1
|
Seif M, Edalat S, Majidpour Azad Shirazi A, Alipouri S, Bayati M. Prediction of the burden of road traffic injuries in Iran by 2030: Prevalence, death, and disability-adjusted life years. Chin J Traumatol 2024:S1008-1275(24)00010-5. [PMID: 38503589 DOI: 10.1016/j.cjtee.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/14/2024] [Accepted: 02/10/2024] [Indexed: 03/21/2024] Open
Abstract
PURPOSE Road traffic accidents pose a global challenge with substantial human and economic costs globally. Iran experiences a high incidence of road traffic injuries, leading to a significant burden on society. This study aims to predict the future burden of road traffic injuries in Iran until 2030, providing valuable insights for policy-making and interventions to improve road safety and reduce the associated human and economic costs. METHODS This analytical study utilized time series models, specifically autoregressive integrated moving average (ARIMA) and artificial neural networks (ANNs), to predict the burden of road traffic accidents by analyzing past data to identify patterns and trends in Iran until 2030. The required data related to prevalence, death, and disability-adjusted life years (DALYs) rates were collected from the Institute for Health Metrics and Evaluation database and analyzed using R software and relevant modeling and statistical analysis packages. RESULTS Both prediction models, ARIMA and ANNs indicate that the prevalence rates (per 100,000) of all road traffic injuries, except for motorcyclist road injuries which have an almost flat trend, remaining at around 430, increase by 2030. Based on estimations of both models, the rates of death and DALYs due to motor vehicle and pedestrian road traffic injuries decrease. For motor vehicle road injuries, estimated trends decrease to approximately 520 DALYs and 10 deaths. Also, for pedestrian road injuries these rates reached approximately 300 DALYs and 6 deaths, according to the models. For cyclists and other road traffic injuries, the predicted DALY rates by the ANN model increase to almost 50 and 8, while predictions conducted by the ARIMA model show a static trend, remaining at 40 and approximately 6.5. Moreover, these rates for the prediction of death rate by the ANN model increased to 0.6 and 0.1, while predictions conducted by the ARIMA model show a static trend, remaining at 0.43 and 0.07. According to the ANN model, the predicted rates of DALY and death for motorcyclists decrease to 100 and approximately 2.7, respectively. On the other hand, predictions made by the ARIMA model show a static trend, with rates remaining at 200 and approximately 3.2, respectively. CONCLUSION The prevalence of road traffic injuries is predicted to increase, while the death and DALY rates of road traffic injuries show different patterns. Effective intervention programs and safety measures are necessary to prevent and reduce road traffic accidents. Different interventions should be designed and implemented specifically for different groups of pedestrians, cyclists, motorcyclists, and motor vehicle drivers.
Collapse
Affiliation(s)
- Mozhgan Seif
- Non-communicable Diseases Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedigheh Edalat
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Majidpour Azad Shirazi
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Somayeh Alipouri
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Bayati
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
2
|
Stevenson M, Mortimer D, Meuleners L, Harris A, Senserrick T, Thompson J, De Silva A, Barrera-Jimenez H, Streatfield A, Perera M. FEEDBACK trial - A randomised control trial to investigate the effect of personalised feedback and financial incentives on reducing the incidence of road crashes. BMC Public Health 2023; 23:2035. [PMID: 37853342 PMCID: PMC10585737 DOI: 10.1186/s12889-023-16886-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/03/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Road crashes continue to pose a significant threat to global health. Young drivers aged between 18 and 25 are over-represented in road injury and fatality statistics, especially the first six months after obtaining their license. This study is the first multi-centre two-arm parallel-group individually randomised controlled trial (the FEEDBACK Trial) that will examine whether the delivery of personalised driver feedback plus financial incentives is superior to no feedback and no financial incentives in reducing motor vehicle crashes among young drivers (18 to 20 years) during the first year of provisional licensing. METHODS A total of 3,610 young drivers on their provisional licence (P1, the first-year provisional licensing) will participate in the trial over 28 weeks, including a 4-week baseline, 20-week intervention and 4-week post-intervention period. The primary outcome of the study will be police-reported crashes over the 20-week intervention period and the 4-week post-intervention period. Secondary outcomes include driving behaviours such as speeding and harsh braking that contribute to road crashes, which will be attained weekly from mobile telematics delivered to a smartphone app. DISCUSSION Assuming a positive finding associated with personalised driver feedback and financial incentives in reducing road crashes among young drivers, the study will provide important evidence to support policymakers in introducing the intervention(s) as a key strategy to mitigate the risks associated with the burden of road injury among this vulnerable population. TRIAL REGISTRATION Registered under the Australian New Zealand Clinical Trials Registry (ANZCTR) - ACTRN12623000387628p on April 17, 2023.
