Road Injuries Research Articles

Impact of high temperature on road injury mortality in a changing climate, 1990-2019: A global analysis.

Previous studies have shown that extreme heat likely increases the risk of road injuries. However, the global burden of road injuries due to high temperature and contributing factors remain unclear. This study aims to characterize the global, regional and national burden of road injuries due to high temperature from 1990 to 2019. Based on the Global Burden of Disease (GBD) study 2019, we obtained the numbers and age-standardized mortality rates (ASMR) and age-standardized disability-adjusted life years (DALY) rates (ASDR) of the road injury due to high temperature at global, regional, and national levels from 1990 to 2019. The world is divided into five climate zones according to the average annual temperature of each country: tropical, subtropical, warm temperate, cold temperate, and boreal. We used the generalized additive models (GAM) to model the trends of road injuries globally and by region. Globally, between 1990 and 2019, the deaths of road injury attributable to high temperature increased significantly from 20,270 (95% uncertainty interval [UI], 7836 to 42,716) to 28,396 (95% UI, 13,311 to 51,178), and the DALYs increased from 1,169,309 (95% UI, 450,834 to 2,491,075) to 1,414,527 (95% UI, 658,347 to 2,543,613). But the ASMR and the ASDR slightly decreased by 8.49% and 13.16%, respectively. The burden of road injury death attributable to high temperature remained high in low SDI and tropical regions. In addition, road transport infrastructure investment per inhabitant is associated with the burden of road injuries attributable to high temperature. Globally, the ASMR and ASDR for road injuries attributable to high temperature decreased from 1990 to 2019, but the absolute death and DALYs continued to increase. Thus, concerning global warming, implementation of prevention and interventions to reduce road injuries from heat exposure should be stressed globally.

Обзор зарубежных программ реабилитации для водителей, управлявших транспортными средствами в состоянии опьянения (Новая Зеландия, Великобритания и Северная Ирландия)

Drink-driving remains one of the leading causes of road accidents with a high level of injury and mortality. In most high- and middle-income countries (according to the World Bank classification), the completion of drink-driving rehabilitation course is provided at the legislative level as a prerequisite for reinstatement of the license. Over the past decade in the Russian Federation, one observes the growth in the proportion of alcohol-related road injuries in the overall structure of road injuries. Despite that, the abovementioned approach to reinstatement of the driving license for drink-driving offenders remains insufficiently studied. Accordingly, the results of the review of foreign rehabilitation programs for drink-drivers will allow us to identify effective strategies, making it possible to develop a pilot project adapted for use in the activities of the narcological service of the Russian Federation. Of particular interest is the study of the experience of rehabilitation programs for drink-drivers in New Zealand and the UK, that started with initially identical approaches to the appointment of rehabilitation programs in these countries and their subsequent development. The obtained results of the review of foreign experience in the rehabilitation of drink-drivers indicate the need to use not only an integrated approach including various stages (educational, if necessary – therapeutic, preventive in order to prevent cases of repeated driving of vehicles in a state of intoxication), but also to provide an approach designed to stimulate the involvement of drivers-offenders in rehabilitation programs. The use of such an approach in most high- and middle-income countries makes it possible to carry out both effective re-admission of offending drivers to driving vehicles and to reduce the frequency of cases of repeated driving while intoxicated.

The paucity of pediatric emergency medicine fellowship training programs in Africa.

Sub-Saharan Africa has the highest burden of childhood and adolescent mortality in the world. The leading causes of mortality in pediatric populations in Africa include preterm birth complications, pneumonia, malaria, diarrheal diseases, HIV/AIDS, and road injuries. These causes of childhood and adolescent mortality often lead to emergency room utilization due to critical presentation, placing emphasis on the importance of pediatric emergency services in Africa. Despite the criticality of pediatric emergency medicine (PEM) in the region, there is a paucity of PEM training programs in Africa. Ongoing interventions focused on addressing the poor access to PEM training and services include isolated efforts to provide PEM-specific training to nonemergency medicine (EM)-trained practitioners and expand current EM training to include PEM piloted in a single center in Kenya. Sustainable efforts require organized efforts with government and graduate medical education bodies. We discuss the existing infrastructure that can be utilized in promoting the establishment of PEM training programs and urge local governments' investment as well as other stakeholders, including graduate medical education, to address the issue of childhood mortality in Africa through the improved provision and access to PEM training.

