Abstract
ObjectiveTo analyse trends in road traffic crashes, injuries and fatalities over 75 years in Sri Lanka.MethodsData on road traffic crashes, injuries and fatalities between 1938 and 2013 were obtained from the Police Statistics Unit. Rates per 100 000 population were calculated and trends were analysed using joinpoint regression analysis.FindingsRoad traffic crashes and injuries rose substantially between 1938 and 2013: annual crashes increased from 61.2 to 183.6 per 100 000 people; injuries, from 35.1 to 98.6 per 100 000; and fatalities, from 3.0 to 10.8 per 100 000 people per year. Joinpoint analysis showed large fluctuations in crashes and injuries over time but the fatalities rose almost continuously. These fluctuations paralleled the country’s political and economic development. In some years, better traffic law enforcement and improved public transportation may have been associated with reduced crashes and injuries, whereas rapid growth in vehicle numbers, especially two- and three-wheeled vehicles, may have contributed to increased crashes and injuries. In addition, insurance policies that did not require a police report to claim may have led to underreporting of crashes and allowed drivers to avoid prosecution.ConclusionFluctuations over time in road traffic crashes and injuries in Sri Lanka are associated with changes in political, economic and traffic policy. There is potential for reducing road traffic crashes and injuries through better traffic law enforcement, restrictions on the importation of two- and three-wheeled vehicles and policies to improve road safety and prevent underreporting of crashes.
Highlights
Road traffic injuries are a major but neglected global public health problem.[1]
The aims of this study were to describe the trends in road traffic crashes, injuries and fatalities in Sri Lanka from 1938 to 2013 and to identify factors associated with these trends
We reviewed the literature on Sri Lanka’s traffic and transportation history to identify events that might have contributed to the significant changes observed in the joinpoint analysis
Summary
Research Road traffic injury trends, Sri Lanka sustained in the crash, irrespective of the time interval between the crash and death); (ii) serious (i.e. the crash resulted in one or more kinds of severe injury, such as bone fractures, damage to internal organs, severe burns, permanent impairment of vision or hearing or serious disfigurement); (iii) minor; or (iv) none (i.e. the crash did not cause any injury and resulted in only damage to vehicles).[9]. Information on the size of the population of Sri Lanka in the middle of each year was obtained from the Department of Census and Statistics[13] and used to calculate road traffic fatality and injury rates per 100 000 population. We analysed long-term trends in road traffic crashes, injuries and fatalities using the Joinpoint Regression Program Version 4.0.4 (National Cancer Institute, Bethesda, USA).[14,15] Joinpoints are points in a time series at which statistically significant changes occur and joinpoint regression fits a series of joined straight lines between these joinpoints. The program uses the Monte Carlo permutation method to test for significance.[14,15] We reviewed the literature on Sri Lanka’s traffic and transportation history to identify events that might have contributed to the significant changes observed in the joinpoint analysis. To supplement our findings, we conducted an additional analysis for the period 1977 to 2013, during which it was possible to separate data on serious and minor injuries
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