Road Traffic Injury Deaths Research Articles

Analysis of traffic injury trends, and strategies for road safety promotion in Lithuania

Abstract Every year, about 1.3 million people die on the world’s roads. The aim of the study was to analyze the mortality trends from traffic injuries, and to discuss strategies for the prevention of road traffic injuries and road safety promotion in Lithuania. A longitudinal study was conducted, and regression analysis was applied. The study showed that, when analyzing the changes in mortality from the main causes of death over 2009-2019, the greatest progress in mortality reduction was observed in the category of deaths from external causes; whereas, the number of deaths from diseases of the circulatory system did not change, and the number of deaths from malignant tumors increased slightly. In Lithuania, the death rate from traffic injuries per 100,000 inhabitants decreased significantly over a 50-year period (1971-2020) (in the whole population, and in the subgroups of men and women). In Lithuania, during the fifty-year period (1971-2020), pedestrian mortality rates decreased significantly in the whole population, and children and adolescents (0-14, 15-19, and 0-19 years). Over 1998-2020, road traffic injury deaths decreased significantly in children age groups 0-14, 15-19, and 0-19. After exploring the preventive strategies used for road safety promotion, it was revealed that the most effective results were achieved, when education, safe environment creation, and legislation with enforcement were used. It was important to create a safe engineering environment, to separate pedestrian and bicycle paths from high-speed traffic on roads, to improve the visibility of road users, to apply measures that reduce driver’s fatigue, and to combat the usage of mobile phones while driving. Preventive activities were aimed at alcohol control, speed limitation, education of safe behavior of drivers, promotion of safe cars operation. The usage of safety belts and safety seats, helmets for motorcyclists and cyclists were increased through legislative and educational measures.

Trends in Road Traffic Injuries Mortality in India: An Analysis from the Global Burden of Disease Study 1990-2021.

Road traffic injury (RTI) is one of the most common causes of accidental deaths in India. The study investigates the changes in trends in age-standardised RTI mortality rates in India by sex and age groups, using data from the Global Burden of Disease (GBD) Study 2021. The trend segments are estimated from 1990 to 2021 employing a joinpoint regression model. Additionally, the influence of age, time period, and birth cohort on mortality rate trends was assessed using the age-period-cohort model. Over the past 32 years, the RTI mortality rates have experienced multiple trend segments. RTI mortality rate in the ≤ 14-year-old population has declined remarkably, dropping from 5.71 (4.65 to 6.88) per lakh population in 1990 to 3.66 (3.01 to 4.35) per lakh population in 2010, and further declining to 1.98 (1.65 to 2.37) per lakh population in 2021. The study found a positive correlation between RTI mortality rates and age, with rates consistently lower for women compared to men across all age groups. The variation in RTI mortality rates across Indian states has widened over time, with the coefficient of variation increasing from 30.58% in 1990 to 32.36% in 2010, and further to 35.11% in 2021. Despite efforts, Indian states are unlikely to achieve the goal of halving RTI deaths by 2030, based on 2010 levels. To address this, road conditions and road safety policies aimed at preventing the incidence of RTIs should be further intensified.

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,...

Piloting a hospital-based road traffic injury surveillance system in Nairobi County, Kenya, 2018–2019

