Road traffic crashes among farm vehicle drivers in southern China: A cross-sectional survey

Refractive error and abnormal stereopsis association with road traffic accidents in Saudi Arabian truck drivers

PURPOSE

To investigate the visual functions of truck drivers of the Kingdom of Saudi Arabia (KSA) in the region of Qassim and Dammam and to see if is there any association between these visual functions and self-reported road traffic accidents (RTA).

METHODS

It is a cross-sectional, descriptive study. LogMAR visual acuity, refractive error, color vision, stereopsis, and confrontation visual fields were measured in 300 truck drivers in the Qassim and Dammam regions of KSA. Driving-related history and incidence of RTA from the past 3 years, systemic history, and general eye compliance history were collected through a self-reporting questionnaire.

RESULTS

Among 300 truck drivers examined, 54 (18.4%) subjects have a refractive error, 14 (4.7%) subjects have color vision deficiency, 37 (12.2%) subjects have abnormal stereo acuity, and none of them have confrontation visual field defect. RTA was reported in 25 (8.3%) subjects. The current study has found RTA is significantly associated with refractive error (P = 0.01) and abnormal stereopsis (P < 0.01). Systemic history revealed that 11% of the subjects had diabetes mellitus.

CONCLUSION

The current study is the first to report on the visual functions of KSA truck drivers. Hence, the current study has found a significant association between visual functions and RTA among truck drivers, we recommend a comprehensive examination need to be part of issuing driver's licenses in KSA. More studies with larger samples from different regions of KSA are needed to extrapolate these findings.

Applying systems thinking to improve the safety of work-related drivers: A systematic review of the literature

INTRODUCTION

Light vehicles (<4.5 tons) driven for work purposes represent a significant proportion of the registered motor vehicles on our roads. Drivers of these vehicles have significant exposure to the dangers of the road transport environment. To optimize safety for these workers, it is critical to understand the factors contributing to risk of being involved in an incident. This information can then be used to inform the review and revision of existing risk controls and the development of targeted prevention activities.

METHOD

The aim of the study was to undertake a systematic review of the literature to identify the factors associated with work-related driving incidents. The factors identified in the review were represented within an adapted version of Rasmussen's risk management framework (Rasmussen, 1997). Fifty studies were analyzed following data screening and review of full text. The highest proportion of risk factors were categorized at the lower levels of the system, including the 'Drivers and Other Road Users' level (n = 20, 44.4%) and the 'Equipment, Environment, and Meteorological Surroundings' level (n = 19, 42.2%). There were no risk factors identified at the 'Regulatory and Government Bodies' levels of the framework, confirming the narrow investigative scope of past research and the need to acknowledge a broader range of factors within and across higher levels of the system.

CONCLUSIONS

The findings of this study inform the direction of future research and design of targeted prevention activities capable of creating system change for the safety of work-related drivers.

Vision impairment and traffic safety outcomes in low-income and middle-income countries: a systematic review and meta-analysis

BACKGROUND

Road traffic injuries are a major public health concern and their prevention requires concerted efforts. We aimed to systematically analyse the current evidence to establish whether any aspects of vision, and particularly interventions to improve vision function, are associated with traffic safety outcomes in low-income and middle-income countries (LMICs).

METHODS

We did a systematic review and meta-analysis to assess the association between poor vision and traffic safety outcomes. We searched MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials in the Cochrane Library from database inception to April 2, 2020. We included any interventional or observational studies assessing whether vision is associated with traffic safety outcomes, studies describing prevalence of poor vision among drivers, and adherence to licensure regulations. We excluded studies done in high-income countries. We did a meta-analysis to explore the associations between vision function and traffic safety outcomes and a narrative synthesis to describe the prevalence of vision disorders and adherence to licensure requirements. We used random-effects models with residual maximum likelihood method. The systematic review protocol was registered on PROSPERO, CRD-42020180505.

