Burden of traffic accidents among pedestrians of Fars province, southern Iran; estimate of years of life lost in a sample of Iranian population from 2009 to 2013

Mortality Rate and Years of Life Lost Due to Road Traffic Accidents in Fars Province, 2004-2019

Background

Traffic accidents are one of the most critical health problems and the ninth leading cause of death globally. We aimed to determine the Mortality rate and the number of Years of Life Lost (YLL) due to road traffic accidents.

Methods

In this retrospective cohort study, mortality rate and YLL due to road traffic accidents were examined in Fars province, central Iran during the years 2004-2019. Mortality statistics were collected through death registration of ministry of health and medical education for Fars Province. Age Standardized mortality Rate (ASR) was calculated and join point regression analysis carried out to examine the trend of YLL rate. Data were analyzed using Excel spreadsheet version 2016 and Join point Regression Program 4.9.0.0.

Results

During the 16-year study period, 25,858 deaths due to road traffic accidents occurred in the province. 79.2% (20483 cases) were in men, and 33.7% (8703 cases) were aged 15-29 years. Total YLL during the 16-year study period were 458,975 (14.6 per 1000 people) in men, 117,999 (3.8 per 1000 people) in women. According to the join point regression, the 16- year trend of YLL rate due to premature mortality was decreasing: AAPC was -4.9% (95% CI: -8.8 to -0.9; P=0.018) for male, and -3.5% (95% CI: -6.3 to-0.5; P=0.011) for female.

Conclusion

Considering that the number of deaths, mortality rate and YLL has decreased in Fars province during the 16 years under study. Therefore, because the mortality rate due to road traffic accidents in Iran is higher than the global average, the need for training programs for drivers, compliance with standards and retrofitting of vehicles, road safety, driving supervision and the use of seat belts are essential.

Hit-and-runs more common with pedestrians lying on the road: Analysis of a nationwide database in Japan

PURPOSE

To determine the trends with fatally or otherwise injured pedestrians lying on the road and the relationship to hit-and-run incidents in Japan.

METHODS

We extracted data for 2012-2016 from the records of the Institute for Traffic Accident Research and Data Analysis, Japan, a nationwide traffic accident database. All the injured and fatally injured pedestrians were selected. We examined the levels of pedestrian injury, vehicle speed immediately before the collision, whether or not the pedestrian was lying on the road, and hit-and-run incidents. Chi-square test was employed to make a statistical comparison between the two groups.

RESULTS

The database contained data on 286,383 pedestrian casualties and 7256 fatalities; 8.3% of fatalities (602 persons) and 0.6% of casualties (1827 persons) involved pedestrians lying on the road. The rates of fatalities and severe injuries were significantly higher for pedestrians who were lying on the road than for those who were not. Hit-and-run incidents were evident in 4.0% of casualties and 7.3% of fatalities. The rate of hit-and-run cases was also significantly higher among pedestrians who were lying on the road. Among fatally injured pedestrians not lying on the road, the rates with speeds of ≥30 km/h did not differ significantly between hit-and-run and other cases. However, when the pedestrians were lying on the road, the rate was significantly increased in hit-and-run cases.

CONCLUSION

This is the first report to focus on pedestrians lying on the road and being involved in hit-and-run incidents. In addition to preventing hit-and-run incidents, prevention of pedestrians lying on the road could also decrease fatalities.

Still careless: findings from a cross-sectional study of young pedestrians' risky road crossing behaviors

Background

Pedestrian-vehicle collision is one of the most common traffic injuries worldwide. This study aimed to investigate the determinants of pedestrians’ road crossing beliefs and behaviors in potentially risky situations using the Theory of Planned Behavior among Iranian young adults.

Methods

This was a population-based study on a sample of 562 young adults aged 18 to 25 years living in Tehran, Iran. Data were collected by using a self-administered validated questionnaire including constructs of the theory of planned behavior and items of perceived risk and severity. The data were analyzed using independent t-test, analysis of covariance and multivariate analysis of variance.

Results

From all the respondents, 17.8% reported that they had previous experience of vehicle-collision. Among the participants, those who had previous experience of vehicle-collision reported less safety behaviors in crossing the road than those who had not experience an accident. It was found significant differences between participants with and without a history of vehicle-collision for perceived risk (mean difference, adjusted multivariate P-value: − 5.77, 0.027) and perceived severity (− 6.08, 0.003), attitude toward traffic regulations (− 6.34, 0.006), attitude toward behavior (− 7.56, 0.005), perceived behavioral control (− 5.20, 0.018), behavioral intention (− 5.35, 0.046) and road crossing behavior in potentially risky situations (− 5.37, 0.004).

Conclusions

Previous unpleasant experience of vehicle-collision is not the only determinant of self-protective behaviors in road- crossing which indicate the role of cognitive and motivational factors such as, subjective norms, attitudes towards risk, feelings of invulnerability in case of facing with vehicle collision.

Results of a Campaign for Motorcycle Helmets Advocacy in a City in Southwest of Iran; A Population-Based Intervention Study

Objective:

We conducted a triple phase project for motorcycle helmets advocacy in Darab, a city in southwest Iran. The aim of this study was to evaluate the effect of the project on decreasing the hazards of motorcycle accidents.

Methods:

Using a questionnaire, data for ICU admission rates, hospital costs for patients who required ICU admission, rate of helmet usage, mortality and the duration of ICU care for patients admitted to Darab hospital due to motorcycle accidents in Winter 2015 (before conducting the project) and Winter 2016 (after conducting the project) were gathered and compared. This feature was also separately done for patients younger than 17 years.

Results:

The rate of wearing helmets increased significantly in winter 2016 (from 3.4 % to 33%). Also ICU admission rate due to head trauma was significantly decreased after the project was done (from 14.5 % to 4%). However, hospital costs for patients required ICU admission were increased in winter 2016. This increase, though not significant, seems to be due to an increase in health service expenses in the year 2016 as compared with the year 2015. The mortality rate was not significantly changed between the two mentioned years results. For patients younger than 17 years, no ICU admissions were needed in winter 2016.

Conclusion:

Even a short period of intervention can have positive effects on increasing the safety of motorcycle drivers.

Prevalence of sleep quality disorder among Iranian drivers: a systematic review and meta-analysis

Background:

Sleep Quality Disorder (SQD) plays a major role in road accidents. So, this study was carried out to determine the prevalence of SQD among occupational drivers using systematic review and meta-analysis in Iran.

Methods:

All Persian and English articles between January, 2000 and October, 2015 which had reported the SQD prevalence in Iranian drivers by Pittsburgh Sleep Quality Index (PSQI) with cross-sectional design, after the quality evaluation process and achieving the required score, were selected. The heterogenic index of the studies was distinguished by using Cochran (Q) and I2 tests. Based on heterogeneity results, a random effects model was used to estimate pooled prevalence of SQD. Meta-regression was also used to investigate the heterogeneity of suspected factors.

Results:

In total, 936 articles were found from national and international databases. Ten articles entered to meta-analysis process, ultimately. Since heterogeneity index suggested that there is a consider-able heterogeneity among the results of primary studies (I-squared = 98.8%, Q= 754.1, p less than 0.001), the overall estimation of SQD among Iranian drivers was conducted using random-effects model and its rate was estimated to be 53.4% (95% CI: 38.9-67.8).

Conclusions:

Our study demonstrated that more than half of Iranian drivers have SQD. Identifying the drivers with SQD by periodic examinations and providing advice and health care among occupational drivers could be appropriate solutions for decreasing the accident risks.