Road Traffic Accident Mortality Research Articles

Socially responsible behaviour of a pedestrian − Obligation or necessity?

As vulnerable road users, pedestrians are the object of research in various areas of road safety. One of the ways to reduce the level of risky behaviour of pedestrians is to increase their social responsibility by applying the “traditional” 3 E: engineering, education, and enforcement. Social responsibility involves a focus on responsibility for both actions related to personal safety and actions that benefit society. This paper deals with the results of a survey of pedestrians regarding their risky behaviour while walking, namely, violation of crossing rules and distraction by using a smartphone or listening to music through headphones. It was found that risky behaviour depends on the age of pedestrians, and listening to music through headphones also depends on the person’s gender. It was established that respondents’ assessment of the safety of transport modes does not correlate with data on mortality in road traffic accidents using different types of transport. It is proposed that social responsibility of pedestrians can be increased by analyzing the causes and events that lead to traffic accidents during the study of safety disciplines in higher education institutions.

Determinants of Road Traffic Crash Fatalities: A Case of Road Accidents in India, 2004–2018

The purpose of this study is to determine the factors that influence deaths in road accidents in India. The study uses panel econometric methodologies such as the fixed effects model, random effects model, and Hausman–Taylor instrumental variable technique to achieve this goal. Unobserved heterogeneity between states/union territories (UTs) and time is accounted for by time-fixed and state-fixed effects. Based on the panel data set from Indian states/UTs for the period 2004–2018, the study confirms previous results that motorisation, population, urbanisation and income level are all potential contributors to road accidents and fatalities. It also shows that spending on health care and law enforcement appears to help the Indian states minimise mortality in road traffic accidents. On the one hand, spending on health care facilities can provide health-related assistance to persons who have been involved in traffic accidents; on the other hand, spending on police increases the enforcement of rules, resulting in a reduction in traffic accidents. Thus, to lessen the economic and financial cost of road accidents in the country, the government should focus on boosting both per capita health expenditure and per capita police expenditure. JEL Codes: C23, C26, H51, I18, L92, O18, R41, R42

IJCM_49A: Mortality trends of road traffic accidents due to human errors in Chhattisgarh and India (2016-2022)

Background: Road safety continues to be a major developmental issue, a public health concern and a leading cause of death and injury affecting not only the victims and their family but also the economy as a whole in terms of untimely deaths, disabilities and loss of potential income. India ranks 2nd in the number of road accidents and 1st in mortality due to RTA in the world. Road accidents are multi-causal due to interplay of various factors. These can be broadly categorized into those relating to (a) Human error (b) Road condition/ environment (c) Vehicle condition. Human errors for RTA include non-compliance to traffic rules and not using helmets and seatbelts, resulting in mortalities which can be mitigated by proper education, adherence and implementation of traffic rules. Objective: To analyze the mortality trends due to RTA by human errors in Chhattisgarh and India 2016-2022 Methodology: The RTA mortality statistics were retrieved from the Road accidents in India report published annually by the Ministry of Road Transport and Highways. A literature search was done in electronic databases like-PubMed, Google Scholar, other platforms using keywords- RTA mortality, Distracted driving Results: From 2016 to 2022, both Chhattisgarh and India experienced a steady rise in fatalities, peaking in 2022 due to overspeeding and helmet non-compliance. In 2019, India saw its peak in fatalities from alcohol-related driving, mobile use, and signal jumping, followed by a decline. Chhattisgarh experienced the highest signal jumping fatalities in 2017 and alcohol-relatedriving deaths in 2018 compared to other years Conclusion: The study reveals a decrease in road traffic accident fatalities caused by certain human errors post-2019, credited to the adoption of the Motor Vehicle Amendment Act 2019. Boosting public awareness and establishing robust surveillance measures are imperative in curbing fatalities caused by road traffic accidents (RTAs)

A Review of the Processes and Procedures of Road Traffic Accident Mortality Data Collection in Zambia

