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Article Excerpt
Introduction
Road traffic injuries are a major cause of morbidity and mortality worldwide, with pedestrians and riders of two-wheeled motor vehicles being the most vulnerable. (1) In Europe, 41 247 road traffic deaths occurred in 2005, (2) and 21.1% of them were among two-wheeled motor vehicle users. (3) In 2005, the number of fatalities among motorcyclists in European Union countries was 22% higher than in 1996, while deaths related to other modes of transportation declined: 37% among pedestrians; 42% among cyclists; 41% among moped riders, and 28% among car riders. (4) In Spain, motorcycles represented approximately 7.2% of all motor vehicles in 2005, (5) and 8.4% of all road traffic fatalities occurred among motorcyclists. Although motorcycle fatalities had decreased progressively to 7.4% of all road traffic injury cases between 19986 and 2004, (7) a dramatic increase of 29.8% was reported from 2006 to 2007. (8)
Until September 2004, drivers of large motorcycles (engine capacity > 125 cubic centimetres) in Spain had to obtain a permit that required passing a written test on the way to drive a motorcycle and on traffic regulations, as well as a road test. In October 2004, a new national law was passed allowing car drivers in possession of a driver's licence for at least 3 years to drive a light motorcycle (engine capacity 51-125 cc) without an additional licence or test. Similar laws had previously been passed in other European countries, but no studies of their effect have been published except for one from 1997-1999 that looked for an association between motorcycle licensing laws and mortality rates. (9) The authors found that licensing requirements specifically for motorcycle drivers (such as a road test, driver education, or the use of a full helmet) were associated with lower mortality rates.
Barcelona, with 1.6 million inhabitants, is the capital of the region of Catalonia, in north-eastern Spain. Motorcycles are a very popular form of transportation in the city, perhaps because of the mild Mediterranean climate and the high traffic density. In 2005, there were 163 motorcycles per 1000 inhabitants--more than in Rome (161), Madrid (30) or London (20). Every year since 1998, more than 10 000 motor vehicles have collided within the city limits, and as a result around 13 000 people suffer injuries and 50 are killed. In 2005, 28% of those injured on the road were car riders; 27%, motorcyclists; 25%, moped users; 13%, pedestrians; 2.4%, cyclists, and 4,6%, riders of other vehicles. The injury severity score (ISS), provided by the city emergency surveillance system, was higher for motorcyclists and pedestrians than for car riders. Moderate injuries were suffered by 15.4% of motorcyclists and severe injuries, by 1.7%. By contrast, such injuries occurred in 13.7% and 1.8% of moped riders, 23.7% and 3.4% of pedestrians, and 5.8% and 0.4% of car riders, respectively.
The objective of this study was to assess the association between the number of motorcycle injuries in Barcelona and the new law requiring no special licence for drivers of light motorcycles in possession of a car driver's licence for at least 3 years. We hypothesize that allowing car drivers to drive light motorcycles without a special licence increases the risk of injuries involving this type of vehicle.
Methods
Study design and population
The study design was quasi-experimental and consisted of a retrospective, controlled time-series analysis with Poisson regression. The study group was composed of people injured while driving or riding a light motorcycle, while the comparison group consisted of drivers or passengers of heavy motorcycles, mopeds or cars who suffered injury in a collision within the city limits. Injured pedestrians or people who suffered no injury were excluded from the analysis.
Study period
The study covers two periods of 3 years. The period before enforcement of the new law runs from 1 January 2002 to 30 September 2004, and the period following runs from 1 October 2004 to 30 April 2008. Data were obtained from the city police registry of traffic collisions. In Barcelona, the city police has a special traffic collision department that ensures comprehensive coverage of all crashes in which people are injured. Specially trained officers use a standardized form to draw up a report for all crashes involving property damage or human injury, and included is information about the vehicle driver, the individuals injured, the vehicle involved in the collision and the circumstances in which the collision occurred.
Some cases with inconsistent data were excluded from the analysis. For example, 22 161 injured individuals were reported as being motorcyclists, yet 284 of their records showed the vehicle brand and model of a moped and 76, those of a car. On the other hand, 32 992 individuals were reported as riders of vehicles other than motorcycles, yet for 1302 (3.9%) of them the vehicle brand and model listed were those of a light motorcycle, and for 63 (0.5%), those of a heavy motorcycle. These cases were included in the analysis according to vehicle brand and model because this information was more...
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