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Background: Trauma is the sixth cause of death worldwide and the fifth main cause of significant disability and carries a great economic and social burden.Objective: This study was carried out to investigate the epidemiological and clinical characteristics of trauma and to assess the correlation between the cause of trauma and its severity in different body areas.Methods: Patients with all kinds of injuries referred to the Emergency Department (ED) of Al-Zahra University Hospital in Isfahan, Iran, who met the inclusion criteria, were recruited to this study from September 2019 to January 2023.Results: Among the 869 trauma patients admitted to the hospital during this period, 444 (51.1%) were married. There was a statistically significant difference in the pattern of trauma between males and females (P = 0.003). There was also a significant relationship between the average age of people and different causes of injury (P 3, according to our findings. These research endeavors will aid in devising improved methods to prevent occurrences and enhance healthcare approaches. To prevent and manage traumatic injuries, a multi-sectoral approach and collaboration between different stakeholders is needed.

Road traffic crashes (RTCs) are significantly high in Nigeria with serious social and health consequences. While existing studies on RTCs have mainly focused on the effect of socio-economic, environmental, human and mechanical factors to address the high rates, the relationship between road transport fares and RTCs has been glossed over in literature. Thus, this study examines the influence of road transport fares and other covariates on RTCs. Data on RTCs and the predictors between 2017 and 2022 were obtained from the records of the National Bureau of Statistics and the Federal Road Safety Corps. Spatial statistical techniques were used for the data analysis. RTCs vary across the country, and Northern Nigeria is the hot spot. Results from the spatial analysis show that road transport fares, population density, and illiteracy rate are significant predictors of RTCs. The study recommends striking a balance between fare affordability, the quality of service provided, and the implementation of effective transportation strategies. [ABSTRACT FROM AUTHOR]

Road traffic crashes and fatalities pose a significant global challenge, particularly in low- and middle-income countries (LMICs), where a major cause is consistently linked to speeding (i.e., excessive or inappropriate speeds). However, the existing body of evidence regarding the estimated contribution of speeding to crashes and fatalities, remains limited and is considered outdated. This paper bridges this knowledge gap by reviewing evidence on the contribution of speeding to crashes and fatalities. The review draws on a wide range of sources including peer-reviewed studies on the subject, road safety monitoring-reports and available data summaries (104 sources). Data reliability was confirmed by including studies based on or linked to primary sources like police records, and excluding those with poor quality, implausible results, or lacked references to primary sources. The included sources contained 37 estimates from high-income countries (HICs), and 67 estimates from LMICs. Globally, HIC and LMIC estimates of contribution were calculated by assigning weights based on the proportion of fatalities in each country under this study. The results indicated that speeding contributes to approximately 54 % of fatalities worldwide, 57 % in LMICs, and 28 % in HICs. This translates to a speeding-related death every 49 s, with a 95 % likelihood of occurring in LMICs. These findings carry significant implications for policymakers emphasizing the urgent need to prioritize interventions that reduce speeding and improve road safety. Investigating gaps in LMICs data sources is a critical priority. In-depth studies and speeding intervention evaluations will enhance our current understanding of speeding contribution to crashes and fatalities.

In the context of developing countries like Nepal, enhancing road traffic safety (RTS) requires prioritizing aspects such as road safety management, infrastructure improvement, vehicle safety, and promoting safer road user behavior. Importantly, establishing a conducive legal framework and ensuring effective enforcement are crucial for improving RTS. This study aims to analyze the enforcement status of road traffic regulatory factors and provide suggestions for improvement. A set of structured questionnaires comprising thirty items measuring six dimensions of road traffic regulation was developed to gather data from 396 Nepal traffic police officers. Confirmatory Factor Analysis (CFA) was employed to construct the measurement model. The statistical analysis revealed that road traffic regulatory factors such as seatbelt, helmet, and license laws, along with insufficient penalties for violations related to drunk and distracted driving, speeding, and mobile phone use contribute to road traffic accidents. The findings highlight the pressing need for effective implementation of traffic regulations. To improve road safety in Nepal stricter penalties for drunk driving, speeding, and mobile phone use, advancing vehicle safety technology, formulating transportation safety policies, accrediting pre-hospital care providers, and safety auditing in road planning, construction, and operation are vital. The model developed herein provides valuable insights to policymakers to reinforce prevailing regulations for reducing traffic-related fatalities not only for Nepal but also for other countries encountering similar road safety challenges.

• Vehicle Electronic Stability Control may not be as effective as currently believed, due to possible over-estimation of effects in crash sample studies. • Fatal crashes data from the US was used to test whether the increase in Electronic Stability Control in the vehicle population was associated with a decline in crashes. • The results indicate that the effect in US data might possibly be two thirds the size of previous estimates, possibly much less. Problem: Electronic Stability Control (ESC) is believed to be among the most efficient vehicle safety interventions with reported effects around 50% for fatal single and rollover crashes. However, such estimates have used sample data, which have not controlled for the possibilities of self-selection, behavioral adaptation, increased access to the technology by less safe drivers, and the calculation of effects on very specific categories of crashes. Effects of ESC in the population can therefore be expected to be smaller than is currently believed. Method: National U.S. data for fatal crashes, driving exposure and other control factors, and market penetration of ESC over 1991–2021 were used to calculate whether the trends in fatalities over time in crash rates for singles, rollovers, and fatal crashes in general matched projections from estimates of effectiveness. Results: It was found that downward trends in the relevant crash types were generally present before ESC was introduced, and that the trends thereafter were weaker. Although some trends were consistent with effects of ESC, they were markedly smaller than the projected ones, and could be explained by other factors such as the number of vehicles per capita. At best, the effect for rollovers could be up to two-thirds of previous estimates, no effect was detected for singles, while for all fatal crashes results depended upon the type of analysis performed. These results conflict with conclusions in all published ESC crash sample studies, which have compared vehicles with and without ESC. This discrepancy can be explained by methodological errors in the previous studies using induced exposure methods and self-selected samples. Practical applications: Traffic safety may not be as much improved by technological interventions as believed. Alternative approaches to traffic safety are needed, which do not rely on technology that interferes with driver behavior. [ABSTRACT FROM AUTHOR]