Road traffic crashes (RTCs) pose significant public health challenges globally, leading to millions of deaths, injuries and disabilities each year. Low- and middle-income countries, including Zambia, bear a disproportionate burden of RTC fatalities and injuries. However, the collection and accuracy of RTC data in Zambia are hampered by various challenges, including underreporting and inadequate data collection procedures. Strengthening RTC data collection systems is crucial to accurately understand the magnitude of the problem and implement effective measures to reduce RTC fatalities and injuries. This article presents a review of RTC mortality data collection processes and procedures in Zambia, focusing on the key stakeholders involved, namely the Zambia Police Service, Health Care Facilities, and the Department of National Registration, Passports and Citizenship. The study identifies key challenges such as paper-based records, inadequate training, resource limitations, varying case definitions, and low death registration rates. The research emphasizes the need to strengthen data systems and improve coordination among stakeholders. Recommendations include establishing a multidisciplinary road crash data analysis team, utilizing technology for data collection and analysis, providing training and capacity building, conducting public awareness campaigns, and enhancing collaboration between the police, hospitals and Civil Registration and Vital Statistics (CRVS). Implementing these recommendations is crucial to improve the accuracy and completeness of RTC mortality data, leading to evidence-based road safety interventions and policies. This research contributes to the understanding of RTC data collection practices in Zambia and provides valuable insights for policymakers, researchers, and practitioners in addressing the challenges in RTC mortality data collection.

A Review of the Processes and Procedures of Road Traffic Accident Mortality Data Collection in Zambia

Road traffic crashes (RTCs) pose significant public health challenges globally, leading to millions of deaths, injuries and disabilities each year. Low- and middle-income countries, including Zambia, bear a disproportionate burden of RTC fatalities and injuries. However, the collection and accuracy of RTC data in Zambia are hampered by various challenges, including underreporting and inadequate data collection procedures. Strengthening RTC data collection systems is crucial to accurately understand the magnitude of the problem and implement effective measures to reduce RTC fatalities and injuries. This article presents a review of RTC mortality data collection processes and procedures in Zambia, focusing on the key stakeholders involved, namely the Zambia Police Service, Health Care Facilities, and the Department of National Registration, Passports and Citizenship. The study identifies key challenges such as paper-based records, inadequate training, resource limitations, varying case definitions, and low death registration rates. The research emphasizes the need to strengthen data systems and improve coordination among stakeholders. Recommendations include establishing a multidisciplinary road crash data analysis team, utilizing technology for data collection and analysis, providing training and capacity building, conducting public awareness campaigns, and enhancing collaboration between the police, hospitals and Civil Registration and Vital Statistics (CRVS). Implementing these recommendations is crucial to improve the accuracy and completeness of RTC mortality data, leading to evidence-based road safety interventions and policies. This research contributes to the understanding of RTC data collection practices in Zambia and provides valuable insights for policymakers, researchers, and practitioners in addressing the challenges in RTC mortality data collection.

Analysis of road accident mortality based on time of occurrence for Kerala, India

Background: Road traffic accidents (RTA) pose a significant socio-economic burden and global public health concern. Monitoring road safety initiatives' efficacy necessitates analysing RTA incidence. This study examines time zone-specific RTA mortality in Kerala state, India, from 2016 to 2021. Methods: Utilizing compiled secondary-level time series data, the study encompasses total RTA fatalities in Kerala from 2016 to 2021. Data includes fatalities per year in nine consecutive three-hour time periods. Exploratory data analysis, time series regression, and exponential smoothing were employed for analysis. Results: Data reveals fluctuating trends in road accident (RA) fatalities, peaking in 2018 with a notable decrease in 2020. 18:00 to 21:00 recorded the highest and lowest fatalities, total 901 deaths. Disproportionate RA fatalities occurred from 06:00 to 09:00 (527 deaths) and 15:00 to 18:00 (697.5 deaths). The study employs Holt-Winters exponential smoothing for short-term forecasting, with a mean absolute scaled error (MASE) less than 1 signifying accurate predictions. Conclusions: The analysis highlights temporal patterns, emphasizing 18:00 to 21:00 as critical. Holt-Winters exponential smoothing proves vital for accurate short-term forecasting, with MASE reflecting precision. Urgency is stressed in adopting targeted measures for time-specific road accidents. Government intervention is pivotal, advocating for improved infrastructure, enhanced driver education, efficient vehicle management, and sustained traffic enforcement. Tailoring traffic laws to time zones, coupled with forecasting techniques, aligns with the overarching goal of enhancing road safety and reducing RA mortality rates.

