Road Traffic Injuries In Iran Research Articles

Prediction of the burden of road traffic injuries in Iran by 2030: Prevalence, death, and disability-adjusted life years

PurposeRoad traffic accidents pose a global challenge with substantial human and economic costs globally. Iran experiences a high incidence of road traffic injuries, leading to a significant burden on society. This study aims to predict the future burden of road traffic injuries in Iran until 2030, providing valuable insights for policy-making and interventions to improve road safety and reduce the associated human and economic costs. MethodsThis analytical study utilized time series models, specifically autoregressive integrated moving average (ARIMA) and artificial neural networks (ANNs), to predict the burden of road traffic accidents by analyzing past data to identify patterns and trends in Iran until 2030. The required data related to prevalence, death, and disability-adjusted life years (DALYs) rates were collected from the Institute for Health Metrics and Evaluation database and analyzed using R software and relevant modeling and statistical analysis packages. ResultsBoth prediction models, ARIMA and ANNs indicate that the prevalence rates (per 100,000) of all road traffic injuries, except for motorcyclist road injuries which have an almost flat trend, remaining at around 430, increase by 2030. Based on estimations of both models, the rates of death and DALYs due to motor vehicle and pedestrian road traffic injuries decrease. For motor vehicle road injuries, estimated trends decrease to approximately 520 DALYs and 10 deaths. Also, for pedestrian road injuries these rates reached approximately 300 DALYs and 6 deaths, according to the models. For cyclists and other road traffic injuries, the predicted DALY rates by the ANN model increase to almost 50 and 8, while predictions conducted by the ARIMA model show a static trend, remaining at 40 and approximately 6.5. Moreover, these rates for the prediction of death rate by the ANN model increased to 0.6 and 0.1, while predictions conducted by the ARIMA model show a static trend, remaining at 0.43 and 0.07. According to the ANN model, the predicted rates of DALY and death for motorcyclists decrease to 100 and approximately 2.7, respectively. On the other hand, predictions made by the ARIMA model show a static trend, with rates remaining at 200 and approximately 3.2, respectively. ConclusionThe prevalence of road traffic injuries is predicted to increase, while the death and DALY rates of road traffic injuries show different patterns. Effective intervention programs and safety measures are necessary to prevent and reduce road traffic accidents. Different interventions should be designed and implemented specifically for different groups of pedestrians, cyclists, motorcyclists, and motor vehicle drivers.

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

ObjectivesReliable and valid information on burden of road traffic injuries (RTIs) is essential for short-term and long-term planning. We designed the present study to describe the levels and trends of...

Developing a National Integrated Road Traffic Injury Registry System: A Conceptual Model for a Multidisciplinary Setting.

IntroductionDespite a high burden of traffic injuries, effective integrated or linked injury surveillance systems are rarely available in many low- and middle-income countries (LMICs). The aim of the current study was to define a conceptual model for developing a national integrated traffic injury registry in Iran.MethodsA mult-method study financially and technically supported by the World Health Organization, Iranian Ministry of Health, Iranian Traffic Police, and the Iranian Legal Medicine Organization was conducted. A theoretical framework, forming the core conceptual components, was developed based on expert reviews. The preliminary conceptual model was developed by a panel of experts and tailored through a national workshop of 50 scientists, authorities and experts from nearly all sectors related to road safety promotion and injury management. It was then sent out to external reviewers in order to assess and improve the content validity of the model.ResultsThe conceptual model was developed to have six components. These included 1) aims and core definitions; 2) content and core measurements; 3) data flow; 4) data collection routines; 5) organizational matrix; 6) implementation organization. The Haddon’s matrix was adapted to be used as the theoretical framework in defining the content and data flow components of IRTIR. Five subcomponents were defined in the content and core measurements component with each having several subcategories. Each subcomponent/subcategory was finally divided into several item groups to guide defining the final data measurement variables. The data flow component was defined with six data sequence stations. Through the organizational matrix component, five major organizations relevant to road traffic safety were defined as core data production contributors. Some organizations also owned several sub-organizations which contributed in this regard.ConclusionIt is concluded that the IRTIR conceptual model includes the required six components for developing a national integrated registry for Iran. Its main component called, content and core measurements, leads the researchers in developing final data collection tools in developing the national registry of road traffic injuries in Iran.

