirror and a general scanning of the environment before looking away from road. Tactile signal in the driver seat was found useful, both for calling for driver attention and to facilitate navigation. Also, of high relevance for the traffic safety aspect and regardless of hearing status, the tactile support lead to higher satisfaction with the navigation system, less time spent to look at the navigation display, and thus more focus on road and better driving performance. The effects of HL on traffic safety consistently point towards a generally more cautious driving behavior. Compensatory strategies associated with HL include driving at lower speeds, more comprehensive visual search behavior and less engagement in distracting activities. Evaluation of a tactile signal suggests that by adding a tactile modality, some driver assistance systems can be made accessible also for drivers with HL. At the same time the systems might be more effective for all users, which could generally increase both traffic safety and mobility. Roth, T.N., Hanebuth, D., & Probst, R. (2001). Prevalence of age-related hearing loss in Europe: a review. European Archives of Oto-Rhino-Laryngology, 268(8), 1101–1107. Stevens, G., Flaxman, S., Brunskill, E., Mascarenhas, M., Mathers, CD., & Finucane, M. (2013). Global and regional hearing impairment prevalence: an analysis of 42 studies in 29 countries. European Journal of Public Health, 23(1), 146–152.

Cardiovascular diseases (CVDs) are number one reason for human mortality around the world (Fig. 1) [1]. Pulse pressure (PP) and pulse rate (PR) are considered as the two most vital physiological markers for CVDs like myocardial infarction, cardiac arrhythmia, and heart failure. Currently, long-term PP and PR analysis is not possible due to the lack of systems that can frequently measure the data over a period of time. Motor vehicle drivers with known CVDs are at higher risk due to traffic air pollution. This paper presents our work on an inexpensive and readily deployable approach that keeps track of PP and PR with simple cameras. The computation of PP and PR makes the real-time monitoring possible. The approach makes it highly customizable and ready for on-the-go use in field by drivers, construction zone workers, healthcare workers, law enforcement agencies, etc. The video recordings of fingertips were made using a cellphone camera. The analysis extracted the pulse pressure, which was the difference between systolic and diastolic pressures, and pulse rate. The PP measured with this system was compared with a standard off-the-shelf tool. The comparison showed high accuracy. The measurement of PRs also showed a high level of reliability in comparison to the standard tool. The fundamental concept of the technology depended on the measurement of blood quantity in the fingertip arteries. The amount of blood on fingertips was different during systolic and diastolic phases. This created light intensity variations, which were extracted by analyzing the video frames. A simple embodiment of this approach can be in the dashboard of cars with a camera to create short high-resolution videos of fingertips. The doctors can remotely monitor their patients through a standard computer interface. The patients can also be trained to interpret the results of the measurement. References: 1. WHO Fact Sheet No. 317. www.who.int/mediacentre/factsheets/fs317/ (Accessed 29 Jul 2015) 2. 1950 Mortality Data: “Leading Causes of Death, 1900-1998,” Centers for Disease Control and Prevention Website (www.cdc.gov/nchs/nvss/mortality_historical_data.htm). 3. 2011 Mortality Data: Hoyert and Xu, “Deaths: Preliminary Data for 2011”, National Vital Statistics Reports, vol. 61, no. 6, 10 Oct 2012

In a report by the WHO Eastern Mediterranean Region(1), the non-use of child restraints for children was identified as a key risk factor that can be addressed by the adoption and enforcement of legislation that will increase their use. Currently, there are no child restraint laws in Qatar. The objective of the study is to report baseline data on child restraint use and to provide evidence to inform the passage of child passenger restraint laws in Qatar. This roadside observational survey was conducted as part of the Young Kids in Safe Seats Project funded by the Qatar Foundation. Trained observers conducted roadside observations of passenger restraint use in vehicles with children, less than 5 years, at 12 sampling sites. Standard data was collected per observation: seating position, restraint used and appropriateness of restraint used. Of 2232 observations of young child passengers: 41% were properly restrained, 21% improperly restrained and 38% unrestrained, 10.9% were on an adult’s lap. The most common seating location was right second row followed by left second row. These 2 locations also had the highest rates of proper restraint use. The positions with the lowest restraint use were the front and second row middle seat. One in 9 children observed was illegally seated in the front row, most on the lap of an adult [38.3%] or unrestrained [34.4%]. This is the first observational study in Qatar that measures child restraint rates in children younger than 5. Less than half of these children are traveling safely. Priority areas for intervention include: enforcement of existent laws banning children in the front seat, education about the risks for children in an adult’s lap and encouraging the proper use of age/size appropriate restraint systems. These findings can inform the development of national child passenger restraint laws. Reference: 1. Road safety in the Eastern Mediterranean Region Facts from the Global Status Report on Road Safety 2013.