We agree with Reinhardt-Rutland's concerns1 about Northern Ireland's
poorly designed and policed bicycle facilities but we doubt that the U.S.
traditional model of simply treating bicycles as vehicles is better. What
works is physically separating bicyclists from fast or heavy motor
traffic. Reinhardt-Rutland further suggested that higher fuel costs could
effect change where risk assessments have failed. While waiting fo...
We agree with Reinhardt-Rutland's concerns1 about Northern Ireland's
poorly designed and policed bicycle facilities but we doubt that the U.S.
traditional model of simply treating bicycles as vehicles is better. What
works is physically separating bicyclists from fast or heavy motor
traffic. Reinhardt-Rutland further suggested that higher fuel costs could
effect change where risk assessments have failed. While waiting for
increases in fuel prices, we wanted to underscore the benefits of cycle
tracks, including their lower injury risk.
Cycle tracks, as described and studied in our paper2 are physically-
separated bicycle-exclusive paths along roads as found in the Netherlands.
Cycle tracks can have dividers that prevent cars from parking on them.
Parallel parked cars alongside a cycle track also separate bicyclists from
moving traffic. These cycle tracks by parked cars can also lower exposure
of cyclists to air pollution. Unlike a shared-use segregated path,
pedestrians have a place on their sidewalk and bicyclists on their cycle
track. With cycle tracks, drivers can see a space has been relegated in
the right-of-way for bicyclists, especially when it comes with its own red
and green bicycle signal.
The Montreal case shows that cycle tracks not only have lower injury
risk2 but they may be an effective strategy for promoting cycling3 just by
themselves or combined with other policies (ex. public bicycle share
program, complete streets, etc.). When successful, drivers can witness
women, children, seniors, and parents bicycling instead of mainly young,
adult, male bicyclists in the road.
Reinhardt-Rutland wrote that the Northern Ireland's problematic
bicycle facilities are often ineffective. By definition, non existent
cycle tracks are also ineffective.
1. Reinhardt-Rutland TH. The effectiveness of dedicated cycling
facilities: perceived and objective risk. Inj Prev 2011;17(3):216.
2. Lusk AC, Furth PG, Morency P, Miranda-Moreno LF, Willett WC, Dennerlein
JT. Risk of injury for bicycling on cycle tracks versus in the street. Inj
Prev 2011.
3. Miranda-Moreno LF. Weather or not to cycle: whether or not cyclist
ridership has grown: a look at weather's impact on cycling facilities and
temporal trends in an urban environment. Transportation Research Record in
press.
I am writing in response to a letter from P Whelan of the organization Coalition of Law Abiding Sporting Shooters Inc.[1]
The authors of this recently published article would like to rebut attacks on the scientific facts and study design related to our research. The authors were careful to state that the dramatic reductions in firearm related fatalities in Victoria and Australia occurred in the cont...
I am writing in response to a letter from P Whelan of the organization Coalition of Law Abiding Sporting Shooters Inc.[1]
The authors of this recently published article would like to rebut attacks on the scientific facts and study design related to our research. The authors were careful to state that the dramatic reductions in firearm related fatalities in Victoria and Australia occurred in the context of tightened regulations. It acknowledged also, in particular, the effects of associated publicity, community awareness and firearm buy-back schemes. It is not possible to precisely separate out these and other possible effects, though impact measures for registered firearms, licensed shooters, household ownership of guns and gun buy-back all trend in the expected directions.
The study utilized a quasi-experimental design, with in-built controls, due to the "natural experiment" of Victoria tightening its firearm laws at an earlier point than the rest of Australia, whereby the rest of Australia became the control for Victoria. Later, when uniform national laws were implemented, Victoria became the control for the rest of Australia. Importantly, the analysis has shown the tight correspondence between death rate trends in Victoria and the rest of Australia in the pre-intervention period.
We estimate that if pre-1988 trends in firearm fatalities had continued in Australia, more than one thousand more lives would have been lost to firearms. This would equate to multi-million dollar costs associated with lives lost.
