Winter sledding tips.

BACKGROUND: It is estimated that by 2020 road traffic crashes will have moved from ninth to third in the world disease burden ranking, as measured in disability adjusted life years, and second in developing countries. The identification of effective strategies for the prevention of traffic related injuries is of global health importance. Area-wide traffic calming schemes that discourage through traffic on residential roads is one such strategy. OBJECTIVES: To evaluate the effectiveness of area-wide traffic calming in preventing traffic related crashes, injuries, and deaths. SEARCH STRATEGY: We searched the following electronic databases: Cochrane Injuries Group's Specialised Register, Cochrane Controlled Trials Register, MEDLINE, EMBASE and TRANSPORT (NTIS, TRIS, TRANSDOC). We searched the web sites of road safety organisations, handsearched conference proceedings, checked reference lists of relevant papers and contacted experts in the area. The search was not restricted by language or publication status. SELECTION CRITERIA: Randomised controlled trials, and controlled before-after studies of area-wide traffic calming schemes. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data on type of study, characteristics of intervention and control areas, and length of data collection periods. Before and after data were collected on the total number of road traffic crashes, all road user deaths and injuries, pedestrian-motor vehicle collisions and road user deaths. The statistical package STATA was used to calculate rate ratios for each study, which were then pooled to give an overall estimate using a random effects model. MAIN RESULTS: We found no randomised controlled trials, but 16 controlled before-after trials met our inclusion criteria. Seven studies were done in Germany, six in the UK, two in Australia and one in the Netherlands. There were no studies in low or middle income countries. Eight trials reported the number of road traffic crashes resulting in deaths. The pooled rate ratio was 0.63 (0.14, 2.59 95% CI). Sixteen studies reported the number of road traffic crashes resulting in injuries (fatal and non fatal). The pooled rate ratio was 0.89 (0.80, 1.00 95% CI). Nine studies reported the total number of road traffic crashes. The pooled rate ratio was 0.95 (0.81, 1.11 95% CI). Thirteen trials reported the number of pedestrian-motor vehicle collisions. The pooled rate ratio was 1.00 (0.84, 1.18). There was significant heterogeneity for the total number of crashes and deaths and injuries. REVIEWER'S CONCLUSIONS: The results from this review suggest that area-wide traffic calming in towns and cities may be a promising intervention for reducing the number of road traffic injuries, and deaths. However, further rigorous evaluations of this intervention are needed.

Accident Prevention↗

PubMed2003

Organisation of truck-driver training for the transportation of dangerous goods in Europe and North America.

In Canada, as in several other countries, truck drivers involved in the transportation of dangerous goods must be trained. However, given the many differences in vehicles, substances transported and driving conditions, international guidelines are very open-ended. This article outlines the domestic training requirements in Canada, the United States, The Netherlands and Sweden, and examines the manner in which the training is provided. In both Canada and the United States, the responsibility for assuring a driver is adequately trained rests with the employer. It is the employer who determines the duration and content of any training program. In addition, the assessment of a driver is also an employer responsibility. In practice, possibility in light of liability issues, many employers use commercial training firms. However, generally speaking there is no national or regional accreditation program for such commercial firms. In Europe, where training is conducted in response to the European Agreement concerning the International Carriage of Dangerous Goods by Road, training and testing must receive national accreditation, although the specific details of such accreditation are not spelled out. Sweden places its emphasis on careful accreditation of those providing training, while in The Netherlands more importance is placed on examinations to be used to test the results of the training. The intent of this article is to show that the same goal in four different countries has resulted in four different schemes, each of which appears to be accepted in the country of use. A comparison of safety achieved in the transportation of dangerous goods in each country is beyond the scope of this article. International evaluation studies would be necessary to draw scientifically-based conclusions on the effectiveness of truck-driver training systems for the safe transportation of dangerous goods.

Accident Prevention↗