Evaluation of injuries sustained by motorcyclists in approach-turn crashes in Taiwan

Objectives: In western countries, a typical car-motorcycle crash occurs at an intersection where a car manoeuvres into the path of an oncoming motorcycle, which involves a car driver violates motorcycle's right of way (ROW). In Taiwan, however, a unique type of crash (approach-turn crash) occurs when a turning (including U-turn) motorcycle frequently infringes upon a car's ROW. The primary objective of this study was to examine injuries sustained by motorcyclists in this unique type of crash. Method: Using the linked data from the National Taiwan Crash Database and the National Health Insurance Research Data from 2003 to 2015, this study examined several anatomical injuries (e.g., head and face, neck, chest and abdomen, spine, and lower extremities), as well as the resulting injury severity (e.g., death within 30 days, hospitalisation, and emergency visit only/outpatient, and length of hospital stay). Variables examined include demographic data (sex, age, alcohol use, license status, and helmet use), vehicle attributes (engine size, type of crash partner, and crash type), road and environmental factors (curvature, crash location, day of week and time of crash). Injuries sustained by motorcyclists in an approach-turn motorcycle-turning crash (motorcycle is a ROW violator) were compared with those sustained by motorcyclists in an approach-turn car-turning crash (car is the ROW violator). Results: A total of 21,919 motorcyclists were enrolled, of whom 18,041 and 3878 were motorcyclists involved in approach-turn car-turning and motorcycle-turning crashes, respectively. The percentage of death within 30 days; hospitalisation; length of hospital stay; and injuries to the head and face, neck, and chest and abdomen were significantly higher for motorcyclists in approach-turn motorcycle-turning crashes. Results of logistic regression models revealed that riding under the influence of alcohol and riding without a licence were associated with death/hospitalisation, and injuries to particular body regions (head and face, neck, and chest and abdomen). Helmet use was associated with a decreased likelihood of head and face and neck injuries. Conclusion: Motorcyclists tended to be more severely or fatally injured and had increased head and face, neck, and chest and abdomen injuries when they were ROW violators than when their ROWs were violated at an intersection. Efforts to curb drunk riding and unlicensed riding may constitute effective intervention points.