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OBJECTIVE: Pedestrian crashes present a growing challenge for public health trauma and road safety researchers around the world. They are associated with substantial morbidity, mortality, and cost, yet there is an international lack of published work on the topic, especially when compared with vehicle occupant safety studies. Our review attempts to quantify the risk of fatal injury among vulnerable road users. The specific objective of this systematic review and meta-analysis is to quantify and compare the impact of light truck vehicles (LTVs) versus conventional cars on pedestrian fatal injury. METHODS: A protocol was developed using methods of the Cochrane Collaboration. We conducted a search for the studies in bibliographic databases that included ATI (Australian Transport Index); Cochrane Injuries Group Specialized Register; EMBASE; ERIC; MEDLINE; National Research Register; PsycINFO; Road Res (ARRB); SIGLE; Science (and Social Science) Citation Index; TRANSPORT (NTIS, TRIS, TRANSDOC, IRRD). Web sites of traffic and road accident research bodies, government agencies, and injury prevention organizations were searched for grey literature. Reference lists from selected papers or topic reviews were scanned for potentially relevant papers. RESULTS: Our initial search identified 878 potentially eligible studies. After thorough review by three of the researchers a total of 12 studies were included in the systematic review, 11 of which were included in the meta-analysis. The overall pooled odds ratio for the risk of fatal injury in pedestrian collisions with LTVs compared to conventional cars was odds ratio 1.54, 95 percent confidence interval 1.15-1.93, p = 0.001. Thus, the risk for pedestrians of sustaining fatal injury is 50 percent greater in collisions with LTVs than in collisions with conventional cars. CONCLUSIONS: Our systematic review and meta-analysis suggests that LTVs pose a greater risk of pedestrian injury death compared to conventional cars. These findings have important implications for the automotive industry and the safety of vulnerable road users.

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OBJECTIVES: To assess the effects of cataract surgery in improving vision and driving performance while reducing driving-related difficulties. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Twelve electronic databases were searched from the date of inception of each database to May 2007. Other sources of potentially relevant information were also identified and examined. REVIEW METHODS: Eligible study designs included randomized controlled trials (RCT), non-RCT, quasi-experimental, case-control, controlled-before-and-after, and cohort studies that examined driving-related indicators in patients undergoing cataract surgery. MAIN OUTCOME MEASURES: The outcome measures included any type of driving-related indicator. A secondary outcome measure was motor vehicle (MV) crash involvement. RESULTS: Seven studies were included in the review and five in the meta-analysis. The overall pooled odds ratio (OR) was 0.12 (95% CI 0.10 to 0.16). Results suggest that the risk of driving-related difficulties was reduced by 88% following cataract surgery. CONCLUSIONS: Cataract surgery is associated with an 88% reduction in the risk of driving-related difficulties. This supports the efficacy of cataract surgery to improve driving in older people, as well as positive implications for a reduction in MV crashes, overall traffic safety, and individual well-being.

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In June of 2002, a revision to part of the Road Traffic Act drastically increased the penalties for drinking and driving offences in Japan. Most notably, the legal blood alcohol concentration (BAC) limit for driving was lowered from 0.05 mg/ml to 0.03 mg/ml. The rationale for the new lower BAC limit was predicated on the assumption that drinking drivers will comply with the new, lower limit by reducing the amount of alcohol they consume prior to driving, thereby lowering their risk of crash involvement. This, in turn, would lead to fewer alcohol-related crashes. A key limitation of previous lower BAC evaluation research in determining the effectiveness of lower legal BAC limit policies is the assumption of population homogeneity in responding to the laws. The present analysis is unique in this perspective and focuses on the evaluation of the impact of BAC limit reduction on different segments of the population. The chief objective of this research is to quantify the extent to which lowering the legal limit of BAC has reduced male, female and teenager involvement in motor vehicle crashes in Japan since 2002. Most notably, the introduction of reduced BAC limit legislation resulted in a statistically significant decrease in the number of alcohol-impaired drivers on the road in Japan, indicating responsiveness to the legal change among adults and teenagers. In addition, this preliminary assessment appears to indicate that the implementation of 0.03 BAC laws and other associated activities are associated with statistically significant reductions in alcohol-involved motor vehicle crashes. In comparison, the rates of total crashes showed no statistically significant decline nor increase in the period following the introduction of the BAC law, indicating that the lower BAC limit only had an effect on alcohol-related crashes in Japan. The evidence suggests that the lower BAC legal limit and perceived risk of detection are the two most important factors resulting in a sustained change in drinking and driving behaviour in Japan. It is recommended that future research and resources in other countries be focused on these factors as determinants to reduced alcohol-related crashes.

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