Vehicle Crash (vehicle + crash)

Distribution by Scientific Domains

Kinds of Vehicle Crash

  • motor vehicle crash


  • Selected Abstracts


    Clinical and Economic Factors Associated with Ambulance Use to the Emergency Department

    ACADEMIC EMERGENCY MEDICINE, Issue 8 2006
    Jennifer Prah Ruger PhD
    Background: Concern about ambulance diversion and emergency department (ED) overcrowding has increased scrutiny of ambulance use. Knowledge is limited, however, about clinical and economic factors associated with ambulance use compared to other arrival methods. Objectives: To compare clinical and economic factors associated with different arrival methods at a large, urban, academic hospital ED. Methods: This was a retrospective, cross-sectional study of all patients seen during 2001 (N= 80,209) at an urban academic hospital ED. Data were obtained from hospital clinical and financial records. Outcomes included acuity and severity level, primary complaint, medical diagnosis, disposition, payment, length of stay, costs, and mode of arrival (bus, car, air-medical transport, walk-in, or ambulance). Multivariate logistic regression identified independent factors associated with ambulance use. Results: In multivariate analysis, factors associated with ambulance use included: triage acuity A (resuscitation) (adjusted odds ratio [OR], 51.3; 95% confidence interval [CI] = 33.1 to 79.6) or B (emergent) (OR, 9.2; 95% CI = 6.1 to 13.7), Diagnosis Related Group severity level 4 (most severe) (OR, 1.4; 95% CI = 1.2 to 1.8), died (OR, 3.8; 95% CI = 1.5 to 9.0), hospital intensive care unit/operating room admission (OR, 1.9; 95% CI = 1.6 to 2.1), motor vehicle crash (OR, 7.1; 95% CI = 6.4 to 7.9), gunshot/stab wound (OR, 2.1; 95% CI = 1.5 to 2.8), fell 0,10 ft (OR, 2.0; 95% CI = 1.8 to 2.3). Medicaid Traditional (OR, 2.0; 95% CI = 1.4 to 2.4), Medicare Traditional (OR, 1.8; 95% CI = 1.7 to 2.1), arrived weekday midnight,8 AM (OR, 2.0; 95% CI = 1.8 to 2.1), and age ,65 years (OR, 1.3; 95% CI = 1.2 to 1.5). Conclusions: Ambulance use was related to severity of injury or illness, age, arrival time, and payer status. Patients arriving by ambulance were more likely to be acutely sick and severely injured and had longer ED length of stay and higher average costs, but they were less likely to have private managed care or to leave the ED against medical advice, compared to patients arriving by independent means. [source]


    Paediatric lap-belt injury: A 7 year experience

    EMERGENCY MEDICINE AUSTRALASIA, Issue 1 2006
    Michael Shepherd
    Abstract Objective:, To highlight the injuries that result from lap-belt use and make recommendations for prevention, the recent experience of a regional paediatric trauma centre was reviewed. Methods:, Retrospective review of admissions to Starship Children's Hospital from 1996 to 2003, with significant injury following involvement in a motor vehicle crash, while wearing a lap-belt. Patients were identified from two prospectively collected databases and discharge coding data. Results:, In total, 19 patients were identified over the 7 year period. The morbidity sustained includes 15 patients with hollow viscus injury, 13 laparotomies, 7 spinal fractures, 2 paraplegia and 1 fatality. A total of 11 patients required laparotomy with a median delay of 24 h. Of patients in the present series, 58% were aged less than 8 years and thus were inappropriately restrained. Conclusions:, Lap-belt use can result in a range of life-threatening injuries or permanent disability in the paediatric population. The incidence of serious lap-belt injury does not appear to be decreasing. Morbidity and mortality could be reduced by the use of three-point restraints, age appropriate restraints and booster seats. [source]


    The Effect of Seatbelt Use on Injury Patterns, Disposition, and Hospital Charges for Elders

