Objectives To determine whether the jurisdiction in which a work-related injury compensation claim is made is an independent predictor of duration of time off work following work injury, and if so, the magnitude of the effect. Setting Eight Australian state and territory workers' compensation systems, providing coverage for more than 90% of the Australian labour force. Administrative claims data from these systems were provided by government regulatory authorities for the study. Participants 95 976 Australian workers with workers' compensation claims accepted in 2010 and with at least 2 weeks of compensated time off work. Primary outcome measure Duration of time lost from work in weeks, censored at 104 weeks. Results After controlling for demographic, worker, injury and employer factors in a Cox regression model, significant differences in duration of time loss between state and territory of claim were observed. Compared with New South Wales, workers in Victoria, South Australia and Comcare had significantly longer durations of time off work and were more likely to be receiving income benefits at 104 weeks postinjury, while workers in Tasmania and Queensland had significantly shorter durations of time off work. Conclusions The jurisdiction in which an injured worker makes a compensation claim has a significant and independent impact on duration of time loss. Further research is necessary to identify specific compensation system policies and practices that promote timely and appropriate return to work and reduce duration of time off work.

Death and injury due to motor vehicle crashes is the world's fifth leading cause of mortality and morbidity. City and urban designs might play a role in mitigating the global burden of road transport injury to an extent that has not been captured by traditional safe system approaches. We aimed to determine the relationship between urban design and road trauma across the globe. Applying a combined convolutional neural network and graph-based approach, 1692 cities capturing one third of the world's population were classified into types based on urban design characteristics represented in sample maps. Associations between identified city types, characteristics contained within sample maps, and the burden of road transport injury as measured by disability adjusted life-years were estimated through univariate and multivariate analyses, controlling for the influence of economic activity. Between Mar 1, 2017, and Dec 24, 2018, nine global city types based on a final sample of 1632 cities were identified. Burden of road transport injury was an estimated two-times higher (risk ratio 2·05, 95% CI 1·84-2·27) for the poorest performing city type compared with the best performing city type, culminating in an estimated loss of 8·71 (8·08-9·25) million disability-adjusted life-years per year attributable to suboptimal urban design. City types that featured a greater proportion of railed public transport networks combined with dense road networks characterised by smaller blocks showed the lowest rates of road traffic injury. This study highlights the important role that city and urban design plays in mitigating road transport injury burden at a global scale. It is recommended that road and transport safety efforts promote urban design that features characteristics inherent in identified high-performance city types including higher density road infrastructure and high rates of public transit. See acknowledgments.

The introduction of fully autonomous vehicles is approaching. This warrants a re-consideration of road crash liability, given drivers will have diminished control. This study, underpinned by attribution theory, investigated blame attribution to different road transport system actors following crashes involving manually driven, semi-autonomous and fully autonomous vehicles. It also examined whether outcome severity alters blame ratings. 396 participants attributed blame to five actors (vehicle driver/user, pedestrian, vehicle, manufacturer, government) in vehicle–pedestrian crash scenarios. Different and unique patterns of blame were found across actors, according to the three vehicle types. In crashes involving fully autonomous vehicles, vehicle users received low blame, while vehicle manufacturers and government were highly blamed. There was no difference in the level of blame attributed between high and low severity crashes regarding vehicle type. However, the government received more blame in high severity crashes. The findings have implications for policy and legislation surrounding crash liability. Practitioner summary: Public views relating to blame and liability in transport accidents is a vital consideration for the introduction of new technologies such as autonomous vehicles. This study demonstrates how a systems ergonomics framework can assist to identify the implications of changing public opinion on blame for future road transport systems. Abbreviation: ANOVA: analysis of variance; DAT: defensive attribution theory; IV: independent variable