Automatic Number Plate Detection for Motorcyclists Riding Without Helmet

The increased usage of motorcycles in recent times has resulted in a rise of road accidents and injuries, with the absence of helmets being a major contributing factor. The current process of physically checking helmet usage at junctions or using CCTV footage to detect motorcyclists without helmets is time-consuming and requires human intervention. To address this issue, a computerized model is proposed to automatically detect motorcycle riders wearing helmets from images. The proposed model utilizes the You Only Look Once (YOLO) Darknet deep learning framework, which is customized to detect riders with and without helmets. The model also automates an alert to the rider found without a helmet. The dataset consists of a large collection of images with 80 different object categories, covering a wide range of real-world scenarios. The solution has the potential to enhance the capabilities of ANPR systems for traffic management, parking management, law enforcement etc.

Characteristics of road traffic accident types and casualties in Guangzhou, China, from 2007 to 2020: A retrospective cohort study based on the general population

IntroductionThis study aimed to explore the trend and main influencing factors of road traffic accidents in Guangzhou, China, from 2007 to 2020 and to provide a reference and guidance for government decision-making. MethodsA retrospective cohort study was used to describe road traffic accidents in Guangzhou. According to the population types, all people with road traffic accidents were divided into migrant workers and the control population. We divided road users, administrative districts, motorcycle types and injury levels into subgroups to investigate the characteristics of road traffic accidents in Guangzhou. The road traffic accident data were derived from the Guangzhou Public Security Traffic Management Integrated System. ResultsThe incidence rate of road traffic accidents per 10,000 vehicles in Guangzhou decreased from 36.55 in 2007 to 10.07 in 2012, remained relatively stable at 9.47 in 2017, and finally rose to 11.12 in 2020. The injury rate showed the same trend as the incidence rate, while the mortality rate gradually decreased from 14.21 in 2007 to 5.19 in 2020. Vulnerable road users such as motorized two-to-three-wheeler drivers and migrant workers were casualties in more than 80% of the cases. The proportion of casualties involving mopeds and electric bicycles increased rapidly after 2018. Motor vehicle drivers frequently caused road traffic accidents and were most often uninjured. ConclusionRoad safety in Guangzhou has shown a clear trend of improvement, but casualties are uneven across administrative districts. More attention should be given to motorized two-to-three-wheelers, migrant workers, and road traffic violations by uninjured individuals.

Performance of Traffic Accidents’ Prediction Models

Modeling traffic-accident frequency is a critical issue to better understand the accident trends and the effectiveness of current traffic policies and practices in different countries. The main objectives of this study are to model traffic road accidents, fatalities and injuries in Jordan, using different modeling techniques, including regression, artificial neural network (ANN) and autoregressive integrated moving average (ARIMA) models and to evaluate the safety impact of travel-restriction strategies during Covid-19 pandemic on trafficaccident statistics for the year 2020. To accomplish these objectives, data of traffic accidents, registered vehicles (REGV), population (POP) and economic gross domestic product (GDP) from 1995 through 2020 were obtained from related sources in Jordan. The analysis revealed that accidents, fatalities and injuries have an increasing trend in Jordan. Root mean of square error (RMSE), mean absolute error (MAE) and coefficient of multiple determination (R2) were sued to evaluate the performance of the developed prediction models. Based on model performance, the ANN models are the best, followed by the ARIMA models and then the regression models. Finally, it was concluded that the strategies undertaken by the government of Jordan to combat Covid-19, including complete and partial banning of travel, resulted in a considerable reduction of accidents, injuries and fatalities by about 35%, 37% and 50%, respectively. KEYWORDS: Traffic accidents, Artificial neural network, Covid-19 pandemic, Regression, Timeseries analysis, Prediction model

Forensic characteristics of injuries in cyclists in collisions with other vehicles

