Head-on crashes on two-way interurban roads: a public health concern in road safety.
OBJECTIVE
To describe the magnitude and characteristics of crashes and drivers involved in head-on crashes on two-way interurban roads in Spain between 2007 and 2012, and to identify the factors associated with the likelihood of head-on crashes on these roads compared with other types of crash.


METHODS
A cross-sectional study was conducted using the National Crash Register. The dependent variables were head-on crashes with injury (yes/no) and drivers involved in head-on crashes (yes/no). Factors associated with head-on crashes and with being a driver involved in a head-on crash versus other types of crash were studied using a multivariate robust Poisson regression model to estimate proportion ratios (PR) and confidence intervals (95% CI).


RESULTS
There were 9,192 head-on crashes on two-way Spanish interurban roads. A total of 15,412 men and 3,862 women drivers were involved. Compared with other types of crash, head-on collisions were more likely on roads 7 m or more wide, on road sections with curves, narrowings or drop changes, on wet or snowy surfaces, and in twilight conditions. Transgressions committed by drivers involved in head-on crashes were driving in the opposite direction and incorrectly overtaking another vehicle. Factors associated with a lower probability of head-on crashes were the existence of medians (PR=0.57; 95%CI: 0.48-0.68) and a paved shoulder of less than 1.5 meters (PR=0.81; 95%CI: 0.77-0.86) or from 1.5 to 2.45 meters (PR=0.90; 95%CI: 0.84-0.96).


CONCLUSIONS
This study allowed the characterization of crashes and drivers involved in head-on crashes on two-way interurban roads. The lower probability observed on roads with median strips point to these measures as an effective way to reduce these collisions.
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain; Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain.
Marta
M
Olabarria
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain; Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain.
Elena
E
Santamariña-Rubio
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain; Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain.
Marc
M
Marí-Dell'Olmo
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain; Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain.
Mercè
M
Gotsens
Agència de Salut Pública de Barcelona, Barcelona, Spain; Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain.
Ana M
AM
Novoa
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain; Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain.
Carme
C
Borrell
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain; Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain. Electronic address: cperez@aspb.cat.
Katherine
K
Pérez
D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D004779:Environment Design; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008685:Meteorological Concepts; D008875:Middle Aged; D011634:Public Health; D012449:Safety; D014504:Urban Health; D055815:Young Adult
Accidente de tráfico; Accidents; Factores de riesgo; Mortalidad; Mortality; Risk factors