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Delavary M, Mesic A, Krebs E, Sesonga P, Uwase-Gakwaya B, Nzeyimana I, Vanlaar W. Assessing the effect of automated speed enforcement and comprehensive measures on road safety in Rwanda. TRAFFIC INJURY PREVENTION 2024:1-9. [PMID: 38832918 DOI: 10.1080/15389588.2024.2354901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 05/08/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVES Daily, approximately 3,400 traffic-related deaths occur globally, with over 90% concentrated in low and middle-income countries (LMICs). Notably, Rwanda has one of the highest road traffic death rates in the world (29.7 per 100,000 people) and is the first low-income country to implement a national Automated Speed Enforcement (ASE) policy. The primary goal of this study is to evaluate the effectiveness of ASE cameras in reducing the primary outcome of road traffic deaths and secondary outcomes of serious injury crashes and fatal crashes. METHODS The study used data on road traffic deaths, and serious injury and fatal crashes collected by the Rwanda National Police between 2010 and 2022. Interrupted time series (ITS) models were fit to quantify the association between ASE and change in road traffic crash outcomes, adjusted for COVID-19-related variables (such as the start of the pandemic, the closure of schools and bars), along with exposure variables (such as GDP and population), and other concurrent road safety measures (such as road safety campaigns). RESULTS The ITS models show that the implementation of ASE cameras significantly reduced road traffic deaths, serious injury crashes, and fatal crashes at the provincial level. For instance, the implementation of ASE cameras in the whole of Rwanda in April 2021 was significantly associated with a 0.14 (95% CI [0.072, 0.212]) reduction in monthly death incidence, equating to a 38.16% monthly decrease compared to the period before their installation (January 2010-March 2021). CONCLUSION This study emphasizes the significant association of ASE in Rwanda with improved road traffic crash outcomes, a result that may inform road safety policy in other LMICs. Rwanda has become the first low-income country to implement nationwide scaling of ASE in Africa, paving the way for the generation of valuable evidence on speed-related interventions. In addition to new knowledge generation, African road safety research efforts like this one are opportunities to grow academic and law enforcement cooperations while improving data systems and sources for future research benefits.
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Affiliation(s)
| | - Aldina Mesic
- Department of Global Health, University of Washington, Seattle, Washington
- Healthy People Rwanda (HPR), Kigali, Rwanda
| | | | | | | | | | - Ward Vanlaar
- Traffic Injury Research Foundation, Ottawa, Canada
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Delavary M, Kalantari AH, Mohammadzadeh Moghaddam A, Fakoor V, Lavallière M, Wilhelm Siebert F. Road traffic mortality in Iran: longitudinal trend and seasonal analysis, March 2011-February 2020. Int J Inj Contr Saf Promot 2024; 31:125-137. [PMID: 37861126 DOI: 10.1080/17457300.2023.2272239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 10/15/2023] [Indexed: 10/21/2023]
Abstract
Road traffic mortalities (RTMs) and injuries are among the leading causes of human fatalities worldwide, particularly in low-and middle-income countries like Iran. Using an interrupted time series analysis, we investigated three interventional points (two government-mandated fuel price increases and increased traffic ticket fines) for their potential relation to RTMs. Our findings showed that while the overall trend of RTMs was decreasing during the study period, multiple individual provinces showed smaller reductions in RTMs. We also found that both waves of government-mandated fuel price increases coincided with decreases in RTMs. However, the second wave coincided with RTM decreases in a smaller number of provinces than the first wave suggesting that the same type of intervention may not be as effective when repeated. Also, increased traffic ticket fines were only effective in a small number of provinces. Potential reasons and solutions for the findings are discussed in light of Iran's Road Safety Strategic Plan.