Collapse
Affiliation(s)
- Mark Stevenson
- Transport, Health and Urban Systems Research Lab, Melbourne School of Design, University of Melbourne, Melbourne, Australia.
- Faculty of Engineering and IT, University of Melbourne, Melbourne, Australia.
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | - Duncan Mortimer
- Centre for Health Economics, Monash University, Clayton, Australia
| | - Lynn Meuleners
- Western Australian Centre for Road Safety Research, School of Psychological Science, University of Western Australia, Perth, Australia
| | - Anthony Harris
- Centre for Health Economics, Monash University, Clayton, Australia
| | - Teresa Senserrick
- Western Australian Centre for Road Safety Research, School of Psychological Science, University of Western Australia, Perth, Australia
| | - Jason Thompson
- Transport, Health and Urban Systems Research Lab, Melbourne School of Design, University of Melbourne, Melbourne, Australia
| | - Anurika De Silva
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Methods and Implementation Support for Clinical and Health (MISCH) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Humberto Barrera-Jimenez
- Transport, Health and Urban Systems Research Lab, Melbourne School of Design, University of Melbourne, Melbourne, Australia
- Faculty of Engineering and IT, University of Melbourne, Melbourne, Australia
| | - Avita Streatfield
- Transport, Health and Urban Systems Research Lab, Melbourne School of Design, University of Melbourne, Melbourne, Australia
| | - Maneesha Perera
- Transport, Health and Urban Systems Research Lab, Melbourne School of Design, University of Melbourne, Melbourne, Australia
- Faculty of Engineering and IT, University of Melbourne, Melbourne, Australia
| |
Collapse
|
3
|
Borges G, Orozco R, Hernández-Becerril Z, Ortega BE, Flores J, Benitez-King G, Flores-Alcantar G, Escamilla-Nuñez A, Scherer JN. Alcohol, drugs, and road traffic injuries in an emergency department in Mexico City. Injury 2023; 54:481-9. [PMID: 36588032 DOI: 10.1016/j.injury.2022.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 12/15/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
There have been no studies reporting on the use of biological specimens in Mexico to analyze the prevalence of alcohol and drug use among Emergency Department (ED) patients with a road traffic injury (RTI). We report here on a sample of 304 adult patients, admitted to the ED of a public hospital in Mexico City from January to April 2022, after being involved in an RTI. Patients gave informed consent for a breath test measuring breath alcohol concentration (BAC) and a saliva screening test for six classes of drugs (amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, and methamphetamine). We found that at least one in every four patients (27.6%) had traces of alcohol or drugs in their body upon arrival in the ED. The breath test found a positive BAC in 16.1% of the sample; the most common substances detected in saliva were amphetamines or methamphetamine (8.6%), followed by cocaine (7.0%) and cannabis (6.9%). Only a few variables differentiated those with positive BAC from those with negative BAC (male, arriving on a weekend day or night, and arriving by ambulance), and even fewer variables differentiated those testing positives for drugs than those testing negative (less than 13 years of education and drivers of cars, bicycles, or other vehicles). While alcohol continues to be the single most used substance, our findings indicate that stimulants are of great concern. Since those testing positives for alcohol or drugs are so similar in their demographic pattern to those testing negative, the introduction of biological testing as a routine practice in the ED is highly recommended. Routine testing makes it possible to provide the patient with the best treatment and is also the best way to assess substance use.
Collapse
|
4
|
Schwartz N, Buliung R, Daniel A, Rothman L. Disability and pedestrian road traffic injury: A scoping review. Health Place 2022; 77:102896. [PMID: 36037674 DOI: 10.1016/j.healthplace.2022.102896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 11/17/2022]
Abstract
Disability and ableism remain a nascent area of inquiry in road traffic injury research. A scoping review of academic literature was conducted to understand the state of knowledge on disability and pedestrian-motor vehicle collisions. Sixty-two eligible articles were identified and included. A significantly higher risk of pedestrian collisions, injuries, and fatalities was consistently found among disabled people. Risk factors included individualized factors such as walking speed and crossing decisions of disabled people. The roles of social/political environments in injury risk were less commonly explored. More research is needed to assess how inaccessible or disabling environments may produce elevated risk of pedestrian injury among disabled populations.
