Kommt es zu einer akuten respiratorischen Insuffizienz, stellt die Beatmung einen wichtigen Eckpfeiler der Therapie dar. Da eine invasive Beatmung über einen endotrachealen Tubus mit Risiken verbunden ist, sollte wann immer möglich, eine nicht-invasive Beatmung eingesetzt werden. Neben den absoluten Kontraindikationen limitieren Undichtigkeit, Ulzerationen im Gesichtsbereich und ein schlechter Tragekomfort die Praktikabilität der Gesichtsmasken. Ziel dieser Arbeit war die Evaluation eines neuartigen Beatmungshelms in einem Lungenmodell und einer Probandenstudie im Hinblick auf Beatmungsparameter (Beatmungsdruck, AZV, AMV, PEEP) Resistance, Compliance, Delay-Zeiten, CO2, SpO2, Triggerzeit und Komfort. Es zeigte sich, dass eine Steigerung des PEEP auf 8 mbar zu einer signifikanten Reduktion der DelayTrigger und DelayPeep-Zeiten führte. Höhere PEEP-Werte gingen hingegen mit einer zunehmenden Leckage und Gefahr einer Desynchronität zwischen Proband und Ventilator einher. Eine zusätzliche Druckunterstützung konnte das AMVLunge signifikant steigern, was zu einem Abfall der CO2-Konzentration sowohl in der transkutanen Messung als auch im Helm führte. Problematisch zeigte sich aufgrund der Compliance des Helms, dass ein hoher Anteil des AMV zum Druckaufbau im Helm verloren geht. Dieser Effekt war abhängig von PEEP, ASB sowie Compliance und Resistance der Lunge. Der Beatmungshelm ist als eine gute Alternative zu betrachten, wenn eine Aufrecherhaltung eines PEEPs im Vordergrund steht, wie etwa bei einer Oxygenierungstörung bei Parenchymversagen.

The requirement to operate vehicles in low light and/or night environments whilst wearing night vision goggle (NVG) systems has become increasingly common during military operations. There is very limited research investigating injury risks associated with these systems during ground vehicle collisions. This study examined the injury risks associated with wearing the Australian Defence Force - Enhanced Combat Helmet (ECH) and NVG system, in frontal vehicle collisions. This project consisted of two components: (1) crash tests using a sled and (2) numerical simulations of impacts. Four dynamic sled tests were conducted using a 50th percentile, male, Hybrid III dummy positioned on a rigid seat. Frontal impact tests were performed at a 40 km/h change in velocity (*v) and 20 g deceleration. The test configurations were as follows: (a) Base; (no helmet or additional equipment); (b) ECH; and, (c) ECH and NVG. Condition (c) was carried out twice, to determine repeatability. The sled test protocols were reconstructed precisely with the numerical simulation package MADYMO and the simulations were shown to correlate well with the experimental results. Using this validated model, four parametric studies were undertaken to assess the influence of counterweights, seat cushion, seatbelt pre-tensioner, and the vehicle's *v and acceleration on injury risks. The study found that neck loads were within acceptable limits, with the exception of the neck extension moment, which was exceeded for all NVG conditions. Based on the parametric studies, no major improvements were observed in the neck extension moments with the use of counterweights or a seat cushion. In contrast the use of a seatbelt pre-tensioner was observed to decrease greatly this neck injury risk in certain scenarios. The study also identified that a *v of 15 km/h and peak acceleration of up to 14 g were required to keep the neck extension moment below the prescribed injury criteria. However, the high neck extension moment values may have been partially attributable to the stiff Hybrid III neck. This study identified a possible injury mechanism for soldiers using the ECH and NVG system during specific impact scenarios. The method applied in this project was designed to be repeatable.