Introduction: In Colombia, road traffic crashes are the eighth leading cause of death. In 2017, as part of the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS), Vital Strategies supported government-led journalist trainings in Colombia to shift media discourse of road safety as a public health and development issue with known risk factors and achievable solutions, to ultimately catalyze public and policymaker concern and action. This study evaluates the effects these trainings had on road safety reporting. Methods: Articles about BIGRS road safety work published between 1 May 2017 and Aug. 30, 2021 were collected from a database maintained by communication officers. The sample included 870 articles, which were systematically analyzed for year-wise frequency by independent coders. Interreliability (Cohen's Kapp K > 0.94) was established using a codebook developed to identify examples of best practices shared during trainings. Results: From 2017 to 2021, there was a 27% increase in articles that situated road traffic collisions (RTCs) as due to systemic issues (thematic framing) rather than isolated events (episodic framing). Almost all observed articles used at least one WHO-recommended story angle (96%) and key element (95%). Reporting angles focused on the human story were largely underutilized (2%-5%). Government representatives (81%), mostly from the Secretary of Mobility (67%), were the most cited sources and road safety advocates were the least (3%). Use of terms "crash" and "collision" increased across the study period (crash: 47% in 2017 to 59% in 2021; collision: 0.4% in 2019 to 5% in 2020). However, RTCs continued to be widely called "accidents" (46%). More than half of articles referenced either "victims" or "vulnerable road users" (55%); use of "person" to refer to victims/vulnerable road users increased from 33% in 2017 to 56% in 2020. Conclusion: Over the course of the BIGRS journalist training program, reporting in Colombia increasingly used best practices to frame road safety as a public health issue. This highlights how media engagement is important to comprehensive road safety strategies and should be more widely adopted. Future training efforts should focus on finding the human story, and on changing overreliance on terms like "accident" that make RTCs seem inevitable. [ABSTRACT FROM AUTHOR]

The official data pertaining to road traffic crashes in Lebanon only encompasses nearly 50% of the projected yearly mortality rate, which exceeds 1,000 people. The lack of legal provisions designed to protect vulnerable road users, including pedestrians and motorcyclists, in Lebanon has led to a notable percentage of road fatalities, ranging from 30% to 40%. The adherence to established driving safety protocols in Lebanon is deficient in frequency, as demonstrated by reports that indicate a mere 15% of front-seat passengers consistently use seatbelts. The objective of the current research is to assess the socioeconomic impact of road traffic crashes in Lebanon; in other words, to assess the crash costs by means of two methods: willing-to-pay (WTP) and human capital (HC). Between 2010 and 2022, the WTP approach yielded an average cost estimate of $1,281,393,100 (with an estimate of $753,563,928 for the year 2022), while the HC approach resulted in a cost estimate of $1,299,475,794. The expenses related to vehicles constituted 5.4% of the overall costs, whereas the productivity expenses constituted 9.4%. According to the results of the survey administered in this study, the respondents demonstrated a readiness to expend a sum between 73 and 74 dollars to attain a 50% reduction in the incidence of crashes and a sum between 60 and 61 dollars to achieve an 80% decrease in the likelihood of crashes. [ABSTRACT FROM AUTHOR]

To perform a spatial analysis of Road Traffic Crashes (RTCs) and assess road safety issues from the perspective of road users. Although many initiatives have been taken to reduce the occurrence and severity of RTCs, they continue to persist. Existing research often investigates the spatial occurrence of RTCs or the perception of road safety issues from the road user. In doing this, only a limited number of factors that contribute to RTCs can be revealed, whereas in most RTC occurrences a multitude of factors plays a role. A more integrated approach combining both knowledge areas can contribute to improving road safety. RTCs that occurred from 2018 to 2020 in Rotterdam, in the Netherlands, were spatially analyzed. This was performed using Network Kernel Density Estimation (NKDE) analysis. Two zones within the study area were selected to understand road users' perceptions of road safety through a survey. Furthermore, opinions toward possible recommendations for improving road safety were also collected through key informant interviews. NKDE resulted in a hot-spot map of the road segments in the study area that showed the frequency of RTCs using different colors. The road segments were classified based on the number of RTCs from 2018 to 2020, ranging from zero to 17.9 RTCs per kilometer. This led to the selection of a hot and cold spot zone for further analysis. The road user perception survey resulted in the discovery of qualitative responses that can be used to improve road safety in future and the possible recommendations would be well received by them. The key-informant interviews acted as a backup to the opinions given by the road users and provided insights on what is being done in the study area to improve road safety. The synthesis of findings unveiled why road users perceive some areas as dangerous and which road policies need to be revised to improve road safety in Rotterdam. [ABSTRACT FROM AUTHOR]

1.3 million people die each year as a result of Road traffic crashes. Road Traffic Injuries are a global health crisis with 90% of global deaths affecting LMICs. Sustainable Development Goal 3.6 focuses on reducing road injury and death. The global plan is based on the Safe Systems approach. In South Africa, the burden of crashes on the health system and society is particularly high with a population death rate of 20.7 per 100 000 population. Understanding local context and culture is critical. Rurality, distorted urban planning, higher travel exposure and alcohol usage disproportionately impact racial and ethnic minorities. Pedestrian safety is a key priority. There is a critical need for the global health community to take an active role in advocacy in order to achieve SDG 3.6 by 2030.

