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Background: Aggressive driving is the leading behavior resulting in fatal or nonfatal disabling injuries. Therefore, programs with the main focus on driving behavior could reduce the risk of traffic injuries remarkably. We aimed to investigate the role of non-punitive performance feedback on drivers' behavior and evaluate the persistence of the altered behavior by using in-vehicle telematics., Methods: This study was done as a randomized controlled trial by repeated-measures design to evaluate the non-punitive behavioral intervention's efficacy on the behavioral transition to safer driving for 1,289 bus and 104 taxi drivers. All participants were studied during 17 weeks through three stages: stage 0 (five weeks for collecting the baseline characteristics of the participants), stage 1 (nine weeks for randomizing the participants into intervention group or control group and sending the intervention group feedback via short message service), and stage 2 (three weeks for following-up the participants without sending feedback). The intervention group drivers received weekly text messages about the driving score and drivers' rank within their peer group.The study's primary outcome was the driver score changing pattern throughout the study calculated by a neuro-fuzzy scoring system composed of four factors: speed violation, harsh acceleration, harsh braking, and harsh turning., Results: Among the bus drivers, a significant positive effect of the intervention was found in stage 1 (P<0.0001) and in stage 2 (P<0.0001) regarding the calculated scoring system. Among the taxi drivers, a significant positive effect of the intervention was found in stage 1 (P<0.0001), but the effect was not significant in stage 2 (P=0.15)., Conclusion: The results of this study were in favor of using telematics and its positive effect on driving performance. The reformed behavior persisted even after the intervention ceased., Practical Application: Behavioral interventions could be considered a promising strategy to enhance and promote safe driving performance., (Copyright © 2022. Published by Elsevier Ltd.)

Background: The adherence to speed limits can reduce deaths associated with road traffic injuries (RTIs) by more than a quarter. This study aimed to evaluate the effective factors on the speeding behavior of Iranian taxi drivers around fixed speed cameras., Method: Telematics devices used in this study collected the location and speed of the vehicles. The units of analysis in this study were trips per camera, including 2.5 km before and after each camera. Linear regression analysis was used to identify kangaroo driving (KD), defined as trips with a significant V-shape in speed distribution around the camera. In the clustered camera zones, cameras were placed at regular intervals of approximately 3.5 km., Findings: A total of 93,160 trips were recorded from 13,857,443 data points. There was an inverse association between drivers' age and KD with an odds ratio (OR) of 0.98 (95% confidence interval: 0.98-0.98). The intercity trips had a substantially higher probability of KD than urban trips (OR: 4.94 [4.73-5.16]). The tendency of drivers toward KD during the daylight hours vs. nighttime was significant for both urban (OR: 1.15 [1.06-1.25]) and intercity (OR: 1.18 [1.14-1.22]) trips. The 4 -8 a.m. period had the highest chance of KD in both urban (10.71% [7.41-14.53]) and intercity (44.13% [41.18-47.09]) trips. There was a significant decrease in the odds of KD inside the clustered camera zones (OR: 0.22 [0.20-0.25])., Conclusion: The heterogeneous occurrence of KD in different locations and times indicates the necessity of evidence-based decision-making in urban planning to improve safe driving behaviors. The lower occurrence of KD in clustered camera zones could be a practical key to the effective control of speeding behaviors by helping in the efficient placement of cameras through sustainable development of cities and roads., (Copyright © 2022 Malekpour, Azadnajafabad, Rezazadeh-Khadem, Bhalla, Ghasemi, Heydari, Ghamari, Abbasi-Kangevari, Rezaei, Manian, Shahraz, Rezaei, Lankarani and Farzadfar.)