Football is a much loved sport in the United States. Unfortunately, it is also hard on the players and puts them at very high risk of concussion. To combat this an inventor in Santa Barbara brought a new design to Cal Poly to be tested. The design was tested in small scale first in order to make some preliminary conclusions about the design. In order to fully test the helmet design; however, full scale testing was required. In order to carry out this testing a drop tower was built based on National Operating Committee on Standards for Athletic Equipment, NOCSAE, specification. The drop tower designed for Cal Poly is a lower cost and highly portable version of the standard NOCSAE design. Using this drop tower and a 3D printed prototype the new design was tested in full scale.

The focus of this thesis was to increase the knowledge in the area of "dynamic friction" during oblique helmet impacts, both experimentally and numerically. Physical experiments have been performed with multiple helmets, different angles of the anvil and different surface materials, with results of impact forces from the anvil and accelerations of the head. By the use of the Coulomb friction model the friction, over time, during the impact of the head and helmet has been calculated. Finite element method has then been used in LS-DYNA to try and replicate the physical results with the goal of creating an accurate friction model. There has been previous work done where the commonly used abrasive paper has been compared to asphalt as ground material in the drop tests. A similar study has been performed in this project which has been compared to the previous work. The results when comparing asphalt to abrasive paper and stainless steel shows that abrasive paper has a higher friction and rotational acceleration of the head compared to asphalt. Stainless steel however displays similar characteristics as asphalt in both friction and accelerations. The load cell used during the experimental testing has been examined carefully since the value of the friction coefficient has differed depending on the angle and the impact location on the anvil. There are still uncertainties surrounding the reliability of the results from the load cell. LS-DYNA has two different ways of modelling friction, one where LS-DYNA uses a modified equation of the Coulomb friction model and another one where the user can insert a table of values on coefficient of friction and relative velocity. Both methods have been used, however the latter method has proven to be more suitable for the kind of tests used in this project. / Fokuset för denna rapport var att öka förståelsen inom området ”dynamisk friktion” under sneda hjälmislag, både experimentellt och numeriskt. Fysiska experiment har genomförts med flertalet hjälmar och olika vinklar samt underlag på städet, med resultat på både krafter från städet samt accelerationer från huvudet. Genom användandet av Coulombs friktionsmodell har friktionen, över tid, under islag med en hjälm beräknats. Finita elementmetoden har använts i LS-DYNA för att försöka efterlikna resultaten från de fysiska experimenten med målet att kunna skapa en friktionsmodell. Det har gjorts liknande arbete tidigare där sandpapper har jämförts mot asfalt som underlagsmaterial i falltesterna. En liknande studie har genomförts i detta projekt vilket har jämförts med den tidigare gjorda studien. Resultaten när asfalt jämförs mot sandpapper och rostfritt stål visar att sandpapper har en högre friktion samt rotations acceleration av huvudet jämfört med asfalt. Rostfritt stål uppvisar dock liknande egenskaper som asfalt när det kommer till både friktion och acceleration. Lastcellen som har använts har undersökts noggrant, då värdet på friktionskoefficienten har förändrats beroende på vinkeln och träffpunkten på städet. Osäkerheter kring trovärdigheten på resultatet från lastcellen kvarstår. LS-DYNA har två olika sätt att modellera friktionen på, antingen så används en modifierad ekvation av Coulombs friktionsmodell eller så skapar användaren en tabell med värden på friktionskoefficienten och den relativa hastigheten. Båda metoderna har använts men det har visat sig att den senare metoden är bättre anpassad för de test som har utförts i detta projekt.