Analysis and forecasting of road traffic mortalities in Azad Jammu and Kashmir.

To analyse road traffic accident mortalities in a geographical region. The retrospective study was conducted in Azad Jammu and Kashmir based on secondary data from 2004 to 2017 collected from the police department. Duncan's multiple range test was used to assess the trends in road traffic accident fatalities with respect to districts and divisions. Different goodness-of-fit criteria were used to compare the performance of different regression models to analyse road traffic accident mortalities with respect to vehicle ownership. The parsimonious time series model was used to forecast the future trends of road traffic accident mortalities. R 3.6.0 software was used for data analysis. There were 5263 major road traffic accidents during the period studied, causing 2317 deaths and 12963 injuries. The number of mortalities in Mirpur division was 923(39.8%), in Muzaffarabad 794(34.3%), and inss Poonch 600(25.9%). The rates of road traffic accident mortalities per 100,000 population increased up to year 2010 and dropped slowly afterwards (Figure 1C). Some disparities were noted among different districts and divisions with respect to road traffic accident mortalities. Based on different goodness-of-fit criteria, the Smeed's model was found to be the most efficient model to analyse the trends of road traffic accident mortalities with respect to vehicle ownership (Table 1). The forecast for road traffic accident mortalities exhibited some fluctuations in the start and a uniform trend afterwards (Figure 6). Disparities in road traffic accident fatalities across different districts and divisions of Azad Jammu and Kashmir were observed. Though the rate of road traffic accident mortality was seen to be decreasing since 2010, the situation is for behind compared to the global Sustainable Development Goals.

Exploring the spatio-temporal patterns of road traffic accidents in Saudi Arabia

Background: Road traffic accidents (RTAs) are a leading cause of mortality and morbidity in the young population and are a growing problem worldwide. This study is a comprehensive analysis of the spatiotemporal patterns of 352,464 RTAs in Saudi Arabia from 2017 to 2018. Methods: This study consists of three principal phases of analysis (exploratory data analysis of the RTA dataset by analyzing population involvement in RTAs and mortality or morbidity, we examined the geographic and temporal distribution of RTA, and we performed a spatial hotspot analysis per region on a monthly basis using local Moran's I hotspot clustering). This study presented the monthly spatiotemporal patterns of RTAs in Saudi Arabia in 1439 Hijri and data were obtained from the Saudi Open Data Portal for all. Results: Four cities, Ar Riyad, Ash Sharqiyah, Makkah, and Jeddah, were in the top 25% of RTA involvement, mortality, and morbidity in Saudi Arabia. Four cities, Ar Riyad, Ash Sharqiyah, Makkah, and Jeddah, were in the top 25% of RTA involvement, mortality, and morbidity in Saudi Arabia. There were 11 injuries and 2 deaths per 100 accidents during the study period. More than 84% and 88% of those who were injured and killed in RTAs were male, respectively. There was a significant decrease in the number of RTAs in the last months of the year (Hajj month in the Hijri calendar) compared to other months in the Makkah region and the Eastern Province. In addition, no significant temporal patterns in daily occurrence rates at the national level. Similarly, there was no significant difference between RTA incidence on weekdays and weekends. Differences between daytime and nighttime were significant, with more accidents occurring during the day. The number of injuries per 1,000 population is the same throughout the year in the provinces of the country. Conclusion: This study identified areas in Saudi Arabia where further investigation is needed to analyze the points that lead to more RTAs and consequently more disabilities and mortalities.

