Summary of a Report on

RESEARCH

Summary of a Report on Motorcycle Accidents In The Ottawa Area, 1967 E. O'F. CAMPBELL, BSc, MD; M. E. MACBETH, BSc; S. WV. RYAN, CPT, RCAMC; IAN M. F. ARNOLD, MD. THE POST WORLD WAR ii advent of modern, efficient, low-cost motorcycles in Canada has given remarkable impetus to their contemporary popularity, both as a means of reliable economic transportation, and as a sporting and recreational activity. A significant number of our younger potential drivers are now able to acquire "wheels" at low costs. A new dimension has been added to the driver population bringing with it problems which are a significant contributing factor in the increasing toll of death and injury on our roads.

New Situation B e c a u s e this situation is relatively new, there is little information about the numbers and types of accidents and the injuries, age, sex or socio-economic status of the individuals involved. Available evidence suggested that many new riders lack adequate training and experience in controlling their vehicles, have not been well enough informed of the dangers inherent in riding motorcycles and are unprepared to overcome hazardous traffic situations. Moreover, pedestrians and drivers of other types of vehicle are not properly prepared to recognize and solve traffic problems involving motorcycles, and some refuse to share the roadway with motorcycle riders. The younger age groups/ appear to be most frequently involved in motorcycle accidents, particularly 17 - year - olds. Injuries are frequently multiple with a significant proportion of head and lower limb involvement. Many so-called human factors contribute to motor-

cycle accidents and there is a need crashes in the area are subject to to study those peculiarities of seasonal influences, but are quite motorcycling which dictate the ne- similar to all motor vehicle accicessity for special accoutrements dents as to time of occurrence. such as protective clothing includ- The 16-25 year-old male is principally implicated as operator of ing footwear. The Traffic Injury Research the motorcycle with the 18-year-old Foundation of Canada undertook most predominantly involved. Moa study of motorcycle accidents in torcycle drivers are relatively inexthe Ottawa area during 1967 to get perienced and show variable bean overall view of the problem and havior in traffic. Pedestrians and to compare findings with those ob- other vehicle operators are to tained elsewhere. Another objec- blame in many accidents involving tive was to suggest more definitive motorcycles. The risk of death and areas for future research. The injury associated with motorcyclstudy further attempts to examine ing in the study area appears more the circumstances of the accident unsatisfactory than in Canada as a and the nature and severity of in- whole. Such risk throughout all of juries. It includes a brief assess- Canada appears about 40 percent ment of ambulance services, and a greater for deaths and 120 percent preliminary socio-economic apprai- greater for injuries than that ensal of some accident-involved per- countered in all motor vehicle acsons compared with non-accident- cidents. involved matched controls. Views expressed by other reAppropriate authorities were ob- searchers in this field are reintained. Police departments provid- forced by the Ottawa study. The ed information about the accident; need for further scientific research hospitals contributed special re- into the factors involved is subports on the injuries; and the am- stantiated. bulance companies submitted reports of their activities. Information was also obtained from the Department of Transport (Ontario). The study was divided into three parts: The Accident, The Injuries and A Pilot Psychosocial Investigation. Here are the findings: The Accident A total of 363 motorcycle accidents were studied in the Ottawa area during 1967. 290 were legally reportable, 73 were not. Injury or Eric O'F. Campbell, BSc, MD, death occurred in 229 accidents. FRCP is the medical Director of 71.7 percent of the dead or injured the Traffic Injury Research Founwere sent to hospital. Motorcycle dation of Canada in Ottawa.

CANADIAN FAMILY PHYSICIAN * AUGUST, 1969

Serial 28

The Injuries Hospital records for 351 motorcycle accident casualties in the Ottawa area (1967) include 180 out of 363 accidents known to police and 171 from accidents unknown to police. Injuries vary greatly in severity and body area involved. We found that 19.7 percent of casualties required hospitalization and of these, 80.6 percent were between 16 and 25 years of age. More than one injury occurred in 59.5 percent and three or more injuries in 27.6 percent of the victims. Out of 657 injuries, 81 (12.3 percent) were classified as severe or worse. Excluding face injuries 8.2 percent of all injuries were to the head. And 71.7 percent of all injuries involved arms and legs. Helmeted riders appear to suffer less severe head injury than those without such protection. All motorcycle rider fatalities occurred in unhelmeted individuals, two attributable to head injury, one to severe cervical cord injury plus head injury, and two to involvement of other vital body organs. Morbidity and mortality in motorcycle accidents represent an important portion of all traffic injuries and death, and require careful remedial consideration of all concerned.