While method substitution was stated to be beyond the scope of our study, we are pleased to report that there has been a reduction in suicide rates in Victoria of 7% between the early 1990s and 2002.[2]
References
1. Whelan PW et al. Monash Uni Report "junk science" [electronic response to J Ozanne-Smith et al. Firearm related deaths: the impact of regulatory reform] injuryprevention.com 2004http://ip.bmjjournals.com/cgi/eletters/10/5/280#115
I read with interest Caroline Finch's Online First editorial
describing her recent experience of attending and giving a key note
address at the third World Conference on Prevention of Injury and Illness
in Sport. As someone who also frequently straddles the fields of sports
medicine, injury prevention and, more broadly, health promotion, I would
like to whole heartedly support Professor Finch's call...
I read with interest Caroline Finch's Online First editorial
describing her recent experience of attending and giving a key note
address at the third World Conference on Prevention of Injury and Illness
in Sport. As someone who also frequently straddles the fields of sports
medicine, injury prevention and, more broadly, health promotion, I would
like to whole heartedly support Professor Finch's call for greater
integration and collaboration across these areas. With sports injury
prevention and falls prevention research now on the trail of the holy
grail of translational and implementation research, both have so much they
can learn from each other and from other fields of health and behavioural
science research. Tobacco control is probably the most mature and
sophisticated area of health promotion research so why not see what has
been learnt there and take what is useful for application in injury
prevention. The same applies to physical activity promotion and obesity
prevention. Road traffic safety, falls prevention among the elderly, and
occupational health and safety are three areas of injury prevention
research where so much is already know about what works (and what doesn't)
to change safety behaviours and to translate research evidence into real-
world reductions in injury mortality and morbidity---yet few sports injury
prevention or sports medicine researchers avail themselves of this body of
knowledge.
We note with interest and concern the exchange between the Monash
Research Group and Mr Whelan,[1] regarding serious flaws in the Monash
study.[2]
Upon close scrutiny, the claim that Victoria’s 1988 firearm
legislation led to significant declines relative to the rest of Australia
is unsupported by the actual data. Rather, we see that firearms suicides
and assaults/homicides have been decl...
We note with interest and concern the exchange between the Monash
Research Group and Mr Whelan,[1] regarding serious flaws in the Monash
study.[2]
Upon close scrutiny, the claim that Victoria’s 1988 firearm
legislation led to significant declines relative to the rest of Australia
is unsupported by the actual data. Rather, we see that firearms suicides
and assaults/homicides have been declining across Australia since the
1980s, and that the pattern of decline is consistent Australia wide. The
Victorian legislation did not, therefore, provide any unique impact upon
firearms deaths. A comprehensive review of the statistical methods used
in the Monash study is currently being compiled.
Despite their very brief acknowledgement that suicide rates overall
were unchanged by firearms legislation (indeed, we have seen a sharp
increase in the rate of suicides by hanging), and the fact that they did
not find any significant ‘effect’ of Victorian legislation on
assault/homicides, the report puts forward the claim that firearms deaths
overall were reduced in Victoria by legislative restrictions. This claim
rests purely on the substantial proportion of ‘firearm suicides’ included
in ‘firearms deaths overall’. In reality, the report only supports the
already well known statistic that firearms suicides have declined over the
years.
Similarly, we are disappointed by the Monash group’s failure to
appropriately contextualise their work. Firearms legislation – whether in
1988 or 1996 – has not made any genuine contribution to overall public
health and safety. Homicide rates remain constant over time, the use of
knives in homicides continues to rise, and the rate of serious assault and
sexual assault is climbing.
Suicide rates overall rose at an alarming rate until the introduction
of intervention programmes. These programmes address the causes of suicide,
and focus upon prevention strategies. We are, therefore, troubled by the
Monash study’s covert acceptance of the counterproductive and outdated
principle that restricting access to one of the many methods of suicide
can have a legitimate effect on overall suicide rates.
A more detailed report is in preparation. In the interim, we urge
health professionals and legislators to ask themselves the difficult
question of whether we wish to move forward and address overall public
health and safety issues by focussing on genuine preventative measures and
effective policing, or whether to take a step backwards by endorsing the
view that legislation alone can prevent suicide, assault, and homicide.
