Pupil Behaviour on School Buses and Potential Risk Factors for Injury: An Observational study/Comportement Des Eleves Dans Les Bus Scolaires et Facteurs De Risque De Traumatisme: Etude observationnelle/Comportamiento De Los Alumnos En Los Autobuses Escolares Y Posibles Factores De Riesgo De Traumatismos: Estudio Observacional

Article excerpt

Introduction

In Israel, 90% of schoolchildren living in rural communities travel daily by school bus. (1) Since 1 September 2006, seatbelts have been mandatory in all vehicles used for school transportation in Israel. (2) The Ministry of Transportation introduced this seatbelt regulation following a tragic collision between a school bus and a jeep on the last day of the 2004 school year, which resulted in the death of three children and minor to severe injury of 50. The implementation of seatbelts in school buses was thus a response to a single mass casualty event rather than the outcome of research regarding day-to-day bus-related injury risks.

Injury data from countries around the world have shown that bus travel is the safest method for travelling to school. (3,4) Data regarding bus-related injuries among Israeli children show that the majority of casualties are not due to road crashes but rather to outside events, such as children getting on and off the bus or pedestrians crossing near the bus. (5) Although information about injuries related to school transportation in Israel has not been sufficiently recorded, data have been collected from various sources. According to the Ministry of Education--which conducts enquiries on school-related traffic injuries at its discretion, usually when fatalities are involved--67 students were injured while travelling on school transportation vehicles from 2003 to 2006 (40 were injured in the above-mentioned crash in 2004) (Y Shaul, Department of Traffic Safety, personal communication, 2006). The Israel Trauma Registry collects data on trauma-related hospitalizations. From 2002 to 2005, 75 children aged 6-17 years were hospitalized for bus-related injuries, although the injuries were not specific to a school bus (the data include injuries to children riding on both school and municipal buses, injuries incurred while boarding or disembarking from a bus and injuries caused by a bus while children were crossing a road). (5)

Most studies regarding school transportation safety and injuries have focused on injuries occurring outside the bus, while few have observed pupil behaviour on buses. (6-9) Rowdiness, excessive noise and violence on the bus have been shown to endanger passengers and interfere with bus driver concentration. (6) One study evaluating pupil behaviour measured suspension of bus-riding privileges, bus driver referrals and teacher and bus driver questionnaire responses. (7) A survey of bus drivers found that noise outbursts (61%), out-of-seat activity (48%) and roughhousing (31%) were among the most distracting pupil behaviours. (9) It is both impractical and dangerous to expect bus drivers to manage pupil behaviour and stop disruptions while also ensuring that they are driving safely.

School bus transportation is challenging, in part because new safety measures are continually being developed, modified and assessed. The initial aim of this study was to examine seatbelt usage on school buses following the introduction of the government regulation requiring seatbelts in all buses used for school transportation. However, since on-bus observations were chosen as the most effective method for measuring seatbelt usage, it was decided also to evaluate pupil and bus driver conduct as possible factors affecting school transportation safety.

Methods

An observational study was conducted on board vehicles used for school transportation in Israel between December 2006 and March 2007. The study population consisted of pupils enrolled in the general education system who lived in rural communities and travelled by means of school transportation to and from school in both the morning and the afternoon. The study sample was designed on the basis of 18 regional councils in a single geographic region in central Israel. The number of daily school transportation routes (over 1300); the number and type of schools (primary and secondary schools, over 100); route direction (to or from school); school bus category (private, public or regional council bus) and number of pupils studying in each regional council (approximately 31 000) were used to select the study sample. …