BackgroundKenya's estimated road traffic injury (RTI) death rate is 27.8/100,000 population, which is 1.5 times the global rate. Some RTI data are collected in Kenya; however, a systematic and integrated surveillance system does not exist. Therefore, we adopted and modified the World Health Organization's injury surveillance guidelines to pilot a hospital-based RTI surveillance system in Nairobi County, Kenya. MethodsWe prospectively documented all RTI cases presenting at two public trauma hospitals in Nairobi County from October 2018–April 2019. RTI cases were defined as injuries involving ≥1 moving vehicles on public roads. Demographics, injury circumstances, and outcome information were collected using standardized case report forms. The Kampala Trauma Score (KTS) was used to assess injury severity. RTI cases were characterized with descriptive statistics. ResultsOf the 1,840 RTI cases reported during the seven-month period, 73.2% were male. The median age was 29.8 years (range 1–89 years). Forty percent (n = 740) were taken to the hospital by bystanders. Median time for hospital arrival was 77 min. Pedestrians constituted 54.1% (n = 995) of cases. Of 400 motorcyclists, 48.0% lacked helmets. Similarly, 65.7% of bicyclists (23/35) lacked helmets. Among 386 motor vehicle occupants, 59.6% were not using seat belts (19.9% unknown). Seven percent of cases (n = 129) reported alcohol use (49.0% unknown), and 8.8% (n = 161) reported mobile phone use (59.7% unknown). Eleven percent of cases (n = 199) were severely injured (KTS <11), and 220 died. ConclusionWe demonstrated feasibility of a hospital-based RTI surveillance system in Nairobi County. Integrating information from crash scenes and hospitals can guide prevention.

Use of a capture-recapture statistical model to assess morbidity and mortality of road traffic accidents in Gaza Strip: a retrospective study

BackgroundIn low-income and middle-income countries, road traffic injuries (RTIs) are commonly under-reported. In this study I estimated the incidence of RTIs and RTI deaths in Gaza Strip using the capture-recapture method. MethodsAll data registered on RTIs and RTI deaths from Jan 1 to Dec 31, 2018, were obtained from police records and Palestinian Ministry of Health hospital records. Linked data from these two sources are available through a web-based registry. When possible, records in the two sets of records were linked by an identification number. I used the Chapman formula of capture-recapture to estimate the numbers of RTIs and RTI deaths: (R=[(R1 + 1)(R2 + 1)/(r+1)]–1). FindingsThe Ministry of Health hospital and the traffic police registries included 1722 and 1356 records, respectively. 970 records could be linked. Although the Ministry of Health hospital records reported more RTIs, fewer than the police records contained information about the injury type and vehicle involved (1053 [61%] vs 1302 [96%] and 849 [49%] vs 1139 [84%], respectively. Most individuals involved in RTIs were men (1313 [76%] in hospital records and 1039 [77%] in police records). 684 (40%) individuals in the hospital records and 516 (38%) in the police records were younger than 15 years and 712 (41%) and 541 (40%), respectively, were in the 15–35-year age group. Most (523 [94%]) of the linked RTIs involved four-wheeled vehicles. The number of RTIs estimated by the Chapman method was 2407 (95% CI 2354–2460), meaning that hospital records captured 72% and police records captured only 56%. The hospital and police records included 16 and 57 deaths, respectively, 14 of which had linked records. Of these deaths, 29 (51%) in the police records and 10 (62%) in the hospital records involved people younger than 15 years, and 45 (79%) and 16 (100%), respectively involved four-wheeled vehicles. The total number of fatalities estimated by the Chapman method was 65 (95% CI 55–74). Therefore, the hospital records captured only 25% whereas police records captured 88%. The population of Gaza Strip in 2018 was 1 932 843 in 2018. Thus, based on the estimated values, the incidence of RTIs would have been 125 per 100 000 population and that for RTI deaths fatalities would have been 3·4 per 100 000 population. InterpretationThe capture re-capture method has some methodological biases, such as it requires an equal probability of capture between data sources, perfect linkage of data from data sources, and closed populations. However, it might be a powerful tool to improve estimates of the incidence of RTIs and RTI deaths where reporting is incomplete. Neither the Ministry of Health hospital nor the police registry independently provided accurate numbers. Both registries should be strengthened to provide reliable information not only on numbers but also on crash circumstances, injury patterns, road users, vehicles involved, and behavioural risk factors. Reporting of injury cause, manifestation, location, severity, and type could be improved by use of a standardised systems, such as ICD-10 codes. FundingNone.