Collapse
Affiliation(s)
- Naomi Schwartz
- School of Occupational and Public Health, Ryerson University, 350 Victoria St, Toronto, ON, M5B 2K3, Canada.
| | - Ron Buliung
- Department of Geography and Planning, University of Toronto Mississauga, Davis Building, 1867 Inner Circle, Mississauga, ON, L5L 1C6, Canada
| | - Arslan Daniel
- Department of Geography and Planning, University of Toronto Mississauga, Davis Building, 1867 Inner Circle, Mississauga, ON, L5L 1C6, Canada
| | - Linda Rothman
- School of Occupational and Public Health, Ryerson University, 350 Victoria St, Toronto, ON, M5B 2K3, Canada; Child Health Evaluative Sciences, SickKids Research Institute, 686 Bay St, Toronto, ON, M5G 0A4, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada
| |
Collapse
|
5
|
Schoeters A, Large M, Koning M, Carnis L, Daniels S, Mignot D, Urmeew R, Wijnen W, Bijleveld F, van der Horst M. Economic valuation of preventing fatal and serious road injuries. Results of a Willingness-To-Pay study in four European countries. Accid Anal Prev 2022; 173:106705. [PMID: 35613526 DOI: 10.1016/j.aap.2022.106705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/03/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
This paper presents the results of a stated choice study for estimating the Willingness-To-Pay of respondents in four European countries (Belgium, France, Germany and the Netherlands) to reduce the risk of fatal and serious injuries in road crashes. Respondents were confronted with hypothetical route choices that differ in respect of travel costs, travel time and crash risk. The survey was completed by 8,002 respondents, equally spread over the four participating countries and representative for each country with regards to gender, age and region. Possible biases caused by problematic choice behaviour such as inconsistent, irrational or lexicographic answers were addressed. The resulting values were estimated by means of a mixed logit model allowing to account for the panel nature of the data. The Value of a Statistical Life (VSL) was estimated at 6.2 Mill EUR, the Value of a Statistical Serious Injury (VSSI) at 950,000 EUR, and the Value of Time (VoT) at 16.1 EUR/h. Consequently, the relative value of avoiding a fatal injury is estimated to be around 7 times higher than the value of an avoided serious injury. The study revealed differences between countries with France showing values that are significantly lower than the average and Germany showing values that are significantly higher. The estimated VSL values are considerably higher than the values currently used in the four countries, but they are within the range of values found in similar stated choice studies. The results can be used as an input in a broad range of socioeconomic studies including cost-benefit analysis and assessments of socioeconomic costs of road crashes.
Collapse
Affiliation(s)
- Annelies Schoeters
- Vias Institute Chaussée de Haecht, Haachtsesteenweg 1405, 1130 Brussels, Belgium.
| | - Maxime Large
- Université Gustave Eiffel, Campus de Lyon Cité des Mobilités 25, Avenue François Mitterrand, Case24, F-69675 Bron Cedex, France
| | - Martin Koning
- Université Gustave Eiffel, Campus de Lyon Cité des Mobilités 25, Avenue François Mitterrand, Case24, F-69675 Bron Cedex, France
| | - Laurent Carnis
- Université Gustave Eiffel, Campus de Marne-la-Vallée 5 Boulevard Descartes, Champs-sur-Marne, F-77454 Marne-la-Vallée Cedex 2, France.
| | - Stijn Daniels
- Vias Institute Chaussée de Haecht, Haachtsesteenweg 1405, 1130 Brussels, Belgium
| | - Dominique Mignot
- Université Gustave Eiffel, Campus de Lyon Cité des Mobilités 25, Avenue François Mitterrand, Case24, F-69675 Bron Cedex, France
| | - Raschid Urmeew
- Federal Highway Research Institute (BASt), Brüderstrasse 53, 51427 Bergisch Gladbach, Germany
| | - Wim Wijnen
- W2Economics Verlengde Hoogravenseweg 274, 3523 KJ, Utrecht, The Netherlands
| | - Frits Bijleveld
- SWOV Institute for Road Safety Research Bezuidenhoutseweg 62 2594 AW Den Haag, The Netherlands.
| | - Martijn van der Horst
- KiM Netherlands Institute for Transport Policy Analysis, Bezuidenhoutseweg 20, 2596 AV The Hague, The Netherlands.
