Public road transport crashes in a low income country

Identification and analysis of accident black spots using Geographic Information System (GIS): A study on Kushtia-Jhenaidah national highway (N704), Bangladesh

Road accidents, mostly on national highways, pose a significant public health and economic burden in Bangladesh, requiring in-depth analysis for road safety measures. This study comprehensively analyzes accident trends, characteristics, causes, and consequences by identifying the accident black spots on the Kushtia-Jhenaidah National Highway (N704). Accident records from 2017 to 2021 were collected from nearby police stations. Additionally, using a cluster random sampling approach, a questionnaire survey with 100 respondents (50% drivers and 50% general road users) was also conducted to capture diverse perceptions and behaviors. The study utilizes descriptive methods, such as trends analysis and frequency distributions, alongside spatial analysis techniques, including severity index, Kernel Density Estimation, and hotspot analysis. Findings indicate a decrease in accidents from 2018 to 2021, yet a concerning rise in fatalities in 2021. Trucks (47.9%) emerge as the primary contributor among 169 vehicles involved in accidents. Head-on collisions (36%) are prevalent, attributed to both human and environmental factors, including driver inexperience (56%), mobile phone use while driving (78%), lack of proper training (12%), overspeeding (28.3%), and nighttime driving (54%) influenced by seasons and land use. Mostly, victims aged from 20 to 40, where men are more affected by fatalities (70.7%) and women by injuries (86.3%). Out of 35 identified accident spots, including Battail, Bittipara Bazar, Laxmipur Bazar, Modhupur Bazar, IU Main Gate, Sheikhpara Bazar, and DM College Front, are designated as blackspot zones based on the frequency of accidents, deaths, and injuries. The study concludes by recommending targeted interventions, driver training, infrastructure improvements, regulatory measures, and victim assistance in collaboration with local and national agencies to enhance road safety and mitigate accident risks.

Causal analysis of coach and bus accidents in China based on road alignments

Given the complexity and the difficulty of controlling contributors effectively, road passenger transport often results in serious injuries and fatalities. The purpose of this study is to identify the main contributors to coach and bus accidents and to provide policy recommendations for making improvements in accident prevention. The Driving Reliability and Error Analysis Method 3.0 (DREAM 3.0) was modified and used to analyze the contributing factors (i.e. phenotypes and genotypes in DREAM) and their casual mechanisms. By having statistical analysis and social network analysis (SNA) adopted, the main genotypes and phenotypes of the DREAM charts were identified. The results of the study showed that A2.1 (too high speed) was the key phenotype and the main genotypic process chain leading to the phenotype was "inadequate safety management → inadequate training → inadequate skills/knowledge → misjudgment of the situation → too high speed" on all types of road. For A2.1 (too high speed), C2 (misjudgment of the situation) was the dominant genotype, while N5 (inadequate safety management) was the root cause of most genotypes. This suggests that road passenger transport companies, as the responsible parties, often fail to implement or violate safety prevention and control systems. Government regulators should promote the policy system and incentivize them to fulfil their safety management responsibilities. The government should also educate the public and improve the road environment to reduce passenger-related risks and the impact of environmental factors on drivers.

Effects of deregulation of the driving licence application process on road safety in Korea: an interrupted time-series analysis

BACKGROUND

Road traffic deaths (RTDs) remain the 9th most common cause of mortality in South Korea despite their decreasing trends in high-income countries. In 2010 and 2011, the Korean government deregulated the process for obtaining a driving licence, and there has been significant concern that such deregulation of the driving licence policy could reduce road safety. This study aimed to explore the effects of the deregulation of driving licence policy on road safety by examining the incidence of road traffic collisions (RTCs), road traffic injuries (RTIs) and RTDs.

METHODS

The monthly incidence of RTCs, RTIs and RTDs was generated by using numbers of RTCs, RTIs and RTDs as numerators and numbers of registered vehicles as denominators. Changes in incidence since the deregulation implementation in February 2010 (phase I) and June 2011 (phase II) were evaluated via interrupted time-series analysis.