Primary trauma care course: Alternative basic trauma course in developing countries. "The Need Of The Hour".

Low- and middle-income countries account for over 90% of all road traffic injury deaths. Despite this, formal training in trauma management is not widely adopted in these countries. No specific training was available in prehospital or emergency department for life support before primary trauma care (PTC) course. This study was conducted to assess the effectiveness of the PTC course in the improvement of knowledge and skills of trauma management among participant in Pakistan. Two days of PTC courses were organised and conducted in various regions of Pakistan, participants per course comprising medical students, doctors, house officers, residents, and paramedics. The course comprises lectures of 5hours and 30minutes, skills workshops for 3hours and discussion and multisystem trauma scenarios for 3hours. Trauma management knowledge and clinical confidence of candidates were assessed using a predetermined multiple-choice questionnaire of 30 MCQs both at pre- and post-course, and using clinical scenarios, confidence matrix was assessed. A total 7852 of participants were trained, an average of 2 courses per month and 302 total courses. Mean score of pre-course MCQs was 60% and mean score of post-course MCQs was 82%. Among the participant postgraduate trainees, average in trauma knowledge and trauma clinical confidence were significantly higher in both pre- and post-course. The mean score of pre-course confidence matrix was 70% and the mean score of post-course confidence matrix was 93%; at the end of course, all participants showed a high level of confidence in managing trauma mock scenarios. A total of 5889 (75%) participants had a ≥78.5% post-workshop knowledge score. However, only 1963 (25%) participants had a trauma skill score with ≤75 marks. PTC workshop could be an alternative and cost-effective flexible course for gaining knowledge and clinical skills of initial trauma management and strengthening the capacity of trauma management training in developing countries with minimal resources for saving the life of trauma victims.

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.

Road Traffic Injury deaths and Correlates in Babylon Province: A Cross- Sectional Study

Background: Road traffic accidents were a major health problem especially in low and middle incomecountries including Iraq, head injuries were found to be the most common fatal injuries during trafficaccidents that causing deaths.Objectives: to identify the relationship of road traffic injury deaths with different associated factors and tomeasure the extent of this problem.Methodology: this was a cross-sectional study included a retrospective analysis of the forensic medicinedata presented in the records of forensic medicine department for three years (2017-2019) the period neededto conduct this study started from 1st of February to the end of November,2019 . After the approval of thestudy protocol by the Babylon nursing college health ethical committee , a semi structured questionnaire wasused to collect data according to the descriptive epidemiologic model (person , place, time).Results: The road traffic accidents death rate in Babylon province was unacceptably high, the mean deathsper month due to Road Traffic Injuries was 43,8 and the mean deaths per week was11victims and the crudedeath rate =27/100000 population; Males in their productive age group were outnumbered victims to thispreventable high priority health problem. Urgent interventional plan of action including provision highquality nursing tertiary care should be started to address this growing problem using the available resourcesto promote the critical care skills among health care providers and to reduce medical errors.

Identification and Prioritization of Key Components Influencing Prehospital Emergency Related to Preventable Road Traffic Injuries Deaths in Iran; A Delphi Study.

To identify and prioritize the key Components of prehospital emergency system to prevent mortality in road traffic injuries. A total of 25 emergency medicine practitioners, emergency ward nurses, and managers of prehospital emergency centers participated in this adjusted Delphi study in three rounds. After extracting the primary components through reviewing systematic studies and interviewing experts, the Delphi rounds were performed with the presence of experts. The data were analyzed with both qualitative content analysis and quantitative analysis using SPSS20 software. For the analysis and selection of the final priorities, the coefficient of agreement of over 70% was used. After doing three Delphi rounds, in the final Delphi round, 10 superior components were selected respectively as follows: correct history taking of the victim, examining possible cervical injury, the time spent from the first call to arrival of technicians to the scene, the time spent from arriving at the scene to the time of hospital transport, passing of re-education courses by EMS technicians, coordination among the rescue organizations, police, the Red Crescent, fire station, and healthcare organizations, integrated commandership at scene, police attendance in the scene before EMS arrival at the scene, proper ambulance equipment with respect to the required equipment (A, B, C) on the basis of victim's condition, and coordination with the target hospital for patient transport. This study determined the most applicable managerial methods of prehospital emergency components pertaining to preventable fatal road traffic injuries through empowerment of EMS systems in the fields of victim assessment, time management indices, personnel training, coordination between the involved organs, and the presence of the main commander in the scene.