| |
Collapse
|
6
|
Cullen P, Möller H, Woodward M, Senserrick T, Boufous S, Rogers K, Brown J, Ivers R. Are there sex differences in crash and crash-related injury between men and women? A 13-year cohort study of young drivers in Australia. SSM Popul Health 2021; 14:100816. [PMID: 34041353 PMCID: PMC8141461 DOI: 10.1016/j.ssmph.2021.100816] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/19/2021] [Accepted: 05/06/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Young men have long been known to be disproportionately impacted by road crash and crash-related injury compared to young women and older drivers. However, there is limited insight into how sex differences in crash and crash-related injury changes over time as men and women get older and gain more driving experience. To explore sex differences in crash and crash-related injury, we undertook a sex disaggregated analysis in a large longitudinal cohort of over 20,000 young drivers in New South Wales, Australia, for up to 13 years after they first attained their independent car driver licence. METHODS DRIVE Study survey data from 2003-04 were linked with police, hospital and deaths data up to 2016. Sex differences were analysed using cumulative incidence curves investigating time to first crash and in negative binominal regression models adjusted for driver demographics and crash risk factors. RESULTS After adjusting for demographics and driving exposure, compared with women, men had 1.25 (95% CI 1.18-1.33), 2.07 (1.75-2.45), 1.28 (95% CI 1.13-1.46), 1.32 (95% CI 1.17-1.50) and 1.59 (95% CI 1.43-1.78) times higher rates of any crash, single vehicle crash, crash on streets with a speed limit of 80 km/h or above, crash in wet conditions and crash in the dark, respectively. By contrast, men were less likely to be involved in crashes that resulted in hospitalisation compared to women 0.73 (95% CI 0.55-0.96). CONCLUSIONS Young men are at increased risk of crash, and this risk persists as they get older and gain more driving experience. Despite lower risk of crash, women are at higher risk of crash related injury requiring hospitalisation. These differences in men's and women's risk of crash and injury signal the need for better understanding of how sex and/or gender may contribute to risk of crash and injury across the life-course.
Collapse
Affiliation(s)
- Patricia Cullen
- School of Population Health, UNSW, Sydney, Australia
- The George Institute for Global Health, UNSW, Sydney, Australia
- Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, NSW, Australia
| | - Holger Möller
- School of Population Health, UNSW, Sydney, Australia
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Mark Woodward
- The George Institute for Global Health, Imperial College, London, UK
| | - Teresa Senserrick
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety – Queensland, Kelvin Grove, QLD, 4059, Australia
| | - Soufiane Boufous
- Transport and Road Safety (TARS) Research, UNSW, Sydney, Australia
| | - Kris Rogers
- The George Institute for Global Health, UNSW, Sydney, Australia
- Graduate School of Health, The University of Technology Sydney, Australia
| | - Julie Brown
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Rebecca Ivers
- School of Population Health, UNSW, Sydney, Australia
- The George Institute for Global Health, UNSW, Sydney, Australia
| |
Collapse
|
7
|
Ali S, Destaw Z, Misganaw A, Worku A, Negash L, Bekele A, Zergaw A, Walker A, Odell C, Naghavi M, Abate E, Mirkuzie AH. The burden of injuries in Ethiopia from 1990-2017: evidence from the global burden of disease study. Inj Epidemiol 2020; 7:67. [PMID: 33342441 PMCID: PMC7751094 DOI: 10.1186/s40621-020-00292-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/24/2020] [Indexed: 12/03/2022] Open
Abstract
Background Mortality caused by injuries is increasing and becoming a significant global public health concern. Limited evidence from Ethiopia on road traffic, unintentional and intentional injuries indicate the potential public health impact of problems resulting from such injuries. However, there is a significant evidence gap about the actual national burden of all injuries in Ethiopia. This data base study aimed to reveal the national burden of different injuries in Ethiopia. Methodology Data for this study were extracted from the estimates of the Global Burden of Diseases (GBD) 2017 study. Estimates of metrics such as Disability-Adjusted Life Years (DALYs), death rates, incidence, and prevalence were extracted. The metrics were then examined at different injury types, socio-demographic categories such as age groups and sex. Trends of the metrics were also explored for these categories across years from 2007 to 2017. The DALYs and deaths due to injuries in Ethiopia were also compared with other East African countries (specifically Kenya, Tanzania, Uganda, and Zambia) in order to evaluate regional differences across years, by sex and by different injury types such as transport injuries, unintentional injuries, self-harm and interpersonal violence. Results The age-standardized injury death rate has decreased to 69.4; 95% UI: (63.0–76.9) from 90.11; 95% UI: (82.41–97.73) in 2017 as compared with 2007. Road injury, falls, self-harm and interpersonal violence were the leading causes of mortality from injuries occurring in 2017. The age-standardized injury DALYs rate has decreased to 3328.2; 95% UI: (2981.7-3707.8) from 4265.55; 95% UI: (3898.11–4673.64) in 2017 as compared with 2007. The number of deaths resulting from injuries in 2017 was highest for males, children under 5 years, people aged 15–24. Conclusion The current age-standardized death rate and DALYs from injuries is high and the observed annual reduction is not satisfactory. There is a difference in gender and age regarding the number of deaths resulting from injuries. The data indicates that the current national efforts to address the public health impact of injuries in Ethiopia are not sufficient enough to bring a marked reduction. As a result, a more holistic approach to address all injuries is recommended in Ethiopia. Supplementary Information The online version contains supplementary material available at 10.1186/s40621-020-00292-9.