Estimating the avoidable burden and population attributable fraction of human risk factors of road traffic injuries in iran: application of penalization, bias reduction and sparse data analysis

The aim of this study was to prioritize human risk factors for preventive interventions by estimating the avoidable burden and population attributable fraction (PAF) of each risk factor using penalization and data augmentation method. To avoid the sparse data bias, Bayesian logistic regression via data augmentation methods, were used for multivariable analysis. Informative normal priors adopted from the studies were used for the studied human risk factors. Weakly informative log-f was used for the covariates. The population attributable fraction was calculated based on direct method. The comparative risk assessment methodology of the WHO was used to estimate the potential impact fraction for each risk factor. The most important human factors influencing the traffic-related deaths were overspeeding (OR = 9.6, 95% CI: 2.45-37.7), reckless overtaking (OR = 8.6, 95% CI: 1.82-40.7), and fatigue and drowsiness (OR = 6.7, 95% CI: 1.79-25). The total PAF for the all studied risk factors was about 56% (PAF = 0.567, 95% CI: 0.37-0.7). The greatest avoidable burden was related to fatigue and drowsiness, overspeeding, and not fastening seatbelt. By considering the high contribution of human risk factors in occurrence of fatal traffic injuries appropriate legislation and prevention programs for these risk factors would decrease half of such deaths.

Epidemiology of Vehicle Fire Fatalities of Road Traffic Injuries in Kerman Province, Iran: A Cross-Sectional Study.

BACKGROUND:Vehicle fires are one of the most important causes of fatalities in road traffic injuries (RTIs), but there are no accurate statistics about vehicle fire fatalities (VFFs) due to RTIs in Iran.AIM:This study aimed to investigate the Epidemiology of vehicle fire fatalities (VFFs) due to road traffic injuries (RTIs) in Iran.METHODS:In this cross-sectional study, a researcher-made checklist was used to collect the required data from the files of RTI fatalities in the Kerman Legal Medicine Organization (KLMO), or coroner’s office. All reported victims of vehicle fires in the ten years from 2007 to 2017 were included in the study. The data were analysed using SPSS ver. 18, with p = 0.05 considered as the level of significance.RESULTS:The authors found 124 cases of vehicle fire fatalities in Kerman, with a mean age of 30.45 ± 12.41, of which 50% were in the 25-49 years age group. Most frequently, the victims were Iranian (91.9%), married (66.1%), self-employed (51.6%), and urban dwellers (79.8%), and had died because of burns (91.9%). In 46.8% of cases, the victims were the driver, and in the remaining 53.2%, they were the passenger of the crashed vehicle. Most frequently, vehicle fires occurred on extra-urban roads (90.3%), during spring (35.5 %) or summer (32.3%), due to a vehicle-to-vehicle collision (66.9%), between sedans (69.9%), and at night (63.7%). Most victims died at the scene of the incident (87.9%) and had been transferred to hospital by an ambulance (71%).CONCLUSION:This study indicated that car fires caused the death of young and middle-aged people. The authors suggest the implementation of preventative measures promoting car safety; establishing speed management; establishing laws governing driving, manufacturing and importation of vehicles; construction of safe roads; identifying accident-prone points; installing road warning signs; establishing more roadside stations; ensuring stricter police monitoring; and improving vehicle safety standards and public awareness about the risks of speeding.

Time trends in gender-specific incidence rates of road traffic injuries in Iran.