Introduction: This study aimed to determine the impact of community socioeconomic status on emergency medical services’ response time for fatal vehicle crashes. Methods: Authors used the 2019 National Highway Traffic Safety Administration Fatality Analysis Reporting System and 2019–2020 Area Health Resource Files to obtain emergency medical services’ time intervals and county socioeconomic characteristics (e.g., median household income, availability of trauma centers, and rurality), generating a study sample of 18,540 individuals involved in fatal vehicle crashes between January and December 2019. Generalized linear models with log-link and Gamma-family were used to obtain estimates, and other variables were adjusted in the model. Results: Both the mean time of the emergency medical service arrival to the site of the crash and the mean transport time from the crash site to hospital varied by county SES. Counties with a higher mean household income had 12% shorter emergency medical services’ arrival times and up to 7% shorter emergency medical services’ hospital transport times than counties with lower SES. The emergency medical services’ hospital transport times by emergency medical services also varied by proximity to trauma centers and were 15% shorter in counties that had ≥2 trauma centers than in counties without trauma centers. Conclusions: This study shows socioeconomic disparities in emergency medical service rescue time for fatal vehicle crashes. Community characteristics play a major role in emergency medical services’ arrival time intervals. Prior research demonstrated a strong link between the timeliness of emergency medical service response and the likelihood of survival in fatal motor vehicle accidents. These findings showing that socioeconomically disadvantaged areas and those lacking trauma facilities had slower emergency medical service rescue times, suggest that socioeconomic status may be a predictor of mortality in fatal motor vehicle accidents. Effective emergency medical services are essential to reduce the morbidity and mortality among motor vehicle crash victims; however, disparities exist in the timeliness of these services by geographic and socioeconomic county characteristics. Further research is urgently needed to inform policy interventions.

Introduction: In Colombia, road traffic crashes are the eighth leading cause of death. In 2017, as part of the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS), Vital Strategies supported government-led journalist trainings in Colombia to shift media discourse of road safety as a public health and development issue with known risk factors and achievable solutions, to ultimately catalyze public and policymaker concern and action. This study evaluates the effects these trainings had on road safety reporting.Methods: Articles about BIGRS road safety work published between 1 May 2017 and Aug. 30, 2021 were collected from a database maintained by communication officers. The sample included 870 articles, which were systematically analyzed for year-wise frequency by independent coders. Inter-reliability (Cohen’s Kapp K > 0.94) was established using a codebook developed to identify examples of best practices shared during trainings.Results: From 2017 to 2021, there was a 27% increase in articles that situated road traffic collisions (RTCs) as due to systemic issues (thematic framing) rather than isolated events (episodic framing). Almost all observed articles used at least one WHO-recommended story angle (96%) and key element (95%). Reporting angles focused on the human story were largely underutilized (2%–5%). Government representatives (81%), mostly from the Secretary of Mobility (67%), were the most cited sources and road safety advocates were the least (3%). Use of terms “crash” and “collision” increased across the study period (crash: 47% in 2017 to 59% in 2021; collision: 0.4% in 2019 to 5% in 2020). However, RTCs continued to be widely called “accidents” (46%). More than half of articles referenced either “victims” or “vulnerable road users” (55%); use of “person” to refer to victims/vulnerable road users increased from 33% in 2017 to 56% in 2020.Conclusion: Over the course of the BIGRS journalist training program, reporting in Colombia increasingly used best practices to frame road safety as a public health issue. This highlights how media engagement is important to comprehensive road safety strategies and should be more widely adopted. Future training efforts should focus on finding the human story, and on changing overreliance on terms like “accident” that make RTCs seem inevitable.

This review aimed to evaluate and synthesize information on the effects of first-aid education in road traffic crashes on knowledge, attitudes, and skills among non-healthcare professionals. A qualitative study was designed according to the Prepared Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards to evaluate three outcomes, knowledge, skills, and attitude. The search strategy was performed in five databases (Science Direct, Scopus, CINAHL Plus, PubMed, and Google Scholar) to retrieve primary studies published between January 2011 and December 2021. In addition, the full texts of randomized controlled trials conducted on adults were included. Among the 2,399 articles retrieved from the databases, 2,388 were discarded, and only five studies met the inclusion criteria and were used in the final analysis and synthesis. Three of the five studies suggested that knowledge and skills are crucial in differentiating outcome factors between intervention and control groups regarding the effectiveness of first aid education. However, two studies on attitude and behaviour toward first-aid found no discernible change between the intervention and the control group. Therefore, our review revealed that only a well-structured first aid education is crucial to leverage the knowledge and skills of non-healthcare professionals before first aid provision, not attitude or behaviours. [ABSTRACT FROM AUTHOR]

Studies on pedestrian deaths and injuries at the urban level in Africa mostly provide overall aggregated figures and do not examine variation in the sub-urban units. Using cluster analysis, this study sought to determine if the observed pattern in the distribution of pedestrian injuries and deaths among parishes in Kampala city is significant. Pedestrian crash data from 2015 to 2019 were collected from the Uganda Traffic Police database. Serious and fatal pedestrian injury rates were mapped by parish using ArcMap and cluster analyses conducted. Results from spatial autocorrelation (Moran's Index of 0.18 and 0.17 for fatal and serious injury rates respectively) showed that the distributions were clustered within parishes crossed by highways and located in the inner city respectively. Z-scores of 3.32 (p < 0.01) for serious injury rates and 3.71 (p < 0.01) for fatal injury rates indicated that the clustering was not random. This study's main contribution was providing a detailed spatial distribution of pedestrian fatal and serious injury rates for Kampala; a city in a low developing country in Africa at the micro-scale of a parish. This foundational exploratory paper formed the first step of a broader study examining built environment factors explaining this pattern. [ABSTRACT FROM AUTHOR]