Head Injuries in Fatal Road Traffic Accidents in Northern Districts of Bangladesh

Objective: To analyze the autopsy findings in the cases of fatal head injuries due to road traffic accidents. Study Design : Retrospective study Place and duration of study: This study was conducted at the Rangpur Medical College morgue among victims of road traffic accidents (RTA) during the period of July 2014 to June 2016. It was conducted to ascertain the patterns of fatal head injuries due to road traffic accidents as documented during autopsies performed at Rangpur Medical College during (July 2014 to June 2016) the two years. Material & Methods: Road traffic accident are the major causes of death worldwide. Head injuries is the single most common cause of mortality in road traffic accidents; head injuries being the most vulnerable part of the body. Total74 victims were taken from the road traffic accidents and died due to head injury. Aim of the study to find out the patterns of head injuries, their age and site distribution of different type of fractures. Results: The cases were seen more in the male victims (87.84%) as compared to female (12.16%). Present study showed that the place of occurrence of road traffic accident was more in the urban areas (77.03%) as compared to rural areas (22.97%). No one of the threewheeler riders was wearing helmets at the time of accidents. We observed subdural hemorrhage (SDH) in 63.83% followed by sub arachnoid hemorrhage (SAH) in 27.66% intracranial hemorrhage (ICH) 6.38% and least was extradural hemorrhage (EDH) 2.13% in twowheeler riders. while in three-wheeler riders SDH in 51.85% followed by SAH in 29.63% ICH in 11.11% and least was EDH in 7.41% in cases where skull fracture occurred. Most of the accident occurred at night. Conclusion: Head injury is one of the important causes of death in road traffic accidents. Most of the deaths occur on spot before any life support can be given to these subjects. The pattern of skull fractures observed in this study was quite comparable to other studies. It indicates that road traffic accidents lead to similar kinds of fatal head injuries throughout the world. J Shaheed Suhrawardy Med Coll 2021; 13(1): 75-79

Comparison of mortality prediction models for road traffic accidents: an ensemble technique for imbalanced data

BackgroundInjuries caused by RTA are classified under the International Classification of Diseases-10 as ‘S00-T99’ and represent imbalanced samples with a mortality rate of only 1.2% among all RTA victims. To predict the characteristics of external causes of road traffic accident (RTA) injuries and mortality, we compared performances based on differences in the correction and classification techniques for imbalanced samples.MethodsThe present study extracted and utilized data spanning over a 5-year period (2013–2017) from the Korean National Hospital Discharge In-depth Injury Survey (KNHDS), a national level survey conducted by the Korea Disease Control and Prevention Agency, A total of eight variables were used in the prediction, including patient, accident, and injury/disease characteristics. As the data was imbalanced, a sample consisting of only severe injuries was constructed and compared against the total sample. Considering the characteristics of the samples, preprocessing was performed in the study. The samples were standardized first, considering that they contained many variables with different units. Among the ensemble techniques for classification, the present study utilized Random Forest, Extra-Trees, and XGBoost. Four different over- and under-sampling techniques were used to compare the performance of algorithms using “accuracy”, “precision”, “recall”, “F1”, and “MCC”.ResultsThe results showed that among the prediction techniques, XGBoost had the best performance. While the synthetic minority oversampling technique (SMOTE), a type of over-sampling, also demonstrated a certain level of performance, under-sampling was the most superior. Overall, prediction by the XGBoost model with samples using SMOTE produced the best results.ConclusionThis study presented the results of an empirical comparison of the validity of sampling techniques and classification algorithms that affect the accuracy of imbalanced samples by combining two techniques. The findings could be used as reference data in classification analyses of imbalanced data in the medical field.

Airbag Fatality: A Case Report From the Kingdom of Bahrain

The main purpose of Airbags installed in automotives is to protect drivers as well as accompanying passengers during an accident. Despite their safety benefits, a considerable number of airbag-associated injuries are reported in the literature. Airbags are designed to open in head-on collisions when vehicle deceleration exceeds a specified threshold. Defective airbags deployment with metal projectiles launching and hitting passenger’s head or neck have been reported. Deaths from defective airbags are rarely reported in the Middle East. This article presents a case in the Kingdom of Bahrain of a driver whose car was in a head-on collision with another car resulting in in severe head trauma and death at the scene. Death scene investigation revealed that a fire has originated from the airbag compartment with a cylindrical metallic object found missing a part of it. Autopsy of the deceased showed an injury to the right side of the head similar to a firearm inlet. Examination of the head revealed a cylindrical metal object that did not resemble firearm projectiles. The object appeared to have come from the interior of the car upon impact. Laboratory analysis confirmed that the two metallic objects recovered from the deceased’s body were actually the broken pieces of airbag compartment. each other. Although airbags have greatly reduced morbidity and mortality in road traffic accidents, defective airbags highlight the need to increase awareness of their hazards and the importance of their regular inspection and replacement if found defective

