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Sadeghian Tafti MR, Ostovar A, Saeedi Moghaddam S, Shobeiri P, Ehrampoush MH, Salmani I, Khajeaminian MR, Fallahzadeh H, Dehghani Tafti A. Burden of road traffic injuries in Iran: a national and subnational perspective, 1990-2019. Inj Prev 2023; 29:101-110. [PMID: 36564169 PMCID: PMC10086501 DOI: 10.1136/ip-2022-044677] [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: 06/18/2022] [Accepted: 09/10/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Reliable and valid information on burden of road traffic injuries (RTIs) is essential for short-term and long-term planning. We designed the present study to describe the levels and trends of burden of RTIs in Iran from 1990 to 2019. METHODS This is an observational epidemiological study. We used the Global Burden of Disease (GBD) 2019 estimates to report RTIs incidence, prevalence, mortality and disability-adjusted life-years (DALYs) by sex, age group and road user category in Iran and each of the 31 provinces from 1990 to 2019. RESULTS Age-standardised incidence, prevalence, death and DALY rates of RTIs decreased by 31.7% (95% uncertainty interval (UI): 29.4 to 33.9), 34.9% (33.8 to 36.0), 57.7% (48.1 to 62.3) and 60.1% (51.7 to 65.2), respectively between 1990 and 2019. The 2019 age-standardised DALY rates varied from smallest value in Tehran 303.8 (216.9 to 667.2) per 100 000 to largest value in Sistan-Baluchistan 2286.8 (1978.1 to 2627.9) per 100 000. The burden of RTIs was mainly related to injuries sustained by drivers or passengers of motorised vehicles with three or more wheels and pedestrians' injuries, mostly affected males aged 15-29 years and individuals aged ≥70 years. CONCLUSION The reducing trend in the burden of RTIs in Iran possibly reflects the effectiveness of the intervention programmes. However, with regard to the Sustainable Development Goals the burden is still at an alarming level. Further reductions are necessary for specific road user groups such as adolescent and adult male drivers or passengers of motorised vehicles, also pedestrians aged ≥70 years.
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Affiliation(s)
- Mohammad Reza Sadeghian Tafti
- Department of Health in Disaster and Emergencies, School of public health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Parnian Shobeiri
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Ehrampoush
- Department of Environmental Health, School of public health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Ibrahim Salmani
- Department of Health in Disaster and Emergencies, School of public health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Mohammad Reza Khajeaminian
- Department of Health in Disaster and Emergencies, School of public health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Hossein Fallahzadeh
- Center for Healthcare Data Modeling, Departments of biostatistics and Epidemiology, School of public health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abbasali Dehghani Tafti
- Department of Health in Disaster and Emergencies, School of public health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
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Aliyari R, Mirrezaie SM, Kazemeini T, Sadeghian F, Fayaz Dastgerdi M, Azizi A. Effect of psychosocial interventions on risky driving behaviours among offender drivers by using simulated and real driving: study protocol for a non-randomised controlled trial. Inj Prev 2022; 29:272-279. [PMID: 36600587 DOI: 10.1136/ip-2022-044779] [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: 09/25/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Risky driving behaviour including anger while driving has led to millions of global road traffic crashes, thousands of mortalities and injuries. These losses are much more in middle-income countries, such as Iran. This paper explains methods of data collection in a controlled trial study for evaluating the effect of psychosocial interventions on risky driving by using simulated and real driving. METHODS This non-randomised controlled trial study will include 180 offender drivers. They will refer to the simulation laboratory by traffic police after their driving licences were suspended. At baseline, all participants will fill five questionnaires including demographic, Driving Anger Scale, Driving Anger Expression Scale, Spielberger's Anger and Manchester Driving Behavioural, and then they will be tested with a driving simulator. Afterwards, they will be allocated to one of three-intervention training arms (mindfulness, meta-cognition and social marketing) or a control arm without any training. Risky driving behaviours will be assessed in three follow-ups after intervention. The primary outcome of interest will be driving offences, recorded by traffic police in two time points: at 6 months and 1 year after the intervention. DISCUSSION This study examines the effect of three interventions in reducing driving offence. The results can end in a new therapeutic training or a new legislation that should be added to current obligatory training for getting driving licence and can lead to long-term safe driving among Iranian drivers. Future research is recommended to study the cost-effectiveness of these interventions in actual driving in Iran. TRIAL REGISTRATION NUMBER UMIN000039493.
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Affiliation(s)
- Roqayeh Aliyari
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Seyed Mohammad Mirrezaie
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Toktam Kazemeini
- Faculty of Educatinal Sciences and Phychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Farideh Sadeghian
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mahsa Fayaz Dastgerdi
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.,Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Alireza Azizi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
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Nassiri H, Mohammadpour SI, Dahaghin M. Forecasting time trends of fatal motor vehicle crashes in Iran using an ensemble learning algorithm. TRAFFIC INJURY PREVENTION 2022; 24:44-49. [PMID: 36278888 DOI: 10.1080/15389588.2022.2130279] [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: 03/16/2022] [Revised: 08/12/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE This study aimed to introduce the random forest (RF) method as a valuable tool for short-term crash frequency prediction. Besides, the study compares the forecast efficiency of the RF model with the classical seasonal autoregressive integrated moving average (SARIMA) model in the multivariate time-series analysis of crash counts. METHODS To this end, fatal accidents reported by the police and intercity traffic flow extracted from the loop detectors were aggregated in intercity highways at the country's level monthly from Farvardin 1395 to Mordad 1400. The first 55 data points were used as the training sample, and the remaining ten months were considered the test sample. The Box-Jenkins and random forest machine learning methods were employed for short-term crash frequency prediction. The mean absolute percentage error (MAPE) criterion was utilized to compare the forecast accuracy of the developed models. RESULTS The performance of the random forest model (MAPE = 2.6) with the exogenous variables of traffic flow, crash year, and month outperformed the best SARIMA (1,0,0) (1,0,0)12 model (MAPE = 5.7) with traffic flow as the regressor. CONCLUSIONS This study suggests that the random forest as an ensemble learning algorithm is a better crash prediction tool compared to the classical Box-Jenkins method, accounting for the non-linear dependencies in crash count time-series. Besides, the results illustrate that the multivariate SARIMA (SARIMAX) model significantly outperforms its univariate counterpart, accounting for the simultaneous impacts of exogenous variables.
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Affiliation(s)
- Habibollah Nassiri
- Department of Civil Engineering, Sharif University of Technology, Tehran, Iran
| | | | - Mohammad Dahaghin
- Department of Civil Engineering, Sharif University of Technology, Tehran, Iran
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Tupetz A, Barcenas LK, Isaacson JE, Nickenig Vissoci JR, Gerald V, Kingazi JR, Mushi I, Peter TA, Staton CA, Mmbaga BT, Bettger JP. "I Don't Do Anything; I'm Just Being Taken Care Of": Experiences of Patients and Their Caregivers Transitioning Back into the Community Following Traumatic Injury in Northern Tanzania. TRAUMA CARE 2022; 2:341-358. [PMID: 37274128 PMCID: PMC10238087 DOI: 10.3390/traumacare2020028] [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] [Indexed: 07/01/2024] Open
Abstract
After discharge from the hospital for traumatic injury, patients and their caregivers face a period of increased vulnerability. This adjustment phase is poorly characterized, especially in low- and middle-income countries. We explored the experiences of patients and their caregivers in Northern Tanzania after hospitalization for a traumatic injury. Patients who received care for traumatic injury at the Kilimanjaro Christian Medical Center and their caregivers were selected as part of a convenience sample from January 2019 to December 2019. Analysts developed a codebook; content and analytic memos were subsequently created. We then applied the biopsychosocial model to further characterize our findings. Participants included 26 patients and 11 caregivers. Patients were mostly middle-aged (mean age 37.7) males (80.8%), residing in urban settings (57.7%), injured in road traffic accidents (65.4%), and who required surgery (69.2%). Most caregivers were female. Seven major themes arose: pain, decreased physical functioning, poor emotional health, lack of support, challenges with daily activities, financial strain, and obstacles to accessing healthcare. This study describes some of the difficulties transitioning back into the community after hospitalization for traumatic injury. Our work demonstrates the importance of mixed methods approaches in characterizing and addressing transitions of care challenges.