Objectives: The study exploits a unique situation in Israel where the distribution of traffic tickets using automatic speed enforcement cameras was suspended, while the system remained physically intact. This situation provides an opportunity to test the effects of non-enforcement on drivers' behavior. Methods: Using 3 years of data on fatal and severe crashes and a quasi-experimental design, we compared the number of casualties in crashes occurring near (< 1 km) and far (> 5 km) from the nearest camera before and after the suspension of automated enforcement. Results: A multivariate negative binomial regression indicates that before the suspension there were significantly fewer casualties (by 22%) in crashes near cameras compared to crashes farther away. After the suspension of automated enforcement, this difference vanished. Conclusions: The findings provide evidence for the effectiveness of stationary speed cameras in reducing casualties and show how human behavior changes in light of deterrence and enforcement. [ABSTRACT FROM AUTHOR]

Governments and authorities worldwide consider road traffic crashes (RTCs) to be a major concern. These crashes incur losses in terms of productivity, property, and life. For a country to establish its road and action plans, it is crucial to comprehend the reasons for and consequences of traffic collisions. The main objective of this research study was to evaluate and rank the important and supporting factors influencing traffic crashes on the road. To identify the most significant accident causation elements, the proportion-based analytic hierarchy process (PBAHP) was used to order the factors in terms of their relative importance. In this study, the city of Al-Ahsa, located in the eastern province of Saudi Arabia, was used as a case study, since this city is the highest RTC-prone area in the region. PBAHP was used to calculate relative importance/weights for different crash types and reasons in terms of their impact on crash severity. It was found that vehicle-overturned collisions which result in fatal crashes have the most weight, whereas "hit motorcycle" crashes result in serious injury crashes. When vehicles (two or more) collide with one another while they are moving, it appears that the likelihood of a fatality in a collision increases. The highest weights for serious injury crashes came from "driver distraction", "leaving insufficient safe distance", and "speeding", which also generated similar and relatively high weights for fatal crashes. Weights from the PBAHP approach were also used to develop utility functions for predicting the severity of crashes. This approach could assist decision-makers in concentrating on the key elements affecting road traffic crashes and enhancing road safety. [ABSTRACT FROM AUTHOR]

Abstract Background information The unprecedented depletion of the productive workforce has been majorly attributed to road traffic crashes (RTCs). The attendant consequences of this depletion have been found to constitute a serious global public health challenge, with the use of psychoactive substances among drivers implicated in every three of five motor vehicle accidents. Hence, this study assessed the pattern and explored the determinants of substance abuse among commercial bus drivers in Umuahia, Abia State. Methods A descriptive cross-sectional design was used for the study. Four hundred commercial bus drivers were recruited from selected motor parks in Abia-state, using a multistage sampling technique from October to December 2020. A pretested, interviewer-administered questionnaire was administered to obtain socio-demographics and information on substance abuse. Data were analyzed using IBM SPSS version 25; bivariate analysis was done using Chi-square. The level of significance was at 5%. Results The mean age of the respondents was 40.03 ± 10.50 years. The proportion of respondents who had ever abused a psychoactive substance was 74.6%. The most commonly abused substances among drivers include alcohol (51%), cigarettes (27%), and alcoholic herbal mixtures (16%). The study participants had poor knowledge (54.5%) and poor perception (63.2%) about psychoactive substance abuse. Among the factors found to be significantly associated with substance abuse among respondents were ethnicity (p = 0.002), religion (p = 0.009) and monthly income (p = 0.013) of the respondents, poor knowledge (p

Road traffic crashes pose a significant challenge worldwide, necessitating increased efforts to reduce them and promote sustainable transport systems. This study aimed to investigate spatiotemporal road traffic crashes and their causes in the State of Qatar by identifying hot spots of crashs and exploring whether they were primiarly attributed to behavioural practices and/or the geometrical design of roads and intersections. The study employed various methods, including Time-Space Cube analysis, Geographically Weighted Regression (GWR), Emerging Hot Spot analysis, and Spatial Autocorrelation analysis, with historical traffic crash data from 2015 and 2019. The findings indicated that crashes were mainly concentrated in the central-eastern region of Qatar and are related to driver behaviour. The analysis also revealed that crashes during the weekdays in 2019 were more strongly clustered than in 2015, suggesting a probable systematic cause of crashes. The results provide valuable information for policymakers to target high-incidence locations, prioritize interventions and develop more effective measures and policies to reduce crashs and promote a sustainable transportation system in Qatar. Overall, this study highlights the importance of continued research and policy development in this area and could potentially be applicable and transferable to similar regions.

• What is already known on the subject Global morbidity and mortality from road traffic injuries (RTIs) are substantial, especially in low- and middle-income countries (LMICs) such as Kenya. RTIs have major economic impacts on households, communities, and nations. RTI surveillance is essential for characterizing the burden of and risk factors for RTIs, as well as for implementing and evaluating the impact of public health interventions aimed at reducing RTIs. Many countries, especially LMICs, lack a comprehensive national RTI surveillance system that consistently collects information on key variables necessary for public health action. • What this study adds We found that RTIs in Nairobi County, an urban setting in Kenya, predominantly affected males and young adults, and we observed that nonuse of safety equipment (i.e., seat belts and helmets) among RTI cases was common. Our study demonstrates that a hospital-based RTI surveillance system is practical in LMIC settings and can provide critical information to guide public health practice and policy. This pilot study also elucidates some challenges related to collecting information on circumstances contributing to RTIs and the need for innovative ways to systematically collect this vital information. Kenya'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. We 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. Of 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. We demonstrated feasibility of a hospital-based RTI surveillance system in Nairobi County. Integrating information from crash scenes and hospitals can guide prevention. [ABSTRACT FROM AUTHOR]