References
1. Whelan PW. Monash Uni Report "junk science" [electronic response to Ozanne-Smith J et al. Firearm related deaths: the impact of regulatory
reform] injuryprevention.com 2004 URL direct link to eLetter
2. Ozanne-Smith J, Ashby K, Newstead S, Stathakis V Z and Clapperton
A. Firearm related deaths: the impact of regulatory reform. Inj Prev
2004;10:280-286.
Mendivil et al's (1) excellent paper demonstrates the cost-benefits
to be derived from investment in speed cameras. It invokes that remarkable
Achilles-heel accompanying mass motoring: the toleration of levels of
preventable danger that are unacceptable in other transport modes (2).
Attitudes to speed-cameras may reflect the misplaced suspicion that
motorists have long directed to the accuracy of their speedomete...
Mendivil et al's (1) excellent paper demonstrates the cost-benefits
to be derived from investment in speed cameras. It invokes that remarkable
Achilles-heel accompanying mass motoring: the toleration of levels of
preventable danger that are unacceptable in other transport modes (2).
Attitudes to speed-cameras may reflect the misplaced suspicion that
motorists have long directed to the accuracy of their speedometers (3). In
the UK, the initial attitude of a considerable section of the motoring
public towards speed-cameras was hostile: Cameras were deliberately
smashed in the context of a campaign which asserted that speed-cameras
were no more than indirect taxation: a cash-cow for government. It was
further asserted that overt placement of speed-cameras would lead to
erratic speeds which would increase the number and severity of crashes.
This problem could of course be alleviated by covert placing of speed-
cameras, but this solution was no emollient; it would likely bring about
greatly increased detection-rates (4)!
The attitude of the current UK government has unfortunately regressed
during the economic downturn: a shift to local decision-making could lead
to the reduction or elimination of speed-cameras in some areas. Mendivel
et al make it clear that this is not an economically sensible path to
follow.
The story of speed-cameras may come to follow the older story of
breathalysers: the latter have steadily achieved acceptance by most
motorists - but a substantial minority continue stubbornly to misbehave
(5). In the meantime, a side-effect of such toleration of danger may be
that measures to promote less intrusive and healthier modes of travel -
cycling and walking both for full journeys and in conjunction with public
transort - remain less effective than they might be in many jurisdictions.
REFERENCES
1. Mendivil J, Gancia-Altes A, Perez K, et al. Speed cameras in an
urban setting: a cost-benefit analysis. Inj Prev
2011:10.1136/ip.2010.030882.
2. Reinhardt-Rutland A H. Attitudes to SUVs and "slam-door" rolling
stock represent a paradox. BMJ 2005; 331:967.
3. Denton G G. The use made of the speedometer as an aid to driving.
Ergonomics 1969;12:447-454.
4. Reinhardt-Rutland A H. Roadside speed-cameras: arguments for
covert siting. Police J 2001;74:312-315.
5. Gunay R A, Haran I. Face-to-face interviews with motorists who
admit to drink driving in rural Northern Ireland. Traffic Eng Control
2005;46:376-379.
I am grateful to Caroline Finch for responding[1] to my letter
suggesting research on soccer headgear.[2] Because there has been
little research on risk factors for sports injury,[3] Finch is correct
that headgear use in soccer is only one opportunity for sport safety
research. However, certain factors make soccer headgear an especially
attractive topic. The population at risk of soccer inj...
I am grateful to Caroline Finch for responding[1] to my letter
suggesting research on soccer headgear.[2] Because there has been
little research on risk factors for sports injury,[3] Finch is correct
that headgear use in soccer is only one opportunity for sport safety
research. However, certain factors make soccer headgear an especially
attractive topic. The population at risk of soccer injury includes 240
million people in the world who play soccer,[4] head injury can lead to
disabling cognitive deficits, and Fédération Internationale de Football
Association (FIFA), which governs soccer throughout the world, in 2003
modified its rules to allow all soccer players to wear padded headgear.[5]
In her intervention study of headgear in Australian rules football,
Finch found that most participants declined to wear the headgear.[6] By
the way, her paper is only the 5th English-language article found from
1966 through October 2004 by a Medline search combining “Head Protective
Devices” and “Soccer” as exploded subject headings, including all
subheadings. Finch notes that randomized controlled trials can be
difficult to conduct, which I accept. However, sport safety
investigations need not be limited to experiments because other study
approaches--including quasi-experimental and observational methods—can be
just as valid.[7] Some potential study topics include headgear
prevalence over time, place, age, and gender; the role of soccer leagues,
clubs, and coaches in the adoption of protective equipment; players’
attitudes and beliefs about headgear; frequency and type of head injury in
players with and without headgear; and headgear efficacy vs.
effectiveness.