    ACADEMIC EMERGENCY MEDICINE, Issue 12 2002
    Andrew Coley MD
    Objective: To study the relationships between seatbelt use and injury patterns, hospital charges, morbidity, and mortality in elder motor vehicle crash victims. Methods: A retrospective review of individuals at least 65 years old presenting to an urban emergency department (ED) after a motor vehicle crash. Results: Over a two-year period, 339 patients had documentation of seatbelt use or non-use at the time of the crash. Of these, 241 (71%) patients had been wearing a seatbelt and 98 (29%) had not. Elders not using seatbelts were more likely to require hospitalization (29% unbelted vs. 17% belted) and had a higher mortality rate. Injury patterns were different in the two groups. Emergency department charges were significantly different between belted and unbelted elders ($351 vs. $451, p = 0.01) and head computed tomography (CT) utilization was higher in the unbelted group (25.6% vs 12.7%, p = 0.005). Conclusions: Improved seatbelt compliance in elders can reduce injuries, hospitalization rates, ED charges, and mortality resulting from motor vehicle crashes. [source]


    A Comparison of Data Sources for Motor Vehicle Crash Characteristic Accuracy

    ACADEMIC EMERGENCY MEDICINE, Issue 8 2000
    Robert J. Grant MD
    Abstract. Objective: To determine the accuracy of police reports (PRs), ambulance reports (ARs), and emergency department records (EDRs) in describing motor vehicle crash (MVC) characteristics when compared with an investigation performed by an experienced crash investigator trained in impact biomechanics. Methods: This was a cross-sectional, observational study. Ninety-one patients transported by ambulance to a university emergency department (ED) directly from the scene of an MVC from August 1997 to April 1998 were enrolled. Potential patients were identified from the ED log and consent was obtained to investigate the crash vehicle. Data describing MVC characteristics were abstracted from the PR, AR, and medical record. Variables of interest included restraint use (RU), air bag deployment (AD), and type of impact (TI). Agreements between the variables and the independent crash investigation were compared using kappa. Interrater reliability was determined using kappa by comparing a random sample of 20 abstracted reports for each data source with the originally abstracted data. Results: Agreement using kappa between the crash investigation and each data source was 0.588 (95% CI = 0.508 to 0.667) for the PR, 0.330 (95% CI = 0.252 to 0.407) for the AR, and 0.492 (95% CI = 0.413 to 0.572) for the EDR. Variable agreement was 0.239 (95% CI = 0.164 to 0.314) for RU, 0.350 (95% CI = 0.268 to 0.432) for AD, and 0.631 (95%= 0.563 to 0.698) for TI. Interrater reliability was excellent (kappa > 0.8) for all data sources. Conclusions: The strength of the agreement between the independent crash investigation and the data sources that were measured by kappa was fair to moderate, indicating inaccuracies. This presents ramifications for researchers and necessitates consideration of the validity and accuracy of crash characteristics contained in these data sources. [source]


    Age of Drinking Onset and Injuries, Motor Vehicle Crashes, and Physical Fights After Drinking and When Not Drinking

    ALCOHOLISM, Issue 5 2009
    Ralph W. Hingson
    Background:, Earlier age of drinking onset has been associated with greater odds of involvement in motor vehicle crashes, unintentional injuries, and physical fights after drinking. This study explores whether early drinkers take more risks even when sober by comparing potential associations between age of drinking onset and these outcomes after drinking relative to when respondents have not been drinking. Method:, From a national sample, 4,021 ever-drinkers ages 18 to 39 were asked age of drinking onset, not counting tastes or sips. They were also asked if they were ever in motor vehicle crashes, unintentionally injured, or in physical fights after drinking and when not drinking. GEE logistic regression models for repeated measures dichotomous outcomes compared whether odds ratios between age of onset and these adverse outcomes significantly differed when they occurred after drinking versus when not drinking, controlling for respondents' demographic characteristics, cigarette and marijuana use, family history of alcoholism, ever experiencing alcohol dependence, and frequency of binge drinking. Results:, Compared with persons who started drinking at age 21+, those who started at ages <14, 14 to 15, 16 to 17, and 18 to 20 had, after drinking, respectively greater odds: 6.3 (2.6, 15.3), 5.2 (2.2, 12.3), 3.3 (1.5, 7.3), and 2.2 (0.9, 5.1) of having been in a motor vehicle crash; 6.0 (3.4, 10.5), 4.9 (3.0, 8.6), 3.7 (2.4, 5.6), and 1.9 (1.2, 2.9) of ever being in a fight; and 4.6 (2.4, 8.7), 4.7 (2.6, 8.6), 3.2 (1.9, 5.6), and 2.3 (1.3, 4.0) of ever being accidentally injured. The odds of experiencing motor vehicle accidents or injuries when not drinking were not significantly elevated among early onset drinkers. The odds of earlier onset drinkers being in fights were also significantly greater when respondents had been drinking than not drinking. Conclusion:, Starting to drink at an earlier age is associated with greater odds of experiencing motor vehicle crash involvement, unintentional injuries, and physical fights when respondents were drinking, but less so when respondents had not been drinking. These findings reinforce the need for programs and policies to delay drinking onset. [source]