As crash data have distinctive behavior like over-dispersion, researchers have used statistical methods to deal with this unique behavior of crash data specifically. This study employed generalized linear modeling techniques to develop the model. It was assumed that the accident counts followed negative-binomial distribution, and the link function was chosen to be the log link function. Negativebinomial modeling technique was chosen over Poisson distribution because it is the most used technique by many researchers as crash data may encounter over-dispersion. The accident data set showed greater variability between its variance and mean. The accident frequency distribution is shown in this study that it is highly skewed, with a very high number of road segments registering zero accidents. Negative binomial distribution was chosen over Poisson distribution after comparing Akaike's Information Criterion (AIC) and Bayesian Information Criteria (BIC). The method is widely applied to count data. Twenty-two parameters were estimated in the model. Since p < 0.05 in the omnibus test, the null hypothesis is rejected, which indicates that the model is reasonably fit. The strongest variables in the model were witnessed to be the length of the links, number of lanes, average daily traffic, bus lane, number of buses and trolleys, and HGVs. [ABSTRACT FROM AUTHOR]

Driving under the influence of alcohol or drugs is one of the main contributing causes of serious road traffic crashes (RTCs). This study aimed to investigate the involvement of alcohol and drugs in driver fatalities in Norway during 2011–2020 and compare the findings with data from the previous decade. We linked the results of forensic toxicology testing for alcohol and the 17 most commonly used drugs assigned with legal limits with data on fatal road traffic crashes obtained from Statistics Norway and the Norwegian Public Roads Administration. The number of fatalities had decreased significantly since the previous decade, while the proportion of drivers and riders tested for alcohol and drug use increased. Blood alcohol concentrations at the legal limit or higher were found in 14.4% and psychoactive drugs were detected in 15.8% of the cases; 10.7% tested positive for illicit drugs, and 10.1% for medicinal drugs. The most prevalent illicit drugs were tetrahydrocannabinol (7.9%) and amphetamine/methamphetamine (4.7%), whereas the most prevalent medicinal drugs were clonazepam (3.7%) and diazepam (2.2%). There was a marked reduction in the number of motor vehicle drivers killed in RTCs compared with the previous decade, and also a reduction in the prevalence of alcohol. For other substances, there were no marked changes in the prevalence. [ABSTRACT FROM AUTHOR]

Increased occurrence of road traffic crashes in Kano metropolis has resulted in a steady loss of lives, injuries, and increased people's risk exposure. This study looked into the emergency response to road traffic crashes in Kano, with a view to improving efficiency by developing linkages and synergy between Emergency Healthcare Facilities (EHCF), ambulances, and crash hotspots. The geographical location and attributes of the major EHCF, crash hotspots along highway intersections, and the two existent ambulances at the Kano State Fire Service (KSFS) and Federal Road Safety Corp head offices (FRSC) were obtained using GPS surveying. Road traffic network data (vector format) was digitized from satellite image, from which two major road classes (highways and minor roads) were identified, as well as their respective speed limits. The length and speed constraints were used to calculate time distances. Nearest Neighbor and Network (closest facility, shortest route, and location-allocation) analyses were carried out. Location-allocation analysis was to determine based on defined criteria the best locations to allocate EHCF or ambulance for optimum coverage. The results demonstrated that EHCF, ambulances, and crash places have different distribution patterns with almost no linkages. Closest ambulance facility analysis revealed the FRSC ambulance takes 9.41 minutes to arrive to crash spot 18 (Maiduguri Road, following NNPC) and 7.52 minutes to arrive at AKTH, the nearest EHCF. Comparatively, getting to Court road incident scene (spot 16) and IRPH as the closest EHCF takes about 3 times the time it takes to get to spot 18 and 4 times the time it takes to get to AKTH. This means that practically almost all victims in the city suffocate before reaching to the hospital. This signifies that, in cases of demand for CPR at the incident scene, there are higher likelihood of dying as it is expected to be provided within the first four minutes after the crash. Based on a maximum of 4 minutes impedance cutoff from all directions towards the occurrences areas, location-allocation analysis found eight new locations to maximize coverage and improve efficiency. It is concluded that current road traffic crash emergency response system has been determined to be ineffective. As a result, more ambulances should be strategically placed to improve emergency response times.

Limited studies have investigated the effects of cannabis use on driving among older adults, who represent the fastest growing segment of drivers globally. We conducted a systematic review and meta-analysis to evaluate the effects of delta-9-tetrahydrocannabinol (THC) exposure on risks of (1) motor vehicle collisions (MVC) and (2) culpability for MVCs among adults 50 years and older. Three reviewers screened 7022 studies identified through MEDLINE, EMBASE, CENTRAL, and PsycINFO. Odds Ratios (OR) were calculated using the Mantel-Haenszel method in Review Manager 5.4.1. Heterogeneity was assessed using I2. The National Heart, Lung, and Blood Institute tool was used to assess the quality of each study. Seven cross-sectional studies were included. Three studies evaluated culpability while four evaluated MVC. The pooled risk of MVC was not significantly different between THC-positive and THC-negative older drivers (OR, 95% CI 1.15 [0.40, 3.31]; I2 = 72%). In culpability studies, THC exposure was not significantly associated with an increased risk of being culpable for MVC among adults over the age of 50 (OR, 95% CI 1.24 [0.95, 1.61]; I2 = 0%). Inspection of funnel plots did not indicate publication bias. Our review found that THC exposure was not associated with MVC involvement nor with culpability for MVCs. [ABSTRACT FROM AUTHOR]