Some clinicians have called for soccer headgear,[8] even though
engineering testimony at a US Institute of Medicine workshop stated that
no protective headgear currently on the market is designed to protect
against concussion.[9] Soccer players experience head collisions with
the ball, another player’s head, another player’s other body part, the
ground, and the goalposts. Because the best time to evaluate preventive
measures is before they are widely practiced,[10] now is the best time to
research soccer headgear.
References
1. Finch CF. Sports safety research is not without its challenges [electronic response to Nordstrom D L. Sport safety research opportunity] Injuryprevention.com 2004 URL direct link to eLetter
2. Nordstrom DL. Sport safety research opportunity. Inj Prev 2004;10:255
3. Weaver NL, Marshall SW, Miller MD. Preventing sports injuries:
opportunities for intervention in youth athletics. Patient Educ Couns
2002;46:199-204.
4. Fédération Internationale de Football Association. Approximately 250
million footballers worldwide: result of a large-scale survey by FIFA.
FIFA News 2001 May;14.
5. Hiestand M. Protective soccer headgear to debut in crowning event.
USA Today 2003 September 4;C2.
6. Braham R, Finch C. Do community football players wear allocated
protective equipment? Results from a randomised controlled trial. J Sci
Med Sport 2004;7(2):216-220.
7. Thompson NJ, McClintock HO. Demonstrating your program’s worth: a
primer on evaluation for programs to prevent unintentional injury.
Atlanta: Centers for Disease Control and Prevention, 2000.
8. Delaney JS, Drummond R. Guest editorial: Has the time come for
protective headgear for soccer? Clin J Sport Med 1999;9:121-123.
9. Patlak M, Joy JE. Is soccer bad for children’s heads? Summary of the
IOM workshop on neuropsychological consequences of head impact in youth
soccer. Washington, DC: National Academy Press 2002:11.
10. Chalmers DJ. Injury prevention in sport: not yet part of the game?
Inj Prev 2002;8(suppl IV):iv22-iv25.
I make brief extra comments in response to Lusk et al.
It is difficult comparing the poor cycle-specific facilities that I
find in Northern Ireland with the lack of cycle-specific facilities
typical in the US: neither scenario helps cyclists and any statements
about which is to be preferred may never be more than impressionistic.
However, I would concede that even imperfect cycle-specific
facilities pr...
I make brief extra comments in response to Lusk et al.
It is difficult comparing the poor cycle-specific facilities that I
find in Northern Ireland with the lack of cycle-specific facilities
typical in the US: neither scenario helps cyclists and any statements
about which is to be preferred may never be more than impressionistic.
However, I would concede that even imperfect cycle-specific
facilities provide publicity for the cause of cycle-commuting. Who knows:
if poor facilities lever enough opprobrium among the community, the
appropriate authorities may be pressured into acting to upgrade the
facilites to something genuinely useful for cyclists.
In contrast, I guess the lack of any cycle-specific facilities
typical of the US conveys the impression that urban and suburban cycling
is nothing more than an extreme sport for young macho males - it is
something to be outlawed if at all possible.
Ackery et al (1) show that risk to cyclists in collisions with motor-
vehicles increases with the size of the motor-vehicle. This evidence may
generalize to other types of collisions: consistent with Ackery et al are
studies concerning different sizes of automobile with pedestrians (2,4)
and collisions concerning different sizes of automobiles in general (3).
One can infer that a smaller entity - both in terms of linear d...
Ackery et al (1) show that risk to cyclists in collisions with motor-
vehicles increases with the size of the motor-vehicle. This evidence may
generalize to other types of collisions: consistent with Ackery et al are
studies concerning different sizes of automobile with pedestrians (2,4)
and collisions concerning different sizes of automobiles in general (3).