ObjectivesEvery day, an average of 3,400 deaths and tens of millions of injuries occur as a result of traffic accidents. This study aims to model and validate road traffic injury (RTI) times series, specifically considering gender.Study designTime trend studies of monthly road traffic injuries (RTI) in Iran from March 2005 to February 2016, as well as those of males and females from March 2009 to February 2016 were performed.MethodsThe seasonal auto-regressive integrated moving average method (SARIMA) was employed to predict RTI time series. The final model was selected from various SARIMA models based on the Akaike information criterion (AIC) and the Bayesian information criterion (BIC). To examine whether the residuals were white noise, the Ljung-Box (LB) test and residuals plots were used for un-correlation, and the zero mean and stationarity, respectively. Additionally, smoothing methods were utilized to validate the SARIMA models for fitting and out-of-range prediction of the time series models under study. The sample auto-correlation function (ACF) and the partial autocorrelation function (PACF) with 20 lags were employed to determine the order of models and to ascertain if the residuals of the model were uncorrelated.ResultsBased on the obtained results, SARIMA (2,1,0)(0,1,1)12, SARIMA (0,1,1)(0,1,1)12, SARIMA (1,1,1)(0,0,1)12, and SARIMA (2,0,0)(1,0,0)12 were chosen for the time series including incidence rates of total road traffic injuries (IRTI), IRTI of males, females, and males-to-females, respectively. The AIC values were -87.57, 413.38, -732.91, and -85.32, respectively. The LB test for the residuals of the time series models of (0.539) IRTI, (0.3) IRTI of males, (0.23) females, and (0.237) males-to-females indicated that residuals were uncorrelated. Furthermore, prediction values for the next 24 months (2016 to 2018) showed no decline in the incidence rate of male and female traffic injuries. Results of the predictions using exponential smoothing methods indicated out-of-range prediction validity of the SARIMA models.ConclusionThis study exemplified the high efficiency of SARIMA models in predicting road traffic injuries (RTIs). Based on observations, the IRTI mean in Iran was 35.57 in 2016. The predicted values of the IRTI for 2016–2018 by the SARIMA model showed no decreasing trend. During the studied period, the observed values of IRTI for males were two to three times the female values. Thus, prediction of RTI can provide a useful tool for traffic safety policymaking by simulating interrupted time series when applying new traffic enforcement interventions and regulations in the future. Additionally, IRTI analysis of males and females showed that men had a non-increasing trend but higher incidence of traffic injuries, whereas the IRTI for women revealed an increasing trend from 2009 to 2012 with a lower incidence of injuries. This growth could be attributed to the impact of increased outdoor activities of women and the increased number of issued driving licenses in the period of 2009–2012.

Prevalence of behavioural risk factors for road-traffic injuries among the Iranian population: findings from STEPs 2016.

To achieve Sustainable Development Goal 3.6 in Iran, we need to have a comprehensive understanding of the distribution of risky behaviours regarding road-traffic injuries at national and sub-national levels. Little is known about the road-use vulnerability patterns of road-traffic injuries in Iran. The aim of this study is to describe the prevalence of self-reported human risk factors in road-traffic injuries using the findings from a large-scale cross-sectional study based on the World Health Organization's stepwise approach to surveillance of non-communicable diseases (STEPs). A cross-sectional survey study in 2016 assessed the road-use pattern and prevalence of risky behaviours of people more than 18 years old. In this study, we planned to recruit 31 050 individuals as a representative sample at national and provincial levels. In practice, 30 541 individuals (3105 clusters) from urban and rural areas of Iran were selected. Basic socio-demographic data, major behavioural risk factors such as seatbelt and helmet non-compliance, drunk driving and occupant in a car with a drunk driver were assessed through baseline interviews gathered through an Android tablet-based questionnaire. The overall prevalence of seatbelt and helmet compliance was 75.2% (95% confidence interval: 74.7-75.7) and 13.9% (13.4-14.5), respectively, at the national level. The prevalence of risk-taking behaviours such as drink driving was 0.5% (0.4-0.6) and for being an occupant in a car with a drunk driver was 3.5% (3.2-3.8). At the provincial level, the highest age-standardized prevalence of seatbelt compliance (89.6%) was almost 1.5 times higher than the lowest provincial prevalence (58.5%). In 63% of provinces, the lowest prevalence of seatbelt compliance was observed among people aged 18-24 years old. In Iran, existing disease-prevention and health-promotion programmes should be expanded to target vulnerable subgroups that have more prevalent human risk factors for road-traffic injuries. Further research is required to investigate the context-specific proximal human risk factors and vulnerability patterns in Iran.