Aeromedical Transportation of Patients With Acute Trauma in a Metropolis: Follow-up on the Issue and Own Experience of Moscow Territorial Scientific and Practical Center for Disaster Medicine Department of the Moscow Health Department

In connection with the expansion of the administrative boundaries of the city of Moscow, the number of trauma cases, including those associated with road traffic accidents, man-made accidents, and industrial accidents, remains at a high level. The provision of emergency medical care and transportation of patients with acute trauma is one of the important tasks of the territorial center of disaster medicine in Moscow. Aeromedical evacuation of victims to hospitals of the metropolis allows adhering to the rule of the “golden hour”, which certainly affects the reduction of disability and mortality in road traffic incidents and accidents.

Use of seat belts among public transport drivers in Tacna, Peru: Prevalence and risk factors.

There are individuals who still refuse to wear seat belts, despite its effectiveness in reducing morbidity and mortality in road traffic accidents. We aimed to determine the prevalence and risk factors according to the use of seat belts among public transport drivers in Tacna, Peru. This analytical transversal study was carried out among public transport drivers (buses and taxis) in a Peruvian city. Questionnaires were used to evaluate the general and occupational characteristics and the use of seat belts (observed). Descriptive statistics and risk factors were obtained, these latter through generalized linear models. Of the 460 drivers, 77% used their seat belts, with a difference in use depending on the type of public transport (p<0.001). In the multivariate model, the risk of not using the belt was associated with the following: older age (p<0.001), having complete studies (p<0.001), a higher level/category of driving license (3 categories had p<0.001), having a higher number of previous road traffic accidents (p = 0.011), and received medical attention in that accident (p<0.001), those who reported using a cell phone while driving (p = 0.005), if the co-driver's belt had 3 anchorage points (p<0.001), and working for > 5 hours that day (p = 0.002). However, male drivers and those who had their belt with 3 anchorage points had greater use (both p<0.001). One in five drivers did not use a seat belt, and important characteristics of those who did not comply with this traffic law were evaluated to generate control and intervention measures.

No effect of the Penalty Point System on road traffic accident mortality among men with a high socioeconomic status in Spain

The purpose of this study was to assess the effect of the Penalty Point System (PPS) on road traffic accident mortality by gender and socioeconomic status. We conducted a nationwide prospective study covering adult people living in Spain on November 2001. They were followed up until 30 Nov 2007 to determine vital status and cause of death. An interrupted time-series analysis was used to assess whether PPS (explanatory variable) had both immediate and long-term effect on the rates of road traffic accident mortality (RTAMs) separately by gender. Subjects were classified by socioeconomic status (low and high) using two indicators: educational attainment (up to lower secondary education; upper secondary education or more) and occupation (manual and non-manual workers). We performed several segmented Poisson regression models, controlling for trend, seasonality, 2004 road safety measures and fuel consumption as proxy for traffic exposure. Among men, we found a decrease on the RTAMs immediately after PPS in those with low educational level (16.2 %, IC95 %: 6.1 %–25.2 %) and manual workers (16.3 %, IC95 %: 2.8 %–27.8 %), and a non-significant increase among those with high education level and non-manual workers (6.2 % and 1.8 %). Among women, there were no significant differences in the immediate effect of PPS by socioeconomic status. We did not identify significant trend changes between pre-PPS and post-PPS periods in any socioeconomic group. In a context of downward trend of traffic mortality, the PPS implementation led to an immediate reduction on death rates only among men with a low socioeconomic status.