    Fatal Injuries of US Citizens Abroad

    JOURNAL OF TRAVEL MEDICINE, Issue 5 2007
    Clare E. Guse MS
    Background US citizens are increasingly traveling, working, and studying abroad as well as retiring abroad. The objective of this study was to describe the type and scope of injury deaths among US citizens abroad and to compare injury death proportions by region to those in the United States. Methods A cross-sectional design using reports of US citizen deaths abroad for 1998, 2000, and 2002 on file at the US State Department was employed. The main outcome measures were the frequencies of injury deaths and proportional mortality ratios (PMRs) comparing deaths abroad to deaths in the United States. Results Two thousand eleven injury deaths were reported in the 3 years, comprising 13% of all deaths. The overall age-adjusted PMR for injury fatalities abroad compared to the United States was 1.6 (95% confidence interval 1.6,1.7). The highest age-adjusted PMRs for motor vehicle crashes were found in Africa (2.7) and Southeast Asia (1.6). The proportion of drowning deaths was elevated in all regions abroad. Conclusions Injuries occur at a higher proportion abroad than in the United States. Motor vehicle crash and drowning fatalities are of particular concern. Improved data quality and surveillance of deaths would help government agencies create more evidence-based country advisories. [source]


    Risk factors for worker injury and death from occupational light vehicles crashes in New South Wales (Australia),

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2010
    Rwth Stuckey MPH
    Abstract Background/Aim To identify risk and protective factors for crash casualty outcomes in occupational light vehicles (OLV), a previously under-recognized work context for injuries and fatalities. Methods A register-based study was conducted using linked vehicle crash and registration data (n,=,13,491) for the Australian state of New South Wales. Univariate and multivariate analyses were undertaken to assess the relationship between casualty outcomes and variables drawn from four domains of potential determinants of severity: user, vehicle, road, and work organization factors. Results Nineteen percent of OLV crashes had OLV-user casualties (n,=,2,506) and 1% fatalities (n,=,34). Adjusted casualty risk factors included tired driver (OR 2.1, 95% CI 1.5,2.7), no seat belt use (OR 1.8, 95% CI 1.4,2.3), and excessive speed (OR 1.4, 95% CI 1.2,1.6). Adjusted fatality risk factors were no seat belt (OR 12.9, 95% CI 4.9,34.3) and high-speed zone crash (OR 5.0, 95% CI 2.1,12.3). Conclusions OLV users are at risk from both recognized road risks and hazards specific to OLV use. Findings suggest that risk reduction could be improved by the use of safer vehicles, fatigue management, and journey planning. Am. J. Ind. Med. 53:931,939, 2010. 2010 Wiley-Liss, Inc. [source]


    Case Report: Fatal Apophysomyces elegans Infection Transmitted by Deceased Donor Renal Allografts

    AMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2010
    B. D. Alexander
    Two patients developed renal mucormycosis following transplantation of kidneys from the same donor, a near-drowning victim in a motor vehicle crash. Genotypically, indistinguishable strains of Apophysomyces elegans were recovered from both recipients. We investigated the source of the infection including review of medical records, environmental sampling at possible locations of contamination and query for additional cases at other centers. Histopathology of the explanted kidneys revealed extensive vascular invasion by aseptate, fungal hyphae with relative sparing of the renal capsules suggesting a vascular route of contamination. Disseminated infection in the donor could not be definitively established. A. elegans was not recovered from the same lots of reagents used for organ recovery or environmental samples and no other organ transplant-related cases were identified. This investigation suggests either isolated contamination of the organs during recovery or undiagnosed disseminated donor infection following a near-drowning event. Although no changes to current organ recovery or transplant procedures are recommended, public health officials and transplant physicians should consider the possibility of mucormycosis transmitted via organs in the future, particularly for near-drowning events. Attention to aseptic technique during organ recovery and processing is re-emphasized. [source]


    At work or play: A comparison of private property vehicle crashes with those occurring on public roads in north Queensland

    AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 4 2009
    Ross Blackman
    Abstract Objective:,To define characteristics of vehicle crashes occurring on rural private property in north Queensland with an exploration of associated risk factors. Design:,Descriptive analysis of private property crash data collected by the Rural and Remote Road Safety Study. Setting:,Rural and remote north Queensland. Participants:,A total of 305 vehicle controllers aged 16 years or over hospitalised at Atherton, Cairns, Mount Isa or Townsville for at least 24 hours as a result of a vehicle crash. Main outcome measure:,A structured questionnaire completed by participants covering crash details, lifestyle and demographic characteristics, driving history, medical history, alcohol and drug use and attitudes to road use. Results:,Overall, 27.9% of interviewees crashed on private property, with the highest proportion of private road crashes occurring in the North West Statistical Division (45%). Risk factors shown to be associated with private property crashes included male sex, riding off-road motorcycle or all-terrain vehicle, first-time driving at that site, lack of licence for vehicle type, recreational use and not wearing a helmet or seatbelt. Conclusions:,Considerable trauma results from vehicle crashes on rural private property. These crashes are not included in most crash data sets, which are limited to public road crashes. Legislation and regulations applicable to private property vehicle use are largely focused on workplace health and safety, yet work-related crashes represent a minority of private property crashes in north Queensland. [source]


    Young driver restrictions: Does the evidence support them?

    AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 6 2008
    Ross Blackman
    Abstract Objective:,To assess the suitability of Queensland's graduated licensing system in the context of rural and remote Queensland. Design:,Age-based comparison of crash data collected by the Rural and Remote Road Safety Study (RRRSS). Setting:,Rural and remote North Queensland. Participants:,A total of 367 vehicle controllers aged 16 years or over hospitalised at Townsville, Cairns or Mount Isa for at least 24 hours, or killed, as a result of a vehicle crash. Measurements:,Specific RRRSS variables are assessed in relation to Queensland's graduated licensing program, including rates of unlicensed driving/riding, late night crashes, crashes with multiple passengers, contributing factors in crashes and vehicle types involved. Results:,While people between 16 and 24 years of age comprise 16% of the target population, 25% of crashes meeting RRRSS criteria involved a vehicle controller in that age group. 12.8% of all cases involved an unlicensed driver/rider, within which 66% were below 25 years of age. Young drivers/riders were represented in 50% of crashes occurring between 11:00 p.m. and 5:00 a.m., and 33% of crashes in vehicles with multiple passengers. Motorcyclists represented about 40% of cases in both age groups. There were no significant differences between age groups in vehicle types used, or circumstances that contributed to crashes. Conclusions:,The general overrepresentation of young drivers/riders in rural and remote North Queensland supports tailored interventions, such as graduated licensing. However, while some measures in the legislation are well supported, problems surrounding unlicensed driving/riding might be exacerbated. [source]


    3 Taking a History from the Challenging Patient in the Emergency Department

    ACADEMIC EMERGENCY MEDICINE, Issue 2008
    Bruce Becker
    This exhibit will use DVD footage, written material, and live real-time interaction to demonstrate an innovative methodology to teaching residents and medical students to gain comfort and expertise in communicating with and taking a history from challenging patients in the ED. I teach this course at our institution every year. Professional actors with improvisational experience play out unscripted interactions with students based on a character or characters, a set scene, and predefined goals and endpoints. Their dialogue and choices evolve from the student's response and the tone, direction, and approach that the student takes. These scenarios are much more realistic and educational than OSCEs which are often described as artificial and flat. Some of the scenarios that I will present include: Daughter trying to make End-of-life choices for her mother, type A man with chest pain trying to sign out, a woman with "dental pain" who is seductive and drug-seeking, an intoxicated attending MD brought in from a motor vehicle crash (MVC) who uses power in a manipulative way. Many of the scenarios contain potential ethical, sexual, gender, racial issues that the student must address along with the medical problems. [source]