Social Differences in the Prevalence of Road Traffic Injuries among Pedestrians, and Vehicle and Motorcycle Users in Iran: Results of a National Multiple Indicator Demographic and Health Survey (IrMIDHS, 2010).

Background:Traffic injuries are considered as the most important health issues for different countries in the world, especially developing countries that are experiencing rapid social changes. The purpose of this study was to investigate the prevalence of road traffic injuries (RTIs) and its socioeconomic differences among road users in Iran as it is one of the countries with high rates of accidents in the world. The study population included all people in Iran. The target sample was 3,096 clusters consisting of 2,187 urban and 909 rural households.Methods:Source of the raw data was the Iran's Multiple Indicator Demographic and Health Survey (IrMIDHS) 2010, which is a multi-stage stratified cluster-random cross-sectional study. The logistic regression has been performed for investigating the socioeconomic determinants which influence the RTIs among pedestrian, vehicle, and motorcycle users.Results:The prevalence of RTIs is 13.8 (95% CI: 13.1, 14.5) per 1,000 people in the year leading up to the study. The injured groups included pedestrians (14.37%), vehicles (38.36%), motorcyclists (43.37%), and 3.9% of users injured with other vehicles. A total of 78.3% of the injured people underwent outpatient treatment or were hospitalized. The mean age in these three groups was significantly increased (27.9, 32.5, 33.4, respectively), and the proportion of men decreased (89.2, 75.2, and 60.6).Conclusions:RTIs in Iran are higher than previous estimates due to consideration of non-hospitalized cases. Considering the high contribution of human factors in developing countries, these measures should prioritize vulnerable groups.

Epidemiological study of hospitalized road traffic injuries in Iran 2011.

Background: In Iran, Road Traffic Injuries (RTIs) is the second-leading cause of deaths, and the first leading cause of disabilityadjusted life year, and has one of the highest rates of death (32.1 per 100 000 population) all over the world. This study’s aim was to investigate the epidemiological pattern and underlying components of hospitalized RTIs in 31 provinces of Iran in 2011. Methods: This study conducted on all hospitalized RTIs during one-year period (March 21, 2011 to March 21, 2012). Data extracted from a hospital-based traffic injury registration system. According to a national law passed in 2005, all hospital expenses of traffic injuries should be covered by ministry of health based on governmental tariffs. The medical costs of eligible patients will be paid to the hospitals only if the patient data are sent to the above mentioned database. Statistical analysis was performed using SPSS v.16 (SPSS Inc., Chicago, USA), and spatial maps are provided using GIS 10.2. Descriptive statistics and t-test were used to compare means. World (WHO 2000-2025) standard population used to calculate age-adjusted incidence rate. All statistical tests were performed at the 5% level of statistical significance. Results: There were 322,064 injured cases recorded in the registration system during the study period. The national age-adjusted incidence rate of RTIs was 405 per 100,000 population. The highest incidence rates were in the age group of 15-29 years (643 per 100,000 population), followed by 30-44 year age groups (401 per 100,000 population). The incidence rate in men was 3.36 times more than women. Motorcyclist were the most frequent type of road users (39.2%) who involved in RTIs, followed by passengers (28.9%) and pedestrians (20.0%). Head injuries were among the most affected part of the body which occurred in 27.2% of the patients. The proportion of urban crashes was 60.7%. Conclusion: The results of this study indicated that the majority of RTI occurred on motorcyclists and head injuries was the most commonly affected body part. Therefore, in order to reduce motorcycle accidents and avoiding head injury among them, stricter law enforcement is urgently needed for helmet use and promotion of safety behaviors among motorcycle riders.