One can infer that a smaller entity - both in terms of linear dimensions
and mass - will likely come off worse than a larger entity. I use the term
"entity" to refer to the road-user in conjunction where appropriate with
her/his means of conveyance. Thus, the smallest entities are pedestrians
and cyclists: larger entities refer to automobiles, pick-up trucks and
articulated trucks.
The study of visual perception provides a number of factors regarding
size. Time-to-collision is determined from visual expansion of the viewed
entity, supplemented by factors such as physical size and the viewer's
expectations: a smaller entity entails reduced visual expansion, so would
be at risk of overestimated time-to-collision. Also important may be
height in the visual field: for example, the driver's height above the
road will be greater in a SUV than in a small hatchback. Height affects
the upper extent of visual expansion generated by the viewed entity; this
is reduced as height increases, so a SUV presents a greater risk than most
other private automobiles (4,5).
A second issue concerns the potential power of the entity. A major
division follows that for size: the slow speeds and accelerations of self-
powered travel contrast with the speeds and accelerations of motor-powered
travel. One obvious consequence concerns kinetic energy reflecting both
mass and speed: there is a mathematically fourth-power relationship
between speed and survivability (6).
The issues of size and power are hardly rocket-science. Yet they
often have meagre effects in shaping road safety policy. One example from
the UK: any attempts to reduce SUV ownership in urban and suburban areas
where the size and power of SUVs are unnecessary in relation to their
function have been ineffectual, even given the savings that can be made in
a time of increasing fuel prices.
REFERENCES
1. Achery AD, McLellan BA, Redelmeier DA. Bicyclist deaths and
striking vehicles in the USA. Inj Prev 2011; 10.1136/injuryprev-1011-
04066l
2. Simms C, O'Neill D. Sports utility vehicles and older pedestrians.
BMJ 2005;331:787-788.
3. Eberts RE, MacMillan AG. Misperception of small cars. In RE
Eberts, CG Eberts (eds). Trends in Ergonomics/Human Factors II. North
Holland: Elsevier 1985;33-40.
4. Stewart D, Cudworth CJ, Lishman JR. Misperception of time-to-
collision by drivers in pedestrian accidents. Perception 1993:22:1227-
1244.
5. Cavallo V, Berthelon C, Mestre D, et al. Visual information and
perceptual style in time-to-collision estimation. Vision in Vehicles VI.
North Holland: Elsevier 1992;81-89.
Injury Prevention asks that responses to articles be kept to less than about 300 words. The volume of errors and omissions in this article by Lusk et al. is so excessive that it took me rather more than that-- including photographs of the actual streets-- just to document them. The result is now hosted on John S. Allen's bicycle pages and can be directly found by searching the internet for e.g. these terms:...
Injury Prevention asks that responses to articles be kept to less than about 300 words. The volume of errors and omissions in this article by Lusk et al. is so excessive that it took me rather more than that-- including photographs of the actual streets-- just to document them. The result is now hosted on John S. Allen's bicycle pages and can be directly found by searching the internet for e.g. these terms: compendium errors Lusk.
A very small sample:
-Authors report results for a path section that did not exist for almost the entirety of their claimed study period.
-Errors of up to 100% in the claimed lengths of path segments, and thus corresponding errors in the reported rates of incidents per kilometre.
-Biased selection of comparison streets, such as comparing a path on a one-way, one or two traffic lane, lightly trafficked residential street having a 30 km/hr speed limit, with cycling on a two-way, 4 traffic lane numbered provincial highway having a 50 km/hr speed limit, located in a heavily trafficked commercial district, with numerous alcohol-serving establishments.
The authors went 10 blocks out of the way to find this comparison street, even though the path-adjacent streets are nearly identical in character to the path street.
-False claim of similar numbers of intersections on path and comparison streets.
-Complete reliance on an untested, illogical, ad hoc indicator of danger to cyclists (contrary to the authors' description as if it were routinely used for this purpose), one whose usefulness is refuted by the authors' own data.
-Here and elsewhere, the authors applaud bicycle paths for substantially skewing the character of the user base, from young athletic males to women, children and seniors. Thus even if the authors did their study properly and reported their results correctly-- they did not-- would their conclusion that cycle paths at least do not increase the injury rates really be an endorsement of the cycle paths, or an indictment of them?
