Road Traffic Injury Mortality Research Articles

PERSIAN traffic safety and health cohort: a population-based precrash cohort study

PurposeDespite to high burden of road traffic injuries (RTIs), the RTI epidemiology has received less attention with rare investments on robust population cohorts. The PERSIAN Traffic Safety and Health Cohort...

11-Year Trend of Mortality from Fatal Road Traffic Injuries in The Center of Iran; a Cross-sectional Study.

Road traffic injuries (RTIs) are one of the major health problems in developed and developing countries. In Iran, RTIs are the first leading cause of years of life lost (YLL). So, the present study investigated the 11-year trend of RTI- related mortalities in Iran. This study was a population-based cross-sectional study. All-cause deaths as well as RTI-related mortalities' data were collected from the Civil Registration Organization (CRO) and Legal medical organization (LMO) of Isfahan during 2011-2021. The mid-year population, number of deaths due to RTIs, the crude and age-standardized mortality (per 100,000) of RTIs, and the percentage of proportional mortality by sex and year of accident during the study period were calculated and reported. Also, trend analysis was done using join point regression program. During the study period, 11,248 deaths occurred due to RTIs in Isfahan province. 8,894 cases were male (79.03%), the highest number of deaths in both male and female cases was reported in those aged 15-39 years. Among the males, trend of standardized mortality in 2011-2015 was decreasing (annual percentage changes = -6.76(CI 95%: -2.53, -15.03)), while in 2015-2021 it was increasing (annual percentage changes = 3.00 (CI 95%: 0.63, 9.87)). However, no significant trend was observed among females. The findings of the present study showed that the number and standardized mortality rate of RTIs decreased during the 11-year period. It seems that applying stricter policies, improving the quality of the roads of the province, improving the quality of cars, and increasing the number of hospital and pre-hospital medical facilities can play an effective role in reducing RTIs.

Evaluating the effectiveness of implementing a more severe law on prevention of road traffic injury mortality in mainland China: an interrupted time series study based on national mortality surveillance

BackgroundIn China, road traffic injury (RTI) is the seventh-leading cause of death More than 1.5 million adults in China live with permanent disabilities due to road traffic accidents. In 2011,...

Prevalence of road traffic injuries in South East and South Asian region - A systematic review.

South and South-East Asian countries report a great liability for the world's road traffic injuries (RTIs) and deaths. A vast number of research studies tested various interventions including specific protective devices to prevent accidents, but no review papers have been conducted to find out the prevalence of RTIs in South-East and South Asian countries. This review paper was an attempt to find out the prevalence of RTIs and their associated factors in South-East and South Asian countries. Following the guidelines of Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), we searched the articles in the electronic databases of PubMed/Medline, Scopus, CINAHL, ProQuest, and Web of Science. Articles were selected if they reported the prevalence of RTI, or road traffic accident (RTA) deaths. In addition, a data quality assessment was done. Out of the 10,818 article hits from the literature search, ten articles found the eligibility and inclusion criteria. Most of the studies reported that males are involved in the RTIs more than females. The male mortality rate is more than the female mortality in RTI mortality. Young adult males are the major victims when compared with the different age groups of male victims. Two-wheelers are the major contributors to the accident rate. Religious or national festivals are not free from accident-prone times. Climatic seasons and nighttime have a major influence on the RTIs. RTIs are increasing due to the sudden and huge increase in the number of motor vehicles and the development of cities and towns. Accidents are non-predictable but controllable disasters in society. Overspeeding, bad conditions on road, the vulnerability of the vehicles, and careless driving are the major reported reasons for RTIs. Making and implementing strict laws can help us to control RTAs. The major effect on the reduction of RTI can be assured only with the presence of responsible people. That can be achieved only by creating awareness in society about traffic rules and responsibilities.

An ecological study of the burden of road traffic crashes in the Middle East and North Africa

Road traffic injuries (RTIs) and deaths constitute a serious preventable global public health problem. To analyse time trends of age-standardized mortality rates and disability-adjusted life years (DALYs) caused by RTIs in 23 Middle East and North Africa (MENA) countries; and to assess the correlation between national implementation of best practice for road safety recommended by the World Health Organization, national income level, and RTI burden. Time trend analysis over 17 years (2000-2016) was conducted using Joinpoint regression. An overall score was calculated for each country to assess implementation of best practice for road safety. Mortality decreased significantly (P < 0.05) in Islamic Republic of Iran, Jordan, Kuwait, Lebanon, Morocco, Oman, Qatar, and Tunisia. In most MENA countries, DALYs increased but they significantly decreased in the Islamic Republic of Iran. The score calculated varied widely among the MENA countries. In 2016, no correlation was identified between the overall score and mortality and DALYs. National income was not associated with RTI mortality or the calculated overall score. Countries in the MENA region had varying levels of success in reducing the burden from RTIs. During the Decade of Action for Road Safety 2021-2030, MENA countries can achieve optimal road safety by implementing measures that are customized for the local context, such as law enforcement and public education. Other focus areas for improving road safety are building capacity in sustainable safety management and leadership, improving vehicle standards, and addressing gaps in areas such as use of child restraint.