In order to identify the features of the injuries formation in cyclists who were injured in a collision of moving vehicles with a blow to the rear wheel area of a bicycle moving at a slower speed in the same direction, the authors analyzed the results of forensic medical examinations in relation to 151 corpses of cyclists who died in road accidents aged 4 to 74 years. It was found that with this type of bicycle injury, the structures of the head, chest, lower extremities, as well as the structures of the abdomen were most often injured. Injuries to the structure of the head were characterized by the formation of depressed-comminuted fractures: more often frontal-temporal, less often occipital bone. Bilateral fractures of the ribs were also quite frequent types of damage, mainly the upper ribs (up to 5-6 ribs) were damaged, most often along the midclavicular and anterior axillary lines. Lung contusions have been identified in most of the injured persons with chest structure injury. Injuries to the abdominal organs and retroperitoneal space were recorded in 22.27% of cases, with liver and spleen ruptures in the majority of cases. Spinal injuries in cyclists were detected in 13.25% of cases, injuries in the cervical spine prevailed: cervico-occipital injuries and fracture-dislocations, mainly between 1-2 and 3-4 or 6-7 cervical vertebrae with separation or contusion of the spinal cord. Injuries to the structure and organs of the pelvis in road accidents in cyclists were observed very rarely, which made it possible to distinguish this type of bicycle injuries from other types of transport and blunt injuries, in particular from automobile injuries. Injuries to the structure of the limbs of the victims were noted quite often: fractures of the upper limbs occurred when falling on the road surface and injury to the lower limbs was formed both during the contact of two vehicles and when the victims fell on the road surface.

Road environment characteristics and fatal crash injury during the rush and non-rush hour periods in the U.S: Model testing and cluster analysis

This study aims to assess the relationship between county-level fatal crash injuries and road environmental characteristics at all times of the day and during the rush and non-rush hour periods. We merged eleven-year (2010 - 2020) data from the Fatality Analysis Reporting System. The outcome variable was the county-level fatal crash injury counts. The predictor variables were measures of road types, junction types and work zone, and weather types. We tested the predictiveness of two nested negative binomial models and adjudged that a nested spatial negative binomial regression model outperformed the non-spatial negative binomial model. The median county crash mortality rates at all times of the day and during the rush and non-rush hour periods were 18.4, 7.7, and 10.4 per 100,000 population, respectively. Fatal crash injury rate ratios were significantly elevated on interstates and highways at all times of the day – rush and non-rush hour periods inclusive. Intersections, driveways, and ramps on highways were associated with elevated fatal crash injury rate ratios. Clusters of high fatal crash injury rates were observed in counties located in Montana, Nevada, Colorado, Kansas, New Mexico, Oklahoma, Texas, Arkansas, Mississippi, Alabama, Georgia, and Nevada. The built and natural road environment factors are associated with county-level fatal crash injuries during the rush and non-rush hour periods. Understanding the association of road environment characteristics and the cluster distribution of fatal crash injuries may inform areas in need of focused intervention.

Epidemiology and burden of pelvic fractures: Results from the Global Burden of Disease Study 2019

IntroductionPelvic fracture is a severe injury resulting in high mortality and disability rate, and brought heavy health burden. However, existing research conclusions only restricted to the national level while global estimation of pelvic fracture was lack. We aimed to estimate the global incidence, prevalence, and years lived with disability (YLDs) of pelvic fracture by region, age, gender, cause and sociodemographic index (SDI). Materials and methodsPublicly available data was gained based on the Global Burden of Disease Study (GBD) 2019. We calculated the estimated annual percent change (EAPC) to analyze the temporal trends of pelvic fractures from 1990 to 2019. Incidence, prevalence and YLDs were analyzed by region, age, gender, cause and SDI. Spearman's rank order correlation was used to determine the correlation between SDI and incidence, prevalence and YLDs. ResultsGlobally, there were about 6 million incident cases, 18.8 million prevalent cases and 3.2 million YLDs cases of pelvic fractures for both sexes in 2019. The incidence number increased over 40% compared to 1990. However, the age standardized rate of incidence (ASIR) (EAPC = −0.22; 95% CI, −0.38 to −0.05), prevalence (ASPR) (EAPC = −0.42; 95% CI, −0.51 to −0.32) and YLDs (ASYR) (EAPC = −0.41; 95% CI, −0.50 to −0.32) all presented downward trends. Males had higher ASIR, ASPR and ASYR than females in each year from 1990 to 2019. The incidence, prevalence and YLDs rates were higher in males in early adulthood but exceeded in females at older age. A positive correlation was observed between ASIR and SDI (rho = 0.3732, p < 0.01). Regions with higher SDI tended to have higher ASIR, ASPR and ASYR than lower SDI regions. Falls and road injuries were the major causes of pelvic fracture at all ages and during the whole period. ConclusionThe global health burden of pelvic fracture still remained high during the past thirty years. More policies and strategies are needed to face the challenge brought by population growth and aging.