Facilitators, Causes and Lesson Learned from Two Bus Incident in Tehran-Qom Highway: A Case Study in Iran

Background: There is an increasing trend of traffic accidents in the world in recent years. Road traffic injuries in Iran, caused 17994 deaths in 2012 - 13. Among these accidents, the most terrible one occurred on September 9, 2012 at 22:48 hour GMT, when two approaching buses had a head-on collision on 28-kilometer Tehran-Qom highway, killing 44 passengers on board and leaving 47 injurers. Objectives: This study aimed to assess factors, causes, and lessons learned from the two bus collision on the Tehran-Qom highway in Iran. Methods: This case study adopted qualitative approach, to explore the different scenarios of the crash focusing on content analysis. Focus Group Discussion, semi-structured individual interviews and review of documentations and evidence were the data sources. Data and evidence gathered from people’s experience and perceptions, such as officials and staffs of rescue teams, were analyzed. Results: After repeated analysis and comparison of data, three categories were explored (agent/host/environment causes, victims’ search and rescue, and psychosocial support). Inadequate bus supervision and driver’s behavior, lack of fire extinguishers, and rescue tools such as hammers in buses, and blocked doors contributed to increased casualties. Effective field assessment for incidence and decentralizing stand-by hospitals would help reduce casualties. Lack of effective coordination, lack of psychosocial support services for victims and participation of ‘lay people’ the scene, were key findings. Conclusions: Lessons learned: controlling per-second speed, improving vehicle manufacturing quality, re-training courses for drivers and the empowerment of rescuing people should help reduce human casualties during accidents. Lack of fire stations and fire extinguishing agent along the road outside cities are major problems. Common dispatch center with national emergency number is explicitly recommended for faster and more coordinated rescue services to reach the accidents scene. We also suggested instruction of psychosocial support for victims, survivors, and even rescuers during and after rescue process. Finally, persistent merge of existing rescue organizations, leading to the development of a national emergency management organization (NEMO) and national data collection system are highly recommended.

Effectiveness of Interventions for Prevention of Road Traffic Injuries in Iran and Some Methodological Issues: A Systematic Review.

To review the effectiveness of Road Traffic Injuries (RTIs) interventions implemented for prevention of RTIs in Iran and to introduce some methodological issues. Required data in this systematic review study were collected through searching the following key words: "Road Traffic Injuries", "Road Traffic accidents", "Road Traffic crashes", "prevention", and Iran in PubMed, Cochrane Library electronic databases, Google Scholar, Scopus, MagIran, SID and IranMedex. Some of the relevant journals and web sites searched manually. Reference lists of the selected articles were also checked. Gray literature search and expert contact was also conducted. Out of 569 retrieved articles, finally 8 articles included. Among the included studies the effectiveness of 10 interventions were assessed containing: seat belt, enforcements of laws and legislations, educational program, wearing helmet, Antilock Braking System (ABS), motorcyclists' penalty enforcement, pupil liaisons' education, provisional driver licensing, Road bumps and traffic improvement's plans. In 7 studies (9 interventions) reduction of RTIs rate were reported. Decreased rate of mortality from RTIs were reported in three studies. Only one study had mentioned financial issue (Anti-lock Brake System intervention). Inadequate data sources, inappropriate selection of statistical index and not mention about the control of Confounding Variables (CV), the most common methodological issues were. The results of most interventional studies conducted in Iran supported the effect of the interventions on reduction of RTIs. However due to some methodological or reporting shortcoming the results of these studies should be interpreted cautiously.

Policy Analysis of Road Traffic Injury Prevention in Iran.

IntroductionDue to the large number of Road Traffic Injuries (RTIs) in Iran, authorities have implemented a number of policies for the prevention of RTIs. However, a scientific analysis of these policies has thus far been neglected. Therefore, this study was conducted for policy analysis of RTIs prevention in Iran.MethodsThis qualitative study with a case study approach was conducted in Iran during 2016 in two phases: First, by reviewing literature and documents of the past ten years, policies that have been executed to prevent RTIs in Iran were identified. In the second phase of the study, the identified policies were ranked by prioritization matrices. The two policies with the highest scores were selected. ‘Policy triangle framework’ was used for Policy analyzing. Stakeholders of these policies (42 people) were interviewed. Data were analyzed manually by implementing Content-Analysis methods.ResultsThe policies of “pupil liaisons” and “safety belt” were selected for analysis from thirteen potential identified polices. The results of some studies revealed that safety belts had not been properly used in Iran (less than 80%). There was an eight-year hiatus between the approval of the safety belts policy and implementation of this policy. Eight actors were identified for safety belts policy. Lack of diligence in implementation of the policy, failing to pay adequate attention to education and the culture of driving, and failing to select an organization for the implementation of the policy, were identified as the main weaknesses of this policy. For ‘pupil liaisons’ policy, five actors were identified. Following the implementation of this policy, the number of penalties was reduced (17.9%). Neglecting scientific findings and individual-based nature of the policy were identified as the primary weaknesses of this policy.ConclusionsTaking serious measures to properly execute the policy, educating people, selecting an efficient organization that is responsible for the implementation of the policies, and using international experience are the measures that can be taken to reduce the number of RTIs in the country.