RESULTS

The second deregulation phase demonstrated significant changes in numbers of RTCs and RTIs: numbers of RTCs and RTIs decreased until they began to increase in November 2011. Since then, the monthly incidence of RTCs and RTIs have increased by 133.5 and 123.8 per 100 000 vehicles per month, respectively (p<0.05). RTD secular trends began to increase consecutively at rates of 0.024 (June 2010), 0.018 (between July 2010 and June 2011) and 0.273 (July 2011 onward) per 100 000 vehicles per month. Over the entire study period, the RTD incidence rate increased by 0.018 deaths per month on average subsequent to the first deregulation phase (p<0.05).

CONCLUSIONS

The deregulation policies that simplified the driving licence process were associated with increased incidence of RTCs, RTIs and RTDs in Korea.

Injuries in the vulnerable road user fatalities; a study from Sri Lanka

Vulnerable Road Users defined as people at risk in traffic due to absence of an outside protective shield to absorb energy during a collision are mainly pedestrians, bicycle riders and motor cyclists. In low income countries, deaths of VRUs outnumber vehicular drivers and occupants. A forensic pathologist not only reports the cause of death but also forms opinions on type of road user. We attempted to find whether pedestrians could be differentiated from other types of VRUs. A retrospective descriptive study, based on case records of VRUs fatalities from 2005 to 2012 referred to a tertiary care unit for post-mortem examination, was conducted. A pro-forma was developed to extract data from the post-mortem reports and toxicology reports. Data was analysed using SPSS version16. Out of the 328 cases 48% (n = 157) were pedestrians while 45% (n = 147) were riders/pillion riders of two wheeled vehicles and 5% (n = 16) were drivers/occupants of three-wheelers. The majority (87%) was males and 43% of pedestrians were elderly. 59% had 10-25 injuries and 87% had external injuries in the head, face and neck. The majority of skeletal injuries were in the skull followed by ribs. Analysis of different variables of pedestrians to other types of VRUs showed that the variables of, elderly male, road crosser, skull injuries, brain injuries, cause of death being head injuries and multiple injuries were significantly greater among pedestrian group (p: <0.001). The traffic hours (peak and off peak), number of injuries, rib injuries, limb injuries, crushed/run over injuries or lung and liver injuries had no significant association. Although some features helped in determining a pedestrian, many other factors were not associated to differentiate a pedestrian from other VRUs. Therefore, a forensic pathologist has to be cautious in expressing opinions when other corroborative evidence is lacking.

A study into blood alcohol concentration in fatal accidents among vulnerable road users in a tertiary care hospital Sri Lanka

Reckless driving behaviour associated with alcohol has been well known. In Sri Lanka, research on blood alcohol concentration (BAC) in road fatalities is scares. Thus, we studied the BAC in vulnerable road users (VRUs) encountered in medico-legal autopsies. A retrospective descriptive study based on case records of VRU fatalities from 2005 to 2012 referred for a tertiary care unit for post-mortem examination was conducted. A pro-forma was developed to extract data from the post-mortem blood alcohol reports. Data were analysed using percentages and p-values. There were 119 cases from the 328 autopsies to investigate blood alcohol tests. A total of 51% (n = 61) out of 119 had BAC above 80 mg/100 ml and mean level was 103 mg/100 ml. 2/3 of pedestrians had a BAC above 80 mg/100 ml with a mean level of 139 mg/dl. The highest mean blood alcohol (158 mg/dl) was reported from three-wheeler users. Majority of cases with more than 80 mg/100 ml BAC was reported in the age group of 40-60 years, while 40% of the elderly too had a BAC above 80 mg/100 ml. The comparison between pedestrians having above 80 mg/100 ml of BAC with that of other VRUs (active road users) showed a significant statistical difference (p = 0.017). The study results suggest that alcohol influence among pedestrians represent a significant risk factor for fatal road traffic accidents.