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Affiliation(s)
- Milad Delavary
- Department of Health Sciences, Laboratoire BioNR and Centre intersectoriel en santé durable (CISD), Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
| | | | | | - Vahid Fakoor
- Department of Statistics, Faculty of Mathematical Sciences, Ferdowsi University of Mashhad, Razavi Khorasan, Iran
| | - Martin Lavallière
- Department of Health Sciences, Laboratoire BioNR and Centre intersectoriel en santé durable (CISD), Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
| | - Felix Wilhelm Siebert
- Department of Technology, Management, and Economics, Technical University of Denmark, Lyngby, Denmark
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Kim EJ, Ganga A, Kim LA. The forgotten protection factor: A nationwide score-based assessment of motorcycle eye protection legislation. JOURNAL OF SAFETY RESEARCH 2023; 87:407-415. [PMID: 38081713 DOI: 10.1016/j.jsr.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 05/20/2023] [Accepted: 08/15/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Motorcycle accidents cause millions of deaths and injuries globally. It is estimated that billions of dollars would be saved in the United States alone if safety equipment, such as helmets and eye protection, was ubiquitously worn. Legislation concerning eye protection specifically is understudied and poorly characterized. METHOD We reviewed all motorcycle-related safety equipment laws in all 50 states of the United States for information regarding eye protection. We graded the rigor of each statute using our six-category Eye Safety Metric and performed a comparative analysis of statutes across all jurisdictions. RESULTS Fourteen states did not have any statutes regarding eye protection. Among states that did, 23 states had weak statutes (0-2 points), 20 states had moderately stringent statutes (3-4 points), and 7 states had strong statutes (5-6 points). States in western United States tended to have less strict eye protection laws. Twenty-six states had eye protection exemptions for windshields, which are a poor form of eye protection. Six states that had universal helmet laws had no laws requiring eye protection. CONCLUSIONS We characterized eye protection legislation across the country and found great diversity in the stringency of laws across all jurisdictions. Despite only two states lacking helmet laws, we found that 14 states lacked eye protection laws. These findings from our Eye Safety Metric can be used as a springboard for future research, which can be used to determine the need for and significance of eye safety legislation for motorcyclists and to inform legislative decision-making. PRACTICAL APPLICATIONS With this research, we hope to further the understanding of legislation regarding eye protection for motorcyclists and help policymakers identify states that need improved eye safety standards.
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Affiliation(s)
- Eric J Kim
- Warren Alpert School of Medicine, Brown University, Providence, RI 02903, USA; Schepens Eye Research Institute of Mass Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, MA 02114, USA
| | - Arjun Ganga
- Warren Alpert School of Medicine, Brown University, Providence, RI 02903, USA
| | - Leo A Kim
- Schepens Eye Research Institute of Mass Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, MA 02114, USA.
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Martínez P, Joseph J, Nazif-Munoz JI. The absence of data on driving under the influence of alcohol in road traffic studies: a scoping review of non-randomized studies with vote counting based on the direction of effects of alcohol policies. Subst Abuse Treat Prev Policy 2023; 18:46. [PMID: 37507756 PMCID: PMC10375679 DOI: 10.1186/s13011-023-00553-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Data on driving under the influence of alcohol (DUIA) are not always available, accurate, or reliable, making it difficult to study the effects of alcohol policies on road traffic outcomes. The objectives of our study were twofold: 1) to describe how road traffic outcomes of alcohol policies are assessed when DUIA data are missing, and 2) to explore the effects of alcohol policies when DUIA data are missing. METHODS We conducted a scoping review of non-randomized studies that assessed the road traffic outcomes of alcohol policies when DUIA data are missing. Until November 2021, we searched studies published between 2000 and 2021, in English or French, via MEDLINE, APA PsycInfo, CINAHL, and SocINDEX. We assessed the risk of bias in the included studies with the Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group. The selection process, data extraction, and the risk of bias assessment were conducted independently and in duplicate. We used vote counting based on the direction of the effects of alcohol policies as a synthesis method. The protocol for this review was published in PROSPERO under record number CRD42021266744. RESULTS Twenty-four eligible studies were included. Regarding objective 1, most studies used uncontrolled interrupted time series designs to assess road traffic fatalities resulting from night-time crashes. The reasons for missing DUIA data were generally not reported. Regarding objective 2, we found evidence for an association between alcohol policies and decreased road traffic fatalities. Subgroup analyses found no evidence for an association between methodological modifiers and positive effect directions for road traffic fatalities. CONCLUSION Caution is needed when interpreting road traffic outcomes associated with alcohol policies when DUIA data are missing. Greater efforts should be made to improve the reporting of outcomes assessments. Future studies must address several methodological issues (e.g., more granular data, well-defined intervention and implementation, and controlled designs). Our results should be compared to those from others reviews where DUIA data were available to confirm or recalibrate the associations found in studies where DUIA data were missing.
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Affiliation(s)
- Pablo Martínez
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 150, Place Charles-Le Moyne, Longueuil, Québec, J4K A08, Canada.