Global, Regional, and National Burden of Road Injuries from 1990 to 2019

(1) Background: Understanding occurrence can help formulate effective preventative laws and regulations. However, the most recent global burden and road injuries (RIs) trends have not been reported. This study reports the burden of RIs globally from 1990 to 2019. (2) Methods: RIs data were downloaded from the Global Burden of Disease 2019. Incidence, deaths, and disability-adjusted life years (DALYs) described the trend and burden of RIs. We calculated age-standardized rates (ASRs) and estimated annual percentage change (EAPC) for the above indexes to evaluate the temporal trend of RIs. We evaluated the social-demographic index (SDI) with epidemiological RI parameters and reported proportions of age-standardized rates due to RI. (3) Results: In 2019, the global incidence of RIs reached 103.2 million. The EAPC of RI incidence increased, whereas deaths and DALYs decreased. Age-standardized incident rate (ASIR) was highest in low-middle SDI regions, age-standardized death rate (ASDR) was high in middle SDI regions, and age-standardized DALYs increased in low SDI regions. The highest accident rates were found in those aged 20-24 years old. Cyclist injuries were the leading RIs (34%), though pedestrian and motor vehicle accidents were the leading cause of death (37.4%, 37.6%) and DALYs (35.7%, 32.3%), respectively. (4) Conclusions: Over the past 30 years, RIs incidence increased annually, though death and DALY rates decreased. RIs places a considerable burden on public health in low SDI countries. Data should be used to develop and implement effective measures to reduce the burden of RIs.

Road safety strategies necessary in the second Decade of Road Safety.

While transport is integral to mobility and the economy, the hidden social costs of rapid motorisation are tremendous. As of 2019, there were around 1.3 million traffic fatalities, accounting for 2.3% of the total deaths and ranked 12th of the causes of mortality worldwide [1]. Road injuries also led to 79 million disability-adjusted life year […]

Odds of self-reported minor cycle crashes with conventional and electric assisted cycles adjusted for cycling frequency in Dutch and Belgian adults a retrospective study

BackgroundCycling for transportation and recreation is gaining in popularity, especially in older age groups. The rise in electric assisted cycles (EAC) may also have a role to play in this. With an increase in the number of cyclists comes an increase in the prevalence of cycle crashes. However, there is a lack of knowledge on EAC crashes and crash studies including cycle use data. An important question is also whether the high number of serious road injuries among older cyclists, is due to increased risk or more serious consequences in the event of a crash. Study aimTo compare the odds of reporting a cycle crash on a conventional (CC) against electrically assisted cycle (EAC), while controlling for age, gender, BMI, impairments while cycling, cycling frequency and region of residence. MethodsA 12-month retrospective cross-sectional survey-based study, including male and female cyclists aged 40+ years, was conducted in Belgium and the Netherlands. Socio-demographics, physical and mental impairments while cycling (such as lower reaction time), crash details and cycling frequency data were collected. Cyclists were grouped into CC, EAC or both (CC + EAC) based on the type of cycle they used during the study period. Logistic regression models were used to calculate the odds of reporting a cycle crash. Main and interaction effects were studied. Results1,919 cyclists were included in the data analysis (63.2 ± 11.1 years; 50% women). 319 (17% of the total sample) cyclists reported a crash in the previous 12 months, of which 36% were EAC crashes. Those reporting a crash were significantly younger compared to those not reporting a crash. The following significant main effects were observed: those cycling on an EAC had a higher odds of reporting a cycle crash compared to those cycling on a CC (OR = 1.41, 95% CI = 1.01–1.97); cyclists in the category average and high on mental impairments while cycling had a higher odds of reporting a cycle crash compared to those in the category low (OR = 1.72, 95% CI = 1.23–2.40 and OR = 3.49, 95% CI = 2.51–4.90, respectively); higher cycling frequency is related to higher odds of reporting a cycle crash (OR = 3.25, 95% CI = 2.25–4.90). A significant interaction effect was observed between age category and gender (OR = 1.93, 95% CI = 1.15–3.26). Post-hoc tests revealed that men in the younger age category (40–64 years) had the highest probability (18.95%) of reporting a cycle crash, whereas men in the oldest age category (65+ years) had the lowest probability (9.99%) of reporting a cycle crash. No significant difference between age categories in women was observed. ConclusionThis study indicates that within a cohort of middle aged and older adults living in regions with high to low cycling modal shares, cycle type, mental impairments while cycling, cycling frequency and region of residence play a significant role in the odds of reporting a (minor) cycle crash. Men in the age category 40–64 years have a significantly higher probability of reporting a cycle crash compared to men of 65+ years. Safety campaigns and instructions should pay particular attention to men in the age category 40–64 years and those with a mental impairment while cycling.