    Local Indicators of Network-Constrained Clusters in Spatial Point Patterns

    GEOGRAPHICAL ANALYSIS, Issue 3 2007
    Ikuho Yamada
    The detection of clustering in a spatial phenomenon of interest is an important issue in spatial pattern analysis. While traditional methods mostly rely on the planar space assumption, many spatial phenomena defy the logic of this assumption. For instance, certain spatial phenomena related to human activities are inherently constrained by a transportation network because of our strong dependence on the transportation system. This article thus introduces an exploratory spatial data analysis method named local indicators of network-constrained clusters (LINCS), for detecting local-scale clustering in a spatial phenomenon that is constrained by a network space. The LINCS method presented here applies to a set of point events distributed over the network space. It is based on the network K -function, which is designed to determine whether an event distribution has a significant clustering tendency with respect to the network space. First, an incremental K -function is developed so as to identify cluster size more explicitly than the original K -function does. Second, to enable identification of cluster locations, a local K -function is derived by decomposing and modifying the original network K -function. The local K -function LINCS, which is referred to as KLINCS, is tested on the distribution of 1997 highway vehicle crashes in the Buffalo, NY area. Also discussed is an adjustment of the KLINCS method for the nonuniformity of the population at risk over the network. As traffic volume can be seen as a surrogate of the population exposed to a risk of vehicle crashes, the spatial distribution of vehicle crashes is examined in relation to that of traffic volumes on the network. The results of the KLINCS analysis are validated through a comparison with priority investigation locations (PILs) designated by the New York State Department of Transportation. [source]


    Post-Traumatic Stress Disorder in Children and Adolescents With Motor Vehicle,Related Injuries

    JOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 3 2003
    Kathleen A. Zink MSN
    ISSUES AND PURPOSE Motor vehicle crashes account for the greatest number of childhood injuries, but there has been little study of the psychological responses. DESIGN AND METHODS This longitudinal, descriptive study included 143 children 7 to 15 years of age who experienced a motor vehicle,related injury. Parents/guardians completed the Child Behavior Checklist Behavioral Problem Scale. Each child and parent completed the post-traumatic stress disorder (PTSD) section of the Diagnostic Interview for Children and Adolescents at 2 and 6 months postinjury. RESULTS Twenty-two percent of the children met criteria for PTSD. There were no associations for presence or absence of PTSD with age, gender, race, injury, or cause of injury. PRACTICE IMPLICATIONS Children who are injured in motor vehicle crashes are at risk for PTSD. Anticipatory guidance about behavioral distress symptoms should be provided to parents of children who experience motor vehicle related injuries. [source]


    Injury Deaths of US Citizens Abroad: New Data Source, Old Travel Problem

    JOURNAL OF TRAVEL MEDICINE, Issue 5 2009
    Daniel J Tonellato BA Candidate
    Background Global travel continues to increase, including among US citizens. The global burden of injuries and violence, accounting for approximately 5 million deaths worldwide in 2000, is also growing. Travelers often experience heightened risk for this biosocial disease burden. This study seeks to further describe and improve our understanding of the variable risk of travel-related injury and death. Methods Information on US civilian citizen deaths from injury while abroad was obtained from the US Department of State Web site. This information was categorized into regional and causal groupings. The groupings were compared to each other and to injury deaths among citizens in their native countries. Results From 2004 to 2006, there were 2,361 deaths of US citizens overseas due to injury. Of these US citizen injury deaths, 50.4% occurred in the Americas region. Almost 40% (37.8%) of US citizen injury deaths in the low- to middle-income Americas were due to vehicle crashes compared to about half that (18.9%) (proportional mortality ratio [PMR] = 1.72, 95% confidence interval [CI] 1.59,1.62) for low- to middle-income Americas citizen injury deaths. Similar differences between US citizen injury death abroad and the in-country distributions were also found for vehicle crashes in Europe (35.9% vs 16.5%, PMR = 2.17, 95% CI 1.78,2.64; p < 0.0005), for drowning deaths in the Americas (13.1% vs 4.6%, PMR = 2.67, 95% CI 2.29,3.11) and many island nations (63.5% vs 3.5%, PMR = 11.38, 95% CI 8.17,15.84), and for homicides in the low- to middle-income European countries (16.9% vs 10.5%, PMR = 1.52, 95% CI .90,2.57). Conclusions US citizens should be aware of regional variation of injury deaths in foreign countries, especially for motor vehicle crashes, drowning, and violence. Improved knowledge of regional variations of injury death and risk for travelers can further inform travelers and the development of evidence-based prevention programs and policies. The State Department Web site is a new data source that furthers our understanding of this challenging travel-related health issue. [source]