Road traffic accident mortality analysis based on time of occurrence: Evidence from Kerala, India

IntroductionRoad Traffic Accidents (RTA) are a global public health concern imposing huge socio-economic costs on a society. Analysis of the incidence of RTA is essential to monitor the effectiveness of different road safety policies implemented to reduce this. The present study analyzes and forecasts time zone's-specific RTA mortality reported during 2005–2018 in Kerala State, India. MethodsAn aggregate level secondary time series data of the total Number of Persons Killed (NPK) due to RTA in Kerala during 2005–2018 recorded at consecutive eight time zones were considered for the analysis. The exploratory data analysis and time series regression were mainly used for analyzing the data. ResultsThe analysis confirms seasonality and upward trend in the RTA deaths in Kerala (549.5 (266.5660)) during 2005–2018. The minimum number of RTA deaths (129 (109,171)) happened from 00.00 a.m. to 3.00 a.m. and the maximum number of deaths occurred from 18.00 p.m. to 21.00 p.m. (810.5 (760,876)). RTA deaths in Kerala during evening and night-time were relatively higher than other time zones. RTA deaths that occurred immediately before dawn from 06.00 a.m. to 9.00 a.m. (504.5 (469,566)) or after dusk from 15.00 p.m. to 18.00 p.m. (719 (663,766)) were also relatively high in Kerala. Since 2016, in the time zones 00.00 a.m.–03.00 a.m., 09.00 a.m.–12.00 a.m., 18.00 p.m.–21.00 p.m. and 21.00 p.m.–24.00 p.m., there is an increasing trend in the RTA deaths in which during 21.00 p.m.–24.00 p.m. the NPK records a steady increase. Time series regression analysis indicates, for every 3hrs rise in time over the year; approximately four persons were killed (P-value < 0.001) due to RTA in Kerala during 2005–2018. Moreover, on average, more than 673 (P-value < 0.001) people were killed during the 18:00 p.m. - 21:00 p.m. due to RTA in Kerala than that of 00:00 a.m. - 03:00 a.m. The forecast of expected RTA deaths in Kerala based on the fitted TSR model with SAR(1)(8) errors for the years 2019–2021 indicate most road accident deaths will likely occur during 18.00 p.m. and 21.00 p.m. and the least is between 00.00 a.m. and 03.00 a.m. The forecast for 2020 shows a decrease in Kerala's RTA deaths for every time zone than 2019 and then increases in 2021. ConclusionsThe findings of the study provide the evidence that there is a significant amount of increase in the RTA deaths in Kerala through time. The study insists on implementing and monitoring the road safety policies concerning specific time zones for lowering RTA death rates.

Features of road safety project implementation until 2024 in Omsk region

Introduction. One of the important problems in the Russian Federation is road safety improvement (RS). This is due to the enormous damage that accidents inflict on the national economy. The Russian Federation lags behind the leading countries of the European Union in the field of road safety in terms of key indicators by 3.5 times. To close the gap, in January 2018, we adopted the 'Strategy for road safety in the Russian Federation for 2018 - 2024’ (Strategy). The goal of the Strategy is to strive for zero mortality in road traffic accidents (RTA) by 2030, and in 2024 to reduce the social risk to 4 deaths per 100 thousand inhabitants.Materials and methods. The developments are based on a new theory developed at SibADI - this is the cyclical dynamics of road accidents on a national scale, subordinate to the level of the economy. During crisis, there is a decrease in the number of accidents; this is influenced by a number of factors, the main one is a decrease in the total mileage of vehicles. During such periods, the effectiveness of measures to reduce road accidents is often confused with the real cause, which leads to a decrease in funding and the curtailment of work to improve road safety, which should not be done. When the economy recovers, the level of road accidents recovers and even begins to grow due to the loss of qualifications of drivers who are idle during the crisis.Results. There are two different approaches to achieving this goal. At the federal level, there is a programmatic approach, while in the regions the project method is used within the framework of the 'Safe and High-Quality Highways’ national project (BKAD). A similar project was adopted in the Omsk region. A feature of the road safety project implementation in the Omsk region is the involvement of science. Research is carried out at the Organization and Traffic Safety Department and is introduced into the educational process and implemented at the Federal Training Center for advanced training of workers involved in the training of drivers, created in SibADI.Discussion and conclusion. The scientific approach guarantees the identification and quality solution of the main problems of the road safety project. This applies to recommendations for stabilizing project financing, justifying the development of public transport, using new technologies, improving the regulatory and legislative framework in all areas of urban planning and infrastructure.