Under reporting of road traffic injuries in the district of Kandy, Sri Lanka

OBJECTIVES

To conduct a community survey to estimate the degree to which road traffic injuries (RTIs) are under reported and to compare the characteristics of RTI reported to the police to those not reported.

DESIGN

A cross-sectional population-based study.

SETTING

Kandy district, Sri Lanka.

PARTICIPANTS

RTIs and deaths during the preceding 12 months were identified through a community-based cross-sectional survey with a sample size of 3080 households. A stratified multistage cluster sampling with population proportion to size was used. 'Events reported' to the police were cross checked against events in the police records of the given or adjacent police stations, and either were 'Events found' or 'Not found'. 'Under reported' included those 'Not reported' and those reported but 'Not found' in the police dataset.

RESULTS

Information about 11 724 persons were obtained from 3080 households, identifying 149 persons who suffered an RTI. Of these, 57% were 'Events reported', and of these 43.6% (n=65) were 'Events found' in police records (95% CI, 36.0 to 51.6). There were 42 events 'Not reported' to police while an additional 7 were 'Not found' in the police records of the given police station. Although they were claimed to have been reported to the police, 33% (95% CI 25.8 to 40.7) were 'Under reported'. There were significant differences in age (p=0.02), family income (p<0.001), road user type (p=0.001), injury severity (p<0.001) and injury category (p=0.01) between 'Events found' in the police records and 'Under reported' events.

CONCLUSIONS

In the Kandy district, 33% of RTIs were 'under reported'. These findings could be used as evidence for policy planning to prevent RTIs, and highlights the need for a nation-wide community-based survey to determine the true rates of RTI for a better understanding of the reasons for under reporting.

Alcohol, drugs, and road traffic crashes in India: a systematic review

OBJECTIVE

India reported the highest number of road traffic crashes, related injuries, and deaths among all countries in the world, with 105,725 road traffic fatalities and 452,922 nonfatal road traffic injuries in 2007. In this report we present a systematic review of available literature on the use of psychoactive substances (alcohol and drugs) among road users, particularly those involved in road traffic crashes (RTCs).

METHODS

MEDLINE, EMBASE, Ind Medica, and several other databases were searched for reports published between 1980 and 2011 that present data on the prevalence or extent of substance use among road users in India.

RESULTS

Among the 23 studies eligible for the review, alcohol was reported by all, but only 2 mentioned the use of drugs. Most of the studies were hospital based, included injured or killed road users, and belonged to southern parts of India. Seven studies did not report any method for detecting alcohol use, whereas 7 used analytical testing, 7 used self-reporting, and 2 used observation. Utilizing the various means of verification, the studies reported that 2 to 33 percent of injured and 6 to 48 percent of killed RTC victims had consumed alcohol or drugs; only 2 mentioned drugs without specifying which types. Most studies did not distinguish between drivers, passengers, bicyclists, and pedestrians, and none investigated alcohol or drug use among those responsible for the accident.

CONCLUSION

A significant proportion of injured or killed road users in India had used alcohol before the accident. However, the existing studies cannot be used to estimate the risk of accident involvement among drunk drivers. There is a need for more rigorous research and capacity building on substance use vis-à-vis road traffic crashes.

Crashes involving motorised rickshaws in urban India: characteristics and injury patterns

INTRODUCTION

Motorised three-wheeled vehicles (motorised rickshaw) are popular in Asian countries including India. This study aims to describe the crash characteristics and injury patterns for motorised rickshaw occupants and the road users hit-by-motorised rickshaw in urban India.

METHODS

Consecutive cases of road traffic crashes involving motorised rickshaw, irrespective of injury severity, whether alive or dead, presenting to the emergency departments of two large government hospitals and three branches of a private hospital in Hyderabad city were recruited. Crash characteristics,details of injuries, injury severity parameters and outcome were documented in detailed interviews.