RT Accidents mortality in Italy: a population-based study in Piedmont on Vulnerable Road Users

Abstract Background Among the largest Italian Regions, Piedmont (Northern Italy) had in 2017 a crude rate of road traffic accidents (RTA) deaths greater than the national average. RTA injuries remain a leading cause of injury deaths in Italy. Among them in both Piedmont and Italy many victims are vulnerable road users (VRU): pedestrians, cyclists and users of motorcycles or motorpeds. The study was aimed to describe their mechanisms of injury. Methods Observational study of the resident population in Piedmont from 2003 to 2015. Transportation Injuries (ICD-10: V01-V99) were considered, because of their greater comparability rate in bridge coding studies. A number of 5,185 RTA deaths was observed. Role, type of vehicle of the victim and collision were studied. Results Piedmont in 2017 had a RTA mortality rate (6.35 deaths per 100,000 inhabitants) greater than Italy (IRR = 1.13, 95% CI: 1.00 - 1.29; p &amp;lt; 0.02), 48.4% of the victims were VRU similarly to national data (49.8%). In the period the proportion of VRU on RTA deaths steadily increased from 25.6% in 2003 to 49.1% in 2015, in a significant way (z = 2.79; p = 0.005), because in a context of marked reduction of RTA mortality (-54.5%), the regional trend for VRU shows only a slight decrease (-12,6%). The VRU were: pedestrians (47.0%), motorized two-wheels users (37.4%) and cyclists (15.6%). Among pedestrians 63.9% deaths were caused by collisions with mainly automobiles (82.1%) and heavy vehicles (12.7%). In case of collision the prevalent causes of death were head injuries (41.5%) and multi-trauma (31.8%). Similar patterns were observed for cyclists, while in motorcyclists 56.5% of deaths were due to loss of control or fixed object. Conclusions VRU injuries remain a public health and social concern. Yet despite their extent, this problem is still not adequately considered in public health prevention programs. The observed mechanisms of injury evidence the importance to enhance the protection of VRU in road traffic circulation. Key messages In Italy, vulnerable road users are becoming a major group among road traffic injury deaths, because they not follow the general trend of large decrease of RTA injuries. Largest VRU group are pedestrians such as cyclists they are hit by cars or heavy vehicles with major trauma, in the motorized two-wheels loss of control and collision with fixed object are important.

A Study to Determine the Nature and Risk Factors for Road Traffic Injuries

Introduction:In 2010, an estimated 1.3 million road traffic injury (RTI) deaths occurred worldwide, accounting for about 2.5% of all deaths. Mortality in serious injuries is 6 times worse in a developing country such as India compared to a developed country. Strengthening and undertaking research on the public health burden and impact and understanding the risk factors of trauma is the need of the hour.Aim:To identify the nature of injury in terms of causes and severity of injury.Methods:Using a quantitative approach, a retrospective cross-sectional survey was conducted at the emergency and trauma center in Ram Manohar Lohia (RML) Hospital, New Delhi. The information of all the injured patients seeking health care during the past one year from October 2015 - September 2016 at Emergency and trauma center was collected from the trauma registry forms filled at the time of registration.Results:A total of 1952 cases of road traffic injury sought health care during the study period. The average number of cases reported per day was five. Maximum of the cases (40%) were reported between 12-6PM. Among the injured, 82% were males and the majority of victims were between 20-30 years age group followed by 30-40 years.Discussion:Trauma services need to be coordinated in infrastructure and human resources so that the right patient is taken to the right hospital at the right time. This calls for a lead agency at the district, state, and finally national level. Safety education regarding road safety should be imparted, especially to all victims, relatives, and the general public to make the care comprehensive. Students in schools and colleges should also be the target for intense safety education.