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Affiliation(s)
- Anna Tupetz
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC 27710, USA
| | - Loren K. Barcenas
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC 27710, USA
| | | | - Joao Ricardo Nickenig Vissoci
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC 27710, USA
- Duke Global Health Institute, Duke University, Durham, NC 27710, USA
| | | | | | - Irene Mushi
- Kilimanjaro Christian Medical Center, Moshi, Tanzania
| | | | - Catherine A. Staton
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC 27710, USA
- Duke Global Health Institute, Duke University, Durham, NC 27710, USA
| | - Blandina T. Mmbaga
- Duke Global Health Institute, Duke University, Durham, NC 27710, USA
- Kilimanjaro Christian Medical Center, Moshi, Tanzania
- Paediatric and Child Health Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Clinical Trial Department, Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Janet Prvu Bettger
- Duke Global Health Institute, Duke University, Durham, NC 27710, USA
- Duke-Margolis Center for Health Policy, Duke University School of Medicine, Durham, NC 27710, USA
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, USA
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Haghdoust Z, Masoumi G, Moslehi S, Ebadi A, Khorasani Zavareh D. Design and psychometric evaluation of sociocultural scale predicting the incidence of road traffic crashes in drivers. J Inj Violence Res 2022; 14:1707. [PMID: 35277955 PMCID: PMC9805668 DOI: 10.5249/jivr.v14i3.1707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 01/15/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Various factors are involved in the occurrence of Road Traffic Crashes (RTCs), one of the most important of these are human factors that can be greatly influenced by the specific sociocultural bases of the drivers. So far, there has not been a scale for measuring Sociocultural Factors (SCFs) predicting the occurrence of RTCs in Iranian drivers. Therefore, the present study was conducted to design and to do psychometric evaluation of a scale for measuring SCFs predicting the occurrence of RTCs in drivers. METHODS This exploratory sequential mixed method was carried out in three phases. In phases 1 and 2, an initial items pool was created based on systematic literature review (phase1), and semi structured interviews (phase 2). In phase 3, the initial scales were validated using face and content validities. Then, principal component analysis and confirmatory factor analysis were performed to assess the construct validity. Finally, the reliability of the scale was evaluated by examining internal consistency and stability. RESULTS The scale content validity index was 0.92. Principal component analysis showed seven factors with 27 items, which explain 55.56% of the total variance. In confirmatory factor analysis, model fit indices were satisfactory. Discriminant analysis was also able to distinguish between two groups of accident-involved drivers and accident-free drivers (P less than 0.0001). The reliability of the scale by Cronbach's alpha, Theta, Omega and intra-class correlation coefficients was 0.82, 0.96, 3.07, and 0.80, respectively. CONCLUSIONS This scale can be used as a valid and reliable scale to evaluate the SCFs predicting the occurrence of RTCs in drivers. Furthermore, the findings of this study will be useful in identifying and planning to reduce RTCs, especially in accident-prone drivers.
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Affiliation(s)
- Zahra Haghdoust
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Masoumi
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.& Health in Disasters and Emergencies Research Center, University of Social Welfare and Rehabilitation, Tehran, Iran.& Department of Emergency Medicine, Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran. E-mail:
| | - Shandiz Moslehi
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.& Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran. Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran. E-mail:
| | - Davoud Khorasani Zavareh
- Workplace Health Promotion Research Center, Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Zakeri R, Nosratnejad S, Sadeghi-Bazargani H, Dalal K, Yousefi M. The economic burden of road traffic injuries until one-year after hospitalization: A survey study. ACCIDENT; ANALYSIS AND PREVENTION 2021; 163:106459. [PMID: 34710782 DOI: 10.1016/j.aap.2021.106459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/15/2021] [Accepted: 10/13/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Road Traffic Injuries (RTIs) are one of the most crucial and challenging public health problems in low and middle income countries. Despite continuous efforts to estimate both personal and societal costs of RTIs however, their long-term effects have remained marginal. The current study aimed to explore the economic burden of RTIs until one year after the victim's hospitalization. METHODS The study included a total of 1150 RTI victims, who were admitted to two trauma-referral hospitals during 2016. Data on direct medical costs, direct non-medical costs and indirect costs were gathered for each study sample via hospital records and phone surveys. Direct and indirect costs from a social perspective were estimated based on Micro Costing Approach followed by the Human Capital Approach. Also, the explanatory variables affecting the costs of RTIs were identified using the liner regression model. RESULTS The average amounts of direct (medical, non-medical), indirect, and total costs of RTI were estimated as 2,908 US$ (1,591 US$, 1,316 US$), 5,790 US$, and 8,701 US$ respectively. Also, several variables were significantly affecting the costs of RTIs including age, marital status, employment status, severity of injury, receiving physiotherapy care, victim's vehicle type in crash, crash time and location. CONCLUSIONS Findings suggest that RTIs are considered as an enormous burden on Iranian GDP per capita and health expenditure per capita occupying 167% and 347% respectively. This enormous economic burden caused by RTIs requires more policy regulations and prevention programs to decrease RTIs.
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Affiliation(s)
- Raana Zakeri
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shirin Nosratnejad
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | | | - Koustuv Dalal
- Department of Public Health Science, School of Health Sciences, Mid Sweden University, Sweden
| | - Mahmood Yousefi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Ranaei V, Hassani L, Jahanlou AS, Roshanaei G, Rezapur-Shahkolai F. Effect of educational intervention on safe traffic behaviors of high school male students in Iran, using the theory of planned behavior: a quasi-experimental study. BMC Public Health 2021; 21:1876. [PMID: 34663278 PMCID: PMC8524979 DOI: 10.1186/s12889-021-11943-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 10/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Behavior change interventions in tackling road traffic injuries are a public health concern. Thus, this interventional research was to survey the effect of safe traffic behaviors among male students in Hamadan, Iran, utilizing theory of planned behavior. METHODS In this quasi-experimental study, 204 students were randomly selected through multistage sampling from male high school students of Hamadan city, west-central of Iran, and non-randomly allocated to control and intervention groups (102 students in every group). The self-administrate questionnaire was used for data collection in this research. Frequency (percentage) and mean (SD) were used for description. Cronbach alpha coefficient, content validity ratio (CVR) and content validity index (CVI) were used for psychometric evaluation of questionnaire and paired/independent sample t-test was used for data analysis. All statistical analyses were done in SPSS 19 and significant level was considered 0.05. RESULTS In both groups, more than 50 % of students walked to school. The two study groups were homogeneous in terms of confounding variables (p > 0.05). The validity of the questionnaire was confirmed and the total Cronbach's alpha value was equal to 0.97. There was no significant difference in the score of safe traffic behaviors between the two groups before the intervention (p > 0.05). But after the intervention, the score in the intervention group was significantly increased (p < 0.05). Intragroup comparison also showed that only in the intervention group the score was significantly changed (p < 0.05). CONCLUSION Theory of planned behavior is a suitable conceptual framework for planning the interventions to increase safe traffic behaviors in students.
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Affiliation(s)
- Vahid Ranaei
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Laleh Hassani
- School of Health, Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Alireza Shahab Jahanlou
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ghodratollah Roshanaei
- Department of Biostatistics, School of Public Health, Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Forouzan Rezapur-Shahkolai
- Department of Public Health, School of Public Health and Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Kalantari M, Zanganeh Shahraki S, Yaghmaei B, Ghezelbash S, Ladaga G, Salvati L. Unraveling Urban Form and Collision Risk: The Spatial Distribution of Traffic Accidents in Zanjan, Iran. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094498. [PMID: 33922679 PMCID: PMC8122926 DOI: 10.3390/ijerph18094498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/09/2021] [Accepted: 04/20/2021] [Indexed: 11/16/2022]
Abstract
Official statistics demonstrate the role of traffic accidents in the increasing number of fatalities, especially in emerging countries. In recent decades, the rate of deaths and injuries caused by traffic accidents in Iran, a rapidly growing economy in the Middle East, has risen significantly with respect to that of neighboring countries. The present study illustrates an exploratory spatial analysis' framework aimed at identifying and ranking hazardous locations for traffic accidents in Zanjan, one of the most populous and dense cities in Iran. This framework quantifies the spatiotemporal association among collisions, by comparing the results of different approaches (including Kernel Density Estimation (KDE), Natural Breaks Classification (NBC), and Knox test). Based on descriptive statistics, five distance classes (2-26, 27-57, 58-105, 106-192, and 193-364 meters) were tested when predicting location of the nearest collision within the same temporal unit. The empirical results of our work demonstrate that the largest roads and intersections in Zanjan had a significantly higher frequency of traffic accidents than the other locations. A comparative analysis of distance bandwidths indicates that the first (2-26 m) class concentrated the most intense level of spatiotemporal association among traffic accidents. Prevention (or reduction) of traffic accidents may benefit from automatic identification and classification of the most risky locations in urban areas. Thanks to the larger availability of open-access datasets reporting the location and characteristics of car accidents in both advanced countries and emerging economies, our study demonstrates the potential of an integrated analysis of the level of spatiotemporal association in traffic collisions over metropolitan regions.