involved in an accident appears to have several factors against him from the moment he steps onto his motorcycle. In one paper on highway accidents it was reported that several traits characteristic of an accident victim were generally found. They include an aggressive, impulsive, risk-taking personality; a less satisfactory home background; and a greater negative involvement with social and credit agencies. Our pilot study suggests that, as a general rule, the accident victim is a less experienced driver than his accident-free contemporary. Not only does he lack experience with other types of motor vehicles, but he has usually been riding his motorcycle for a significantly shorter period of time. He may or may not still be at school but there is relatively little chance of having graduated from high school. He will probably have completed only Grade 10, although his average is similar to his non-accident compatriot who is two years ahead of him. The accident victim also stands a higher risk of being a regular smoker and has a 20 percent chance of having a criminal record. It is also probable that he has been on a full-time job at least once. On the other (seemingly more settling) side of the ledger, he is more likely to have more A Pilot Psychosocial Investigation stable parental background and This paper has described a pilot fewer family moves. 4 project of a psychosocial investigation of motorcycle accident vic- Editor's Note: tims. The accident victims were This report is a resume of a comprematched with accident-free control hensive report of the study. Those subjects for age and sex. The roles interested in the minute detail of of driving experience and school the investigation may obtain copies records in the overall picture were of the full report from: discussed and suggestions were The Medical Director made to further decrease motorTraffic Injury Research cycle accidents from the point of Foundation of Canada view of the motorcyclist himself. 74 Stanley Avenue The motorcyclist who becomes Ottawa 2, Ont.

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ORAL CONTRACEPTIVE FORMULA: 16 red tablets each containing Ethinyl oestradiol 0.1 mg. 5 white tablets each containing Ethinyl oestradiol 0.1 mg. Megestrol acetate 1.0 mg. 7 blue tablets each containing Lactose. Megestrol Acetate is 6-Dehydromedroxy progesterone acetate. INDICATIONS: Oral contraception and regulation of menstrual cycle. DOSAGE AND ADMINISTRATION: Serial 28 consists of a twenty-eight-day treatment course. Treatment starts on the fifth day of the menstrual cycle, the first day being the onsetof menstruation. One tablet is taken daily until the package is finished. A new package is to be started the day after the previous package is finished, irrespective of the presence or absence of vaginal bleeding. If during the course of treatment a bleeding similarto menstruation begins, the present package should be discarded and a new one started five days later. AVAILABILITY: 28 day Pack CONTRAINDICATIONS: Genital and breast cancer; liver impairment; history of thrombophlebitis, embolism, cerebrovascular accident; presence of proptosis; any ocular lesions associated with neurovascular disease, such as partial or complete loss of vision, defects in visual fields or diplopia; incomplete epiphyseal closure; lactation of nursing mother; undiagnosed vaginal bleeding. PRECAUTIONS: Predisposition to excessive fluid retention may be aggravated by the administration of estrogens. Caution should be exercised in patients with histories of cardiac or renal disease, asthma, epilepsy, migraine or hypertension. Patients with endocrine or metabolic disorders should be closely watched. Size of uterine fibroids may increase. Patients with metabolic bone disease should be carefully observed. Persons with psychic depression should be watched. When the suspicion of pregnancy arises due to two missed periods, treatment should be discontinued until the diagnosis of pregnancy is ruled out. Diabetic persons should be carefully followed while on medication. Patients should undergo a complete medical examination, including the Papanicolau tests, with special attention to the breasts and pelvic organs. The drug should be discontinued before liver or endocrine function tests are performed. In the presence of breakthrough bleeding the possibility of nonfunctional causes should be considered. The possible influence of prolonged therapy on pituitary, ovarian, adrenal, thyroid, hepatic or uterine function awaits further study. The pathologist should be advised of Serial 28 therapy when relevant specimens are submitted. WARNINGS: Medication should be discontinued pending careful examination if there is a sudden onset of severe headache, dizziness, blurred vision or migraine. The physician should be alert to the earliest manifestations of thrombophlebitis and pulmonary embolism. ADVERSE EFFECTS: Nausea, vomiting, spotting, breakthrough bleeding, amenorrhea, edema, chloasma, breast tenderness, weight changes, headache, jaundice, suppression of lactation, mood changes, allergic skin rash, increase of varicosity, premenstrual tension, abdominal fullness, acne. The following occurrences have been observed during the use of oral contraceptives: neuroocular lesions, thrombophlebitis, pulmonary embolism and monilial vaginitis. DETAILED INFORMATION ON REQUEST

CANADIAN FAMILY PHYSICIAN * AUGUST, 1969