Reducing road traffic injuries: effectiveness of speed cameras in an urban setting. The crash reduction effectiveness of a network-wide traffic police deployment system. Controlled evaluation of a community based injury prevention program in Australia. The effects of mobile speed camera introduction on road traffic crashes and casualties in a rural county of England. Safety effects of speed reducing measures in Danish residential areas. Reducing injury rates using a community-based approach. Prevention of farm injuries in Denmark. Reducing alcohol-impaired driving in Massachusetts: the Saving Lives Program. Randomised controlled trial of site specific advice on school travel patterns.
We assessed the effectiveness of speed cameras on Barcelona's beltway in reducing the numbers of road collisions and injuries and the number of vehicles involved in collisions.
                We designed a time-series study with a comparison group to assess the effects of the speed cameras. The "intervention group" was the beltway, and the comparison group consisted of arterial roads on which no fixed speed cameras had been installed. The outcome measures were number of road collisions, number of people injured, and number of vehicles involved in collisions. We fit the data to Poisson regression models that were adjusted according to trends and seasonality.
                The relative risk (RR) of a road collision occurring on the beltway after (vs before) installation of speed cameras was 0.73 (95% confidence interval [CI]=0.63, 0.85). This protective effect was greater during weekend periods. No differences were observed for arterial roads (RR=0.99; 95% CI=0.90, 1.10). Attributable fraction estimates for the 2 years of the study intervention showed 364 collisions prevented, 507 fewer people injured, and 789 fewer vehicles involved in collisions.
                Speed cameras installed in an urban setting are effective in reducing the numbers of road collisions and, consequently, the numbers of injured people and vehicles involved in collisions. Random Road Watch (RRW) is a traffic policing program in operation in Queensland, Australia. It differs from conventional traffic policing in that an explicit resource management technique is used which randomly schedules low levels of police enforcement in a manner intended to provide long-term, widespread coverage of a road network and hence maximise road safety benefits. Implementation of the program studied in Queensland covered 55% of total crashes within the state. This study aimed to measure the crash effects of the RRW program in Queensland. A quasi-experimental study design was used for the evaluation incorporating Poisson regression statistical analysis techniques. Analysis of the effects of the Queensland RRW program on crash frequency has shown the program to be effective overall. Estimated program effects were largest on fatal crashes, with an estimated reduction of 31%. Estimated aggregate program crash effects reduced with crash severity and increased with time after program introduction. Crash reductions in the third year after program introduction translated into savings, at state level, of some 12% of the state's crashes of all severities and some 15% of the state's fatal road crashes. Overall, the program produced a significant 11% reduction in total crashes in areas outside of metropolitan Brisbane. The opportunity-cost benefit/cost ratio for the program was estimated to be 55:1. To evaluate the effects of a community based, all age, all injury prevention program, the Safe Living Program, on injury risk and injury rates.
                A quasiexperimental population based evaluation using an intervention and comparison community design.
                The intervention community (Shire of Bulla, n = 37,257) is an outer metropolitan area of Melbourne, Australia. The demographically matched comparison community (Shire of Melton, n=33,592) is located nearby.
                The Safe Living Program in the Shire of Bulla targeted injury reduction in all settings with a focus on high risk groups. Strategies included program publicity, education and training, injury hazard reduction, and environmental change. Baseline and follow up measures of program reach, risk factors, and injury rates in both communities were used to evaluate program process, impact, and outcome.
                Increase in program awareness was moderate and similar to other community based programs. The program achieved injury hazard reduction on the road, in schools, and, to a more limited extent, in the home. Other changes in injury risk factors could not necessarily be attributed to the program as similar changes were observed in the comparison community. No significant changes were found in rates of injury deaths, hospitalisations, or emergency department presentations in the Shire of Bulla after six years. Self reported household injuries, mostly minor, were reduced in the intervention community, but had been higher at program launch than in the comparison community.
                The Safe Living Program was unable to replicate the significant reductions in injuries reported in other community based interventions. Replication of apparently successful community based injury prevention programs in different settings and populations requires evidence based interventions, sustained and effective program penetration, reliable data systems to measure change, at least one control community, and sufficient budget and time for effects to be observable. This study assesses the impact of crash and casualty numbers in correspondence to the introduction of mobile speed cameras in the rural county of Norfolk, England.
                Road traffic accident casualty and crash data were collected for two years before the introduction of cameras and two years subsequently. The casualties and crashes occurring at 29 camera sites were identified and separated from those occurring in the rest of the county. Trends in crashes and casualties, and their severity, were examined graphically and comparisons were made between before and after periods. The regression to the mean effect at individual sites was estimated.
                After the introduction of cameras, overall crashes declined by 1% and crashes involving fatalities or serious injuries declined by 9% on the roads without cameras. At the camera sites, crashes decreased by 19% and fatal and serious crashes by 44%. The reduction in total crashes was significantly greater than that expected from the effect of regression to the mean in 12 out of 20 sites tested.
                The introduction of cameras appears to have resulted in real and measurable reductions in crash risk in this rural county.