Despite strong advocacy, the UN Decade of Action for Road Safety (2011-2020) is ending with most low- and middle-income countries (LMICs) no closer to the Sustainable Development Goals target of reducing traffic mortality by half. In contrast, most high-income countries (HICs) have seen large benefits in recent decades from large-scale safety interventions. We aimed to assess how much LMICs would benefit from interventions that address six key risk factors related to helmet use, seatbelt use, speed control, drink driving, and vehicle design for safety of occupants and pedestrians. We use a comparative risk assessment framework to estimate mortality and health loss (disability adjusted life years lost, DALYs) that would be averted if these risks were reduced through intervention. We estimate effects for six countries that span all developing regions: China, Colombia, Ethiopia, India, Iran, and Russia. We find relatively large benefits (27% reductions in road traffic deaths and DALYs) from speed control in all countries, and about 5%-20% reductions due to other interventions depending on who is at risk in each country. To achieve larger gains, LMICs would need to move beyond simply learning from HICs and undertake new research to address risk factors particularly relevant to their context.

Objective: Deaths due to road traffic accidents (RTAs) are a major public health concern around the world. Developing countries are over-represented in these statistics. Punitive measures are traditionally employed to lower RTA related behavioural risk factors. These are, however, resource intensive and require infrastructure development. This is a randomised controlled study to investigate the effect of non-punitive behavioural intervention through peer-comparison feedback based on driver behaviour data gathered by an in-vehicle telematics device., Design, Setting, and Participants: A randomised controlled trial using repeated measures design conducted in Iran on the drivers of 112 public transport taxis in Tehran province and 1309 inter-city busses operating nationwide. Driving data is captured by an in-vehicle telematics device and sent to a centrally located data centre using a mobile network. The telematics device is installed in all vehicles. Participants are males aged above 20 who have had the device operating in their vehicles for at least 3 months prior to the start of the trial., Intervention: The study had three stages: 1- Driver performance was monitored for a 4-week period after which they were randomised into intervention and control groups. 2- Their performance was monitored for a 9-week period. At the end of each week, drivers in the intervention group received a scorecard and a note informing them of their weekly behaviour and ranking within their peer group. Drivers in the control group received no feedback via short messaging service (SMS). 3- Drivers did not receive further feedback and their behaviour was monitored for another 4 weeks., Primary and Secondary Outcome Measure: Primary outcome was changes in weekly driving score in intervention and control groups during stage 2 of intervention. Taxis and busses were analysed separately using generalised estimating equation analysis., Funding and Ethical Approval: This project was funded by the National Institute for Medical Research Development (Grant No.940576) and approved by its ethics committee (Code: IR.NIMAD.REC.1394.016). This trial was registered at www.irct.ir as IRCT20180708040391N1., (© 2018 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Objective: To use a range of existing information sources to develop a national snapshot of the burden of road traffic injuries in one developing country-Iran., Methods: The distribution of deaths was estimated by using data from the national death registration system, hospital admissions and outpatient visits from a time-limited hospital registry in 12 of 30 provinces, and injuries that received no institutional care using the 2000 demographic and health survey. Results were extrapolated to national annual incidence of health burden differentiated by age, sex, external cause, nature of injuries and institutional care., Results: In 2005, 30,721 Iranians died annually in road traffic crashes and over one million were injured. The death rate (44 per 100,000) is the highest of any country in the world for which reliable estimates are available. Road traffic injuries are the third leading cause of death in Iran. While young adults are at high risk in non-fatal crashes, the elderly have the highest total death rates, largely due to pedestrian crashes. While car occupants lead the death count, motorized two-wheeler riders dominate hospital admissions, outpatient visits and health burden., Conclusions: Reliable estimates of the burden of road traffic injuries are an essential input for rational priority setting. Most low income countries are unlikely to have national injury surveillance systems for several decades. Thus national estimates of the burden of injuries should be built by collating information from all existing information sources by appropriately correcting for source specific shortcomings.

Recent studies have made it clear that Iran has too many road traffic injuries (RTI). This paper explains the reasons for high traffic injury rates and points to solutions. It also provides detailed data on the burden of traffic injury in Iran in 2005. Traffic injury rates have rapidly risen out of control because for a variety of possible reasons such as increasing number of non-standard cars and motorcycles, low gas price, decreasing ratio of travels via public transportation than with private vehicles, and problems with safety design. Besides a high need for a system safety approach, Iran needs to deal with the problem of producing a high number of cars and motorcycles. Providing safe mobility for the people of Iran needs to be a top priority of the government.