Collapse
Affiliation(s)
- Solomon Ali
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia. .,Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
| | - Zelalem Destaw
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Awoke Misganaw
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia.,Institute for Health Metrics and Evaluation, Department of Health Metrics Science, University of Washington, Seattle, USA
| | - Asnake Worku
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Legesse Negash
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Abebe Bekele
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Ababi Zergaw
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Ally Walker
- Institute for Health Metrics and Evaluation, Department of Health Metrics Science, University of Washington, Seattle, USA
| | - Chris Odell
- Institute for Health Metrics and Evaluation, Department of Health Metrics Science, University of Washington, Seattle, USA
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, Department of Health Metrics Science, University of Washington, Seattle, USA
| | - Ebba Abate
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Alemnesh H Mirkuzie
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia.,University of Bergen, Bergen, Norway
| |
Collapse
|
8
|
Shanthosh J, Rogers K, Lung T, Brown J, Ivers R, Wilson A, Jan S. Effectiveness of child restraint legislation to reduce motor vehicle related serious injuries and fatalities: A national interrupted time series analysis. Accid Anal Prev 2020; 142:105553. [PMID: 32388143 DOI: 10.1016/j.aap.2020.105553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 01/29/2020] [Accepted: 04/12/2020] [Indexed: 06/11/2023]
Abstract
Children that are unrestrained while travelling in a motor vehicle are more vulnerable to serious injury and death. The greatest levels of crash protection are achieved when children use the most age or size appropriate form of restraint. In this study, we aimed to examine the effectiveness of the introduction of age-appropriate child restraint legislation on serious and fatal injury in five Australian states and territories. For this interrupted time series analysis, we used a segmented regression method to assess the association between the implementation of child-restraint legislation and motor-vehicle related serious injuries and fatalities using data obtained from transport authorities in each jurisdiction. We estimated the change in annual rates after the implementation of legislation with the number of motor-vehicle accidents resulting in fatalities or serious injuries as the outcome, and the total number of injuries (minor, serious and fatal) as an offset in the model. We identified 10882 motor-vehicle related crashes resulting in fatalities (n = 188), serious injuries (n = 1730) and minor injuries (n = 8964). In NSW and VIC, the rate ratio was statistically significant and positive, indicating an increase in the rate of serious injuries and fatalities in the period post-legislation compared to the period prior to legislation. In all other states and territories, we did not find a statistically significant effect of legislation Road safety programs incorporating interventions targeted at increasing awareness of optimal restraint practices, strengthened enforcement and measures to improve the affordability of restraints are needed to support legislation.