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), 150, Place Charles-Le Moyne, Longueuil, Québec, J4K A08, Canada.
- Institut universitaire sur les dépendances, 950 Rue de Louvain Est, Montréal, Québec, H2M 2E8, Canada.
| | - Junon Joseph
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 150, Place Charles-Le Moyne, Longueuil, Québec, J4K A08, Canada
| | - José Ignacio Nazif-Munoz
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 150, Place Charles-Le Moyne, Longueuil, Québec, J4K A08, Canada
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), 150, Place Charles-Le Moyne, Longueuil, Québec, J4K A08, Canada
- Institut universitaire sur les dépendances, 950 Rue de Louvain Est, Montréal, Québec, H2M 2E8, Canada
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Guimarães RA, de Sena KG, de Morais Neto OL, Malta DC. Magnitude and factors associated with motor road traffic injuries in Brazil: Results from the National Health Survey, 2019. Injury 2023:S0020-1383(23)00244-9. [PMID: 36934008 DOI: 10.1016/j.injury.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 03/03/2023] [Accepted: 03/05/2023] [Indexed: 03/20/2023]
Abstract
OBJECTIVE To estimate the magnitude and factors associated with self-reported road traffic injuries (RTI) in Brazil. METHODS Cross-sectional study conducted using data from individuals aged 18 years or older, participants in the 2019 National Health Survey, a population-based conducted on 88,531 adult individuals in Brazil. Three indicators were analyzed: (i) Proportion (%) of individuals aged 18 years or older who were involved in RTI in the past 12 months; (ii) Proportion (%) of car drivers who were involved in RTI in the past 12 months; and (iii), Proportion (%) of motorcycle drivers who were involved in RTI in the past 12 months. In the inferential analysis, multiple Poisson regression was used to analyze the association between demographic and socioeconomic variables and RTI, stratified for the general population, population of car and motorcycle drivers. RESULTS The estimated prevalence of self-reported RTI in the past 12 months was 2.4%. The South, Southeast, Northeast, Central-West, and North regions of Brazil had prevalences of 2.0%, 2.1%, 2.7%, 3.2%, and 3.4%, respectively. The results also show that most developed regions (South and Southeast) showed the lowest prevalence's, the highest frequencies were observed in those with lower socioeconomic development levels (Central-West, North, and Northeast). The prevalence was also higher in the subgroup of motorcyclists when compared to car drivers. In the general sample, the Poisson model showed an association between male sex, younger age, low level of education, residing outside capitals and metropolitan regions, in the North, Northeast and South regions and the prevalence of RTI. In car drivers, similar associations were found, except for area of residence. In motorcycle drivers, young age, low level of education, living in urban areas were associated with increased prevalence of RTI. CONCLUSION The prevalence of RTI is still high within the country, with disparities between regions, affecting more motorcyclists, young people, males, individuals with low education, and residents of the countryside.
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Affiliation(s)
- Rafael Alves Guimarães
- Faculdade de Enfermagem. Universidade Federal de Goiás, Goiânia, Goiás, Brasil; Instituto de Patologia Tropical e Saúde Pública. Universidade Federal de Goiás, Goiânia, Goiás, Brasil.