Genomgående i Sverige under de senaste 20 åren så har hot- och våldssituationer ökat för blåljuspersonal. Det är ett problem då det leder till en ökad oro och känsla av otrygghet hos de som arbetar inom yrkesområdet. Studiens författare är verksamma inom ambulansområdet Södra Älvsborgs Sjukhus (SÄS) och med detta arbete är syftet bland annat att undersöka hur ofta som ambulanspersonalen inom området upplever att de har blivit utsatta för hot och våld de senaste 12 månaderna. Fokus ligger även på frågan om huruvida deltagarna i studien önskar få tillgång till ytterligare skyddsutrustning i sitt arbete i form av skyddsväst och en bättre skyddande hjälm, så kallad ballistisk hjälm. Metoden som använts är en kvantitativ enkätstudie som tilldelats personal inom ambulansområdet. Det framkom under studien att personalgruppen utsatts för förhållandevis få hot- och våldssituationer de senaste 12 månaderna. Det finns ingen signifikant skillnad mellan män och kvinnor gällande våldsamma situationer och inte heller någon skillnad jämfört om man arbetat länge eller ej, ej heller skillnad beroende på vilken station personalen arbetar på. En majoritet har svarat att de gärna vill ha tillgång till utrustningen men att den troligtvis enbart används om nödvändigt samtidigt som ett fåtal är negativt inställda. Det finns en förhållandevis liten risk att bli utsatt för hot och våld, men trots detta önskar flertalet tillgång till mer skyddsutrustning för en ökad trygghet och större beredskap för det okända i arbetssituationer. Författarna finner ämnet intressant då det samtalas mycket kring säkerhet och trygghet på arbetsplatser idag och bedömer att det finns mer att forska på i detta ämne. / Throughout Sweden in the past 20 years there has been an increase in incidents of threats and violence towards emergency personnel. This is a problem as it leads to increased concern and a sense of insecurity among those working in the area. The authors of the study who are active in the ambulance sector of SÄS aim to investigate how often ambulance personnel have experienced threats and violence in the past 12 months. The focus is also on whether the participants in this study wish to have additional protective equipment, such as protective vests and better helmets, known as ballistic helmets. The method used is a quantitative survey distributed to ambulance personnel. The study found that the personnel group has experienced relatively few incidents of threats and violence in the past 12 months. There is no significant difference between men and women regarding violent situations and no difference based on the length of service or placement of the workplace. A majority of the respondents express that they have a desire to have access to the equipment but will only use it when necessary while a few have a negative attitude towards it. Despite the relatively low risk of being subjected to threats and violence, the majority still wishes to have access to more protective equipment for increased security and preparedness in unknown work situations. The authors find the topic interesting because of the talk about safety in workplaces today and believe that there is more to research in this area.

Företaget Mips har utformat en teknik vilket ökar skyddet mot hjärnskador vid olyckor då det sker ett islag mot huvudet och hjälm används. Tekniken är ett utformat glidskikt mellan hjälmens yttre skal och användaren som minskar rotationsvåldet mot hjärnans nervtrådar i huvudet. Vid islag mot bakhuvudet hjälper däremot inte glidskiktet i den mån som önskas enligt Mips. Detta är på grund av att storleksjusteringen vid bakhuvudet för hjälmen agerar som en fast punkt för det annars roterande glidskiktet. Gruppen har därför undersökt alternativa lösningar och utformningar av glidskiktet för att öka den positiva effekten vid islag mot bakhuvudet. Gruppen har som mål att komma med flera lösningsförslag på utformning av glidskiktet för att undkomma den fasta punkten och integrera glidskikt med storleksjusteringen. Under projektet ska gruppen göra en förstudie av dagens lösningar och varför det finns ett problem idag. Förutom att göra en förstudie ska gruppen även tillverka fysiska prototyper och utföra funktionstester som påvisar en förbättring enligt uppdragsgivarens testmetod. De flesta av dagens lösningar för justering i höjdled av justersystemet använder sig av ett snäppförband. Gruppen har valt att använda ett standardiserat justersystem från uppdragsgivaren som konceptframtagningen kommer utgå från. Gruppen valde därefter att skapa tre olika prototyper som berör stiften. De tre olika innefattar ändringar av stiftens utformning, ta bort stiften och behålla stiftens ursprungliga utformning. Gruppen genomförde därefter