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Affiliation(s)
- Mohsen Kalantari
- Department of Human Geograhy and Spatial Planning, Faculty of Earth Sciences, Shahid Beheshti University, 1613778314 Tehran, Iran;
| | | | - Bamshad Yaghmaei
- Department of Remote Sensing and Geographical Information Systems, Faculty of Earth Sciences, Shahid Beheshti University, 1613778314 Tehran, Iran;
| | - Somaye Ghezelbash
- Faculty of Earth Sciences, Shahid Beheshti University, 1613778314 Tehran, Iran;
| | - Gianluca Ladaga
- Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro (INAIL), Viale Vincenzo Verrastro 3/C, I-85100 Potenza, Italy;
| | - Luca Salvati
- Department of Economics and Law, University of Macerata, Via Armaroli 43, I-62100 Macerata, Italy;
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Abstract
Background: As the world is busy addressing COVID-19, road traffic injuries, another major cause of death is continuously killing people on the roads. In Nepal, there were frequent media reports of occurrences of road crashes, injuries, and deaths despite nationwide lockdown. This paper aims to describe the situation of road traffic crashes and casualties during the period of complete lockdown. Methods: This study used secondary data from two sources: Nepal Police and media reports between 24 March and 14 June 2020 (because the government lifted the nationwide lockdown from 15 June 2020). Available details of crashes, deaths, and injuries for this period were extracted from media reports and the summary data that was obtained from the Police. We have included data from both sources in the results. Results: Nepal Police recorded 1,801 incidents of road crashes during the 82 days of the COVID-19 lockdown with 256 deaths (on average 3.1 deaths daily) and 1,824 injuries (on average 22.2 injuries daily). Motorcycles comprised over 21% of all vehicles involved in crashes. Ambulances and other vehicles for essential services were also found to be involved in crashes. Speeding itself was the cause for almost a quarter of the incidents during the lockdown. Conclusions: Although a reduction in the number of road crashes and related injuries and fatalities was observed, this reduction was not as substantial as anticipated during the heavy restrictions on vehicular movement imposed during the lockdown. Media reports were mainly found to be reporting the crashes where deaths occurred, but police records also included nonfatal injuries. The incidence of crashes in this period shows that it is important to work for road safety to save lives from road traffic crashes in Nepal.
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Affiliation(s)
- Bhagabati Sedain
- Department of Population Studies, Padma Kanya Multiple Campus, Tribhuvan University, Kathmandu, Bagmati, 44600, Nepal
| | - Puspa Raj Pant
- Centre for Academic Child Health, University of the West of England, Bristol, UK
- Nepal Injury Research Centre, Bhaktapur, Nepal
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Abstract
Background: As the world is busy addressing COVID-19, road traffic injuries, another major cause of deaths is continuously killing people on the roads. In Nepal, there were frequent media reports of occurrences of road crashes, injuries, and deaths despite nationwide lockdown. This paper aims to describe the situation of road traffic crashes and casualties during the period of complete lockdown. Methods: This study used secondary data from two sources: Nepal Police and media reports between 24 March and 14 June 2020 (because the government lifted the nationwide lockdown from 15 June 2020). Available details of crashes, deaths, and injuries for this period were extracted from media reports and the summary data that was obtained from the Police. We have included data from both sources in the results. Results: Nepal Police recorded 1,801 incidents of road crashes during the 82 days of the COVID-19 lockdown with 256 deaths (on average 3.1 deaths daily) and 1,824 injuries (on average 22.2 injuries daily). Motorcycles comprised over 21% of all vehicles involved in crashes. Ambulances and other vehicles for essential services were also found to be involved in crashes. Speeding itself was the cause for almost a quarter of the incidents during the lockdown. Conclusions: Even when the movement restrictions were imposed in Nepal, the number of road crashes was not substantially reduced. Media reports were mainly found to be reporting the crashes where deaths occurred, but police records also included nonfatal injuries. The incidence of crashes in this period shows that it is important to work for road safety to save lives from road traffic crashes in Nepal.
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Affiliation(s)
- Bhagabati Sedain
- Department of Population Studies, Padma Kanya Multiple Campus, Tribhuvan University, Kathmandu, Bagmati, 44600, Nepal
| | - Puspa Raj Pant
- Centre for Academic Child Health, University of the West of England, Bristol, UK
- Nepal Injury Research Centre, Bhaktapur, Nepal
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Ang KXM, Chandrakumara SBMD, Kon Kam King C, Loh SYJ. The Orthopedic Injury Burden of Personal Mobility Devices in Singapore - Our Experience in the East Coast. J Clin Orthop Trauma 2020; 13:66-69. [PMID: 33717878 PMCID: PMC7920089 DOI: 10.1016/j.jcot.2020.08.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE Personal mobility devices (PMDs) have become increasingly popular as a modality of transport worldwide. Starting out as novelty toys, PMDs are gradually being adopted as the mainstream mode of travel. There is an increasing number of accidents involving both PMD riders and other road users since its introduction, leading to a concomitant increase in demand for healthcare resources to manage the injuries. The main objective of this study was to evaluate the inpatient cost and the orthopedic injury pattern due to PMD accidents. METHODS All patients admitted to the Department of Orthopedic Surgery between December 2016 to February 2018 with injuries due to PMD accidents were recruited. Data collection was performed retrospectively on the demographic profiles, injury patterns, admission related outcomes and expenditures of these patients. RESULTS 43 patients were included in this study. The mean duration of admission was 7.81 days and the median cost of admission was S$7835.01 (approximately US$5620). These were comparable to accidents arising from other modes of transport, such as motorcycles and bicycles. In addition, more than 80% of patients were not wearing protective gear at time of accident. These patients had a slightly higher median cost payable per patient as compared to those who donned protective gear, with a difference of S$1669.78 (approximately US$1221). CONCLUSION There is a significant health and financial cost to the individual and society from PMD injuries and admission. This can be reduced with strict regulations on PMD use, advocating protective gear use, and promoting awareness on safety measures and the consequences of PMD accidents. The most common injury mechanism and orthopedic injury type for PMD accidents are different from motorcycle accidents.
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Ghodsi Z, Saadat S, Barzegar A, Baigi V, Rahimi-Movaghar V, Zafarghandi M, Sheikhazadi A, Salamati P. A three source capture–recapture study of fatal injuries in Iran. J Inj Violence Res 2020; 12. [PMCID: PMC7487132 DOI: 10.5249/jivr.vo112i2.1170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
Background: Well-functioning health systems and effective preventive measures require registering the exact number and valid data of fatal injuries. The present study aimed to determine the completeness of fatal injuries reported by LMO with the use of the capture-recapture method and finding the reasons for those unregistered fatal injuries in Hamedan County. Methods: This cross-sectional study was conducted in Hamadan County from 22 August 2015 to 21 August 2016. The completeness of fatal injuries reported by LMO, as the main source of fatal injuries was estimated with the employ of the capture-recapture method including Health Department and Police. Log-linear modeling was used for statistical analysis. The number of fatal injuries that probably had not been detected in any three sources was estimated by using the GENLOG command. Results: A total of 451 fatal injuries were registered in LMO for one year. The registries were included different amounts of detailed information from at least five variables in the Emergency Medical System (EMS) up to all detailed information in the LMO and Health Department. More fatal injuries occurred in males than females at all ages and the two-sex difference spectrum was wider between about 20 to 45 years old. Among cases of LMO, we found 29 unreported deaths. Therefore, the completeness of reported fatal injuries by LMO was estimated to be 86.9%. Conclusions: Fatal injuries are under-reported by the main source of this type of death in Iran. Identification of fundamental causes, integrated death registry system, and using a standard cause of death classification are needed to promote the registration of fatal injuries.
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Affiliation(s)
- Zahra Ghodsi
- a Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
,b Department of Midwifery, Tuyserkan Branch, Islamic Azad University, Tuyserkan, Iran.
| | - Soheil Saadat
- a Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Vali Baigi
- a Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Vafa Rahimi-Movaghar
- a Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Ardeshir Sheikhazadi
- d Forensic Medicine Department, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Payman Salamati
- a Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
,
Corresponding Author at:
Payman Salamati: MD, Community Medicine specialist, Sina Trauma and Surgery Research Center, Sina Hospital, Hassan Abad Sq., Imam Khomeini Ave., Tehran, Iran. Tel: +98 21 66757001-5, Fax: +98 21 66757009, E-mail: (Salamati P.). https://orcid.org/0000-0001-9313-3977
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Banstola A, Kigozi J, Barton P, Mytton J. Economic Burden of Road Traffic Injuries in Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124571. [PMID: 32630384 PMCID: PMC7345187 DOI: 10.3390/ijerph17124571] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 12/26/2022]
Abstract
The evidence of the economic burden of road traffic injuries (RTIs) in Nepal is limited. The most recent study, conducted in 2008, is now considered outdated because there has been a rapid increase in vehicle numbers and extensive road building over the last decade. This study estimated the current economic costs of RTIs in Nepal, including the direct costs, productivity costs, and valuation of pain, grief, and suffering. An incidence-based cost-of-illness analysis was conducted from a societal perspective, employing a bottom-up approach using secondary data. All costs incurred by the patients, their family members, and costs to society were estimated, with sensitivity analyses to consider uncertainty around the data estimates available. Productivity loss was valued using the human capital approach. The total costs of RTIs in 2017 were estimated at USD 122.88 million. Of these, the costs of productivity loss were USD 91.57 million (74.52%) and the pain, grief, and suffering costs were USD 18.31 million (14.90%). The direct non-medical costs were USD 11.50 million (9.36%) whereas the direct medical costs were USD 1.50 million (1.22%). The economic costs of RTIs increased by threefold since 2007 and are equivalent to 1.52% of the gross national product, indicating the growing national financial burden associated with preventable RTIs.