Burden of road traffic injuries in Iran: a national and subnational perspective, 1990−2019

ObjectivesReliable 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...

Attributable road traffic injury mortality: differences in statistical systems in Ecuador

This paper aims to estimate the differences in mortality from road traffic injuries according to the records present in the information sources in the Republic of Ecuador, 2017 - 2019. Methodologically, the cases of deaths and mortality rates are compared between police records and death certificates by age group and sex. During the study period, 7291 traffic fatalities were recorded in police records, compared to 9509 in medical certificates. Mortality rates vary significantly by age and sex between data sources, with police records showing a decreasing trend, but no significant change according to medical death certificates. The study reveals that there is no consistency between data sources, possibly to mask weaknesses in police actions inroad traffic policing.

Mortality of drowning and road traffic injury among children aged 5-14 in China from 2008 to 2019

Objective: To analyze the trajectory of drowning and road traffic injury mortality among children aged 5-14 years in China from 2008 to 2019. Methods: Mortality data of unintentional injuries were from the Mortality Surveillance Data Set of National Disease Surveillance System from 2009 to 2018 and grouped by regions, urban and rural areas, genders, and age groups. The trajectory model was used to analyze the trend of drowning and road traffic injury mortality with years. Results: The mortality of drowning and road traffic injury showed a similar trend. In the trajectory model of drowning mortality, east, middle and west rural boys and western urban boys of all ages belonged to the high mortality group. The moderate mortality group included eastern urban boys and western girls aged 5-9 years and also contained eastern and middle urban boys and western urban girls aged 10-14 years. The other combinations belonged to the low mortality group. In the trajectory model of road traffic injury mortality, western urban boys, all rural boys and western rural girls aged 5-9 years, middle and western rural boys and western urban boys aged 10-14 years belonged to the high mortality group. Eastern urban girls aged 5-9 years and 10-14 years belonged to the low mortality group. The other combinations belonged to the moderate mortality group. Conclusion: There are different groups in the trajectory model of drowning and road traffic injury mortality among children in China. Identifying the trajectory of injury mortality is helpful to carry out more targeted prevention in China.

Mortality due to road traffic injuries in older adults in the Republic of Ecuador between 1990 and 2018: a descriptive study

Mortality due to road traffic injuries in older adults in the Republic of Ecuador between 1990 and 2018: a descriptive study

"Viet Nam’s Mandatory Motorcycle Helmet Law 2007 and its Impact on Road Traffic Injuries Mortality in a Mountainous Province: A Population-Based Mortality Registration, 2005-2018"

"Viet Nam’s Mandatory Motorcycle Helmet Law 2007 and its Impact on Road Traffic Injuries Mortality in a Mountainous Province: A Population-Based Mortality Registration, 2005-2018"

Prediction of Seat Belt Use Behavior among Adolescents Based on the Theory of Planned Behavior.

Background: Road Traffic Injuries (RTIs) are the important causes of unintentional injuries and deaths. In this respect, seat belt wearing is an influential factor in reducing the mortality and severity of road traffic injuries. The rate of seat belt use among is lower adolescents, compared to adults. The present study aimed to investigate the influential factors on seat belt-wearing behavior among adolescent students as car occupants based on the Theory of Planned Behavior (TPB). Study design: A cross-sectional design. Methods: This study was conducted among 952 adolescent students studying in grades 7, 8, and 9 in the schools of Tabriz, Iran, in the 2019-20 academic year. A researcher-made questionnaire was designed based on TPB for data collection, the validity and reliability of which have been confirmed. Results: The results indicated that the rate of seat belt use in the front seat inside the city was lower than that outside the city. Regarding TPB constructs, perceived behavioral control (β=0.137; 95% CI: 0.006, 0.013; P<0.001), subjective norm (β=0.313; 95% CI: 0.021, 0.032; P<0.001), and attitude (β=0.322; 95% CI: 0.034, 0.053; P<0.001) had a significant and positive relationship with the intention of seat belt-wearing behavior. Moreover, the behavioral intention (β=0.571; 95% CI: 0.62, 0.64; P<0.001) had a significantly positive relationship with seat belt-wearing behavior. Conclusion: The Theory of Planned Behavior is appropriate to determine predictor factors of seat belt-wearing behavior among adolescent students as car occupants. In addition, the results of the present study may provide a theoretical basis for policy-making to improve adolescent students' seat belt use.