Objective: There has been growing recognition that broader economic and organizational factors play a role in creating work environments that facilitate high-risk driving behavior. This study investigates the association between compensation methods for drivers, fatigue-related driving behavior, and sleepiness among Australian heavy-vehicle drivers. Specifically, we hypothesized that piece-rate compensation methods linked to performance outcomes would be associated with greater levels of fatigue-related driving behaviors and sleepiness. Methods: We examined data from a random sample of 346 long-haul heavy-vehicle drivers who had not been involved in a crash. A 40-min interview was conducted that elicited information regarding driver demographics, truck characteristics, and compensation arrangements. Specific details about drivers’ behavior on their most recent trip including load(s) carried, distances driven, hours driven, rest breaks, and hours of sleep on the previous night were taken. The interview also included a standardized assessment of sleepiness using the Epworth Sleepiness Scale (ESS). Results: A multivariate analysis of covariance demonstrated a significant multivariate effect for compensation methods across the combined, fatigue-related driving behavior dependent variables, F (10, 676) = 2.80, p <.01. Between-subject effects demonstrated significant association between compensation methods and 4 of 5 fatigue-related variables under study, including kilometers driven per day, F (2, 340) = 7.75, p <.001, hours driven per day, F (2, 341) = 2.64, p <.05, total hours worked per week, F (2, 340) = 5.27, p <.01, and mean driving time between breaks, F (2, 341) = 4.45, p <.05. Post hoc tests revealed that piece-rate compensation methods were associated with higher levels of fatigue-related driving than non-piece-rate methods. Follow-up analysis also revealed higher caffeine and amphetamines use among piece-rate drivers for the purpose of staying awake while driving. Despite this, no association between compensation methods and sleepiness were revealed. Conclusions: Results confirmed that performance-based compensation methods are associated with work practices that may exacerbate driving behaviors associated with fatigue. Despite this finding, however, performance-based compensation methods were not associated with higher levels of sleepiness. This highlights the presence of potential differences in self-selection, operational, or fatigue management practices that may be common to drivers paid under various methods. Implications of these results for safety policy and future safety research within the heavy-vehicle industry are discussed.

Objective: Increasing levels of active transport provide benefits in relation to chronic disease and emissions reduction but may be associated with an increased risk of road trauma. The safety in numbers (SiN) effect is often regarded as a solution to this issue; however, the mechanisms underlying its influence are largely unknown. We aimed to (1) replicate the SiN effect within a simple, simulated environment and (2) vary bicycle density within the environment to better understand the circumstances under which SiN applies. Methods: Using an agent-based modeling approach, we constructed a virtual transport system that increased the number of bicycles from 9% to 35% of total vehicles over a period of 1,000 time units while holding the number of cars in the system constant. We then repeated this experiment under conditions of progressively decreasing bicycle density. Results: We demonstrated that the SiN effect can be reproduced in a virtual environment, closely approximating the exponential relationships between cycling numbers and the relative risk of collision as shown in observational studies. The association, however, was highly contingent upon bicycle density. The relative risk of collisions between cars and bicycles with increasing bicycle numbers showed an association that is progressively linear at decreasing levels of density. Conclusions: Agent-based modeling may provide a useful tool for understanding the mechanisms underpinning the relationships previously observed between volume and risk under the assumptions of SiN. The SiN effect may apply only under circumstances in which bicycle density also increases over time. Additional mechanisms underpinning the SiN effect, independent of behavioral adjustment by drivers, are explored.

Road traffic injuries are already the leading cause of injury mortality and morbidity globally and by 2030 are predicted to be the fifth leading cause of mortality in the world. Australia has seen a dramatic reduction in road deaths and serious injuries since the 1970s and holds an international reputation for road traffic injury prevention due, in part, to its success in pioneering the multidisciplinary and intersectoral approach needed to address this significant issue and by applying an evidence‐led approach to policy development. The paper will discuss Australia's early success in road traffic injury prevention (road safety), particularly the achievements following the implementation of targeted programs that focussed on road user behaviours for which health promotion played a role. The most successful of these programs was the introduction of comprehensive seat belt laws, random breath testing and more recently, strategic speed enforcement programs. Amid an array of significant challenges faced by the transport system in the future, the rapid development in information and communication technologies applied to transport is likely to provide the next generation of road safety benefits. The potential for a semi‐autonomous transport system is likely to provide the next significant decline in road fatalities and serious injuries over the next 2 decades and the role of health promotion in relation to raising community engagement and building coalitions to increase uptake of new technologies will be discussed.