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Affiliation(s)
- Amrit Banstola
- Faculty of Health and Applied Sciences, University of the West of England, Bristol BS16 1QY, UK;
- Health Economics Unit, University of Birmingham, Birmingham B15 2TT, UK; (J.K.); (P.B.)
- Correspondence:
| | - Jesse Kigozi
- Health Economics Unit, University of Birmingham, Birmingham B15 2TT, UK; (J.K.); (P.B.)
| | - Pelham Barton
- Health Economics Unit, University of Birmingham, Birmingham B15 2TT, UK; (J.K.); (P.B.)
| | - Julie Mytton
- Faculty of Health and Applied Sciences, University of the West of England, Bristol BS16 1QY, UK;
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Azami-Aghdash S, Abolghasem Gorji H, Derakhshani N, Sadeghi-Bazargani H. Barriers to and Facilitators of Road Traffic Injuries Prevention in Iran; A Qualitative Study. Bull Emerg Trauma 2019; 7:390-398. [PMID: 31858002 PMCID: PMC6911722 DOI: 10.29252/beat-070408] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective: To identify the barriers to and facilitators of the prevention of road traffic accidents (RTIs) in Iran. Methods: In this qualitative study 42 key stakeholders and experts in the field of traffic injuries in Iran were selected based on purpose and theoretical sampling to reach informational saturation. Their views concerning barriers to and facilitators of the prevention of traffic injuries in Iran were studied using semi-structured interviews. Data were analyzed using Content Analysis method. Results: Five themes were identified: structural barriers, organizational barriers and planning, socio-cultural barriers, scientific barriers, and inter-sector barriers and 22 sub-themes were extracted. The lack of lead agency, which was among structural barriers, was selected as the main barrier. The five general facilitators included: sensitization of society and authorities, improving the resources and infrastructure (software and hardware), increasing the attention to safety of vehicles and roads, increasing the information and awareness, and use of expert manpower. The sensitization of society and authorities was selected as the most important facilitator. Conclusion: According to the key experts, the barriers of policy changes to prevent the RTIs are more numerous than its facilitators. Therefore, planning and paying more attention to removing these barriers and promoting the facilitators seems necessary to reduce RTIs. Having a lead agency in this regard should be the highest priority.
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Affiliation(s)
- Saber Azami-Aghdash
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hassan Abolghasem Gorji
- School of health management and information sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Naser Derakhshani
- Health management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
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Roshanfekr P, Malek Afzali Ardakani H, Sajjadi H, Khodaei-Ardakani MR. Social Differences in the Prevalence of Road Traffic Injuries among Pedestrians, and Vehicle and Motorcycle Users in Iran: Results of a National Multiple Indicator Demographic and Health Survey (IrMIDHS, 2010). Int J Prev Med 2019; 10:98. [PMID: 31360345 PMCID: PMC6592099 DOI: 10.4103/ijpvm.ijpvm_206_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 07/05/2018] [Indexed: 11/04/2022] Open
Abstract
Background Traffic injuries are considered as the most important health issues for different countries in the world, especially developing countries that are experiencing rapid social changes. The purpose of this study was to investigate the prevalence of road traffic injuries (RTIs) and its socioeconomic differences among road users in Iran as it is one of the countries with high rates of accidents in the world. The study population included all people in Iran. The target sample was 3,096 clusters consisting of 2,187 urban and 909 rural households. Methods Source of the raw data was the Iran's Multiple Indicator Demographic and Health Survey (IrMIDHS) 2010, which is a multi-stage stratified cluster-random cross-sectional study. The logistic regression has been performed for investigating the socioeconomic determinants which influence the RTIs among pedestrian, vehicle, and motorcycle users. Results The prevalence of RTIs is 13.8 (95% CI: 13.1, 14.5) per 1,000 people in the year leading up to the study. The injured groups included pedestrians (14.37%), vehicles (38.36%), motorcyclists (43.37%), and 3.9% of users injured with other vehicles. A total of 78.3% of the injured people underwent outpatient treatment or were hospitalized. The mean age in these three groups was significantly increased (27.9, 32.5, 33.4, respectively), and the proportion of men decreased (89.2, 75.2, and 60.6). Conclusions RTIs in Iran are higher than previous estimates due to consideration of non-hospitalized cases. Considering the high contribution of human factors in developing countries, these measures should prioritize vulnerable groups.
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Affiliation(s)
- Payam Roshanfekr
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hossein Malek Afzali Ardakani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Homeira Sajjadi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Hasani J, Erfanpoor S, Rajabi A, Barzegar A, Khodadoost M, Afkar M, Hashemi Nazari SS. Spatial analysis of mortality rate of pedestrian accidents in Iran during 2012-2013. TRAFFIC INJURY PREVENTION 2019; 20:636-640. [PMID: 31283359 DOI: 10.1080/15389588.2019.1628223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 06/01/2019] [Accepted: 06/02/2019] [Indexed: 06/09/2023]
Abstract
Objectives: Considering the high mortality rate of pedestrians in traffic accidents in Iran, the present study aimed to determine the high-risk and low-risk areas of accidents resulting in pedestrian deaths and the spatial analysis of their mortality rates. Methods: This cross-sectional study included 4,371 deceased pedestrians reported by the Legal Medicine Organization in Iran from March 2012 to March 2013. For spatial analysis, the collected data were entered into ArcGIS software version 10.2 and a spatial map of the mortality rate was drawn according to the distribution of data in the provinces. Using this software, high-risk and low-risk areas were identified by calculating the spatial autocorrelation of the data. The Moran's index of road accident patterns was surveyed and high-risk and low-risk points were identified using the local Getis index. Results: The age-standardized incidence rate was 6.8 per 100,000. After analyzing the data using ArcGIS software, the local Moran's index showed a cluster pattern with a high mortality rate in 3 provinces of Mazandaran, Gilan, and Qazvin. In identifying high-risk and low-risk points, the local Getis index showed 3 hot spots with a confidence interval of 99% in Qom, Qazvin, and Mazandaran and 5 hot spots with a 95% confidence interval in Markazi, Tehran, Zanjan, Gilan, and Golestan provinces. Conclusions: According to the cluster pattern of accidents in the 3 provinces and the presence of hot spots in 9 provinces, it is necessary to identify factors that increase the risk of death in the study provinces in order to reduce the mortality rate among pedestrians due to traffic accidents. Therefore, to reduce the pedestrian mortality rate, especially in high-risk provinces, some studies need to be conducted to determine the risk factors in pedestrian mortality.
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Affiliation(s)
- Jalil Hasani
- a Department of Public Health, Torbat Jam Faculty of Medical Sciences , Torbat Jam , Iran
| | - Saeed Erfanpoor
- b Social Determinants of Health Research Center, Department of Social Medicine, Faculty of Medicine, Gonabad University of Medical Sciences , Gonabad , Iran
| | - Abdolhalim Rajabi
- c Department of Biostatistics and Epidemiology, School of Health, Golestan University of Medical Sciences , Gorgan , Iran
| | | | - Mahmood Khodadoost
- e School of Traditional Medicine, Traditional Medicine and Material Medical Research Center, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Mohamad Afkar
- f Torbat Jam Faculty of Medical Sciences , Torbat Jam , Iran
| | - Seyed Saeed Hashemi Nazari
- g Safety Promotion and Injury Prevention Research Center, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences , Tehran , Iran
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HASHEMPOUR R, TAHMASEBI A, VEYSI M, AMINI M, TAVAKOLI N. Cost Analysis of Accidents according to Demographic Factors in Iran. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:1346-1353. [PMID: 31497557 PMCID: PMC6708525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND The first cause of death and disability constituting to the burden of disease in Iran has been accident and injury incidents. Young people are more at risk, these accidents have a negative effect on the national gross domestic product (GDP), on the one hand, and they increase the costs of the health system on the other hand. Therefore, this study aimed to analyze the costs and epidemiological pattern of accidents. METHODS The study variables in the first 8 months of 2016 included from Tehran Province, Iran; age, sex, how to transfer to the hospital, consequences of an accident, the injured area, and costs. Overall, 400 cases were investigated by referring to the patients' files and deriving the intended data. SPSS software used to analyze the data and statistical tests of t-test and ANOVA were applied. RESULTS Most accidents have happened in summer months of Jun, Jul and Aug. Most of the files (48%) were related to the age group of 16-30. The mean cost was 9024.82 dollar. In total, 39% of the road accidents had occurred by motorcycle and 90.8% of the patients discharged from the hospital. CONCLUSION Since about half of the traffic accidents were related to the age of 16 to 30 who were the active population of a community, therefore, any disability or death in these groups could cause an economic burden on the community and increase DALY. Thus, it appears essential to develop proper programs such as education for appropriate driving and strict rules for giving driving license to these ages.