Cost-Effectiveness of Lay First Responders Addressing Road Traffic Injury in Sub-Saharan Africa

To investigate the cost-effectiveness of training lay first responders (LFRs) to address road traffic injury (RTI) in sub-Saharan Africa (SSA) as the first step toward formal emergency medical services (EMS) development. Cost data from five LFR programs launched between 2008 and 2019 in SSA was collected for LFR cost estimation, including three prospective collections from our group. We systematically reviewed literature and projected aggregate disability-adjusted life years (DALYs) from RTI in SSA that are addressable by LFRs to inform cost-effectiveness ratios ($USD cost per DALY averted). Cost-effectiveness ratios were then compared against African per capita gross domestic product (GDP) to determine the cost-effectiveness of LFRs addressing RTIs in SSA, following WHO-CHOICE guidelines, which state cost-effectiveness ratios less than GDP per capita are considered "very cost-effective." Average annual cost per LFR trained across five programs was calculated to be 16.32USD (training=4.04USD, supplies=12.28USD). Following WHO and Disease Control Priorities recommendations for adequate emergency catchment, initial training of 750 LFRs per 100,000 people would cost 12,239.47USD with projected total annual DALYs averted equal to 227.7 per 100,000. Cost per DALY averted would therefore be 53.75USD with appropriate LFR availability, less than sub-Saharan African GDP per capita (1,585.40USD) and the lowest sub-Saharan African GDP per capita (Burundi, 261.20USD). Following WHO-CHOICE guidelines, training LFRs can be a highly cost-effective means to address RTI morbidity and mortality across sub-Saharan Africa. With EMS unavailable for 91.3% of the African population, training LFRs can be an affordable first step toward formal EMS development.

Impact of Mexican Road Safety Strategies implemented in the context of the UN’s Decade of Action

ObjectiveTo evaluate advancements in the prevention of road traffic injuries (RTI) in Mexico in the context of the United Nation’s Decade of Action for Road Safety. MethodsAn analysis of the trend and age-period-cohort effects of RTI mortality from 1999 to 2018 was conducted. Mortality figures were age-standardized using the direct method and population estimates of 2018 as the standard. To evaluate whether advancements might be attributed to higher levels of death misclassification, we conducted sensitive analysis using multiple imputation to redistributed deaths allocated to non-specific ICD-10 codes. Non-fatal RTI from four nationally representative health surveys (2000, 2006, 2012 and 2018) were analyzed. FindingsImplementation of Mexico’s National Road Safety Strategy 2011–2020 was associated with an average annual percentage change reduction in the age-standardized RTI mortality rate of 1.3% (95%-CI: −1.8,-0.9). Reductions are more evident in pedestrians and four + wheelers (−6.7% and −5.3%, respectively, from 2011 to 2018); mortality trend in motorcyclists increased from 1999 to 2018 an average of 12.8% annually (95%-CI: 9.9, 15.9). Potential underestimation of mortality due to death misclassification decreased from 22.7% in 1999 to 16.4% in 2018; sensitive analysis showed that reductions might not be attributed to death misclassification. Non-fatal injuries decreased in four + wheelers but increased in motorcyclists. The number of individuals suffering permanent consequences from RTI increased. ConclusionsResults showed some potential gains of Mexico’s road safety strategies: RTI in four + wheelers decreased. Efforts should be put in place urgently to prevent the growing number of RTI in motorcyclists.

Global trends in adolescents’ road traffic injury mortality, 1990–2019

ObjectiveThe aim of this study was to determine the trends of road traffic injury (RTI) mortality among adolescents aged 10–14 years and 15–19 years across different country income levels with...

Prevalence and risk factors for road traffic injuries and mortalities in Ethiopia: systematic review and meta-analysis

BackgroundRoad traffic injuries, which are responsible for premature deaths and functional losses, are the leading causes of unintentional injuries in Ethiopia. As most studies on road traffic injuries, so far,...