tester enligt uppdragsgivarens testmetod för att komma fram till effekten av de olika koncepten. För att väga de olika idéerna mot varandra användes en beslutsmatris där olika relevanta parametrar värderas. Gruppen har med hjälp av beslutsmatrisen beslutat om rekommendationer för vidare arbete. De två lösningsförslag som gruppen rekommenderar vidare arbete med är idé 1 och idé 3 då de ses med störst potential enligt beslutsmatrisen. Båda de presenterade lösningsförslagen har olika potential beroende på förutsättningar. / The company Mips has developed a technology that enhances protection against brain injuries in accidents where there is an impact to the head while wearing a helmet. The technology consists of a designed low friction layer between the helmet's outer shell and the user, reducing the rotational force on the brain's nerve fibers inside the head. In cases of impacts to the back of the head, the low friction layer doesn't provide as much help as desired by Mips. This is because the size adjustment acts as a fixed point in the back of the head for the otherwise rotating low friction layer. Therefore, the group has investigated alternative solutions and designs of the low friction layer to enhance its effectiveness in impacts to the back of the head. The group aims to propose several design solutions for the low friction layer to avoid the fixed point and integrate it with the size adjustment. During the project, the group will conduct a preliminary study of current solutions and why there is a problem today. In addition to the preliminary study, the group will manufacture physical prototypes and perform functional tests demonstrating improvement according to the client's testing method. Most of today's solutions for height adjustment of the adjustment system use a snap-fit solution. The group has chosen to use a standardized adjustment system from the client as the basis for concept development. The group then decided to create three different prototypes concerning the pins. The three different prototypes include changes to the design of the pins, removing the pins, and retaining the original design of the pins. The group then conducted tests according to the client's testing method to determine the effectiveness of the different concepts. To weigh the different ideas against each other, a decision matrix was used where various relevant parameters were evaluated. With the help of the decision matrix, the group has decided on recommendations for further work. The two solution proposals that the group recommends for further work are idea 1 and idea 3 as they are seen to have the greatest potential according to the decision matrix. Both presented solution proposals have different potential depending on the conditions.

Head injuries in American football is a serious issue regarding player health which is highly affected by velocity and its direction. Impact location can affect the severity of the head injury in both helmet-to-helmet impacts and helmet-to-ground impacts hence the understanding of concussive outcome from velocities and impact locations must be improved. In this thesis a video analysis resulted in simulation of five helmet-to-helmet impacts and two helmet-to-ground impacts, where velocity in each impact also was approximated with the method of least squares to avoid extreme values. The average velocity in helmet-to-helmet impacts was 5.1728 m/s for tackler player and 4.4766 m/s for tackled player and in helmet-to-ground impacts it instead was 6.1975 m/s. With the regression method an average velocity of 4.3982 m/s for tackler player and 5.3854 m/s for the tackled player in helmet-to-helmet impacts and 5.874 m/s in helmet-to-ground impacts. The simulations were performed with LS-DYNA and examined in LS-PrePost where head kinematics and the strain of brain tissue or more specific the maximum principal strain (MPS) was of interest. Further the MPS was scaled to its 95th percentile which determined the concussive likelihood for each impact scenario. The highest concussive outcome for an impact scenario was 100% and the lowest was 15%. The head kinematics of interest was linear acceleration, angular acceleration and angular velocity which in high risk for concussive outcome wasn't dominated by a single head kinematic. Impacts locations in helmet-to-helmet impacts didn't show any connection between impact location and high concussive risk. In helmet-to-ground impacts a connection between impact location at the back of the head and high concussive risk was observed. / Huvudskador inom Amerikansk fotboll är ett återkommande problem när det gäller spelarnas hälsa. Hastigheten och vart tacklingen träffar är starkt kopplat till hur allvarlig en huvudskada kan bli i både hjälm-mot-hjälm tacklingarn och hjälm-mot-mark. För att förhindra huvudskador måste förståelsen om kinematiken och vart tacklingen träffar förbättras.  