Bus safety represents an important topic for injury prevention. When drivers experience conflict with their passengers, it likely distracts them from the driving task, both physically and mentally, and jeopardizes the safety of all passengers. However, detailed information concerning the frequency and type of conflicts between bus drivers and passengers is unavailable. We conducted a driver-reported cross-sectional survey to investigate the characteristics of driver-passenger conflict in the past month. The survey was completed in Changsha city, China in August 2019. In total, 779 bus drivers were surveyed. Of 732 drivers who completed the questionnaire, 635 (86.7%; 95% confidence interval: 84.3–89.1%) drivers reported experiencing at least one conflict with passengers in the past month. After adjusting for other demographic variables, drivers who were male, younger, less educated, less experienced as a bus driver, and with a comparatively high self-reported work intensity were more likely to report experiencing conflicts. Of the reported conflicts, verbal quarrels and abuses were most common, followed by “passengers attacked driver with physical objects like sticks or knives” and “passengers spat on or threw objects toward the driver”. Most drivers reported that they had experienced only conflicts causing no physical injury or financial loss in the past month, but a small portion experienced conflicts causing injuries to themselves. The most frequent reasons for driver-passenger conflicts were “passenger refused to pay fare”, “passenger requested to get off the bus at a location that was not a bus stop”, and “passenger was drunk or deliriously attacked the driver”. Bus drivers responded to some of the passengers’ verbal or physical attacks, but not all. Some preventive measures were adopted frequently by bus companies (e.g., bus alarms, protective shields for drivers) but others were not. Least often adopted were efforts to offer safety training for drivers (46.6%) and to offer psychological counseling services for drivers (39.1%). We conclude that bus driver-passenger conflicts are common in Changsha city, China. The conflicts impose a substantial threat to the safety of both drivers and passengers. We recommend multiple preventive actions to reduce driver-passenger conflicts and improve bus safety.
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