Road traffic injury mortality and morbidity by country development status, 2011-2017

PurposeThis research examined road traffic injury mortality and morbidity disparities across of country development status, and discussed the possibility of reducing country disparities by various actions to accelerate the pace of achieving Sustainable Development Goals target 3.6 – to halve the number of global deaths and injuries from road traffic accidents by 2020. MethodsData for road traffic mortality, morbidity, and socio-demographic index (SDI) were extracted by country from the estimates of the Global Burden of Disease study, and the implementation of the three types of national actions (legislation, prioritized vehicle safety standards, and trauma-related post-crash care service) were extracted from the Global Status Report on Road Safety by World Health Organization. We fitted joinpoint regression analysis to identify and quantify the significant rate changes from 2011 to 2017. ResultsAge-adjusted road traffic mortality decreased substantially for all the five SDI categories from 2011 to 2017 (by 7.52%–16.08%). Age-adjusted road traffic mortality decreased significantly as SDI increased in the study time period, while age-adjusted morbidity generally increased as SDI increased. Subgroup analysis by road user yielded similar results, but with two major differences during the study period of 2011 to 2017: (1) pedestrians in the high SDI countries experienced the lowest mortality (1.68–1.90 per 100,000 population) and morbidity (110.45–112.72 per 100,000 population for incidence and 487.48–491.24 per 100,000 population for prevalence), and (2) motor vehicle occupants in the high SDI countries had the lowest mortality (4.07–4.50 per 100,000 population) but the highest morbidity (428.74–467.78 per 100,000 population for incidence and 1025.70–1116.60 per 100,000 population for prevalence). Implementation of the three types of national actions remained nearly unchanged in all five SDI categories from 2011 to 2017 and was consistently stronger in the higher SDI countries than in the lower SDI countries. Lower income nations comprise the heaviest burden of global road traffic injuries and deaths. ConclusionGlobal road traffic deaths would decrease substantially if the large mortality disparities across country development status were reduced through full implementation of proven national actions including legislation and law enforcement, prioritized vehicle safety standards and trauma-related post-crash care services.

Mortality by road traffic injuries in Brazil (2000-2016): capital cities versus non-capital cities.

ABSTRACTOBJECTIVES:To compare the magnitude and trend of mortality by road traffic injuries (RTI) in the capitals and other municipalities of each Brazilian state between 2000 and 2016.METHODS:A time series analysis of mortality rates by RTI standardized by age was performed, comparing the capitals and the cluster of non-capital municipalities in each state. Data on deaths were obtained from the Sistema de Informações sobre Mortalidade (SIM – Mortality Information System). RTI deaths were considered to be those, whose root cause was designated by ICD-10 codes V01 to V89, with redistribution of garbage codes. To estimate mortality rates, we used the population projections of the Brazilian Institute of Geography and Statistics (IBGE) from 2000 to 2015 and the population estimated by polynomial interpolation for 2016. The trend analysis was performed using the Prais-Winsten method, using the Stata 14.0 program.RESULTS:There were 601,760 deaths due to RTI in the period (114,483 of residents in capital cities). Mortality by RTI did not present an increasing trend in any of the Capitals in the period under study. Among non-capital municipalities, the trend was growing in 14 states. The greatest increase was observed in Piaui (AIR = 7.50%; 95%CI 5.50 – 9.60). There was a decreasing trend in RTI mortality in 14 capitals, among which Curitiba showed the greatest decrease (AIR = −4.82%; 95%CI −6.61 – −2.92). Only São Paulo and Rio Grande do Sul showed a decreasing trend in mortality by RTI in non-capital cities (AIR = 2.32%; 95%CI −3.32 – −1.3 and AIR = 1.2%, 95%CI −2.41 – 0.00, respectively).CONCLUSIONS:We conclude that RTI mortality rates in non-capital cities in Brazil showed alarming trends when compared with those observed in capital cities. The development of effective traffic safety actions is almost always limited to Brazilian capitals and large cities. Municipalities with higher risk should be prioritized to strengthen public policies for prevention and control.

Socio-Demographic Determinants of Road Traffic Fatalities in Women of Reproductive Age in the Republic of Georgia: Evidence from the National Reproductive Age Mortality Study (2014).