Road Traffic Accidents: Development's Collateral Damage and a Major Public Health and Economic Concern

Road construction is viewed as a core development activity. The unfortunate downside of this is the increasing burden of Road traffic Injuries(RTIs). 50 years ago, the WHO was called upon to do something about the heavy human toll of RTIs. However, RTIs remain a very significant contributor to human morbidity and mortality. It is significant to note that the burden of RTIs has shifted to low and middle income countries (LMICs), which despite having only about 50% of the world's motor vehicles, account for 90% of the burden of 12.5 lakh road traffic deaths and 2 to 5 crore non fatal road traffic injuries. UN Sustainable development goal (SDG) target 3.6 is to reduce by 50% the number of deaths and injuries from road traffic crashes across the globe by 2020. This implies the saving of 50 lakh lives, the prevention of 5 crore serious injuries, and an economic benefit to the tune of over US$3 trillion. This is a major challenge. The WHO says that RTIs have a significant negative macroeconomic impact in LMICs. The loss to national GDP ranges from 1.03 percent in South Korea to 2.9 percent in Vietnam. Reducing RTI morbidity and mortality by 50% over a 24 year timeline can generate an additional flow of income equivalent to 22.2% GDP(2014) in Thailand, 15% in China, 14% in India, 7.2% in the Philippines and 7.1% in Tanzania. RTI deaths in India have consistently increased year on year from 1990 to 2015.

Complexities of Road Safety Interventions in Low and Middle Income Countries (LMICs) posed a major challenge in achieving Decade Goal- Lessons for the next span

Background: Most of the Low and Middle Income Countries in the world unsucessful to reduce the fifty percent of the Road Traffic Injury (RTI) deaths, which was target set in the last decade goals (2011-2020). This failure is largely due to the result of complexities of the problem itself, its causes, designing and implementing interventions and evaluation of Road Traffic Injury in low resource settings. The paper aimed to explore the nature of these complexities and provide a direction to address the RTIs efficiently in next decade in LMICs. Methods: Review of literatures related to the RTI prevention in LMICs especially nature of problem, factors related to RTIs and policy & interventions. Special emphasis was given on the complexity of road transport system, perception of road safety issues, road user’s behavior, public health system and policy maker’s behavior in LMIC context. The Global Status Reports on Road Safety were critically analyzed to explore the complexities of road safety related to low resources. Results: The complexities related to the RTI prevention in LMICs are mostly expressed on its i) incorrect perception of the problem, ii) factors related to RTIs, iii) multi-dimensional preventive approach, iv) inequalities in health and well-being, v) complicated evaluation modalities. Factors linked to incorrect perception of RTI problem are insufficient information, societal insights about the RTIs and health system’s inability to capture the RTI events. Complex risk factors of RTIs related to demographic, social, environmental, and economic and inequity that exists in low resource settings and most of them are interlinked. There is no one- single approach effective for RTI prevention. Conclusion: Although RTI is a leading killer of productive peoples in many LMICs, it failed to create enough importance in national and global policy issues as magnitude and causes and interventions of RTIs are unclear, and complex. So the complex RTI landscaping hinders in priority setting, resource allocation and prevention efforts. It is high time to reinvent new strategies beside existing preventive approach for RTIs prevention considering all these complexities in LMICs through intensive research.