I detta examensarbete gjordes en videoanalys vilket resulterade i fem hjälm-mot-hjälm simuleringar och två hjälm-mot-mark. Hastigheten approximerades också genom att använda uppskattnings metoden minsta kvadratmetoden. Medel-värdet av hastigheterna från videoanalysen blev 5.1728 m/s för spelaren som utförde tacklingen och 4.4766 m/s för spelaren som blev tacklad i hjälm-mot-hjälm tacklingar. I hjälm-mot-mark blev det istället ett medelvärde på 6.1975 m/s. Med uppskattnings metoden blev hastigheterna istället 4.3982 m/s för den tacklande spelaren och 5.3854 m/s för den tacklade spelaren i hjälm-mot-hjälm tacklingar. För hjälm-mot-mark blev medelvärdet av hastigheten 5.874 m/s med uppskattnings metoden. Simuleringarna av tacklings fallen gjordes med LS-DYNA och analyserades i LS-PrePost där huvudets kinematik och töjningen av hjärnvävnad är av intresse. Töjningen mättes av maximum principal strain (MPS) och den 95:e percentilen av MPS för att bestämma risken för hjärnskakning där den största risken för hjärnskakning var 100% och den minsta 15%. För huvudets kinematik var det linjär acceleration, vinkelacceleration och vinkelhastighet som var av intresse. Det fanns ingen koppling mellan endast en av kinematikerna och hög risk för hjärnskakning. Gällande vart tacklingen träffar fanns det ingen koppling mellan vart den träffar och hög risk för hjärnskakning i hjälm-mot-hjälm tacklingar. För hjälm-mot-mark tacklingar fanns det ett samband mellan att bakre delen av huvudet träffar marken och hög risk för hjärnskakning.

Introduction : La promotion du port du casque à vélo exige une bonne connaissance des déterminants du port du casque. Objectifs : Estimer l’association entre les caractéristiques sociodémographiques et le port du casque à vélo dans la population des cyclistes de Montréal et examiner les associations entre le port du casque et les comportements sécuritaires à vélo ainsi que les habitudes de vie. Méthode : Le devis est transversal à mesures répétées, via trois sondages téléphoniques complétés entre 2009 et 2010. L’échantillon analysé comprend 3309 Montréalais de 18 ans et plus ayant fait du vélo au cours des douze derniers mois. Des informations sur le port du casque, les caractéristiques sociodémographiques, les autres comportements sécuritaires à vélo, les habitudes de vie et l’environnement routier ont été recueillies. Des analyses de régression logistique, bivariées et multivariées, ont été réalisées. Résultats : Le port du casque est significativement associé à un revenu et un niveau d’éducation plus élevés, au lieu de naissance (Canada vs hors Canada), à d’autres comportements sécuritaires à vélo, à certaines habitudes de vie (non-fumeur, boire une ou deux consommations alcoolisées quotidiennement vs ne pas boire, ou boire trois consommations ou plus quotidiennement) et à l’absence d’une station de vélo en libre-service proche du lieu de résidence. Conclusion : Le port du casque s’inscrit dans l’ensemble des comportements permettant aux cyclistes de se protéger. La présence d’inégalités sociales devrait être prise en compte dans les interventions de promotion du port du casque. / Background: Cyclists are vulnerable road users. Helmet use may reduce injury severity. Yet, its promotion requires a good knowledge of the determinants related to helmet use. Objectives: The objectives are to estimate the association between sociodemographic characteristics and helmet use among cyclists’ from Montreal and to examine associations between helmet use and safe cycling behaviours as well as lifestyles behaviour. Methods: We used a cross sectional design with repeated measures through three telephone surveys completed in 2009 and 2010. The sample includes 3309 Montrealers aged 18 years and over, who had cycled in the previous 12 months. Information on sociodemographic characteristics, safe cycling behaviours, lifestyles and road environments were collected. Bivariate and multivariate logistic regression analyses were conducted. Results: Results show associations between wearing a helmet and income, higher level of education, being born in Canada, other safe cycling behaviours, some lifestyles (non-smoking and drinking one or two alcoholic beverages daily vs not drinking, or drinking three alcoholic beverages or more daily) and the absence of public bicycle share docking stations near one’s dwelling. Conclusions: Helmet use is one of the behaviours allowing cyclists to protect themselves. Social inequalities should be considered when developing interventions to promote helmet use among cyclists.