| | - Kamylla Guedes de Sena
- Instituto de Patologia Tropical e Saúde Pública. Universidade Federal de Goiás, Goiânia, Goiás, Brasil
| | | | - Deborah Carvalho Malta
- Departamento de Enfermagem Materno Infantil e Saúde Pública. Escola de Enfermagem. Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
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Delaney PG, Eisner ZJ, Thullah AH, Turay P, Sandy K, Boonstra PS, Raghavendran K. Evaluating feasibility of a novel mobile emergency medical dispatch tool for lay first responder prehospital response coordination in Sierra Leone: A simulation-based study. Injury 2023; 54:5-14. [PMID: 36266111 DOI: 10.1016/j.injury.2022.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/02/2022] [Accepted: 10/10/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The global injury burden, driven by road traffic injuries, disproportionately affects low- and middle-income countries, which lack robust emergency medical services (EMS) to address injury. The WHO recommends training lay first responders (LFRs) as the first step toward formal EMS development. Emergency medical dispatch (EMD) systems are the recognized next step but whether small groups of LFRs equipped with mobile dispatch infrastructure can efficiently respond to geographically-dispersed emergencies in a timely fashion and the quality of prehospital care provided is unknown. MATERIALS AND METHODS We piloted an EMD system utilizing a mobile phone application in Sierra Leone. Ten LFRs were randomly selected from a pool of 61 highly-active LFRs trained in 2019 and recruited to participate in an emergency simulation-based study. Ten simulation scenarios were created matching proportions of injury conditions across 1,850 previous incidents (June-December 2019). Fifty total simulations were launched in randomized order over 3 months, randomized along 10 km of highway in Makeni. Replicating real-world conditions, highly-active LFR participants were blinded to randomized dispatch timing/scenario to assess response time and skill performance under direct observation with a checklist using standardized patient actors. We used novel cost data tracked during EMD pilot implementation to inform the calculation of a new cost-effectiveness ratio ($USD cost per disability-adjusted life year averted (DALY)) for LFR programs equipped with dispatch, following WHOCHOICE guidelines, which state cost-effectiveness ratios less than gross domestic product (GDP) per capita are considered "very cost-effective." RESULTS Median total response interval (notification to arrival) was 5 min 39 s (IQR:0:03:51, 0:09:18). LFRs initially trained with a 5-hour curriculum and refresher training provide high-quality prehospital care during simulated emergencies. Median first aid skill checklist completion was 89% (IQR: 78%, 90%). Cost-effectiveness equals $179.02USD per DALY averted per 100,000 people, less than Sierra Leonean GDP per capita ($484.52USD). CONCLUSION LFRs equipped with mobile dispatch demonstrate appropriate response times and effective basic initial management of simulated emergencies. Training smaller cohorts of highly-active LFRs equipped with mobile dispatch appears highly cost-effective and may be a feasible model to facilitate efficient dispatch to expand emergency coverage while conserving valuable training resources in resource-limited settings.
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Affiliation(s)
- Peter G Delaney
- University of Michigan Medical School, 1301 Catherine St., Ann Arbor, MI 48109, United States; LFR International, 4835 Oak Park Ave, Encino, California, United States; Michigan Center for Global Surgery, Ann Arbor, Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, United States.
| | - Zachary J Eisner
- University of Michigan Medical School, 1301 Catherine St., Ann Arbor, MI 48109, United States; LFR International, 4835 Oak Park Ave, Encino, California, United States; Michigan Center for Global Surgery, Ann Arbor, Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, United States
| | - Alfred H Thullah
- LFR International - Sierra Leone, Plot 4, Lunsar-Makeni Highway, Makeni, Sierra Leone
| | | | - Kpawuru Sandy
- Sierra Leone Red Cross Society, 6, Liverpool St., Freetown, Sierra Leone
| | - Philip S Boonstra
- University of Michigan Department of Biostatistics, 1415 Washington Heights, Ann Arbor, MI, United States
| | - Krishnan Raghavendran
- Michigan Center for Global Surgery, Ann Arbor, Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, United States; University of Michigan Health System Department of Surgery, 1500 E Medical Center Dr, Ann Arbor, MI, United States
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Motorized 2-3 wheelers death rates over a decade: a global study. World J Emerg Surg 2022; 17:7. [PMID: 35081985 PMCID: PMC8791086 DOI: 10.1186/s13017-022-00412-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Motorized 2-3-wheelers-related death is high due to the exposed body of the driver/passenger and the high speed. The United Nation (UN) Decade of Action for road safety aimed to reduce road traffic deaths by 50% by the year 2020. We aimed to study the factors affecting the death rates of motorized 2-3 wheelers injured victims and whether the reduction in the death rates has met the UN target. METHODS Data were retrieved from the WHO Global Status Reports on Road Safety published over 2009 to 2018 which covered the years of 2007 to 2016. Studied variables included motorized 2-3 wheelers death rates, percentage of helmet-wearing rate, helmet law enforcement, speed law enforcement, gross national income per capita, vehicles/person ratio, and motorized 2-3 wheelers/person ratio. A mixed linear model was used to define factors affecting the change of motorized 2-3 wheelers death rates over time. RESULTS The global mean motorized 2-3 wheelers death rates increased from 2.37/100,000 population to 3.23/100,000 population over the studied decade (a relative ratio of 1.36) which was not statistically significant. Factors that affected mortality included GNI (p = 0.025), motorized 2-3 wheelers per person ratio (p < 0.0001), percentage of helmet wearing rate (p = 0.046), and the interaction between vehicle/person ratio and motorized 2-3 wheelers/person ratio (p = 0.016). There was a significant increase in the death rates over time in the low-income countries (a relative ratio of 2.52, p = 0.019, Friedman test), and middle-income countries (a relative ratio of 1.46, p < 0.0001, Friedman test), compared with a significant decrease in the high-income countries (a relative ratio of 0.72, p < 0.0001, Friedman test). CONCLUSIONS Global mortality of motorized 2-3 wheelers has increased by a relative ratio of 1.36 over a recent decade. The UN target of reducing death was not met. The increase was related to the increase in motorized 2-3 wheelers per person ratio and economic inequity which has to be addressed globally. The economic global gap significantly impacts the mortality rates of motorized 2-3 wheelers.