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Affiliation(s)
- Reza HASHEMPOUR
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali TAHMASEBI
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad VEYSI
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Milad AMINI
- Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nader TAVAKOLI
- Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran,Corresponding Author:
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The Cost Analysis of Patients with Traffic Traumatic Injuries Presenting to Emergency Department; a Cross-sectional Study. ADVANCED JOURNAL OF EMERGENCY MEDICINE 2019; 3:e2. [PMID: 31172115 PMCID: PMC6548086 DOI: 10.22114/ajem.v0i0.108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction Road traffic traumatic injuries are the leading cause of death especially among young men who are mostly vulnerable victims. This catastrophe is more complicated in low to middle-income countries. Objective This study assessed the financial costs of traffic casualties in a level-1 trauma university hospital. Method One thousand trauma patients presenting to the emergency department of Shohaday-e-Tajrish Hospital were included in the study. The prehospital and hospital costs as well as the expenses of physiotherapy, rehabilitation, outpatient visits and further surgical interventions were considered as direct expenses. The costs of productivity loss were estimated as indirect expenses. Results The direct and indirect costs were assessed 27.4% and 72.6% of total, respectively. The mean age of permanent disability was 43 years old. The average expenses of temporary and permanent disabilities were 2934.4 million rials, equal to 106 thousand $ (nearly 4.2 million rials or 153 $ per patient) and 23.9 billion rials, equal to 866.3 thousand $ (1.1 billion rials or 39.2 thousand $ per person), respectively. Conclusion The national burden of traffic injuries in Iran is significantly destructive as it consists of 2.19 % of Gross Domestic Product annually. Besides, young men are involved in most of the traffic accidents representing the need to establish rigorous preventive instructions and reduce human, and financial costs.
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Root Causes of Preventable Prehospital Deaths in Road Traffic Injuries: A Systematic Review. Trauma Mon 2019. [DOI: 10.5812/traumamon.88412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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The Economic and Social Burden of Traumatic Injuries: Evidence from a Trauma Hospital in Port-au-Prince, Haiti. World J Surg 2018; 42:1639-1646. [PMID: 29164295 DOI: 10.1007/s00268-017-4360-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The cost of traumatic injury is unknown in Haiti. This study aims to examine the burden of traumatic injury of patients treated and evaluated at a trauma hospital in the capital city of Port-au-Prince. METHODS A retrospective cross-sectional chart review study was conducted at the Hospital Bernard Mevs Project Medishare for all patients evaluated for traumatic injury from December 2015 to January 2016, as described elsewhere (Zuraik and Sampalis in World J Surg, https://doi.org/10.1007/s00268-017-4088-2 , 2017). Direct medical costs were obtained from patient hospital bills. Indirect and intangible costs were calculated using the human capital approach. RESULTS A total of 410 patients were evaluated for traumatic injury during the study period. Total costs for all patients were $501,706 with a mean cost of $1224. Indirect costs represented 63% of all costs, direct medical costs 19%, and intangible costs 18%. Surgical costs accounted for the majority of direct medical costs (29%). Patients involved in road traffic accidents accounted for the largest number of injuries (41%) and the largest percentage of total costs (51%). Patients with gunshot wounds had the highest total mean costs ($1566). Mean costs by injury severity ranged from $62 for minor injuries, $1269 for serious injuries, to $13,675 for critical injuries. CONCLUSION Injuries lead to a significant economic burden for individuals treated at a semi-private trauma hospital in the capital city of Port-au-Prince, Haiti. Programs aimed at reducing injuries, particularly road traffic accidents, would likely reduce the economic burden to the nation.
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Razmara A, Aghamolaei T, Madani A, Hosseini Z, Zare S. Risky behaviors of taxi drivers in Bandar Abbas, Iran. Electron Physician 2018; 10:6588-6595. [PMID: 29881520 PMCID: PMC5984012 DOI: 10.19082/6588] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/19/2018] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND AND AIM It has been revealed that taxi drivers break more traffic rules than ordinary drivers. Such risky behaviors include stopping at prohibited areas and sudden change of direction. The present study aimed to determine the Risky Behaviors of Taxi Drivers in Bandar Abbas, Iran. METHODS In this cross-sectional study, 184 taxi drivers were randomly selected from eight taxi stations located at different parts of Bandar Abbas city in 2016. Taxi drivers' risky behaviors were evaluated via a 20-item questionnaire. Data were analyzed by SPSS version 19, using descriptive statistics and independent-samples t-test. The p-values less than 0.05 were considered as statistically significant. RESULTS The mean age of the drivers was 45.1 (±11.1) years. The mean of their occupational experience was 18.7 (±10.8) years. The risky behaviors which showed the highest frequency were respectively, failure to use signal-lights, driving too close to the cars in front, refusing to drive within the lanes and erratic lane changing.The lowest frequency belonged to running a red light, ignoring 'no entry' signs and taking illegal U-turns. Risky driving behaviors were shown to be significantly more prevalent among drivers with previous experience of crashes or tickets than drivers with no such experiences (p<0.01). CONCLUSION Increasing the role of police supervision for the strict implementation of driving laws, and modification of the drivers' behavior and implementation of periodic training programs on drivers' safety issues can be considered for reducing taxi drivers' unsafe behaviors.
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Affiliation(s)
- Asghar Razmara
- PhD by Research Student, Hormozgan Health Institute, Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Professor of Health Education, Hormozgan Health Institute, Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Abdoulhossain Madani
- Associate Professor of Epidemiology, Hormozgan Health Institute, Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zahra Hosseini
- Assistant Professor of Health Education and Promotion, Hormozgan Health Institute, Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shahram Zare
- Professor of Statistics, Department of Social Medicine, Medical School, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Saei A, Rahmani A, Ebadi A, Khankeh HR. Research Paper: Driver’s Effective Factors in Traffic Accident: A Sequential Explanatory Mixed Methods. HEALTH IN EMERGENCIES & DISASTERS QUARTERLY 2017. [DOI: 10.29252/nrip.hdq.3.1.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Bazeli J, Aryankhesal A, Khorasani-Zavareh D. Exploring the perception of aid organizations' staff about factors affecting management of mass casualty traffic incidents in Iran: a grounded theory study. Electron Physician 2017; 9:4773-4779. [PMID: 28894534 PMCID: PMC5586992 DOI: 10.19082/4773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 05/16/2017] [Indexed: 12/03/2022] Open
Abstract
Background Traffic incidents are of main health issues all around the world and cause countless deaths, heavy casualties, and considerable tangible and intangible damage. In this regard, mass casualty traffic incidents are worthy of special attention as, in addition to all losses and damage, they create challenges in the way of providing health services to the victims. Aim The present study is an attempt to explore the challenges and facilitators in management of mass casualty traffic incidents in Iran. Methods This qualitative grounded theory study was carried out with participation of 14 purposively selected experienced managers, paramedics and staff of aid organizations in different provinces of Iran in 2016. Semi-structured interviews were conducted in order to develop the theory. The transcribed interviews were analyzed through open, axial and selective coding. Results Despite the recent and relatively good improvements in facilities and management procedure of mass casualty traffic incidents in Iran, several problems such as lack of coordination, lack of centralized and integrated command system, large number of organizations participating in operations, duplicate attempts and parallel operations carried out by different organizations, intervention of lay people, and cultural factors halt provision of effective health services to the victims. Conclusion It is necessary to improve the theoretical and practical knowledge of the relief personnel and paramedics, provide public with education about first aid and improve driving culture, prohibit laypeople from intervening in aid operations, and increase quality and quantity of aid facilities.
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Affiliation(s)
- Javad Bazeli
- Ph.D. Student in Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran university of Medical Sciences, Tehran, Iran
| | - Aidin Aryankhesal
- Associate Professor, Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.,Associate Professor, Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Davoud Khorasani-Zavareh
- Associate Professor, Department of Health in Disaster and Emergency, Faculty of Safety, Health and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Post Doc Research Fellowship, Department of Clinical Sciences and Education, Karolinska Institute, Stockholm, Sweden
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Wangdi C, Gurung MS, Duba T, Wilkinson E, Tun ZM, Tripathy JP. Burden, pattern and causes of road traffic accidents in Bhutan, 2013-2014: a police record review. Int J Inj Contr Saf Promot 2017; 25:65-69. [PMID: 28691568 DOI: 10.1080/17457300.2017.1341930] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Road traffic accidents (RTAs) are a major cause of death and injury globally. There was little information on the burden and causes of RTAs in Bhutan. The study estimates the burden and characteristics of RTAs and describes the victims of RTAs in Bhutan. A descriptive cross-sectional study conducted analysing police case records. In 2013-2014, 1866 accidents resulted in 1143 injuries and 157 deaths. We identified 39% more deaths from RTAs than that submitted to WHO in 2013 as the 30-day mortality. The main causes were careless driving and drunk-driving. Drivers and passengers constituted 86% of the deaths with few pedestrian deaths. Data for in-hospital deaths or after discharge were not available. Productivity loss due to RTA is around 1% of national GDP. There is significant mortality and morbidity from RTAs in Bhutan. There is no coordinated system for data collection and surveillance to monitor SDG goal 3.6.