Collapse
Affiliation(s)
- Janani Shanthosh
- The George Institute for Global Health, University of New South Wales, Australia; The Australian Prevention Partnership Centre, Australia.
| | - Kris Rogers
- The George Institute for Global Health, University of New South Wales, Australia; Graduate School of Health, University of Technology Sydney, Australia
| | - Thomas Lung
- The George Institute for Global Health, University of New South Wales, Australia
| | - Julie Brown
- The George Institute for Global Health, University of New South Wales, Australia
| | - Rebecca Ivers
- School of Public Health and Community Medicine, University of New South Wales, Australia
| | - Andrew Wilson
- Menzies Centre for Health Policy, Faculty of Medicine and Health, University of Sydney, Australia; The Australian Prevention Partnership Centre, Australia
| | - Stephen Jan
- The George Institute for Global Health, University of New South Wales, Australia; The Australian Prevention Partnership Centre, Australia
| |
Collapse
|
9
|
Värnild A, Larm P, Tillgren P. Incidence of seriously injured road users in a Swedish region, 2003-2014, from the perspective of a national road safety policy. BMC Public Health 2019; 19:1576. [PMID: 31775706 PMCID: PMC6882055 DOI: 10.1186/s12889-019-7937-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 11/11/2019] [Indexed: 11/23/2022] Open
Abstract
Background Since 1997 Sweden has a policy for road safety called Vision Zero. Given that Vision Zero is mainly used to reduce fatalities among car occupants, the question has been raised by the research community whether a Vision Zero approach promotes health for all road traffic users. The objective is to measure target fulfilment of the national road safety policy for a Swedish region by examining incidence of serious injury during 2003–2014 in rural and urban road spaces with or without implemented measures. Methods Data on seriously injured road users, defined as ISS > 8 (Injury Severity Score), were retrieved from STRADA (Swedish Traffic Accident Data Acquisition) together with data from NVDB (National Road Database). These data are used to describe where road users are seriously injured in relation to implemented national policy and using a conceptual model of a road space comprising roads, pavements and tracks for walking and cycling. Seriously injured road users in single and multiple crashes with and without vehicles are included. The development of the incidence is analysed for different road users and places in the road space. Results Despite implemented road safety measures in the region, the incidence of seriously injured road users per 100,000 inhabitants in rural areas increased from 7.8 in 2003 to 9.3 in 2014 but doubled in urban areas from 8.0 in to 16.3 respectively. In areas not transformed by Vision Zero, only 36% were injured in rural areas while 64% were injured in urban areas. In contrast, in transformed areas 61% of injuries occurred in rural areas, whereas 39% occurred in urban areas. While the incidence decreased for car occupants on transformed national roads in rural areas, the incidence of serious injuries increased among unprotected road users in urban areas, in particular on pavements and tracks for cycling and walking than on the roads where Vision Zero had been implemented. Conclusion The reduction in the incidence for car occupants in the region may not be adequate to contribute to fulfilling the national target. More needs to be done, especially in the urban areas, where more active mobility is desired.
Collapse
Affiliation(s)
- Astrid Värnild
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, SE-721 23, Västerås, Sweden.
| | - Peter Larm
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, SE-721 23, Västerås, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Per Tillgren
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, SE-721 23, Västerås, Sweden
| |
Collapse
|
10
|
Wang Y, Ye PP, Jin Y, Er YL, Deng X, Gao X, Ji CR, Yang L, Wang W, Duan LL, Wang LH. [Disease burden on road injury in the Chinese population, in 1990 and 2013]. Zhonghua Liu Xing Bing Xue Za Zhi 2017; 38:1320-4. [PMID: 29060972 DOI: 10.3760/cma.j.issn.0254-6450.2017.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the disease burden of road injuries in China. Methods: The results of Global Burden of Disease 2013 including death rate, disability-adjusted of life years (DALY), years of life lost due to premature mortality (YLL), years lived with disability (YLD), were used to describe the burden caused by road injuries in 2013 and the trends from 1990 to 2013, in China. Results: In 2013, there were 313 676 deaths caused by traffic accidents in China. Death rate, rates on DALY, YLL and YLD were 22.52 per 100 000, 1 076.54 per 100 000, 971.21 per 100 000 and 105.34 per 100 000, respectively. Rates on deaths, YLL and YLD appeared higher in males, pedestrians than in females and other types of road travelers. Burden of injuries caused by traffic accidents was seen higher in those aged 15 to 49-year-old. From 1990 to 2013, the overall death rate on road injuries increased by 0.54 per 100 000 in China, with an increase of 2.34 per 100 000 and 0.81 per 100 000, respectively in males and pedestrians. The rates on DALY, YLL and YLD decreased by 164.21 per 100 000, 115.06 per 100 000 and 49.06 per 100 000, respectively. Conclusions: During the past 20 years, achievements had been made on road injury prevention and control, with the decrease of disease burden caused by road accidents. Males, young adults and pedestrians should be called for more attention to prevent road injuries.
Collapse
|