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Background: Road traffic injuries (RTIs) are a leading cause of death and unintentional injuries globally. They claim 1.35 million lives and produce up to 50 million injuries each year, causing a major drain on health systems. Despite this high burden, there is a lack of robust data on the long-term consequences of RTIs, specifically the level of disability experienced by many survivors and its impact on their everyday lives. Objective: This study aims to characterize RTIs, disability level, and related consequences affecting adult road traffic crash survivors in 5 low- and middle-income countries (LMICs). In addition, this study estimates the role of demographic and crash- and treatment-related factors in predicting adverse outcomes and disability as well as examining the disability level among patients with RTIs, likelihood of return to normal life, and the environmental factors that may influence these outcomes after discharge from the hospital. Methods: This prospective observational study was conducted at selected hospitals in Bangladesh, Cambodia, Ethiopia, Mexico, and Zambia. The study sample included all adult patients with RTIs admitted to the hospital for at least 24 hours. Consecutive sampling was performed until the minimum required sample size of 400 was reached for each participating country. Data were collected from patients or their caregivers using a hospital-based surveillance tool administered at the participating sites as well as a telephone-based follow-up instrument administered 1, 3, and 6 months after discharge. Descriptive analysis and multivariate models will be used to estimate the contribution of a range of factors in predicting adverse outcomes, disability, and return to normal life. Results: Enrollment began in June 2021 and was completed in April 2022. Follow-up data collection ended in September 2022. Data analysis is currently underway, with results expected for publication in mid-2023. Expected results include estimates of disability among patients with RTIs as well as identifying the predictors of adverse outcomes, disability, and the likelihood of return to normal life. Conclusions: Research findings will help better understand the long-term burden of disability from RTIs in the 5 LMICs and the challenges facing survivors of road traffic crashes. They will be used to inform interventions aimed at improving the health care, social, physical, and policy conditions in LMICs that can facilitate recovery and rehabilitation for patients with RTIs, reduce the burden of disability, and enhance their participation in society. [ABSTRACT FROM AUTHOR]

Abstract Introduction Many people die as a result of road traffic crashes globally every year. Low- and middle-income countries had higher road crashes mortality compared to high-income countries and Iran is one of the countries with the high road crashes mortality in the world. Regarding the important and basic role the social components plays in health. The current study aims to investigate social determinants of traffic crash mortality in Isfahan during the 2014-2017. Methods: This study was a cross-sectional data secondary analysis. 29909 traffic crashes were analyzed. Data were extracted from the Hospital Information System (HIS) and analyzed using logistic regression. Social determinants were selected using the Commission on Social Determinants of Health conceptual framework. Data were analyzed with Stata 14 software at a significance level of less than 0.05 Results: we found that 719(2.8%) mortalities were related to traffic accident injury. The death rate due to traffic crash in the hospital was 2.4%. Multivariate logistic regression showed that men (P-value =0.00), unemployed people, less than 65 years of age, injured transported from suburb and passengers of small vans/trucks (P-value

Road traffic deaths and serious injuries are a global public health issue, particularly in the Arab region, where the mortality rate from road crashes surpasses the global average and is more than three times higher than the European region's average. In this regard, an Arab Integrated Road Safety Observatory is being developed to help Arab countries execute evidence-based policies, strategies, and action plans, as well as meet the global targets of the second decade of action (2021 2030). Because numerous experiences exist at the worldwide level, the current paper aims to serve as a platform and reference for the Arab Observatory's development of an integrated Regional Road Safety Information System (RRSIS). In this regard, current RRSISs in various parts of the world were extensively examined and compared using literature and semi-structured interviews with international specialists. Six RRSIS from regional observatories or RRSISs with regional data sets were included in the benchmarking. As a result, various parallels and contrasts were found: a) at the technical level, each RRSIS has its own areas of interest (data, policy, or both), scope (aggregated or disaggregated data), and thus different sets of collected variables and values; b) at the organizational level, several similarities are identified, particularly with regard to the organizational structure; c) at the financial level, multiple differences are revealed, either for financial resources or scale expenditure. On the one hand, benchmarking is required to learn from prior experiences and current models as a source of inspiration. On the other hand, harmonization and coordination assure and guarantee consistency, integrity, and communication between the future Arab RRSIS and the existing regional RRSIS [ABSTRACT FROM AUTHOR]

A customized 27-item driver behavior questionnaire (DBQ) for professional long-distance bus and passenger van drivers in Bihar, India was tested separately and the underlying factor structures identified. In total, 156 bus and 149 passenger van drivers were surveyed and their self-reported aberrations, measured using the DBQ, were recorded along with their self-reported traffic citation and crash involvement in the past 3 years. A 21-item seven-factor DBQ and a 19-item five-factor DBQ were obtained for bus and passenger van drivers respectively through exploratory and confirmatory factor analysis. Structural equation modeling was used to find relations between DBQ factors and drivers’ number of crashes and traffic citations involvements. Only speed issues could significantly explain traffic citation involvement but no factor could significantly explain crash involvement for bus drivers. For passenger van drivers, only aggressive violations could explain traffic citation involvement while unmindfulness, aggressive violations and errors could explain crash involvement. [ABSTRACT FROM AUTHOR]

Background: Road traffic crashes (RTCs) are among the eight-leading causes of death globally. Strategies and policies have been put in place by many countries to reduce RTCs and to prevent RTCs and related injuries/deaths. Methods: In this review, we searched the following databases Ovid Medline, Embase, Cochrane Database of Systematic Reviews, Epistemonikos, Web of Science, and LILACS for reviews matching our inclusion criteria between periods January 1950 and March 2020. We did not apply language or publication restrictions in the searches. We, however, excluded reviews that focused primarily on injury prevention and reviews that looked at crashes not involving a motor vehicle. Results: We identified 35 systematic reviews matching our inclusion criteria and most of the reviews (33/35) included studies strictly from high-income countries. Most reviews were published before 2015, with only 5 published between 2015 and 2020. Methodological quality varied between reviews. Most reviews focused on enforcement intervention. There was strong evidence that random breath testing, selective breath testing, and sobriety checkpoints were effective in reducing alcohol-related crashes and associated fatal and nonfatal injuries. Other reviews found that sobriety checkpoints reduced the number of crashes by 17% [CI: (− 20, − 14)]. Road safety campaigns were found to reduce the numbers of RTCs by 9% [CI: (− 11, − 8%)]. Mass media campaigns indicated some median decrease in crashes across all studies and all levels of crash severity was 10% (IQR: 6 to 14%). Converting intersections to roundabouts was associated with a reduction of 30 to 50% in the number of RTCs resulting in injury and property damage. Electronic stability control measure was found to reduce single-vehicle crashes by − 49% [95% CI: (− 55, − 42%)]. No evidence was found to indicate that post-license driver education is effective in preventing road traffic injuries or crashes. Conclusion: There were many systematic reviews of varying quality available which included studies that were conducted in high-income settings. The overview has found that behavioural based interventions are very effective in reducing RTCs. [ABSTRACT FROM AUTHOR]