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Affiliation(s)
- Chador Wangdi
- a Department of Public Health, Ministry of Health , Thimphu , Bhutan
| | | | - Tashi Duba
- a Department of Public Health, Ministry of Health , Thimphu , Bhutan
| | - Ewan Wilkinson
- b Institute of Medicine, University of Chester , Chester , UK
| | - Zaw Myo Tun
- c Saw Swee Hock School of Public Health, National University of Singapore , Singapore
| | - Jaya Prasad Tripathy
- d The Union South East Asia Office, International Union Against Tuberculosis and Lung Disease , New Delhi , India
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Karimi H, Soleyman-Jahi S, Hafezi-Nejad N, Rahimi-Movaghar A, Amin-Esmaeili M, Sharifi V, Hajebi A, Saadat S, Akbari Sari A, Rahimi-Movaghar V. Direct and indirect costs of nonfatal road traffic injuries in Iran: A population-based study. TRAFFIC INJURY PREVENTION 2017; 18:393-397. [PMID: 27574963 DOI: 10.1080/15389588.2016.1211272] [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: 12/28/2015] [Accepted: 07/05/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES The objective of this study was to assess the incidence rate as well as direct and indirect costs of nonfatal road traffic injuries (RTIs) in Iran in 2011. METHODS Data from the 2011 national household survey were used. In this survey, data on demographics, history, and costs of injury were obtained in 2 steps: first, direct face-to-face interview and second, telephone calls. We estimated the incidence rate of nonfatal RTIs in this year. The direct costs included medical care as well as nonmedical costs paid by the patient or insurance services. The indirect costs were estimated by considering the cost of absence from work or education. We also used logistic regression analyses to investigate risk factors of nonfatal RTIs. RESULTS We found 76 nonfatal RTI cases (0.96%) out of 7,886 whole reference study cases. These 76 injured patients had a history of RTI in the preceding 3 months. The annual incidence of RTIs was estimated at 3.84%. The mean age of RTI cases was 28.5 ± 10.6 and 88.16% of them were male. Male gender was a major risk factor (odds ratio [OR] = 9.64, 95% confidence interval [CI], 4.79-19.41) and marriage was a protective factor (OR = 0.44, 95% CI, 0.28-0.70) for RTI. The medians of direct, indirect, and total costs were US$214, US$163, and US$387, respectively. The total cost of nonfatal RTIs in Iran was estimated at 1.29% of the gross domestic product (GDP) in 2011. CONCLUSIONS In Iran, nonfatal RTIs imposed a total cost of almost US$7 billion to the country for one year. Extension and more serious implementation of preventive measurements seem necessary to decrease this notable burden of RTIs.
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Affiliation(s)
- Hasti Karimi
- a Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences (TUMS) , Tehran , Iran
- b School of Public Health, Tehran University of Medical Sciences (TUMS) , Tehran , Iran
| | | | - Nima Hafezi-Nejad
- a Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences (TUMS) , Tehran , Iran
- b School of Public Health, Tehran University of Medical Sciences (TUMS) , Tehran , Iran
| | - Afarin Rahimi-Movaghar
- d Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences (TUMS) , Tehran , Iran
| | - Masoumeh Amin-Esmaeili
- d Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences (TUMS) , Tehran , Iran
| | - Vandad Sharifi
- e Department of Psychiatry , Tehran University of Medical Sciences (TUMS) , Tehran , Iran
| | - Ahmad Hajebi
- f Mental Health Research Centre, Tehran Psychiatric Institute, Iran University of Medical Sciences (IUMS) , Tehran , Iran
| | - Soheil Saadat
- a Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences (TUMS) , Tehran , Iran
| | - Ali Akbari Sari
- g Department of Health Management and Economics , School of Public Health, Tehran University of Medical Sciences (TUMS) , Tehran , Iran
| | - Vafa Rahimi-Movaghar
- a Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences (TUMS) , Tehran , Iran
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Epidemiology of Road Traffic Injuries in Iran: Based on the Data from Disaster Management Information System (DMIS) Of the Iranian Red Crescent. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016. [DOI: 10.5812/ircmj.38743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Spatial analysis to identify high risk areas for traffic crashes resulting in death of pedestrians in Tehran. Med J Islam Repub Iran 2016; 30:450. [PMID: 28210615 PMCID: PMC5307606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 08/16/2016] [Indexed: 12/01/2022] Open
Abstract
Background: More than 20% of deaths from traffic crashes are related to pedestrians. This figure in Tehran, the capital of Iran, reaches to 40%. This study aimed to determine the high-risk areas and spatially analyze the traffic crashes, causing death to pedestrians in Tehran. Methods: Mapping was used to display the distribution of the crashes. Determining the distribution pattern of crashes and the hot spots/ low-risk areas were done, using Moran's I index and Getis-Ord G, respectively. Results: A total of 198 crashes were studied; 92 of which, (46.4%) occurred in 2013 to 2014 and other 106 cases (63.6%) occurred in 2014 to 2015. The highest and the lowest frequency of crashes was related to January (26 cases) and June (10 cases), respectively. One hundred fifty- eight cases (79.8%) of crashes occurred in Tehran highways. Moran's index showed that the studied traffic crashes had a cluster distribution (p<0.001). Getis- Ord General G index indicated that the distribution of hot and cold spots of the studied crashes was statistically significant (p<0.001). Conclusion: The majority of traffic crashes causing death to pedestrians occurred in highways located in the main entrances and exits of Tehran. Given the important role of environmental factors in the occurrence of traffic crashes related to pedestrians, identification of these factors requires more studies with casual inferences.
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Rezaei S, Karami Matin B, Hajizadeh M. Comment on: "Economic Burden of Thalassemia Major in Iran, 2015". J Res Health Sci 2016; 16:233-234. [PMID: 28087858 PMCID: PMC7189930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 11/08/2016] [Indexed: 11/18/2022] Open
Affiliation(s)
- Satar Rezaei
- a Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Behzad Karami Matin
- a Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Mohammad Hajizadeh
- b School of Health Administration, Faculty of Health Professions, Dalhousie University, Halifax, Canada
,Correspondence to: Mohammad Hajizadeh (PhD) E-mail:
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Mohtasham-Amiri Z, Dastgiri S, Davoudi-kiakalyeh A, Imani A, Mollarahimi K. An Epidemiological Study of Road Traffic Accidents in Guilan Province, Northern Iran in 2012. Bull Emerg Trauma 2016; 4:230-235. [PMID: 27878129 PMCID: PMC5118576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 09/12/2016] [Accepted: 09/21/2016] [Indexed: 06/06/2023] Open
Abstract
OBJECTIVE To determine the epidemiological characteristics of the road traffic injuries (RTIs) in Guilan province, northern Iran. METHODS This study was a cross-sectional study which included all of RTIs admitted to medical centers of Guilan province (northern Iran) during 2012. ICD-10 was used as diagnostic criteria. Demographic variables also injury circumstance and in hospital variables such as length of stay, time of admission, type of surgery, ICU admission, final outcome and mechanism of injury, anatomical part of injury according to Abbreviated Injury Scale (AIS) classification were derives from records by trained research team. Descriptive data is reported. The predictors of mortality were also determined. RESULTS The prevalence of road traffic injuries in Guilan province was 31 in 10,000 populations. Of total 7671 accidents, 5976 (77.9%) were men and 1695 (22.1%) were women. Mean age of these victims was 33.3 ± 17.289 years (32.64±16.939 for men, 35.62±18.312 for women). Most of them (32.5%) were 20-29 years old. Motorcycle-car accidents had the highest frequency followed by car-car crashes and car accidents involving pedestrians. Most of the patients (85.9%) were hospitalized and 280 injured died (3.7%). Upper extremities were the most sites of injuries. Male sex, length of hospital stay, multiple injuries and increased age were associated with road traffic accident associated mortality. CONCLUSION RTIs cause enormous death and disability in this area and more road traffic preventive programs should be enforcement in these areas to reduce incidences RTI.