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Hangoma P, Moonga-Mukale K. Impact of night travel ban on road traffic crashes and fatalities in Zambia: an interrupted time series analysis. BMJ Glob Health 2021; 6:bmjgh-2021-005481. [PMID: 34903564 PMCID: PMC8671927 DOI: 10.1136/bmjgh-2021-005481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 11/09/2021] [Indexed: 11/29/2022] Open
Abstract
Background The burden of road traffic crashes (RTCs) and road traffic fatalities (RTFs) has been increasing in low-income and middle-income countries (LMICs). Most RTCs and RTFs happen at night. Although few countries, including Zambia, have implemented night travel bans, there is no evidence on the extent to which such policies may reduce crashes and fatalities. Methods We exploit the quasi-experimental set up afforded by the banning of night travel of public service vehicles in Zambia in 2016 and interrupted time series analysis to assess whether the ban had an impact on both levels and trends in RTCs and RTFs. We use annual administrative data for the period 2006—2020, with 10 pre-intervention and 4 post-intervention data points. In an alternative specification, we restrict the analysis to the period 2012—2020 so that the number of data points are the same pre-interventions and post-interventions. We also carry out robustness checks to rule out other possible explanation of the results including COVID-19. Results The night travel ban was associated with a reduction in the level of RTCs by 4131.3 (annual average RTCs before the policy=17 668) and a reduction in the annual trend in RTCs by 2485.5. These effects were significant at below 1%, and they amount to an overall reduction in RTCs by 24%. The policy was also associated with a 57.5% reduction in RTFs. In absolute terms, the trend in RTFs reduced by 477.5 (Annual average RTFs before the policy=1124.7), which is significant at below 1% level. Our results were broadly unchanged in alternative specifications. Conclusion We conclude that a night travel ban may be an effective way of reducing the burden of RTCs and RTFs in Zambia and other LMICs. However, complementary policies are needed to achieve more gains.
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Affiliation(s)
- Peter Hangoma
- Department of Health Policy and Management, University of Zambia, Lusaka, Zambia .,Development Learning Lab, Chr. Michelsen Institute, Bergen, Norway.,Bergen Centre for Ethics and Priority Setting (BCEPS), University of Bergen, Bergen, Norway
| | - Kantu Moonga-Mukale
- Department of Health Policy and Management, University of Zambia, Lusaka, Zambia.,School of Health Sciences, Levy Mwanawasa Medical University, Lusaka, Zambia
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Inada H, Tomio J, Nakahara S, Ichikawa M. Effect of annual road safety publicity and enforcement campaign on road fatalities in Japan: a time series study from 1949 to 2019. J Epidemiol Community Health 2021; 76:146-151. [PMID: 34193570 DOI: 10.1136/jech-2021-216532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/20/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND In 1948, Japan started a short-term publicity and enforcement campaign for traffic safety nationwide, and since 1952, the campaign has been conducted twice a year for 10 days. We aimed to quantify the short-term effect of the spring sessions of the campaign, which were conducted in different months in different years, on road fatalities in Japan using data from 1949 to 2019. METHODS We obtained national police data on the monthly number of road deaths and conducted a time series regression analysis with three steps: smoothing the long-term patterns with the natural cubic spline function, calculating the ratio of the monthly number of deaths to the corresponding smoothed value, and regressing the ratio on the number of months from January 1949 and the binary variable for the conduct of spring sessions. We repeated the analysis for four subperiods (1949-1964, 1965-1989, 1990-2004 and 2005-2019). RESULTS During the study period, there were 632577 road deaths. Our analysis revealed that the spring sessions changed the number of deaths per day by -2.5% (95% CI -4.1% to -0.9%) in the months when they were conducted. In the four subperiods, the estimated changes were -4.5% (95% CI -8.9% to -0.1%), -2.6% (95% CI -5.0% to -0.1%), -0.1% (95% CI -2.9 to 2.7) and -3.5% (95% CI -7.9 to 0.9). CONCLUSIONS Road fatalities were reduced in the months when the spring sessions of the campaign were conducted, but the reduction was modest. The effect might have been somewhat larger until 1964, when Japan was a middle-income country.