Attributable disease burden related to low bone mineral density in Iran from 1990 to 2019: results from the Global Burden of Disease 2019.

Low bone mineral density (BMD) including low bone mass and osteoporosis is a bone state that carries the risk of fractures and the consequent burden. Since Iran has an aging population and is considered a high-risk country regarding fracture, the objective of this study was to report the low BMD attributable burden in Iran from 1990 to 2019 at national and subnational levels. In this study, the Global Burden of Disease (GBD) study 2019 estimates of exposure value and attributable burden were used. For each risk-outcome pair, following the estimation of relative risk, exposure level, and the Theoretical Minimum Risk Exposure Level (TMREL), the Population Attributable Fractions (PAFs) and attributable burden were computed. The Summary Exposure Value (SEV) index was also computed. Although the age-standardized DALYs and deaths decreased (- 41.0 [95% uncertainty interval: - 45.7 to - 33.2] and - 43.3 [- 48.9 to - 32.5]), attributable all age numbers in Iran increased from 1990 to 2019 (64.3 [50.6 to 89.1] and 66.8 [49.7 to 102.0]). The male gender had a higher low BMD attributed burden in Iran at national and subnational levels except for Tehran. Among low BMD-associated outcomes, motor vehicle road injuries and falls accounted for most of the low BMD-attributed burden in Iran. The SEV for low BMD remained constant from 1990 to 2019 in the country and females had higher SEVs. Low BMD and the associated outcomes has to gain attention in Iran's health system due to an aging population. Hence, timely interventions by health systems and the population at stake might assist in reducing the burden attributed to low BMD.

Construction of group norms in a radical acceptanceonline forum for heavy alcohol users: A corpus-based discourse analysis.

Alcohol use is a major source of morbidity and mortality globally. Numerous adverse health outcomes have been linked to alcohol use, including liver disease, road injuries, violence, cancer, cardiovascular disease, suicide, domestic violence and family breakdown. Alcohol use is responsible for approximately three million deaths per year across the globe. Different paradigms have been employed in the treatment of alcohol use disorder, including abstinence-based and harm-reduction models. Radical acceptance, which has been successfully applied elsewhere in mental health treatment, has not gained purchase in the treatment of addictions. We used a set of corpus linguistics techniques to analyze a dataset of approximately 10,000 posts in an online forum for self-identified severe alcoholics. The forum we studied explicitly claims a radical acceptance approach to alcohol use disorder. The forum is "for people who accept their lifestyle choice and don't want to be interrupted . . ." We combined quantitative methods (keyword and collocation analysis) and qualitative methods (concordancing) to conduct a discourse analysis of the linguistic and rhetorical practices employed in the forum. We found that although the forum purports to embrace acceptance and eschew change, in fact, the discursive practices in the forum reveal a highly ambivalent relation with both acceptance and change. We found that acceptance and change are in dialectical tension that mirrors the structure agency dialectic described in critical realism. We suggest there may be merit in considering employing a radical acceptance paradigm in addictions treatment.