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Affiliation(s)
- Zahra Mohtasham-Amiri
- Department of Preventive and Social Medicine, Guilan Road Traffic Research Center, Guilan University of Medical Science, Rasht, Iran
| | - Saeed Dastgiri
- Department of Epidemiology, Department of Social Medicine, Tabriz University of Medical Science, Tabriz, Iran
| | - Ali Davoudi-kiakalyeh
- Department of Social Medicine, GuilanRoad Traffic Research Center, Guilan University Medical Science, Rasht, Iran
| | - Ali Imani
- Pharmaco-Economics and Pharmaceutical Management Center, Health Services Management Department, Health Services Management Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Keyvan Mollarahimi
- Department of Epidemiology, Tabriz University Medical Science, Tabriz, Iran
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Rad M, Martiniuk AL, Ansari-Moghaddam A, Mohammadi M, Rashedi F, Ghasemi A. The Pattern of Road Traffic Crashes in South East Iran. Glob J Health Sci 2016; 8:51677. [PMID: 27157159 PMCID: PMC5064071 DOI: 10.5539/gjhs.v8n9p149] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 08/19/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In the present study, the epidemiologic aspects of road traffic crashes in South East of Iran are described. METHODS This cross-sectional study included the profile of 2398 motor vehicle crashes recorded in the police office in one Year in South East of Iran. Data collected included: demographics, the type of crash, type of involved vehicle, location of crash and factors contributing to the crash. Descriptive statistics were used for data analysis. RESULTS Collisions with other vehicles or objects contributed the highest proportion (62.4%) of motor vehicle crashes. Human factors including careless driving, violating traffic laws, speeding, and sleep deprivation/fatigue were the most important causal factors accounting for 90% of road crashes. Data shows that 41% of drivers were not using a seat belt at the time of crash. One- third of the crashes resulted in injury (25%) or death (5%). CONCLUSIONS Reckless driving such as speeding and violation of traffic laws are major risk factors for crashes in the South East of Iran. This highlights the need for education along with traffic law enforcement to reduce motor vehicle crashes in future.
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Affiliation(s)
- Mahdieh Rad
- Zahedan University of Medical Sciences, Zahedan, Iran..
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Sadeghi-Bazargani H, Ayubi E, Azami-Aghdash S, Abedi L, Zemestani A, Amanati L, Moosazadeh M, Syedi N, Safiri S. Epidemiological Patterns of Road Traffic Crashes During the Last Two Decades in Iran: A Review of the Literature from 1996 to 2014. ARCHIVES OF TRAUMA RESEARCH 2016; 5:e32985. [PMID: 27800461 PMCID: PMC5078874 DOI: 10.5812/atr.32985] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 01/21/2016] [Accepted: 01/30/2016] [Indexed: 11/23/2022]
Abstract
Context Despite considerable attention given to health statistics of road traffic crashes (RTCs), the epidemiological aspects of injuries resulting from RTCs are not fully understood in Iran and other developing countries. The aim of this review was to study the epidemiological pattern and issues arising due to RTCs in Iran. Evidence Acquisition The scope of this study involves data from a broad range of published literature on RTCs in Iran. Data collection for this study was conducted by searching for keywords such as traffic accidents, traffic crashes, motorcycle accidents, motorcycle crashes, motorcycle injury, motor vehicle injury, motor vehicle crashes and motor vehicle accidents, Iran and Iranian in various databases such as Embase, PubMed, Google Scholar, Scopus, Magiran, Iranian scientific information database (SID) and IranMedex. Results This study comprised of 95 articles. It is evident from this review that a large number of severe RTCs occur due to collision of two or more vehicles and most of the victims are males aged between 30 and 39 years. Male pedestrian, drivers and passengers are more likely to be severely injured in comparison to females. One of the most prevalent causes of death among adults involved in the RTCs are head injuries and the majority of deaths occur prior to hospitalization. Mortality rates for RTCs are higher in summer, especially during midnight among all age groups. The most common individual and environmental risk factors associated with RTCs include lack of attention, getting trapped in the car, listening to music, fatigue and sleepiness, duration and distance and negligence of seatbelt usage while driving. Conclusions The findings of the current study will be beneficial in prevention of RTCs and its associated complications and hence will be vital for policy makers, health service managers and stakeholders.
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Affiliation(s)
- Homayoun Sadeghi-Bazargani
- Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Erfan Ayubi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Saber Azami-Aghdash
- Department of Health Services Management, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Leila Abedi
- Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Alireza Zemestani
- Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Louiz Amanati
- Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Naeema Syedi
- School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - Saeid Safiri
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, IR Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Saeid Safiri, Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, IR Iran., E-mail:
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Bahadori M, Ghardashi F, Izadi AR, Ravangard R, Mirhashemi S, Hosseini SM. Pre-Hospital Emergency in Iran: A Systematic Review. Trauma Mon 2016; 21:e31382. [PMID: 27626016 PMCID: PMC5003496 DOI: 10.5812/traumamon.31382] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 12/15/2015] [Accepted: 02/07/2016] [Indexed: 11/26/2022] Open
Abstract
CONTEXT Pre-hospital care plays a vital role in saving trauma patients. OBJECTIVES This study aims to review studies conducted on the pre-hospital emergency status in Iran. DATA SOURCES Data were sourced from Iranian electronic databases, including SID, IranMedex, IranDoc, Magiran, and non-Iranian electronic databases, such as Medline, Embase, Cochrane Library, Scopus, and Google Scholar. In addition, available data and statistics for the country were used. DATA SELECTION All Persian-language articles published in Iranian scientific journals and related English-language articles published in Iranian and non-Iranian journals indexed on valid sites for September 2005 - 2014 were systematically reviewed. DATA EXTRACTION To review the selected articles, a data extraction form developed by the researchers as per the study's objective was adopted. The articles were examined under two categories: structure and function of pre-hospital emergency. RESULTS A total of 19 articles were selected, including six descriptive studies (42%), four descriptive-analytical studies (21%), five review articles (16%), two qualitative studies (10.5%), and two interventional (experimental) studies (10.5%). In addition, of these, 14 articles (73.5%) had been published in the English language. The focus of these selected articles were experts (31.5%), bases of emergency medical services (26%), injured (16%), data reviews (16%), and employees (10.5%). A majority of the studies (68%) investigated pre-hospital emergency functions and 32% reviewed the pre-hospital emergency structure. CONCLUSIONS The number of studies conducted on pre-hospital emergency services in Iran is limited. To promote public health, consideration of prevention areas, processes to provide pre-hospital emergency services, policymaking, foresight, systemic view, comprehensive research programs and roadmaps, and assessments of research needs in pre-hospital emergency seem necessary.
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Affiliation(s)
- Mohammadkarim Bahadori
- Health Management Research Centre, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Fatemeh Ghardashi
- Health Management Research Centre, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Ahmad Reza Izadi
- Health Management Research Centre, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Ramin Ravangard
- School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Sedigheh Mirhashemi
- Trauma Research Centre, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Seyed Mojtaba Hosseini
- Department of Health Services Management, Tehran North Branch, Islamic Azad University, Tehran, IR Iran
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Mohammadi A, Ahmadi M, Gharagozlu A. Developing a Minimum Data Set for an Information Management System to Study Traffic Accidents in Iran. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e23677. [PMID: 27247791 PMCID: PMC4884271 DOI: 10.5812/ircmj.23677] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 10/03/2014] [Accepted: 10/22/2014] [Indexed: 11/16/2022]
Abstract
Background: Each year, around 1.2 million people die in the road traffic incidents. Reducing traffic accidents requires an exact understanding of the risk factors associated with traffic patterns and behaviors. Properly analyzing these factors calls for a comprehensive system for collecting and processing accident data. Objectives: The aim of this study was to develop a minimum data set (MDS) for an information management system to study traffic accidents in Iran. Materials and Methods: This descriptive, cross-sectional study was performed in 2014. Data were collected from the traffic police, trauma centers, medical emergency centers, and via the internet. The investigated resources for this study were forms, databases, and documents retrieved from the internet. Forms and databases were identical, and one sample of each was evaluated. The related internet-sourced data were evaluated in their entirety. Data were collected using three checklists. In order to arrive at a consensus about the data elements, the decision Delphi technique was applied using questionnaires. The content validity and reliability of the questionnaires were assessed by experts’ opinions and the test-retest method, respectively. Results: An (MDS) of a traffic accident information management system was assigned to three sections: a minimum data set for traffic police with six classes, including 118 data elements; a trauma center with five data classes, including 57 data elements; and a medical emergency center, with 11 classes, including 64 data elements. Conclusions: Planning for the prevention of traffic accidents requires standardized data. As the foundation for crash prevention efforts, existing standard data infrastructures present policymakers and government officials with a great opportunity to strengthen and integrate existing accident information systems to better track road traffic injuries and fatalities.