An increase of 153,375 to 248,418 traumatic brain injuries (TBI) due to incidents in sports and recreation activities has been reported in the past couple of years in the US alone. These are grounds for concern for athletes partaking in sports with a high incidence of TBI’s such as football and soccer. The latter, traditionally not classified as a contact-sport, has attracted research due to participants using their head as an instrument for heading. Voluntary heading, in combination with lenient laws and regulations concerning TBI expose how soccer players are easily at risk of injury. On the other hand football, an aggressive sport by nature, has brought attention to the possible neurocognitive and neurophysiological ramifications of repetitive subconcussive impacts. One of these is in the form of a progressive neurodegenerative pathology known as chronic traumatic encephalopathy (CTE). A priori reasons revealed, led to a need to characterize the most important variables involved in ball-player interactions within soccer simulated gameplay. By understanding these, it would be possible to obtain parameters to design and manufacture new composite-material based protective headgear unlike products that are commercially available nowadays. In addition, development of a testing protocol focused on frequency domain variables - transmissibility and mechanical impedance - would allow to evaluate the performance of football helmets. A focus would be set on low impacts categorized as subconcussive impacts. Incoming velocity and inflation pressure were identified as the most influential variables affecting the peak impact force of a soccer ball. An innovative 6-layer carbon fiber headband, with silicone padding, was manufactured that out-performed existing headgear at attenuating peak linear acceleration. Lastly, quantification of the transmissibility and mechanical impedance indicated poor performance of football helmets below 60 Hz.

Contexte : les deux-roues motorisés (2RM) sont en forte évolution et la vulnérabilité de leurs usagers est de plus en plus manifeste. En 2013, dans le monde, les usagers de 2RM ont compté pour 23 % de la mortalité routière, devant les piétons (22 %). Dans ce contexte, la sécurité des usagers de 2RM est devenue une préoccupation sérieuse dans la plupart des pays. Contrairement à beaucoup de problèmes de santé publique, les principaux facteurs de l'insécurité routière en 2RM sont connus. L'enjeu d'aujourd'hui est surtout de quantifier leur effet sur la survenue d'accidents et d'évaluer les effets des quelques dispositifs de protection disponibles. Les objectifs de cette thèse sont de mieux connaitre les problèmes d'interaction entre les conducteurs de 2RM et les automobilistes selon différentes situations accidentelles (en particulier en intersection), de quantifier les effets des facteurs à l'origine de la survenue des accidents issus de la perte de contrôle du 2RM, et de mesurer l'efficacité des dispositifs de protection portés par les usagers de 2RM (casque intégral, blouson de moto, pantalon de moto, gants, bottes ou chaussures montantes et protection dorsale). Données : la réalisation des objectifs de la thèse s'appuie sur les données du projet VOIESUR, les données du Registre des accidents de la circulation du Rhône et les données recueillies au moyen d'une enquête postale réalisée auprès de 7 148 usagers de 2RM accidentés entre 2010 et 2014 identifiés par le Registre du Rhône. Résultats : Le problème de détectabilité des motos au niveau des intersections est confirmé. Dans la même situation d'interaction entre deux véhicules en intersection, un automobiliste a plus de difficulté à détecter une moto qu'à détecter un véhicule léger. Les facteurs suivants sont associés à la survenue des accidents de type perte de contrôle : alcool, type de moto, jour de l'accident, sinuosité de la route, adhérence de la route et vitesse. Nous soulignons le fait qu'une mauvaise adhérence de la route augmente considérablement le risque de perte de contrôle, en particulier lorsque la dégradation de l'adhérence est inattendue pour les motocyclistes en raison de la présence de gravillons, de corps gras, de nids de poule, etc. sur la route. En cas d'accident, les vêtements dédiés à la moto protègent les usagers des blessures. Ils sont efficaces pour éviter les dermabrasions et les plaies cutanées, mais ne semblent pas protéger des blessures plus graves telles que fracture, luxation ou entorse, sauf pour les bottes ou