Abstract Background Road traffic crashes (RTCs) are among the eight-leading causes of death globally. Strategies and policies have been put in place by many countries to reduce RTCs and to prevent RTCs and related injuries/deaths. Methods In this review, we searched the following databases Ovid Medline, Embase, Cochrane Database of Systematic Reviews, Epistemonikos, Web of Science, and LILACS for reviews matching our inclusion criteria between periods January 1950 and March 2020. We did not apply language or publication restrictions in the searches. We, however, excluded reviews that focused primarily on injury prevention and reviews that looked at crashes not involving a motor vehicle. Results We identified 35 systematic reviews matching our inclusion criteria and most of the reviews (33/35) included studies strictly from high-income countries. Most reviews were published before 2015, with only 5 published between 2015 and 2020. Methodological quality varied between reviews. Most reviews focused on enforcement intervention. There was strong evidence that random breath testing, selective breath testing, and sobriety checkpoints were effective in reducing alcohol-related crashes and associated fatal and nonfatal injuries. Other reviews found that sobriety checkpoints reduced the number of crashes by 17% [CI: (− 20, − 14)]. Road safety campaigns were found to reduce the numbers of RTCs by 9% [CI: (− 11, − 8%)]. Mass media campaigns indicated some median decrease in crashes across all studies and all levels of crash severity was 10% (IQR: 6 to 14%). Converting intersections to roundabouts was associated with a reduction of 30 to 50% in the number of RTCs resulting in injury and property damage. Electronic stability control measure was found to reduce single-vehicle crashes by − 49% [95% CI: (− 55, − 42%)]. No evidence was found to indicate that post-license driver education is effective in preventing road traffic injuries or crashes. Conclusion There were many systematic reviews of varying quality available which included studies that were conducted in high-income settings. The overview has found that behavioural based interventions are very effective in reducing RTCs.

Background: This study aimed to determine the rates of road traffic injuries and deaths as well as the factors affecting their levels in the Al-Najaf governorate for 3 years (2017–2019). Materials and Methods: Data were collected and analysed from the annual report of traffic crashes statistics of the Iraqi Ministry of Planning/Central Statistical Organisation. Al-Najaf governorate was selected as the study model for the period between 2017 and 2019. This selection was based on its urban growth, important location and standing for religious tourism. Results: Of the 8824, 9852 and 10,753 crashes reported in Iraq in 2017, 2018, and 2019, Al-Najaf governorate recorded 1057 (12%), 1041 (10.6%) and 1148 (10.7%), respectively. The percentage of injuries in Al-Najaf governorate to the total of injuries in Iraq decreased as follows: (11.9%), (10.2%) and (9.9%) for 2017, 2018 and 2019 respectively, while the mortality rate decreased as follows: (8.4%), (7.7%) and (7.1%), respectively. The number of deaths and injuries on main roads and highways was higher. Besides, the rates of injuries and deaths among males were higher than in females. Driving at excessive speed was the most statistically significant factor leading to a high proportion of deaths and injuries. Conclusion: This study showed a decrease in the deaths and injuries caused by road traffic crashes during the 3 years 2017–2019 in the Al-Najaf Governorate, Iraq. It seems that driving rules and regulations need to be revised so that they can have more deterrent power in preventing injuries and deaths from driving accidents.

To investigate the visual function correlates of self-reported vision-related night driving difficulties among drivers. One hundred and seven drivers (age: 46.06 ± 8.24, visual acuity [VA] of 0.2logMAR or better) were included in the study. A standard vision and night driving questionnaire (VND-Q) was administered. VA and contrast sensitivity were measured under photopic and mesopic conditions. Mesopic VA was remeasured after introducing a peripheral glare source into the participants' field of view to enable computation of disability glare index. Regression analyses were used to assess the associations between VND-Q scores, and visual function measures. The mean VND-Q score was -3.96±1.95 logit (interval scale score: 2.46±1.28). Simple linear regression models for photopic contrast sensitivity, mesopic VA, mesopic contrast sensitivity, and disability index significantly predicted VND-Q score (P <0.05), with mesopic VA and disability glare index accounting for the greatest variation (21 %) in VND-Q scores followed by photopic contrast sensitivity (19 %), and mesopic contrast sensitivity (15 %). A multiple regression model to determine the association between the predictors (photopic contrast sensitivity, mesopic VA, mesopic contrast sensitivity, and disability index) and VND-Q score yielded significant results, F (4, 102) = 8.58, P < 0.001, adj. R2 = 0.2224. Seeing dark-colored cars was the most challenging vision task. Changes in mesopic visual acuity, photopic and mesopic contrast sensitivity, as well as disability glare index are associated with and explain night driving-related visual difficulties. It is recommended to incorporate measurement of these visual functions into assessments related to driving performance. [ABSTRACT FROM AUTHOR]

Governments and authorities worldwide consider road traffic crashes (RTCs) to be a major concern. These crashes incur losses in terms of productivity, property, and life. For a country to establish its road and action plans, it is crucial to comprehend the reasons for and consequences of traffic collisions. The main objective of this research study was to evaluate and rank the important and supporting factors influencing traffic crashes on the road. To identify the most significant accident causation elements, the proportion-based analytic hierarchy process (PBAHP) was used to order the factors in terms of their relative importance. In this study, the city of Al-Ahsa, located in the eastern province of Saudi Arabia, was used as a case study, since this city is the highest RTC-prone area in the region. PBAHP was used to calculate relative importance/weights for different crash types and reasons in terms of their impact on crash severity. It was found that vehicle-overturned collisions which result in fatal crashes have the most weight, whereas “hit motorcycle” crashes result in serious injury crashes. When vehicles (two or more) collide with one another while they are moving, it appears that the likelihood of a fatality in a collision increases. The highest weights for serious injury crashes came from “driver distraction”, “leaving insufficient safe distance”, and “speeding”, which also generated similar and relatively high weights for fatal crashes. Weights from the PBAHP approach were also used to develop utility functions for predicting the severity of crashes. This approach could assist decision-makers in concentrating on the key elements affecting road traffic crashes and enhancing road safety.