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Affiliation(s)
- Ali Mohammadi
- Department of Health Information Technology, Paramedical School, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
| | - Maryam Ahmadi
- Department of Health Information Management, School of Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Maryam Ahmadi, Department of Health Information Management, School of Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188794302, Fax: +98-2188883334, E-mail:
| | - Alireza Gharagozlu
- Geomatics College of National Cartographic Center of Iran, Tehran, IR Iran
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Boniface R, Museru L, Kiloloma O, Munthali V. Factors associated with road traffic injuries in Tanzania. Pan Afr Med J 2016; 23:46. [PMID: 27217872 PMCID: PMC4862800 DOI: 10.11604/pamj.2016.23.46.7487] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 02/07/2016] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Injuries represent a significant cause of morbidity and mortality worldwide and road traffic crashes accounts for a significant proportion of these injuries. Tanzania is among the countries with high rates of road traffic crashes. The aim of this study was to determine the pattern, associated factors and management of road traffic injury patients in Tanzania. METHODS A cross-sectional study of patients involved in motor traffic crashes and attended in six public hospitals of Tanzania mainland between April 2014 and September 2014. RESULTS A total of 4675 road traffic injury patients were seen in studied hospitals, 76.6% were males. Majority (70.2%) were between 18 - 45 years age group. Motorcycles were the leading cause of road traffic crashes (53.4%), and drivers (38.3%) accounted for majority of victims. Fractures accounted for 34.1%, and injuries were severe in 2.2% as determined by the Kampala trauma score II (KTS II). Majorities 57.4% were admitted and 2.2% died at the casualty. Factors associated with mortality were; using police vehicles to hospital (P = 0.000), receiving medical attention within 2 to 10 hours after injury (P = 0.000), 18 - 45 years age group (P = 0.019), not using helmet (P = 0.007), severe injuries (P = 0.000) and sustaining multiple injury (P = 0.000). CONCLUSION Road traffic Injuries in Tanzania are an important public health problem, predominantly in adult males, mostly due to motorcycle crashes. It is therefore important to reinforce preventive measures and pre-hospital emergency service is urgently needed.
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Affiliation(s)
- Respicious Boniface
- Muhimbili Orthopaedic Institute (MOI), Dar es Salaam, Tanzania; Injury Control Centre Tanzania (ICCT); Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Lawrence Museru
- Injury Control Centre Tanzania (ICCT); University of Dar es Salaam, School of Health Sciences, Dar es Salaam, Tanzania
| | - Othman Kiloloma
- Muhimbili Orthopaedic Institute (MOI), Dar es Salaam, Tanzania; Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Victoria Munthali
- Muhimbili Orthopaedic Institute (MOI), Dar es Salaam, Tanzania; Injury Control Centre Tanzania (ICCT)
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Sargazi A, Sargazi A, Nadakkavukaran Jim PK, Danesh H, Aval F, Kiani Z, Lashkarinia A, Sepehri Z. Economic Burden of Road Traffic Accidents; Report from a Single Center from South Eastern Iran. Bull Emerg Trauma 2016; 4:43-47. [PMID: 27162926 PMCID: PMC4779469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 11/13/2015] [Accepted: 12/28/2015] [Indexed: 06/05/2023] Open
Abstract
OBJECTIVE To determine the economic burden of road traffic accidents (RTAs) in patients admitted to a single center in south eastern Iran. METHODS This cross-sectional study was conducted in Amir-Al-Momenin hospital of Zabol affiliated with Zabol University of Medical Sciences during a 12-month period from April 2012 to April 2013. All the RTAs patients who were admitted to our emergency department were included. The direct expenses of hospital care were recorded according to their medical charts and the accountant registration information. Data are presented according to different RTAs characteristics. RESULTS Overall 1155 patients were included in the current study with mean age of 36.7 ± 5.14 years among whom there were 673(58.3%) men and 482 (41.7%) women. The annual incidence of RTAs were calculated to be 288 per 100,000 population. The RTAs economic burden in our center was 589,448.49 USD which accounted for 10.4% of total hospital expenses during the study period. The money spend on RTAs in our center was 130 times more than gross national income per capita. Cost of each patient in road traffic was 15 times more than cost of an average patient of the hospital in other sections. CONCLUSION With considerable high ratio of accidents in Zabol, proper intervention is needed for controlling and preventing RTAs in order to decrease its injuries, impact and the associated economic burden.
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Affiliation(s)
- Aliyeh Sargazi
- Medical Student, Zabol University of Medical Sciences, Zabol, Iran
| | - Atefeh Sargazi
- Civil Engineering Student, Sistan and Baloochestan University, Zahedan, Iran
| | | | | | | | - Zohre Kiani
- Medical Student, Kerman University of Medical Sciences, Kerman, Iran
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Hashemiparast M, Montazeri A, Nedjat S, Negarandeh R, Sadeghi R, Hosseini M, Garmaroudi G. Pedestrian Road-Crossing Behaviours: A Protocol for an Explanatory Mixed Methods Study. Glob J Health Sci 2015; 8:27-32. [PMID: 26652086 PMCID: PMC4877220 DOI: 10.5539/gjhs.v8n5p27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 07/25/2015] [Accepted: 08/23/2015] [Indexed: 11/14/2022] Open
Abstract
Background: Pedestrian crossing is an important traffic safety concern. The aim of this paper is to report the protocol for a sequential explanatory mixed methods study that set out to determine the pedestrians’ traffic behaviors, the associated factors and exploring the perception of young people about the traffic risky behaviors in crossing the road. The ultimate purpose of the study is to design a preventive and cultural based strategy to promote young people’s health. Methods: This is a sequential explanatory mixed methods design. The study has two sequential phases. During the first phase, a population-based cross-sectional survey of a sample of young people will be conducted using the proportional random multistage cluster sampling method, in Tehran, Iran. Data will be collected by a questionnaire including items on socio-demographic information, items on measuring social conformity tendency, and questions on subjective norms, attitudes, and perceived behavioral control based on the Theory of Planned behavior. In the second phase, a qualitative study will be conducted. A purposeful sampling strategy will be used and participants who can help to explain the quantitative findings will be selected. Data collection in qualitative phase will be predominately by individual in-depth interviews. A qualitative content analysis approach will be undertaken to develop a detailed understanding of the traffic risky behaviors among young pedestrians. Conclusion: The findings of this explanatory mixed methods study will provide information on traffic risky behaviors in young pedestrians. The findings will be implemented to design a cultural based strategy and intervention programs.
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Karim H, Mohammadi M, Bazargan-Hejazi S, Ahmadi A. Removing the economic burden of road traffic injuries from patients: a successful model. J Inj Violence Res 2015; 7:95-6. [PMID: 25836741 PMCID: PMC4522323 DOI: 10.5249/jivr.v7i2.744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 04/02/2015] [Indexed: 11/06/2022] Open
Affiliation(s)
| | | | | | - Alireza Ahmadi
- Department of Anesthesiology, Critical Care and Pain Management, Imam Reza Hospital, Kermanshah University of Medical Science, Kermanshah, Iran. E-mail:
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Kavosi Z, Jafari A, Hatam N, Enaami M. The economic burden of traumatic brain injury due to fatal traffic accidents in shahid rajaei trauma hospital, shiraz, iran. ARCHIVES OF TRAUMA RESEARCH 2015; 4:e22594. [PMID: 25834791 PMCID: PMC4377539 DOI: 10.5812/atr.22594] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 02/13/2015] [Accepted: 02/17/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Traumatic Brain Injuries (TBIs) as a result of traffic accidents are one of the major causes of deaths, which lead to the loss of individuals' productive and working years of life. OBJECTIVES This study aimed to calculate the economic burden of traumatic brain injuries in fatal crashes at Shahid Rajaei Trauma Hospital, Shiraz, Iran for a period of five years. PATIENTS AND METHODS In this descriptive, cross-sectional study the population included people who had died as a result of TBIs during 2009 to 2013 in Shiraz Shahid Rajaei Trauma Hospital. Cost and demographic data were obtained from the participants' medical records using data gathering forms, and some other information was also collected via telephone calls to the victims' families. Economic burden of TBIs due to traffic accidents, which led to death, was estimated using the human capital as direct costs of treatment, and the number of potential years of life lost and lost productivity as indirect costs. RESULTS Deaths resulting from TBIs due to traffic accidents in Shiraz imposed 6.2 billion Rials (511000 USD) of hospital costs, 6390 potential years of life lost, and 506 billion Rials (20 million USD) of productivity lost. In the present study, the mean age of the individuals who died was 38.4 ± 19.41 and the productivity lost per capita was 1.8 billion Rials (73000 USD). CONCLUSIONS The findings of this study indicated that the economic burden of TBIs was high in fatal accidents in Fars Province so that it was equivalent to 0.00011% of Iran's Gross Domestic Product (GDP) in 2013. Therefore, more attention has to be paid to the rules to prevent the fatal accidents.
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Affiliation(s)
- Zahra Kavosi
- Social Determinants of Health Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Abdosaleh Jafari
- Health Economics Department, School of Management and Medical Information, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Nahid Hatam
- School of Management and Medical Information, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Meysam Enaami
- Student Research Committee, School of Management and Medical Information, Shiraz University of Medical Sciences, Shiraz, IR Iran
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