                Our results suggest the deployment of mobile speed cameras is an effective tool for organizations wishing to reduce road traffic casualties in areas where high crash rates have been associated with excessive vehicle speeds. On May 1, 1977 a new code was introduced into the Danish Road Traffic Act. The result was a change in layout and speed limits in a great number of residential streets; in most cases the streets were transformed into 30 km/h streets and in few cases into 15 km/h streets. In addition to speed signs, both types of streets were equipped with speed reducing measures. Based on experiences from a selection of experimental streets, mostly 30 km/h streets, different, but very positive effects were found. Overall there was a reduction in the mean speed in these areas of 11 km/h. On the 223 km, 30 km/h streets there was a reduction of 77 accidents and 88 casualties within a period of three years. These reductions were caused by the implementation of speed signs, speed reducing measures, and a reduction in traffic. On the basis of 44 experimental streets, where traffic was recorded both before and after the changes, the reduction in risk of casualties, i.e. the number of casualties per road user km, was 72%, while the risk of accidents seemed to be unchanged. Considering serious injuries alone, a very high reduction of 78% was found. Accidents included in the study consist of all police reported accidents, i.e. accidents with personal injury as well as damage only accidents. Injuries are the number one cause of morbidity and mortality to persons aged 1-44 years in the United States. Community-based interventions offer one approach to reducing injuries.
                To determine whether injuries could be reduced over a 5 year period by at least 20% in a midwestern community using a proven community-based model compared with three control communities.
                The Injury Free Coalition for Kids of Greater Cincinnati began its injury-reducing efforts within one Intervention Community (IC) in 2000. After reviewing injury data, engaging community members, and holding focus groups to assess community needs, specific structural and social alterations were made to engage youth in safe, supervised activities and provide them with safe play places. Data were obtained from the Hamilton County Injury Surveillance System from 1999-2004 for deaths, hospitalizations, and emergency department visits. Data in our IC were compared with three control communities in the city with similar demographics and socioeconomic characteristics. 2000 Census data were used to calculate injury rates.
                During study period, 5065 IC youth sustained 3796 injuries, while 9297 youth from the control settings sustained 5445 injuries. Injury rate in the IC decreased 42% from 1999 to 2004, 17551.83 to 10187.56 injuries/100,000 children/year, respectively, compared with the mean rate among the three control sites, which decreased 25.7%, 12950.41 to 9626.76 injuries/100,000 children/year. This difference was statistically significant, p < 0.001.
                Community prevention efforts that engage youth in supervised activities and provide safe play areas can help to reduce youth injuries within specific high-risk communities. This study examined the effects of a 4-year randomized intervention program that combined a safety audit with safety behavior training in the prevention of farm injuries.
                From a random sample of farms in the county of Ringkoebing, Denmark, 393 farms with 1597 residents and employees participated in a weekly self-registration of work-related accidents and injuries during 1 year. Worktasks and time at risk were recorded. A questionnaire including items on safety behavior was also mailed to each farm. Thereafter, the farms were randomly assigned to an intervention or control group. Two hundred and one farms with 990 persons at risk participated in the intervention study. The main outcome measures were the number and severity of accidents, safety behavior, and farmsite safety audits.
                Pre- and postmeasurements showed a substantial reduction in injury rates in the intervention group in comparison with a slight reduction in the control group. In a multivariate regression analysis the intervention effect was estimated to be a 30% injury-rate reduction of all injuries, while there was a 42% reduction for medically treated injuries only. Although none of these effects are statistically significant with the present sample size, their magnitude and direction support an intervention effect. The measures of safety behavior revealed significant improvements, and this finding supports the conclusion that the intervention effect was positive, since they concern some of the mediating factors on the pathway from intervention to improved injury rates.
                This intervention, which focused on safety behavior and was performed as a randomized controlled trial, was followed by a substantial reduction in the number of farm injuries. The reduction was particularly marked for the more severe injuries demanding medical treatment. The purpose of this study ws to assess whether a community program begun in March 1988 that organized multiple city departments and private citizens could reduce alcohol-impaired driving, related driving risks, and traffic deaths and injuries.
                Trends in fatal crashes and injuries per 100 crashes were compared in Saving Lives Program cities and the rest of Massachusetts from March 1984 through February 1993. In annual roadside surveys conducted at randomly selected locations, safety belt use among occupants of 54577 vehicles and travel speeds of 118442 vehicles were observed. Four statewide telephone surveys (n = 15188) monitored self-reported driving after drinking.
                In program cities relative to the rest of Massachusetts during the 5 program years in comparison with the previous 5 years, fatal crashes declined 25%, from 178 to 120, and fatal crashes involving alcohol decreased 42%, from 69 to 36. Visible injuries per 100 crashes declined 5%, from 21.1 to 16.6. The proportions of vehicles observed speeding and teenagers who drove after drinking were cut in half.
                Interventions organized by multiple city departments and private citizens can reduce driving after drinking, related driving risks, and traffic deaths and injuries. To evaluate the effect of site specific advice from a school travel coordinator on school travel patterns.
                Cluster randomised controlled trial of children attending 21 primary schools in the London boroughs of Camden and Islington. A post-intervention survey measured the proportion of children walking, cycling, or using public transport for travel to school, and the proportion of parents/carers very or quite worried about traffic and abduction. The proportion of schools that developed and implemented travel plans was assessed.
                One year post-intervention, nine of 11 intervention schools and none of 10 control schools had travel plans. Proportions of children walking, cycling, or using public transport on the school journey were similar in intervention and control schools. The proportion of parents who were very or quite worried about traffic danger was similar in the intervention (85%) and control groups (87%). However, after adjusting for baseline and other potential confounding factors we could not exclude the possibility of a modest reduction in parental concern about traffic danger as a result of the intervention.
                Having a school travel coordinator increased the production of school travel plans but there was no evidence that this changed travel patterns or reduced parental fears. Given the uncertainty about effectiveness, the policy of providing school travel coordinators should only be implemented within the context of a randomised controlled trial.
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 such interventions are needed.