The Results of this study are interesting, particularly comparisons
to other countries. I'd be also interested in looking into driver license
test standards. Having worked as an expat in the UK 1999-2005, I knew many
who have tried unsuccessfully to obtain a driver's license because of the
high test standards. You must pass a written test, video response test and
the road test. Only 30% successfully complete all three on t...
The Results of this study are interesting, particularly comparisons
to other countries. I'd be also interested in looking into driver license
test standards. Having worked as an expat in the UK 1999-2005, I knew many
who have tried unsuccessfully to obtain a driver's license because of the
high test standards. You must pass a written test, video response test and
the road test. Only 30% successfully complete all three on the first
attempt. I'm sure the USA pass rate is much higher. It's not unusual for
Brits to repeat the tests 3 or more times and practice intensively
between tries. Several experienced American drivers have had great
difficulty in meeting the test standards, also.
We agree with Reinhardt-Rutland's concerns1 about Northern Ireland's poorly designed and policed bicycle facilities but we doubt that the U.S. traditional model of simply treating bicycles as vehicles is better. What works is physically separating bicyclists from fast or heavy motor traffic. Reinhardt-Rutland further suggested that higher fuel costs could effect change where risk assessments have failed. While waiting fo...
Dear Editor
I am writing in response to a letter from P Whelan of the organization Coalition of Law Abiding Sporting Shooters Inc.[1]
The authors of this recently published article would like to rebut attacks on the scientific facts and study design related to our research. The authors were careful to state that the dramatic reductions in firearm related fatalities in Victoria and Australia occurred in the cont...
Dear Editor
I read with interest Caroline Finch's Online First editorial describing her recent experience of attending and giving a key note address at the third World Conference on Prevention of Injury and Illness in Sport. As someone who also frequently straddles the fields of sports medicine, injury prevention and, more broadly, health promotion, I would like to whole heartedly support Professor Finch's call...
Dear Editor
We note with interest and concern the exchange between the Monash Research Group and Mr Whelan,[1] regarding serious flaws in the Monash study.[2]
Upon close scrutiny, the claim that Victoria’s 1988 firearm legislation led to significant declines relative to the rest of Australia is unsupported by the actual data. Rather, we see that firearms suicides and assaults/homicides have been decl...
Mendivil et al's (1) excellent paper demonstrates the cost-benefits to be derived from investment in speed cameras. It invokes that remarkable Achilles-heel accompanying mass motoring: the toleration of levels of preventable danger that are unacceptable in other transport modes (2).
Attitudes to speed-cameras may reflect the misplaced suspicion that motorists have long directed to the accuracy of their speedomete...
Dear Editor
I am grateful to Caroline Finch for responding[1] to my letter suggesting research on soccer headgear.[2] Because there has been little research on risk factors for sports injury,[3] Finch is correct that headgear use in soccer is only one opportunity for sport safety research. However, certain factors make soccer headgear an especially attractive topic. The population at risk of soccer inj...
I make brief extra comments in response to Lusk et al.
It is difficult comparing the poor cycle-specific facilities that I find in Northern Ireland with the lack of cycle-specific facilities typical in the US: neither scenario helps cyclists and any statements about which is to be preferred may never be more than impressionistic.
However, I would concede that even imperfect cycle-specific facilities pr...
Ackery et al (1) show that risk to cyclists in collisions with motor- vehicles increases with the size of the motor-vehicle. This evidence may generalize to other types of collisions: consistent with Ackery et al are studies concerning different sizes of automobile with pedestrians (2,4) and collisions concerning different sizes of automobiles in general (3). One can infer that a smaller entity - both in terms of linear d...
Injury Prevention asks that responses to articles be kept to less than about 300 words. The volume of errors and omissions in this article by Lusk et al. is so excessive that it took me rather more than that-- including photographs of the actual streets-- just to document them. The result is now hosted on John S. Allen's bicycle pages and can be directly found by searching the internet for e.g. these terms:...
The Results of this study are interesting, particularly comparisons to other countries. I'd be also interested in looking into driver license test standards. Having worked as an expat in the UK 1999-2005, I knew many who have tried unsuccessfully to obtain a driver's license because of the high test standards. You must pass a written test, video response test and the road test. Only 30% successfully complete all three on t...
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