PurposeGlobally and in the European region, the road traffic injuries (RTI) have emerged as a major public health and development problem, killing the most productive adult members of a population, including women. This study aimed to identify the key socio-demographic determinants of premature and avoidable RTI mortality in reproductive-aged women (15–49 years) in Georgia.Materials and MethodsThe study employed verbal autopsy data from the second national reproductive age mortality survey (RAMOS 2014). Univariate and multivariate logistic regression models were fitted using the Firth method to assess the crude and adjusted effects of each individual level socio-demographic factor on the odds of RTI-attributed death, with corresponding 95% confidence intervals (COR and AOR, 95% CI).ResultsOf 843 women aged 15–49 years, 78 (9.3%) were the victims of fatal traffic crashes. After multivariate adjustment, the odds of dying from RTI were significantly higher in women aged 15–29 years (AOR=7.73, 95% CI= 4.20 to 14.20), those being employed (AOR=2.11, 95% CI= 1.22 to 3.64) and the wealthiest (AOR=2.88, 95% CI= 1.44 to 5.77) compared, respectively, to their oldest (40–49 years), unemployed and poorest counterparts. Conversely, there were no statistically significant ethnic, marital, rural/urban, and educational disparities in women’s RTI fatalities. Overall, motorized four-wheeler occupants (78.2%), particularly passengers (71.8%), appeared to be the most common victims of fatal road injuries than pedestrians (20.5%). Alarmingly, the vast majority (85.9%) of any type of road users died instantly at the scene of collision, as compared to deaths en route to hospital (1.3%) or in hospital (11.5%).ConclusionAge, employment, and wealth status appeared to be the strong independent predictors of young women’s RTI mortality in Georgia. Future comprehensive research would be advantageous for further deciphering the differential impact of social determinants on traffic-induced fatalities, as a vital platform for evidence-based remedial actions on this predictable and preventable safety hazard.

Decreasing Trends in Road Traffic Injury Incidence and Mortality in Nigeria: A Ten-Year Analysis

BackgroundRoad traffic accidents constitute a significant public health burden in Nigeria. In this study, we aim to (1) characterize the temporal burden of road traffic injury (RTI) and mortality rates in Nigeria over a decade, (2) identify regional RTI incidence, mortality trends, and high-risk regions, and (3) assess the impact of state population on injury and mortality. Materials and methodsWe retrospectively reviewed aggregate state-level RTI incidence and mortality counts reported by the Federal Road Safety Corps from January 2001 through December 2010. We also reviewed population data from the National Population Commission. In addition to national analyses, regional analyses were performed in Nigeria's six geopolitical zones and one Federal Capital Territory (FCT). Regression analysis was also performed to determine the relationship between population and RTI incidence and mortality. ResultsThe national median RTI incidence and mortality rates declined by 53% and 75%, respectively, between 2001 and 2010. Analysis by geopolitical zone yielded the greatest increases for both injury and mortality in the FCT and the greatest decreases for both in the South-South region. The average geopolitical zone, apart from the FCT, experienced a 24% decrease in the incidence rate and a 69% decrease in the mortality rate. An analysis of variance, run to assess potential differences in RTI incidence and mortality rates by state population, yielded significant values of P = 0.0023 for injury and P = 0.0002 for mortality. ConclusionsAcknowledging the potential for underreporting, a more holistic surveillance approach would generate more accurate data for future policy creation to improve clinical outcomes.

Trends in mortality from road traffic injuries in South Korea, 1983–2017: Joinpoint regression and age-period-cohort analyses

Although mortality trends can be influenced by different ages, periods, and cohorts, few studies have demonstrated the age-period-cohort (APC) effect on road traffic injury (RTI) mortality. Moreover, APC effects in Korea have never been documented despite the high mortality rates from RTIs. This study aimed to describe the trends in mortality from RTIs and examine APC effects on RTI mortality in Korea. Using the national death certificate and census mid-year population estimates data during 1983–2017, trends in age-standardized mortality rates from RTIs were analyzed using Joinpoint regression. Intrinsic estimator regression models were used to estimate APC effects on RTI mortality. Consistent with the trend in period effects, RTI mortality increased sharply with the economic growth in the 1980s, decelerated after the implementation of road safety policies in the early 1990s, plummeted owing to the 1997–1998 financial crisis, and gradually decreased from the early 2000s. A J-shaped age effect indicated that the relative risk of road traffic death surged in people aged ≥65 years. Educational expansion from the mid-1950s turned an increasing birth cohort effect into a continuously decreasing trend after peaking around the 1938–1943 birth cohorts. The risk of road traffic death was relatively high among the Korean Generation Y, i.e., those born in 1978–1983. RTI mortality trends in Korea have been affected by diverse socioeconomic changes through cohort and period effects. Despite the recent favorable trend, RTI mortality remains high, especially among older people. Road safety policies to address the burden of RTIs require further improvement.