chaussures montantes qui réduisent le risque de fracture de la cheville ou du pied. Concernant les plaques dorsales, aucune efficacité n'a été montrée. Les casques intégraux protègent mieux le visage de l'usager du 2RM comparés aux non-intégraux, alors qu'aucune différence de protection du crâne ou du cerveau n'est mise en évidence entre les deux types de casques. Conclusion : Nos résultats mettent en évidence le problème de détectabilité d'un 2RM par les automobilistes en intersection et l'importance de l'état de la chaussée dans les accidents associés à une perte de contrôle du 2RM par son conducteur. Il est fortement recommandé pour les automobilistes de bien faire attention aux véhicules prioritaires venant de la gauche ou d'en face avant de tourner à gauche, particulièrement aux 2RM venant d'en face. L'amélioration de l'état de la chaussée et une signalisation adaptée représentent aussi un enjeu fort pour la sécurité des usagers de 2RM. Nos résultats soutiennent la recommandation faite par les organismes de sécurité routière du port plus systématique des équipements vestimentaires chez les usagers de 2RM. Enfin, nos résultats encouragent l'utilisation d'un casque intégral chez les usagers de 2RM afin de mieux protéger le visage / Background: Motorized two-wheelers (MTW) are evolving rapidly and the vulnerability of their users is becoming more obvious. MTW users were the most vulnerable road users, accounting for 23 % of all road traffic fatalities worldwide in 2013, in front of pedestrians (22 %). In this context, the safety of MTW users has become a serious concern in most countries. In contrast to many public health problems, the main factors of MTW road safety have been identified. The issue today is to quantify their effects on the occurrence of accidents and to measure the effects of protective devices. The present thesis aims to better understand the interaction problems between MTW drivers and automobilists according to different accident configurations (in particular at intersection), to identify and assess the effect of critical factors on the risk of MTW loss-of-control crashes, and to measure the effectiveness of protective clothing (motorcycle jacket, trousers, gloves, knee-high or ankle boots, back protection) for MTW users. Data: This study used MTW accident data collected in a French project VOIESUR, injury data from the Rhône Registry, plus data collected by means of a postal survey which was conducted among 7148 MTW riders injured between 2010 and 2014 and identified in the Rhône Registry. Results: We confirmed the problem of motorcycle detection for other road users. In the similar conditions, the motorists have more difficulty to detect a motorcycle than a car oncoming, in particular at intersections. The following factors are associated with the occurrence of motorcycle loss-of-control accidents: alcohol use, motorcycle type, weekend vs. weekday, road alignment, road adhesion and traveling speed. We emphasize that poor road adhesion significantly increases the risk of losing control, especially when deteriorated road adhesion is encountered unexpectedly, due to the presence of loose gravel, ice, oil, potholes, etc. on the roadway. In case of accident, motorcycle clothing protects users from injury. It can protect riders against injuries such as dermabrasion and laceration, but not against more serious injuries, such as fracture and sprain, except for boots, which reduce foot-and-ankle fracture risk. No effect of dorsal protectors was shown. Full-face helmets provide significantly greater protection against facial injury than do other helmets. However, no significant difference of protection against skull or brain injury is found between the two types of helmets. Conclusion: Our results highlight the problem of MTW detection for motorists at intersections and the important role of road conditions in the occurrence of accidents resulting from loss of control of MTW. It is recommended for motorists to pay extra attention to priority vehicles oncoming from their left or the opposite direction, before turning left at an intersection, especially to MTW. Regular road maintenance and immediate installment of appropriate warning signs concerning road deterioration are also highly recommended in consideration of MTW safety. Finally, our results support road safety organizations’ recommendation that protective clothing be worn: this should be more systematic for MTW users, the same for the use of full-face helmets