FINDINGS

We identified 49 (1·8%) eligible articles of 2653 assessed and included 29 (59·2%) in the various data syntheses. 15 394 participants (mean sample size n=530 [SD 824]; mean age of 39·3 years [SD 9·65]; 1167 [7·6%] of 15 279 female) were included. The prevalence of vision impairment among road users ranged from 1·2% to 26·4% (26 studies), colour vision defects from 0·5% to 17·1% (15 studies), and visual field defects from 2·0% to 37·3% (ten studies). A substantial proportion (range 10·6-85·4%) received licences without undergoing mandatory vision testing. The meta-analysis revealed a 46% greater risk of having a road traffic crash among those with central acuity visual impairment (risk ratio [RR] 1·46 [95% CI 1·20-1·78]; p=0·0002, 13 studies) and a greater risk among those with defects in colour vision (RR 1·36 [1·01-1·82]; p=0·041, seven studies) or the visual field (RR 1·36 [1·25-1·48]; p<0·0001, seven studies). The I2 value for overall statistical heterogeneity was 63·4%.

INTERPRETATION

This systematic review shows a positive association between vision impairment and traffic crashes in LMICs. Our findings provide support for mandatory vision function assessment before issuing a driving licence.

FUNDING

None.

Visual assessment of commercial drivers in the South West Region of Cameroon

BACKGROUND

Driving is a visually intensive task. In Cameroon, where the burden of road traffic deaths is high, visual assessment is not universally performed before the issuance of driver licenses. This study aims to assess the visual status of commercial drivers (CDs) in the southwestern region of Cameroon, and to find its relation to road traffic crashes (RTCs).

METHODS

This work was a cross-sectional community-based study on CDs in Limbe and Buea. Questionnaires were used to assess sociodemographic parameters, the incidence of RTCs, and self-reported visual status. Visual acuity (VA) was measured using a standard Snellen chart at 6 m. Statistical analysis was performed using descriptive methods: frequencies, the paired Student's t-test, and the chi-square test.

RESULTS

Two hundred seven CDs were enrolled in this study, all of which were male, with a mean age of 41.8 ± 12.1 years. A total of 15.0% had undergone an eye exam prior to licensure, and 3.4% had undergone an eye exam within the past 10 years. The VA in the better-seeing eye of participants was less than 6/9 and 6/12 in 14.1 and 10.6% of CDs, respectively. Seventy-five percent of CDs with self-reported poor vision and 95% of CDs with VA < 0.5 had a history of RTCs compared to 55.8% of CDs with self-reported good vision and 55.7% of CDs with VA ≥ 0.5 (p < 0.05). Injuries from RTCs were more common in CDs with self-reported poor vision (81.1%) and in those with VA < 0.5 (90.5%) compared to CDs who self-reported good vision (55.8%) and those with VA ≥ 0.5 (55.7%) (p < 0.05).

CONCLUSIONS

A large proportion of CDs did not undergo a visual assessment before the issuance or renewal of their driver licenses. A substantial number of CDs had poor vision in their better-seeing eye and suffered from RTCs and related injuries, which suggests that the visual status of CDs in Cameroon is related to the gruesome number of road traffic crashes and deaths in the country. Therefore, concerned authorities should consider making vision tests a necessary requirement for the obtention of driver licenses.

Road traffic accident severity analysis: A census-based study in China

BACKGROUND

In China, despite the decrease in average road traffic fatalities per capita, the fatality rate and injury rate have been increasing until 2015.

PURPOSE

This study aims to analyze the road traffic accident severity in China from a macro viewpoint and various aspects and illuminate several key causal factors. From these analyses, we propose possible countermeasures to reduce accident severity.

METHOD

The severity of traffic accidents is measured by human damage (HD) and case fatality rate (CFR). Different categorizations of national road traffic census data are analyzed to evaluate the severity of different types of accidents and further to demonstrate the key factors that contribute to the increase in accident severity. Regional data from selected major municipalities and provinces are also compared with national traffic census data to verify data consistency.

RESULTS

From 2000 to 2016, the overall CFR and HD of road accidents in China have increased by 19.0% and 63.7%, respectively. In 2016, CFR of freight vehicles is 33.5% higher than average; late-night accidents are more fatal than those that occur at other periods. The speeding issue is severely becoming worse. In 2000, its CFR is only 5.3% higher than average, while in 2016, the number is 42.0%. Conclusion and practical implementation: A growing trend of accident severity was found to be contrasting to the decline of road traffic accidents. From the analysis of casual factors, it was confirmed that the release way of the impact energy and the protection worn by the victims are key variables contributing to the severity of road traffic accidents.