Unintentional Injury Research: Motor Vehicle Research (Continued)

 
Pedestrians

• CDC researchers studied why children don’t walk to school more often. Analysis of the 1999 HealthStyles^® Survey, which assesses how individuals think, feel, and act regarding personal health issues, found that 19% of children walked and 6% of children biked to or from school at least once during an average week. Parents reported multiple barriers that inhibit walking and biking to school: long distances (55%), traffic danger (40%), weather (24%), crime (18%), and school policy (7%). The 16% of children whose parents reported no barriers were three times more likely to walk or bike to school than the population as a whole, and six times more likely than children with one or more reported barriers. 
  CDC. Barriers to children walking and biking to school—United States, 1999. MMWR 2002; 51(32);701–4.

• Researchers at Johns Hopkins University are studying community characteristics that may affect interventions to prevent child pedestrian injuries. They are comparing four neighborhoods that vary by risk of pedestrian injury and by median household income. The researchers will assess several key community characteristics that may affect acceptance of interventions, including environmental characteristics such as traffic patterns, roadways, and play areas; parents’ perceptions of risk; parents’ knowledge of and willingness to support environmental changes and other pedestrian safety programs; level of parental supervision; amount and patterns of walking by children in the community and injury experiences of child pedestrians. Data from this CDC-funded study will help researchers and practitioners identify potential strategies to reduce injury risks among child pedestrians, as well as barriers against such efforts. Project results will help guide development of safety interventions for child pedestrians in similar communities.
   

Motor Vehicle Crashes

• Scientists at CDC examined rates of motor vehicle–related deaths in a U.S. military population over a 15-year period and compared fatality rates with the U.S. population overall. They found that motor vehicle death rates among U.S. Army personnel have decreased 50% since the early 1980s. Factors such as decreased alcohol use and higher rates of seat belt use among U.S. Army personnel have likely contributed to this decline. 
  Jones BH, Amoroso PJ, guest editors. Injuries in the U.S. Armed Forces: Surveillance, research, and prevention. American Journal of Preventive Medicine 2000;18(3 Suppl).

• Injuries sustained during low-speed, rear-end car crashes, and the injury-related pain that follows, have become national and international problems, costing society billions of dollars annually. CDC-funded researchers at the Medical College of Wisconsin are examining what happens to the head and neck to cause pain during low-speed, rear-end crashes. Current scientific literature about this topic is diverse and confusing. Findings from this research will help guide development of interventions to prevent acute and chronic pain resulting from low-speed, rear-impact crashes.

• Little information exists about the disabling conditions endured by seriously injured crash survivors. CDC is analyzing data from the 1995 disability supplement of the National Health Interview Survey to estimate the prevalence of disability resulting from motor vehicle crashes among adults ages 18 years and older in the United States; to describe the chronic conditions associated with disability; to estimate the number of adults whose ability to work was affected by motor vehicle crash–related disability; and to compare the age distributions of persons with disabilities resulting from motor vehicle crashes with those whose disabilities are the result of other causes.

• CDC is funding Colorado State University to evaluate an intervention to reduce anger among drivers. “High anger” drivers report having more motor vehicle crashes during their lifetimes and more minor crashes in the past year than do “low anger” drivers. The intervention now being evaluated teaches high anger drivers to use relaxation and other coping skills to reduce their anger. Results so far have shown that drivers who participated in the intervention reduced their frequency of risky driving behavior. This effect was maintained one month after intervention. 

 
Motor Vehicle Occupant Safety Technology

• Wheelchairs and their associated seating systems have not typically been designed to function as motor vehicle seats and consequently do not offer their users the same level of safety as vehicle seats. CDC-funded researchers at the University of Pittsburgh have tested wheelchair seating systems and found them unable to withstand many crash scenarios. Based on the results of these tests, researchers are developing standards for wheelchair seating systems used in motor vehicles that will reduce the risk of motor vehicle injuries among persons with disabilities. These standards will help translate research into prevention by providing manufacturers with design guidelines and testing methods they need to produce safer products.

• Researchers at Harborview Medical Center in Seattle, with funding from CDC, are testing a device to reduce the whiplash motions that an occupant may experience during a rear-end motor vehicle crash. The device is a relatively inexpensive seat cushion that can be retro-fitted to an existing motor vehicle seat. The retrofit cushion would more closely fit the shape of the occupant, thus reducing head and torso motions during a crash and absorbing a greater amount of energy from the crash. This research may lead to engineering solutions that reduce the number and severity of neck and upper back injuries resulting from rear-impact crashes. 