Crash counterpart vehicles play important role in on pre-hospital mortality: A Study Based on ‎an eight-year period, 2006-2014

Background: To study the association between crash counterpart vehicles and pre-hospital car-users fatalities ‎during eight years, in East Azerbaijan, Iran. ‎ Methods: The data related to 3051 car user road traffic fatalities (CURTFs) were registered in East ‎Azerbaijan forensic medicine organization database, Iran, during 2006-2014. Data analysis was ‎run using Stata 13 statistical software package. Descriptive statistics (Pvalue < 0.05) and ‎inferential statistical methods such as Chi-squared test and multivariate logistic regression with ‎P < 0.1 were applied. ‎ Results: ‎3051 (39%) of 7818 road traffic injury death were car users of whom 71% were male (mean age ‎of 36.7±18.5 years). In assessing the role of type of crash counterpart vehicle on pre-hospital ‎mortality, considering the other cars to be the reference group for comparison, deceased victims ‎were 1.83 times more likely to die before hospital when the counterpart vehicle was a truck and ‎‎1.66 times more for buses. ‎ Conclusion: It seems necessary to identify those risk factors making crash counterpart vehicles have ‎significant role on pre-hospital mortality

Road traffic injury Epidemiology

About 25% of all fatal injuries or 1.35 million deaths on the world’s roads are due to road traffic injuries (RTIs). For every road traffic fatality, at least 20 people sustain non-fatal injuries. Deaths from RTIs has been increased from 2015 to 2018 global report. Distribution of these deaths varies by epidemiological patterns. For instance, the global road traffic fatality rate is 18 per 100 000 population, however, 20.1 in middle-income countries while 8.7 in high-income ones. About 80% of road traffic deaths occur in middle-income countries, with 72% of the world’s population, and only 52% of the world’s registered vehicles. Road traffic crashes cost countries up to 4-8% of their Gross National Product (it is 4.46% in Iran). The patterns of RTIs vary in different countries and regions. For example, 38% of all African road traffic deaths occur among pedestrians, while 36% of road traffic deaths in the Western Pacific Region are among motorcyclists. Pedestrians are the largest group of vulnerable road users in most countries. Close to 40% of all pedestrians killed belong to the age group 65+. Inappropriate behaviour of road users, such as excessive and inappropriate speed, driving under the influence of alcohol and/or drugs and the non-use of safety equipment such as seat belts and crash helmets, remain important contributory factors in fatal crashes and for injuries. Almost 60% of RTI deaths are among 15–44 year olds. Common Risk factors on RTIs include factors influencing; exposure to risk (e.g. rapid motorization, increased need for travel and choice of less safe forms of travel), crash involvement (e.g. Driver fatigue, speeding, inadequate visibility), injury severity (e.g. non-use of crash helmets and seatbelts), and post-crash injury outcome (pre-hospital and hospital care factors). Deaths from RTIs are one of the top causes of deaths in Iran and are higher than the region and world rates. The pace of legislative change is too slow. Countries need to increase adoption of comprehensive legislation relating to key risk factors for road traffic injuries. There are minimum elements needed in national laws related to the key risk factors (speed, drink–driving, motorcycle helmets, seat-belts and child restraints), and these should be rolled out in all countries. In addition, experience from high-performing countries has demonstrated that a continual process of legislative review to further strengthen laws can lead to additional benefits. Education is a key component of road safety and five key interventions including control of speeding, drinking and driving, seatbelt use, helmet use and child Restraint use should be addressed to reduce a significant amount of RTIs. Crude experiences, trial and error could not be effective and cost effective for reducing RTIs. Having valid and reliable data, good domestic research and evidence-based decision making are essential approaches for preventing of fatal RTI particularly in low and middle income countries.