    Fatal Injuries of US Citizens Abroad

    JOURNAL OF TRAVEL MEDICINE, Issue 5 2007
    Clare E. Guse MS
    Background US citizens are increasingly traveling, working, and studying abroad as well as retiring abroad. The objective of this study was to describe the type and scope of injury deaths among US citizens abroad and to compare injury death proportions by region to those in the United States. Methods A cross-sectional design using reports of US citizen deaths abroad for 1998, 2000, and 2002 on file at the US State Department was employed. The main outcome measures were the frequencies of injury deaths and proportional mortality ratios (PMRs) comparing deaths abroad to deaths in the United States. Results Two thousand eleven injury deaths were reported in the 3 years, comprising 13% of all deaths. The overall age-adjusted PMR for injury fatalities abroad compared to the United States was 1.6 (95% confidence interval 1.6,1.7). The highest age-adjusted PMRs for motor vehicle crashes were found in Africa (2.7) and Southeast Asia (1.6). The proportion of drowning deaths was elevated in all regions abroad. Conclusions Injuries occur at a higher proportion abroad than in the United States. Motor vehicle crash and drowning fatalities are of particular concern. Improved data quality and surveillance of deaths would help government agencies create more evidence-based country advisories. [source]


    The Effect of State Regulations on Motor Vehicle Fatalities for Younger and Older Drivers: A Review and Analysis

    THE MILBANK QUARTERLY, Issue 4 2001
    David C. Grabowski
    Policymakers have had a long-standing interest in improving the motor vehicle safety of both younger and older drivers. Although younger and older drivers share the distinction of having more crashes and fatalities per mile driven than other age groups, the problems posed by these two groups stem from different origins and manifest in different ways. A number of state-level policies and regulations may affect the number of motor vehicle crashes and fatalities in these two high-risk groups. A critical review of the existing literature in regard to the risk factors and the effects of various policy measures on motor vehicle crashes in these two high-risk populations provides direction for policymakers and high-priority areas of interest for the research community. [source]


    Coroners' recommendations following fatal heavy vehicle crash investigations

    AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2010
    Lisa Brodie
    Abstract Objective: This paper quantifies and describes the nature of coroners' recommendations and comments on fatal heavy vehicle crashes in Victoria, Australia. Methods: A retrospective, descriptive study was performed using coroners' findings. Fatal heavy vehicle crashes between January 2001 and December 2007 were identified through coronial databases. Individual findings were examined by incident type. Identified recommendations or preventative comments were reviewed and compared with national heavy vehicle safety objectives. Results: Of 330 fatal crashes, which resulted in 376 deaths, recommendations were made in 21 incidents (6%). From these 21 incidents, 45 separate recommendations or comments were made by coroners. Ten (22%) called for specific remedial action, predominantly targeting road environment changes; the remainder had a broader application for prevention. Of the 21 incidents from which these recommendations arose, 11 (52%) were from a public inquest. No recommendation was made following any of the 45 single heavy vehicle crashes. Conclusion: The frequency of coroners' recommendations varied by crash nature including vehicle type involved and number of resulting fatalities. Multiple factors are likely to influence their development, including the holding of a public inquest and the perceived level of preventability. Implications: Coroners' investigations serve an important public health and safety role. Recognition of the significance of recommendations for reducing the extent of injury from heavy vehicle crashes and monitoring of their uptake is vital. [source]


    Risk factors for worker injury and death from occupational light vehicles crashes in New South Wales (Australia),

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2010
    Rwth Stuckey MPH
    Abstract Background/Aim To identify risk and protective factors for crash casualty outcomes in occupational light vehicles (OLV), a previously under-recognized work context for injuries and fatalities. Methods A register-based study was conducted using linked vehicle crash and registration data (n,=,13,491) for the Australian state of New South Wales. Univariate and multivariate analyses were undertaken to assess the relationship between casualty outcomes and variables drawn from four domains of potential determinants of severity: user, vehicle, road, and work organization factors. Results Nineteen percent of OLV crashes had OLV-user casualties (n,=,2,506) and 1% fatalities (n,=,34). Adjusted casualty risk factors included tired driver (OR 2.1, 95% CI 1.5,2.7), no seat belt use (OR 1.8, 95% CI 1.4,2.3), and excessive speed (OR 1.4, 95% CI 1.2,1.6). Adjusted fatality risk factors were no seat belt (OR 12.9, 95% CI 4.9,34.3) and high-speed zone crash (OR 5.0, 95% CI 2.1,12.3). Conclusions OLV users are at risk from both recognized road risks and hazards specific to OLV use. Findings suggest that risk reduction could be improved by the use of safer vehicles, fatigue management, and journey planning. Am. J. Ind. Med. 53:931,939, 2010. 2010 Wiley-Liss, Inc. [source]