 
Guide to Community Preventive Services
Community-Based Interventions to Reduce Motor Vehicle–Related Injuries
Evidence of Effectiveness from Systematic Reviews

Many community-based interventions have been developed to address motor vehicle–related injuries as a public health problem. To assess which community-based interventions are effective in reducing motor vehicle injuries, CDC scientists conducted systematic reviews of the literature on community-based interventions to reduce alcohol-impaired driving, increase child safety seat use, and increase safety belt use. 

These reviews were used by the Task Force on Community Preventive Services—an independent, nonfederal panel of community health experts—to develop recommendations on the use of these interventions. In November 2001, the reviews and recommendations were published in a supplement of the American Journal of Preventive Medicine. In 2003, they will be compiled into The Guide to Community Preventive Services, a resource for policymakers and public health practitioners. The findings can be used to support or expand local programs to prevent motor vehicle injury and to promote the adoption, maintenance, or strengthening of state and national traffic safety laws. To access the full text articles and learn more about The Guide to Community Preventive Services, visit www.thecommunityguide.org. 

Zaza S, Thompson RS, guest editors. The guide to community preventive services, reducing injuries to motor vehicle occupants: Systematic reviews of evidence, recommendations from the Task Force on Community Preventive Services, and Expert Commentary. American Journal of Preventive Medicine 2001;21(4 suppl):23–30.

CDC. Motor-vehicle occupant injury: Strategies for increasing use of child safety seats, increasing use of safety belts, and reducing alcohol-impaired driving. A report on recommendations of the Task Force on Community Preventive Services. MMWR Recommendations and Reports 2001:50(RR-7);1–13. 

Key Review Findings:

• Interventions to increase child safety seat use
  Based on strong evidence of effectiveness, the Task Force recommended two interventions to increase child safety seat use: laws mandating the use of child safety seats (all 50 states currently have such laws) and programs that distribute child safety seats and educate parents about their use. They also recommended two other interventions based on sufficient evidence of effectiveness:

  • community-wide information and enforcement campaigns 
  • incentive and education programs.

  Zaza S, Sleet DA, Thompson RS, Sosin DM, Bolen JC. Task Force on Community Preventive Services. Reviews of evidence regarding interventions to increase use of child safety seats. American Journal of Preventive Medicine 2001;21(4 Suppl):31–47.

• Interventions to increase safety belt use
  Based on strong evidence of effectiveness, the Task Force recommended all three reviewed interventions to increase safety belt use: safety belt use laws, primary enforcement laws (versus secondary enforcement laws), and enhanced enforcement programs. 
  Dinh-Zarr TB, Sleet DA, Shults RA, Zaza S, Elder RW, Nichols JL, et al. Task Force on Community Preventive Services. Reviews of evidence regarding interventions to increase use of safety belts. American Journal of Preventive Medicine 2001;21(4 Suppl):48–65.

• Interventions to reduce alcohol-impaired driving
  Based on strong evidence of effectiveness, the Task Force recommended three interventions to reduce alcohol- impaired driving: sobriety checkpoints, 0.08% blood alcohol concentration (BAC) laws, and minimum legal drinking age laws. They also recommended two interventions based on sufficient evidence of effectiveness: “zero tolerance” laws for young drivers, and training programs for people who serve alcohol.

The systematic review of the effectiveness of 0.08% BAC laws revealed that states that lowered the legal BAC for drivers from 0.10% to 0.08% reduced alcohol-related fatalities by a median of 7%, which translates to 500 lives saved annually. These findings were helpful in the debate that led Congress to pass a new national standard for alcohol-impaired driving. In October 2000, the President signed the fiscal year 2001 transportation appropriations bill, requiring states to pass a 0.08% BAC law by October 2003 or risk losing federal highway construction funds. By September 2002, 13 additional states had enacted 0.08% BAC laws, bringing the total number of states with such laws to 32. 
 
Shults RA, Elder RW, Sleet DA, Nichols JL, Alao MO, Carande-Kulis VG, et al. Task Force on Community Preventive Services. Reviews of evidence regarding interventions to reduce alcohol-impaired driving. American Journal of Preventive Medicine 2001;2(4 Suppl):66–88.

 

 

This page last reviewed 09/07/06.

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