RESULTS

A total of 139 (18%) of the 781 participants recruited were injured as a motorised rickshaw occupant (11%) or were hit by a motorised rickshaw (7%) in 114 crashes involving motorised rickshaw. Amongst motorised rickshaw occupants, single-vehicle collisions (54%) were more frequent than multivehicle collisions (46%), with overturning of motorised rickshaw in 73% of the single-vehicle collisions.Mortality (12%), the mean Injury Severity Score (5.8) and rate of multiple injured (60%) indicated a substantial trauma load. No significant differences in injury pattern were found between motorised rickshaw occupants and hit-by-motorised rickshaw subjects, with the pattern being similar to that of the pedestrians and two-wheeled vehicle users. With bivariate analysis for motorised rickshaw occupants,the risk of fatal outcome (odds ratio (OR) 2.60, 95% confidence interval (CI): 0.64–10.54), upper limb injury (OR 2.25, 95% CI: 0.94–5.37) and multiple injuries (OR 2.03, 95% CI 0.85–4.83) was high, although not statistically significant in multi-motorised-vehicle collisions as compared with the single-vehicle collisions or overturning. The risk of having multiple injuries (OR 4.55, 95% CI: 1.15–17.95) was significantly higher in motorised rickshaw occupants involved in front collisions. Being a front-seat motorised rickshaw passenger in a vehicle collision increased the risk of having a fatal outcome (OR 7.37,95% CI: 0.83–65.66) and a Glasgow coma score 12 (OR 2.21, 95% CI: 0.49–9.89), although not significantly when compared to the back-seat passengers.

CONCLUSION

These findings can assist with planning to deal with the consequences and prevention of road traffic injuries due to crashes involving motorised rickshaw, given the high use of these and substantial morbidity of related injuries in India. The need for improved understanding of the risk characteristics of motorised rickshaw is highlighted.

[Road traffic crashes in developing countries]

Road traffic crashes pose a major threat to individuals and national health systems. Developing countries account for 48% of motorized vehicles, but for 91% of the 1.3 million fatalities per annum. While ranked ninth among the causes of disabilities adjusted life years lost in 2004, crash injuries are projected to rise to third position by 2030. This article reviews current prognoses of deaths and disabilities, the characteristics of crashes in low and middle income countries and evidence-based road safety interventions. This article is considered a wake-up call for trauma, orthopaedic, and emergency surgeons in high-income countries to join the global community in fighting the neglected yet potentially curable epidemic named road traffic injuries.

Sociodemographic factors associated with aggressive driving behaviors of 3-wheeler taxi drivers in Sri Lanka

Little is known about the nature and scope of aggressive driving in developing countries. The objective of this study is to specifically examine the sociodemographic factors associated with aggressive driving behavior among 3-wheeler taxi drivers in Sri Lanka. Convenience samples of 3-wheeler taxi drivers from Rathnapura, Ahaliyagoda, Sri Lanka were surveyed from June to August 2006. Analyses included bivariate and multivariate logistic regression. Drivers with less than high school education were 3.5 times more likely to drive aggressively (odds ratio [OR] = 3.46; 95% confidence interval [CI] = 1.08, 11.1). Single drivers were 9 times more likely to run red lights (OR = 8.74; 95% CI = 2.18, 35.0), and being single was a major risk factor for drunk driving (OR = 4.80; 95% CI = 1.23, 18.7). Furthermore, high school completers were 4 times more likely to bribe a policeman (OR = 4.27; 95% CI = 1.23, 14.9) when caught violating the road rules. Aggressive driving and risk-taking behavior are amenable to policy initiatives, and preventive programs targeted at key groups could be used to improve road safety in Sri Lanka. This study demonstrates that aggressive driving behavior is associated with sociodemographic factors, including the level of education, marital status, and other socioeconomic factors. Hence, economic factors should be addressed to find solutions to traffic-related issues. It will be the government's and policy makers' responsibility to try and understand the economic factors behind risky road behavior and bribe-taking behavior prior to legislating or enforcing new laws.