Using bayesian model to estimate the cost of traffic injuries in Iran in 2013.

Background and Aim:A significant social and economic burden inflicts by road traffic injuries (RTIs). We aimed to use Bayesian model, to present the precise method, and to estimate the cost of RTIs in Iran in 2013.Materials and Methods:In a cross-sectional study on costs resulting from traffic injuries, 846 people per road user were randomly selected and investigated during 3 months (1st September–1st December) in 2013. The research questionnaire was prepared based on the standard for willingness to pay (WTP) method considering perceived risks, especially in Iran. Data were collected along with four scenarios for occupants, pedestrians, vehicle drivers, and motorcyclists. Inclusion criterion was having at least high school education and being in the age range of 18–65 years old; risk perception was an important factor to the study and measured by visual tool. Samples who did not have risk perception were excluded from the study. Main outcome measure was cost estimation of traffic injuries using WTP method.Results:Mean WTP was 2,612,050 internal rate of return (IRR) among these road users. Statistical value of life was estimated according to 20,408 death cases 402,314,106,073,648 IRR, equivalent to 13,410,470,202$ based on the dollar free market rate of 30,000 IRR (purchase power parity). In sum, injury and death cases came to 1,171,450,232,238,648 IRR equivalents to 39,048,341,074$. Moreover, in 2013, costs of traffic accident constituted 6.46% of gross national income, which was 604,300,000,000$. WTP had a significant relationship with age, middle and high income, daily payment to injury reduction, more payment to time reduction, trip mileage, private cars drivers, bus, minibus vehicles, and occupants (P < 0.01).Conclusion:Costs of traffic injuries included noticeable portion of gross national income. If policy-making and resource allocation are made based on the scientific pieces of evidence, an enormous amount of capital can be saved through reducing death and injury rates.

Epidemiology of Road Traffic Injuries in Iran: Based on the Data from Disaster Management Information System (DMIS) Of the Iranian Red Crescent

Background: Road traffic injuries (RTIs) are the leading cause of injuries and the second cause of mortality in Iran. Objectives: The aim of this study was to investigate the epidemiological pattern of RTIs in Iran based on the data from disaster management information system (DMIS) of the Iranian Red Crescent. Methods: In this cross-sectional study, the pattern of RTIs in Iran was studied based on the data from DMIS in the period from 20 March 2012 to 19 February 2016 (35 months). All of the 78775 RTIs recorded were selected through census. Data analysis was done using the SPSS.16 software package. P value less than 0.05 was considered statistically significant. Results: Among the 19 types of accidents whose data are recorded, road traffic accidents with a 78775 number of occurrence (136.1 ± 86.5 per 100000 people), 186860 injuries (332.1 ± 220 per 100000 people) and 12596 deaths (22.6 ± 11.1 per 100000 people) were the highest in ranking. The most common annunciator of the accidents was the emergency. Receiving the first report of the rescue operation was most done by telephone. The mean number of the operational forces involved in RTIs per 100000 people was 529.2 ± 407. The results showed that there was a significant difference between high, moderate and low population rate provinces in the mean number of injuries cases, the mortality of RTIs and the total number of Red Crescent operational forces (P Conclusions: Considering the high occurrence of the mortality and the injuries of the RTIs compared to that of the other types of accidents, more attention to RTIs in planning and interventions seems necessary. Keywords: Road Traffic; Injuries; Accidents; Epidemiological Mortality Language: en