Police experiences of bystander assistance in pre-hospital care of road traffic accident victims in Abuja, Nigeria: a cross-sectional study

BackgroundGlobally, most deaths from road traffic accidents (RTA) occur before the injured person reaches hospital. This mortality burden is disproportionately higher in Africa, with Nigeria having a mortality burden from RTA, at 21·4 per 100 000 people, that is six-times higher than that in high-income countries such as Norway (3·1 per 100 000 people). Bystander first aid is associated with improved survival of trauma victims and Norway has a high rate of bystander first aid to RTA victims (89%); however, data on bystander first aid for RTA victims are lacking in Nigeria. The objectives of this study were to: (1) determine the bystander assistance rate to RTA victims; (2) assess the prevalence of bystander first aid to RTA victims; and (3) evaluate bystander non-helping behaviours to RTA victims. MethodsThis was a cross-sectional study that used observer-report data collected from police officers at 31 police stations in Abuja, Nigeria. A stratified randomised sample of 428 police officers were interviewed using a structured electronic pre-tested questionnaire for data collection. The questionnaires were self-administered. We collected data on sociodemographic characteristics of police officers and they were asked to report information on bystander assistance, first aid, and non-helping behaviours during their last pre-hospital care encounters with RTA victims in Abuja. To calculate the bystander assistance rate and the prevalence of first aid, we defined bystander assistance as any activities such as calling the police or ambulance service and first aid to save the lives of RTA victims. First aid was defined as basic care such as chest compression or wound dressing given to stabilise RTA victims either at the scene of injury or during transportation to the hospital. Descriptive statistics were summarised using STATA v. 14.0. FindingsBetween Nov 21, 2018, and Dec 8, 2018, we included data from 281 police officers who had ever provided pre-hospital care to RTA victims in Abuja. The bystander assistance rate to RTA victims was 93·2% (n=262). Provision of first aid and calling the police or ambulance service were the most common form of bystander assistance (31·3% [n=82] and 28·2% [74], respectively). Other bystander assistance included provision of safety for RTA victims or first-aiders (20·2% [53]), and search and rescue for life and property near the accident scene (19·8%% [52]). The rate of bystander first aid to RTA victims was 29·2% (82). Of the bystander non-helping behaviours reported (6·8% [19]), gazing or just looking accounted for the most (68% [13]), followed by stealing victims' property (21% [4]). InterpretationThe rate of bystander first aid to RTA victims in Nigeria is significantly lower than those in high-income countries such as Norway and is likely to contribute to increased RTA mortality. Our findings highlight the need to increase community access to first aid trainings and behaviour-change interventions to improve RTA victims' health outcomes. FundingNIH and Fogarty International Center Training Grant for Partnerships to Develop Injury Research Capacities in Sub Saharan Africa (5D43TW010463-03) by Office of Global Health, University of Texas Southwestern Medical Center, USA.

Macroeconomic changes and educational inequalities in traffic fatalities in the Baltic countries and Finland in 2000\u20132015: a register-based study

This study examined trends and inequalities in road traffic accident (RTA) mortality in the Baltic countries (Estonia, Latvia, Lithuania) and Finland in relation to large-scale macroeconomic changes in the 2000s. Educational inequalities in RTA mortality in 2000–2003, 2004–2007, 2008–2011 and 2012–2015 among 30–74 year olds were examined using census-linked longitudinal mortality data and by estimating the relative and slope index of inequality. Overall RTA mortality decreased substantially between 2000–2003 and 2012–2015. From 2004–2007 to 2008–2011, the RTA mortality decline accelerated but was larger in the Baltic countries. Among men the RTA mortality decline was mostly driven by a larger fall among the high and middle educated. Among women, the changes in RTA mortality by educational level had no clear pattern. From 2000–2003 to 2012–2015 relative educational inequalities in RTA mortality increased among men, although more in the Baltic countries. Among women the pattern was mixed across countries. Absolute inequalities fell in all countries among both sexes. Educational inequalities in male RTA mortality may be growing because of increasingly less access to safer cars and a more hazardous driving culture among the lower educated.