Applying the Consolidated Framework for Implementation Research (CFIR) to examine barriers and facilitators to built environment change in five Canadian municipalities: Lessons from road safety and injury prevention professionals

IntroductionRoad traffic injury and death continue to be a concern in Canada. The built environment (BE) is a contributing factor affecting the health of road users, yet there are significant challenges to making injury-reducing BE changes. This research increases our knowledge of these challenges by investigating the opinions of injury prevention and road safety professionals working in Canada about the barriers and facilitators to BE change. MethodsSemi-structured interviews and virtual focus groups (VFG) were conducted with 80 key informants (KIs) working in transport and injury prevention sectors in five Canadian cities: Vancouver, Calgary, Peel Region, Toronto, and Montréal. The Consolidated Framework for Implementation Research (CFIR) informed the interview guides. Thematic analysis was used to systematically analyze the data, a process that involved developing codes aligning with the research question, what are the barriers and facilitators to BE change? Themes were cross-referenced with the CFIR domains and constructs to illustrate how barriers and facilitators influence implementation of BE changes. ResultsThe prioritization of motor vehicles, lack of funding and resources, lack of political will, and sectoral silos were described as the most significant barriers to BE change. Cross-sectoral collaboration, data sharing, and champions and advocates were the most significant facilitators. ConclusionsCross-referencing themes with the CFIR situated our findings within the scope of implementation science, which demonstrated how barriers and facilitators influence BE change project implementation. The prioritization of motor vehicles results in disproportionate injury and health risks for VRUs. Collaboration across sectors, with the support of champions and advocates, can facilitate sharing of resources, data, and expertise, which results in more opportunities to enact BE change. Knowledge of these barriers and facilitators, contextualized by the CFIR, makes a case for policy/decision-makers in Canada to approve BE projects that reduce risk of road traffic injury and death.

Alcohol drinking and driving habit particularly in Nigeria and the role forensic science could play

Alcohol drinking habit is a serious epidemic that afflicts people worldwide regardless of socioeconomic class and the country’s development or civilization. The purpose of this systematic review was to summarize research findings on drinking and driving, its implications for Nigerian society, and the role forensic science can play in drunk driving. Nigeria, in particular has seen a lot of fatal accidents attributed to alcohol but due to a lack of forensic sobriety and toxicology drug tests at the crash scene that is not yet in place in the country, the offenders are not punished for this crime. The only two African countries that have legislation on Blood Alcohol Concentration (BAC) are South Africa and Zimbabwe. Nigeria has no such legislation and does not conduct such tests in injury and fatal accident cases. The prevalence of drinking habits among Nigerians and in particular the drivers cannot be ignored. This study examined global drinking habits including its prevalence in Nigeria and more importantly understudied the need for forensic science interplay in a criminal investigation against drunk driving in the country. Drunk driving in Nigeria is a serious problem. Establishing and enforcing drunken driving laws as a criminal offense would assist the country in the reduction of road accidents, injuries, and fatalities relating to road accidents. Forensic science is a unique field that is equipped with skills and knowledge that could be useful for criminal investigation in the country including accident cases. Forensic scientists have outstanding technical skills to identify, detect, and even assist the country’s prosecutors in the administration of justice in crime investigations. Nigeria as a country will be well served if forensic scientists work in partnership with the government. Drinking and driving in addition to other crimes has become a matter of concern. The country’s police force and courts still rely mostly on eyewitness circumstantial evidence, testimonies, and suspects’ confessions. Based on this, I personally believe that the advent of Forensic science in the country’s system will assist a great deal in solving crimes and reducing fatal accidents due to drunk driving.

