Revisiting exposure: fatal and non-fatal traffic injury risk across different populations of travelers in Wisconsin, 2001-2009.

Comparing the injury risk of different travel modes requires using a travel-based measure of exposure. In this study we quantify injury risk by travel mode, age, race/ethnicity, sex, and injury severity using three different travel-based exposure measures (person-trips, person-minutes of travel, and person-miles of travel) to learn how these metrics affect the characterization of risk across populations. We used a linked database of hospital and police records to identify non-fatal injuries (2001-2009), the Fatality Analysis Reporting System for fatalities (2001-2009), and the 2001 Wisconsin Add-On to the National Household Travel Survey for exposure measures. In Wisconsin, bicyclists and pedestrians have a moderately higher injury risk compared to motor vehicle occupants (adjusting for demographic factors), but the risk is much higher when exposure is measured in distance. Although the analysis did not control for socio-economic status (a likely confounder) it showed that American Indian and Black travelers in Wisconsin face higher transportation injury risk than White travelers (adjusting for sex and travel mode), across all three measures of exposure. Working with multiple metrics to form comprehensive injury risk profiles such as this one can inform decision making about how to prioritize investments in transportation injury prevention.

[1]  Carolyn McAndrews.  Traffic risks by travel mode in the metropolitan regions of Stockholm and San Francisco: a comparison of safety indicators , 2011, Injury Prevention.

[2]  D. Prybylski,et al.  Motor-vehicle crash fatalities among American Indians and non-Indians in Arizona, 1979 through 1988. , 1997, American journal of public health.

[3]  Philip S. Carroll,et al.  Classifications of driving exposure and accident rates for highway safety analysis , 1973 .

[4]  S W Johnson,et al.  THE CRASH OUTCOME DATA EVALUATION SYSTEM (CODES). NHTSA TECHNICAL REPORT , 1996 .

[5]  Mau-Roung Lin,et al.  A review of risk factors and patterns of motorcycle injuries. , 2009, Accident; analysis and prevention.

[6]  C. Bay,et al.  Pedestrian fatalities by race/ethnicity in Arizona, 1990-1996. , 2002, American journal of preventive medicine.

[7]  D W Fleming,et al.  Pedestrian and hypothermia deaths among Native Americans in New Mexico. Between bar and home. , 1992, JAMA.

[8]  Elisa R Braver,et al.  Race, Hispanic origin, and socioeconomic status in relation to motor vehicle occupant death rates and risk factors among adults. , 2003, Accident; analysis and prevention.

[9]  M. Szklo,et al.  Epidemiology: Beyond the Basics , 1999 .

[10]  C. Wiggins,et al.  Pedestrian fatalities--New Mexico, 1958-1987. , 1991, MMWR. Morbidity and mortality weekly report.

[11]  C. Bay,et al.  Motor vehicle crash fatalities by race/ethnicity in Arizona, 1990–96 , 2003, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[12]  M Schiff,et al.  Trends in motor vehicle traffic fatalities among Hispanics, non-Hispanic whites and American Indians in New Mexico, 1958-1990. , 1996, Ethnicity & health.

[13]  Asha Weinstein Agrawal,et al.  How Far, by Which Route and Why? A Spatial Analysis of Pedestrian Preference , 2007 .

[14]  J. Samet,et al.  Injury mortality in New Mexico's American Indians, Hispanics, and non-Hispanic whites, 1958 to 1982. , 1989, The Western journal of medicine.

[15]  Ann M Dellinger,et al.  Motor vehicle crash injury rates by mode of travel, United States: using exposure-based methods to quantify differences. , 2007, American journal of epidemiology.

[16]  D G Schlundt,et al.  Seat belt use among Hispanic ethnic subgroups of national origin , 2006, Injury Prevention.

[17]  S. Lowenstein,et al.  Motor vehicle crash fatalities: A comparison of Hispanic and non-Hispanic motorists in Colorado. , 2000, Annals of emergency medicine.

[18]  D Chisholm,et al.  group : a global comparison Distribution of road traffic deaths by road user , 2009 .

[19]  A. Smiley,et al.  The role of exposure in comparisons of crash risk among different drivers and driving environments. , 1993, Accident; analysis and prevention.

[20]  M. Fay.  Approximate confidence intervals for rate ratios from directly standardized rates with sparse data , 1999 .

[21]  P. Layde,et al.  Increased risk of death or disability in unhelmeted Wisconsin motorcyclists. , 2005, WMJ : official publication of the State Medical Society of Wisconsin.

[22]  Young-Jun Kweon,et al.  Overall injury risk to different drivers: combining exposure, frequency, and severity models. , 2003, Accident; analysis and prevention.

[23]  Nancy McGuckin.  Walking and Biking in California: Analysis of the CA-NHTS , 2012 .

[24]  W. Flanders.  Approximate variance formulas for standardized rate ratios. , 1984, Journal of chronic diseases.

[25]  E. Feuer,et al.  Confidence intervals for directly standardized rates: a method based on the gamma distribution. , 1997, Statistics in medicine.

[26]  A. Smiley,et al.  Time vs. distance as measures of exposure in driving surveys. , 1992, Accident; analysis and prevention.

[27]  S. L. Murphy,et al.  Deaths: final data for 2002. , 2004, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.