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Affiliation(s)
- Haruhiko Inada
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jun Tomio
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Shinji Nakahara
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Kanagawa, Japan
| | - Masao Ichikawa
- Department of Global Public Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Inada H, Tomio J, Ichikawa M, Nakahara S. Reduced road injuries while commuting due to heavy snowfall and ensuing modal shifts among junior high school students in Japan. J Epidemiol 2021; 32:408-414. [PMID: 33583936 PMCID: PMC9359898 DOI: 10.2188/jea.je20200504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Modal shifts in transport may reduce overall road injuries. Cyclist junior high school students are at a high risk of road injuries while commuting in Japan, and injuries among junior high school students could be reduced if the cyclists switch to other transport modes. Methods We estimated the change in the incidence of road deaths and serious injuries while commuting in months with heavy snowfall, when cyclists are likely to switch to other transport modes. Using police data on the monthly number of road injuries while commuting among junior high school students in Japan between 2004 and 2013 and corresponding population statistics and snowfall data, we calculated the monthly injury rate (number of deaths and serious injuries divided by population) at the prefecture level. We conducted Poisson regression analysis to estimate the change in the rate in months with a snowfall of ≥100 cm, compared to months without snowfall. Results A total of 3,164 deaths and serious injuries occurred during 2004 to 2013. The injury rate among cyclists was almost zero in months with a snowfall of ≥100 cm. That among cyclists and pedestrians in these months was reduced by 68% (95% confidence interval, 43–82%). Conclusion In months with heavy snowfall, road injuries while commuting were reduced due to the near-elimination of cycling injuries among junior high school students in Japan. Switching from cycling to other transport modes would reduce overall road injuries among this population, and inducing modal shifts can be an important tool for road safety.
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Affiliation(s)
| | - Jun Tomio
- Graduate School of Medicine, University of Tokyo
| | | | - Shinji Nakahara
- Graduate School of Health Innovation, Kanagawa University of Human Services
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Yasin YJ, Grivna M, Abu-Zidan FM. Reduction of pedestrian death rates: a missed global target. World J Emerg Surg 2020; 15:35. [PMID: 32430037 PMCID: PMC7236348 DOI: 10.1186/s13017-020-00315-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 05/07/2020] [Indexed: 12/19/2022] Open
Abstract
Background The UN Decade of Action for Road Safety aimed to reduce road traffic deaths by half by year 2020. We aimed to study risk factors affecting global pedestrian death rates overtime, and whether the defined target of its reduction by WHO has been achieved. Methods The studied variables were retrieved from the WHO Global Status Reports on Road Safety published over 2010–2018. These covered years 2007–2016 and included the estimated road traffic death rates per 100,000 population, policies to promote walking and cycling, enforcement levels of national speed limits, the gross national income per capita and the vehicle/person ratio in each country. A mixed linear model was performed to define the factors affecting the change of pedestrian death rates overtime. Results Global pedestrian mortality decreased by 28% over 10 years. This was significant between years 2007 and 2010 (p = 0.034), between years 2013 and 2016 (p = 0.002) but not between 2010 and 2013 (p = 0.06). Factors that reduced pedestrian death rates included time (p < 0.0001), GNI (p < 0.0001), and vehicle/person ratio (p < 0.0001). There was a significant drop overtime in both the middle-income, and high-income countries (p < 0.0001, Friedman test), but not in the low-income countries (p = 0.35, Friedman test). Conclusions Global pedestrian mortality has dropped by 28% over a recent decade, which is less than the 50% targeted reduction. This was mainly driven by improved GNI and using more vehicles. The economical gap between poor and rich countries has a major impact on pedestrian death rates.
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Affiliation(s)
- Yasin J Yasin
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.,Department of Environmental Health and Behavioral Sciences, School of Public health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Michal Grivna
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Fikri M Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
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