Direct and indirect costs of nonfatal road traffic injuries in Iran: A population-based study

ABSTRACTObjectives: The objective of this study was to assess the incidence rate as well as direct and indirect costs of nonfatal road traffic injuries (RTIs) in Iran in 2011.Methods: Data from the 2011 national household survey were used. In this survey, data on demographics, history, and costs of injury were obtained in 2 steps: first, direct face-to-face interview and second, telephone calls. We estimated the incidence rate of nonfatal RTIs in this year. The direct costs included medical care as well as nonmedical costs paid by the patient or insurance services. The indirect costs were estimated by considering the cost of absence from work or education. We also used logistic regression analyses to investigate risk factors of nonfatal RTIs.Results: We found 76 nonfatal RTI cases (0.96%) out of 7,886 whole reference study cases. These 76 injured patients had a history of RTI in the preceding 3 months. The annual incidence of RTIs was estimated at 3.84%. The mean age of RTI cases was 28.5 ± 10.6 and 88.16% of them were male. Male gender was a major risk factor (odds ratio [OR] = 9.64, 95% confidence interval [CI], 4.79–19.41) and marriage was a protective factor (OR = 0.44, 95% CI, 0.28–0.70) for RTI. The medians of direct, indirect, and total costs were US$214, US$163, and US$387, respectively. The total cost of nonfatal RTIs in Iran was estimated at 1.29% of the gross domestic product (GDP) in 2011.Conclusions: In Iran, nonfatal RTIs imposed a total cost of almost US$7 billion to the country for one year. Extension and more serious implementation of preventive measurements seem necessary to decrease this notable burden of RTIs.

Estimation of the population attributable fraction of road-related injuries due to speeding and passing in Iran.

OBJECTIVESSpeeding and passing are considered to be the main human factors resulting in road traffic injuries (RTIs). This study aimed to estimate the population attributeable fraction (PAF) of speeding and passing in RTIs in rural Iran during 2012.METHODSThe contribution of speeding and passing to RTI-related morbidity and mortality was estimated using the PAF method. The prevalence of speeding and passing was obtained from the national traffic police data registry. A logistic regression model was used to measure the association between the above risk factors and RTIs.RESULTSSpeeding accounted for 20.96% and 16.61% of rural road-related deaths and injuries, respectively. The corresponding values for passing were 13.50% and 13.44%, respectively. Jointly, the PAF of these factors was 31.63% for road-related deaths and 27.81% for injuries.CONCLUSIONSThis study illustrates the importance of controlling speeding and passing as a high-priority aspect of public-health approaches to RTIs in Iran. It is recommended that laws restricting speeding and passing be enforced more strictly.

Medical Costs and Economic Burden Caused by Road Traffic Injuries in Iran

BACKGROUND: Road traffic injuries (RTIs) impose significant social and economic burden. Objectives: The objective of this study was to estimate the medical costs and economic production losses caused by RTI in Iran Methods: The major components included in this study were medical costs, lost output, and indirect costs. Cost components and their values in 2011 were obtained using previous experiences and data collected during the study. A general approach that included a consideration of human capital was used to calculate the cost of RTIs. Results: The economic burden of RTIs was estimated to be more than 111,000 billion Iranian rials (IRR) ($4.44 billion USD) in 2011. This cost relates only to the health sector and does not include components such as vehicle damage, lost time in accidents, and the administrative costs of insurance and police services. The estimated cost of RTIs to the health sector was about 2.18% of Iran's total GDP in 2011. Conclusions: The medical costs and economic production losses caused by RTIs in Iran clearly indicate that injuries should be a significant concern for health policymakers and medical planners. Keywords: Road Traffic Injuries; Economic Cost; Medical Costs; Lost Output; Indirect Costs Language: en

Temporal Patterns of Road Traffic Injuries in Iran.