Cars dent, horse riders break: Analysis of police-recorded injury incidents involving ridden horses on public roads in Great Britain

Introduction: Police-recorded road injury data are frequently used to approximate injury risk for different road user groups but a detailed analysis of incidents involving ridden horses has not previously been conducted. This study aims to describe human injuries resulting from interactions between ridden horses and other road users on public roads in Great Britain and identify factors associated with severe to fatal injuries. Method: Police-recorded road incident data involving ridden horses (2010–2019) were extracted from the Department for Transport (DfT) database and described. Multivariable mixed-effects logistic regression modeling was used to identify factors associated with severe/fatal injury outcomes. Results: A total of 1,031 injury incidents involving ridden horses were reported by police forces, involving 2,243 road users. Out of 1,187 road users injured, 81.4% were female, 84.1% were horse riders, and 25.2% (n = 293/1,161) were in the 0–20 year age category. Horse riders represented 238/267 serious injuries and 17/18 fatalities. Vehicle types involved in incidents where horse riders were seriously/fatally injured were mostly cars (53.4%, n = 141/264) and vans/light goods vehicles (9.8%, n = 26). Horse riders, cyclists, and motorcyclists had higher odds of severe/fatal injury compared to car occupants (p < 0.001). Severe/fatal injuries were more likely on roads with 60–70 mph speed limits versus 20–30 mph roads, while odds of severe/fatal injury increased with increasing road user age (p < 0.001). Conclusions: Improved equestrian road safety will largely impact females and young people as well as reducing risk of severe/fatal injuries in older road users and those using modes of transport such as pedal-cycles and motorcycles. Our findings support existing evidence that reductions in speed limits on rural roads would help reduce the risk of serious/fatal injuries. Practical applications: More robust equestrian incident data would better inform evidence-based initiatives to improve road safety for all road users. We suggest how this can be done.

Post‐flood infectious disease prevention and control: Current scenario in Pakistan

Post‐flood infectious disease prevention and control: Current scenario in Pakistan

Methodological considerations when assessing the Burden of Disease due to injuries

Abstract Measuring the burden of disease due to injury is a similar process compared to the disease burden. However, burden calculations for injuries impose an extra complexity for the non-fatal burden, as it is important to consider both the ‘cause’ and the ‘nature’ of the injury. Cause of injury (e.g., road injuries, falls, drowning) have historically been used for assigning cause of death as opposed to the ‘nature’ of injury, which more directly specifies the pathology that resulted in death or disability. However, precisely estimating the disability as a result of an injury requires a mapping of, for example, individuals that have suffered a fracture hip (‘nature’ of the injury) because of falling (‘cause’ of the injury). This process would require a matrix of the nature-cause relation of injuries, which are only scarcely available, because they required dual-coded data registers. The presentation will zoom into the differences between disease and injury estimations and will appraise the methodological considerations for the estimations of injury-related burden of disease estimates. References James, S. L., Castle, C. D., Dingels, Z. V., Fox, J. T., Hamilton, E. B., Liu, Z., ... &amp; Fomenkov, A. A. (2020). Estimating global injuries morbidity and mortality: methods and data used in the Global Burden of Disease 2017 study. Injury Prevention, 26(Suppl 2), i125-i153. Haagsma, J. A., James, S. L., Castle, C. D., Dingels, Z. V., Fox, J. T., Hamilton, E. B., ... &amp; Mahotra, N. B. (2020). Burden of injury along the development spectrum: associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017. Injury prevention, 26(Suppl 2), i12-i26.

Factors leading to alcohol use among adolescents in Asia

Drinking indecently is a severe public health issue. Sipping or tasting frequently leads to regular alcohol or worsening habits such dangerous excessive drinking or addiction, alcoholism, or even death. Social and structural factors that have an impact on adolescents' health at the individual, family, community, and societal levels have a significant impact. Violence, mental health issues, creating the risk but rather self-harm, HIV or other viral infections, poor educational performance and dropout rates, limited employment opportunities, and accidents here on road or other unintentional injuries are just a slew of negative effects of adolescent alcohol consumption. The purpose of this review is to look at the research and determine what factors lead to teen consumption in Asian countries. The study made extensive use of internet resources including Pubmed and CINHAL. The study made extensive use of internet resources including Pubmed and CINHAL. After that, databases were accessed to conduct a more extensive literature search using key phrases and chemical operator to find publications pertinent to the issue. 64 records were found. Duplicate entries and those that didn't fit the criteria were removed. A criteria for inclusion/exclusion was used to filter 8 items.