Motorcycle Accidents and Their Outcomes amongst Victims Admitted to Health Facilities in Guinea: A Cross-Sectional Study.

Background Motorcycle road traffic accidents (RTA) constitute an increasing public health challenge with victims more likely to sustain fatal injuries compared with other types of RTA. The aim of this study was to analyze motorcycle RTA-related morbidity and mortality among victims admitted to hospitals in Guinea from 2015 to 2017. Materials and Methods This was a cross-sectional study based on hospital records from six districts (Boké, Kindia, Mamou, Faranah, N'Zérékoré, and Siguiri) from January 1, 2015, to December 31, 2017. Bivariate analysis and multivariate logistic regression were used to explore associations between RTA types and mortality. Results There were 14,962 RTA victims with motorcycle RTA accounting for 58.3% and other RTA 45.3% of hospital admissions. Overall, motorcycle RTA accounted for 77.7%, with young adults (96.2%) and males (73.5%) more affected when compared to victims of other types of RTA. Median age of motorcycle RTA victims was 23 years (IQR: 17–33 years). Students (29.7%), employees (23.6%), and farmers/housewives (23.3%) were the commonest groups affected by motorcycle RTA. The highest burden of motorcycle RTA occurred in the mining zones (Boké and Siguiri). Wounds (39.2% and 27.3%) and multiple injuries (43.8% and 43.8%) were the commonest types of injury sustained by victims of both motorcycle and other types of RTA, respectively. Motorcycle RTA accounted for 54% of overall deaths. Using multivariate logistic regression analysis, sustaining a motorcycle RTA in N'Zérékoré (AOR: 4.2; 95% CI: 1.6–11.2) and being admitted with mild (AOR: 7.4; 95% CI 2.1–25.8) and heavy or deep coma (AOR: 776.1; 95% CI: 340.2–1770.7) were significantly associated with mortality. Conclusions Motorcycle RTA are an important cause of morbidity and mortality in Guinea. Males, young adult users, students, employees, and people from mining zones are the most affected. Better law enforcement and awareness raising among Guinean young adults are promising prevention strategies.

Lagos state ambulance service: a performance evaluation

ObjectivesThe mortality rate from road traffic accidents (RTAs) in Nigeria is almost double that of the USA. In Nigeria, the first emergency medical services (EMS) system was established in March 2001, The Lagos State Ambulance Service (LASAMBUS). The objectives of this study are to (1) determine the burden of RTAs in Lagos, (2) assess RTA call outcomes, and (3) analyze LASAMBUS’s response time and causes for delay.MethodologyWe reviewed completed LASAMBUS intervention forms spanning December 2017 to May 2018. We categorized the call outcomes into five groups: I. Addressed Crash, II. No Crash (False Call), III. Crash Already Addressed, IV. Did Not Respond, and V. Other. We further explored associations between the (1) causes for delay and outcomes and (2) response times and the outcomes.ResultsOverall, we analyzed 1352 intervention forms. We found that LASAMBUS did not address 53% of the RTA calls that they received. Of this, Outcome II. No Crash (False Call) accounted for 26% and Outcome III. Crash Already Addressed accounted for 22%. Self-reported causes for delay were recorded in 180 forms, representing 13.7% of the RTA burden. Traffic congestion accounted for 60% of this distribution.ConclusionLASAMBUS response rates are significantly lower than response rates in high-income countries such as the USA and lead to increased RTA mortality rates. Eliminating causes for delay will improve both LASAMBUS effectiveness and RTA victims’ health outcomes. Changing the public perception of LASAMBUS and standardizing LASAMBUS’ contact information will aid this as well.