Childhood road traffic injuries in Canada \u2013 a provincial comparison of transport injury rates over time

BackgroundIn Canada, road traffic injuries are the leading cause of death among children and youth ≤19. Across the country, there is variability in road traffic injury prevention policies and legislation. Our objective was to compare pediatric road traffic related injury hospitalization and death rates across Canadian provinces.MethodsPopulation-based hospitalization and death rates per 100,000 were analyzed using data from the Discharge Database and provincial coroner’s reports. Road traffic related injuries sustained by children and youth ≤19 years were analyzed by province and cause between 2006 and 2012.ResultsThe overall transport-related injury morbidity rate for children in Canada was 70.91 per 100,000 population between 2006 and 2012. The Canadian population-based injury hospitalization rates from all transport-related causes significantly decreased from 85.51 to 58.77 per 100,000 (− 4.42; p < 0.01; − 5.42; − 3.41) during the study period. Saskatchewan had the highest overall transport related morbidity rate (135.69 per 100,000), and Ontario had the lowest (47.12 per 100,000). Similar trends were observed for mortality rates in Canada.ConclusionsTransport-related injuries among children and youth have significantly decreased in Canada from 2006 to 2012; however the rates vary by province and cause.

Epidemiology of Road Traffic Injury Fatalities among Car Users; A Study Based on Forensic Medicine Data in East Azerbaijan of Iran.

To study the epidemiology of car user road traffic fatalities (CURTFs) during eight years, in East Azerbaijan, Iran. A total of 3051 CURTFs registered in East Azerbaijan forensic medicine organization database, Iran, during 2006-2014, were analyzed using Stata 13 statistical software package. Descriptive statistics (p<0.05) and inferential statistical methods such as Chi-squared test and multivariate logistic regression with p<0.1 were applied. Of the 7818 road traffic injury (RTI) deaths, 3051 (39%) were car users of whom 71% were male (mean age of 36.7±18.5 years). The majority of accident mechanisms were vehicle-vehicle crashes (63.95%), followed by rollover (26.24%). Crash causing vehicle fall increased the pre-hospital death likelihood by 2.34 times. The prominent trauma causing death was head trauma (in 62.5%). In assessing the role of type of counterpart vehicle on pre-hospital mortality, considering the other cars to be the reference group for comparison, deceased victims were 1.83 times more likely to die before hospital when the counterpart vehicle was a truck and 1.66 times more for buses. Decreasing the car users' fatalities using appropriate strategies such as separating the roads for heavy and light vehicles and improving the injury related facilitation may be effective. Male drivers with low education could be prioritized for being trained.

Child road traffic injury mortality in Victoria, Australia (0–14 years), the need for targeted action

IntroductionExtensive efforts to reduce unintentional injury were enacted in the last three decades of the 20th century. Examination of road traffic injury mortality indicates the extent of fatal, unintentional child injuries (0–14 years) future interventions must address. Aims(1) describe in-depth child road traffic injury (RTI) deaths 2001–2012 in Victoria, Australia (2) identify the potential preventability of the RTI causes by currently available countermeasures and scope for enhanced implementation and novel solutions. MethodFatal Victorian child injury data were extracted from the National Coronial Information System (NCIS) for the 12 year period January 2001–December 2012. All on-road data was analysed. Data for passenger and pedestrian deaths was examined in depth. Associated factors were determined using univariate and pairwise analysis of factors. Published WHO key prevention strategies, and the recent literature were reviewed, focusing on the identified fatalities among children 0–14 years. ResultsFor 172 RTI deaths, head injury was the leading medical cause of death (68%). Significantly, the most vulnerable age group for both passengers and pedestrians was 0–4 years. Rural children were over-represented with children aged 0–4 years at greatest risk. Common factors for occupants were loss of control and veering to the incorrect side. For pedestrians the major factors related to rural residence and supervision. Discussion and ConclusionsThis study confirms that RTIs are complex and follow chains of events. Numerous promising interventions were identified. Wider implementation of these advanced engineering, education and enforcement strategies may further improve mortality rates in Victoria. Feasible solutions for aspects of the child pedestrian problem remain elusive. This study describes the RTI problem in greater depth than previous studies and reveals that some existing measures are not fully implemented. The need for targeted action in: 0–4 year olds; head injury; and rural regions of Victoria is highlighted. The need for a safe systems approach is paramount.