BackgroundRoad traffic injuries (RTIs) are the main causes of death and disability in Iran. However, very few studies about the temporal variations of RTIs have been published to date.ObjectivesThis study was conducted to investigate the temporal pattern of RTIs in Iran in 2012.Materials and MethodsAll road traffic accidents (RTAs) reported to traffic police during a one-year period (March 21, 2012 through March 21, 2013) were investigated after obtaining permission from the law enforcement force of the Islamic Republic of Iran. Distributions of RTAs were obtained for season, month, week, and hour scales, and for long holidays (more than one day) and the day prior to long holidays (DPLH). The final analysis was carried out using the Poisson regression model to calculate incidence rate ratios for RTIs. All analyses were conducted using STATA 13.1 and Excel software; statistical significance was set at P < 0.05.ResultsA total of 452,192 RTAs were examined. The estimated rate of all accidents was 219 per 10,000 registered vehicles, or 595 per 100,000 people. About 28% of all RTAs, and more than one third of fatal RTAs, occurred during the summer months. The incidence rate for all traffic accidents on DPLH was 1.20, compared to workdays as a reference category, and it was 1.40 for fatal crashes. The rate of fatal road traffic accidents in outer cities was 3.2 times higher than in inner ones.ConclusionsOur findings reveal that there are temporal variations in traffic accidents, and long holidays significantly influence accident rates. Traffic injuries have different patterns on outer/inner city roads, based on weekday and holiday status. Thus, these findings could be used to create effective initiatives aimed at traffic management.

Cost of Road Traffic Injuries in Iran: A mini-systematic review

Purpose: Due to the high economic burden of Road Traffic Injuries (RTIs) in Iran and the ambiguities in this field, the aim of this study was to mini systematic review about the economic burden of RTIs in Iran. Material and Methods: Required data in this mini systematic review study were collected through searching the following key words: “road traffic injuries”, “road traffic accidents”, “road traffic crashes”, “road traffic collision”,” economic*”, cost and Iran. The following databases were used: Google Scholar, PubMed, Scopus, MagIran, Iranian scientific information (SID) databases and IranMedex. Some of the relevant journals and web site searched manually. Reference lists check of the selected articles also was conducted. In final stage of literature review we also conducted search of gray literature and experts contact. Results: The results of the 11 studies examined show that the Human Capital (HC) approach is used more than other cases among different approaches to calculating the cost of RTIs. Using the willingness to pay (WTP) approach, the total cost of RTIsin Iran in 2013 was reported to be 6.64% of the GNP. Using the HC approach, the share of RTIs costs in the whole of Iran has been reported to be 1.4% and 2.1% of GNP, respectively. Health care costs of RTIs have been more explored, compared to other types of RTIs costs. The costs of vehicles were higher than other types of expenses. Conclusion: Economic burden of RTIs in Iran are high. Hence, more planning and attention to preventing RTIs, and increasing the safety of roads and vehicles are essential.

Road safety and traffic medicine in Iran: Achievements and challenges

Road traffic injuries found to be the second rank of Years of Life Lost (YLL) and third rank of Disability Adjusted Life Years (DALY) in Iran based on Global Burden of Disease 2010. The number of annual fatalities, which had been on the rise for several decades, reached to the maximum number of over 27500 deaths in 2005. The number decreased to 23000 in 2010 and less than 18000 in 2013. The reduction in number of deaths happened despite a four-fold increase in number of motor vehicles. Some of the interventions that might be contributing to this achievement include the following: a) the new traffic law passed in 2010 that replaced the previous one dating back to 1968. Heavier penalties for major offences like: speeding, driving under the influence and dangerous driving are considered in the new law; b) stricter law enforcement by traffic polices(1); c) mass media campaign for traffic injury prevention (1); d) using fixed speed camera systems and laser speed guns; e) universal coverage of hospital treatment costs for all traffic injuries by Ministry of Health and Medical Education(2); and f) graduated driving license. On the other side, there are areas that need to be improved, including: a) driving behavior of both public and private drivers; b) driving under influence of drugs specially among public vehicle drivers (3,4) c) motorcycle riding behavior with special emphasis on helmet use (5); d) medical and psychological fitness to drive examinations; e) vehicle safety specifically for cars manufactured within the country; f) transportation engineering with emphasis on expansion of railroads and safe highways.