Pattern of Road Traffic Injuries in Rural Bangladesh: Burden Estimates and Risk Factors.

Globally, road traffic injury (RTI) causes 1.3 million deaths annually. Almost 90% of all RTI deaths occur in low- and middle-income countries. RTI is one of the leading causes of death in Bangladesh; the World Health Organization estimated that it kills over 21,000 people in the country annually. This study describes the current magnitude and risk factors of RTI for different age groups in rural Bangladesh. A household census was carried out in 51 unions of seven sub-districts situated in the north and central part of Bangladesh between June and November 2013, covering 1.2 million individuals. Trained data collectors collected information on fatal and nonfatal RTI events through face-to-face interviews using a set of structured pre-tested questionnaires. The recall periods for fatal and non-fatal RTI were one year and six months, respectively. The mortality and morbidity rates due to RTI were 6.8/100,000 population/year and 889/100,000 populations/six months, respectively. RTI mortality and morbidity rates were significantly higher among males compared to females. Deaths and morbidities due to RTI were highest among those in the 25–64 years age group. A higher proportion of morbidity occurred among vehicle passengers (34%) and pedestrians (18%), and more than one-third of the RTI mortality occurred among pedestrians. Twenty percent of all nonfatal RTIs were classified as severe injuries. RTI is a major public health issue in rural Bangladesh. Immediate attention is needed to reduce preventable deaths and morbidities in rural Bangladesh.

Development and pilot study road traffic injury surveillance, Kaduna Nigeria

ObjectiveWe pilot a RTI surveillance system using data from FRSC, Policemotor traffic division and Health facilities in Kaduna metropolis,Nigeria to ascertain its feasibility and generate data needed for actiontoward achieving sustainable development goals 3.6 target.IntroductionRoad Traffic Injury is common cause of unintentional injuryglobally and Low and middle income countries account for 90%of 1.3 million Road Traffic Injury (RTI) deaths. In Africa region,Nigeria accounts for 25% of RTI mortality but has no comprehensiveand reliable RTI surveillance system. Data from Federal RoadSafety Commissions (FRSC) shows gaps in RTI reporting with largedisparity with estimated value from World Health Organization.MethodsKaduna metropolis is the capital of Kaduna State with estimatedpopulation of 1.96 million. It is a major route between Abuja, theNational capital and 15 northern Nigeria states with high vehicularmovement. We adapted WHO Injury surveillance guideline andCenters for Disease Control and Prevention surveillance trainingmanual for this study. A case of RTI is any person injured or diedwithin 30 days as a result injuries incurred from vehicular collision ona public road in Kaduna Metropolis. Data collected using a pretestedquestionnaire for RTI cases at health facilities, Police and FRSC.Data were linked by deterministic method, cleaned and analysed.Frequency and proportion were calculated to characterize the RTI.The study was supported by a mini-grant from Center for DiseaseControl and Prevention.ResultsData was collected from February to April 2016. Of the 324crashes reported, 566 people injured and 66 deaths with case fatalityrate of 11.7%. Male gender accounts for 81.8% and age 20 – 39 yearswere 64.6%. Commercial drivers were 20.7%, pedestrian 21% andpassengers were 53.7%. Sixty percent of the crash occurred betweencars or buses while 21% were without collision with any vehicle orstationary objects. Of the 66 deaths reported 61(92.4%) died at crashsite. FRSC evacuated 21%, 38.6% were evacuated by other road users.No use of seat belt and crash helmets reported and only 5.1% receivedfirst aid care before reaching reporting facility. RTI Incidence peakedbetween 6:00 PM to 8:59 PM with 26 persons per hour.ConclusionsEssential to sustainable development goal 3, a multisectorRTI surveillance system that generate data for action in Kadunametropolis, Nigeria is feasible and data generated was used for actionat different levels to mitigate against the burden of RTI