This study proposes a comprehensive Geographic Information System (GIS) based time series analysis of varying trends of Road Traffic Crashes (RTCs) in different regions of province Punjab, Pakistan. GIS provides geographical framework to analyze spatial characteristics of a particular event for accurate road safety risk assessment. In order to evaluate potentially emerging accident ratios, monthly data based on RTCs from 2015 to 2018 collected from all the units of study area is initially geographically displayed using GIS. The results and analysis has been based on 3125094 emergency events occurred in Punjab, providing a strong base to the conclusive spatio-temporal patterns. The peak RTCs regions of Lahore, Faisalabad, Gujranwala and Multan have been studied for 227111, 102276, 64036 and 70194 events occurred in the four year span, whereas the rate of annual increase in RTCs in these cities has been measured to be 11153, 3229, 1730 and 4000 respectively. A comparative analysis of time rate of change of RTCs not only highlights varying trends along mutually bounded regions but also reveals prominence of seasonal and local factors behind increasing and decreasing ratios of road accidents. However, despite limited local information regarding road crash events, conclusions suggest that GIS based temporal analytical practices for precise risk assessment provide a cost effective decision support system to local administration and policy makers. [ABSTRACT FROM AUTHOR]

The use of alcohol among road users injured in road traffic crashes and admitted to three major hospitals in Cameroon was studied. Alcohol use was measured using breathalyzers, and data on age, gender, education level, religion, type of road user, time of the crash, crash characteristics, and injury severity were recorded using a questionnaire. Of the 350 participants, 30.9% had blood alcohol concentrations (BACs) above 0.08% (legal limit for drivers); the proportion was highest among motorcycle riders (36.5%), followed by pedestrians (24.8%) and motor vehicle drivers (18.9%). The proportion with BAC above 0.08% was highest on weekend nights and among those who were most seriously injured. Those who reported being Muslims had a lower prevalence of alcohol. Multivariable logistic regression analysis confirmed those associations. Many road traffic injuries could have been avoided if the patient had not consumed alcohol. Actions should therefore be taken to reduce the proportion of alcohol-impaired road users. Supplemental data for this article is available online at https://doi.org/10.1080/17457300.2022.2030365. [ABSTRACT FROM AUTHOR]

Background: Road traffic crashes (RTCs) are a global public health burden whose resulting morbidity and mortality disproportionately impact low‐ and middle‐income countries with stressed health systems. There is a paucity of published studies that evaluate the sociodemographic distribution of RTCs using nationally representative samples from the African region. Aim: To examine population‐wide associations between sociodemographic factors and involvement in RTCs in Kenya. Methods: Data were obtained from the 2014 Kenyan Demographic Health Survey, representing all 47 counties in Kenya, from May to October of 2014. We estimated the prevalence of RTCs and utilized logistic regression for bivariate and multivariable analyses to determine the sociodemographic factors associated with RTCs. Study variables included age, place of residence, household wealth index, educational attainment, and history of alcohol consumption. We computed odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Results: A higher prevalence was reported among men (8.76%) versus women (3.22%). The risk factors among men included being 20−34 years of age, living in a rural area (OR 1.38, 95% CI 1.09, 1.74), drinking alcohol (OR 1.33, 95% CI 1.11, 1.59), and having not higher than a primary (OR 1.90, 95% CI 1.19, 3.03) or secondary (OR 1.68, 95% CI 1.04, 2.71) education. The strongest risk factors for women included the being aged 45−49 (OR 2.30, 95% CI 1.44, 3.67) and 20−24 years (OR 1.81, 95% 1.17, 2.79) as well as being in the fourth wealth quintile (OR 1.83, 95% CI 1.15, 2.91). Conclusion: Men and the most economically productive age groups were more likely to report being involved in RTCs. Strategies to reduce the occurrences of RTCs should prioritize the most vulnerable sociodemographic groups. [ABSTRACT FROM AUTHOR]

Road traffic crashes (RTCs) are a major problem for authorities and governments worldwide. They incur losses of property, human lives, and productivity. The involvement of teenage drivers and road users is alarmingly prevalent in RTCs since traffic injuries unduly impact the working-age group (15–44 years). Therefore, research on young people's engagement in RTCs is vital due to its relevance and widespread frequency. Thus, this study focused on evaluating the factors that influence the frequency and severity of RTCs involving adolescent road users aged 15 to 44 in fatal and significant injury RTCs in Al-Ahsa, Saudi Arabia. In this study, firstly, descriptive analyses were performed to justify the target age group analysis. Then, prediction models employing logistic regression and CART were created to study the RTC characteristics impacting the target age group participation in RTCs. The most commonly observed types of crashes are vehicle collisions, followed by multiple-vehicle and pedestrian crashes. Despite its low frequency, the study area has a high severity index for RTCs, where 73% of severe RTCs include individuals aged 15 to 44. Crash events with a large number of injured victims and fatalities are more likely to involve people in the target age range, according to logistic regression and CART models. The CART model also suggests that vehicle overturn RTCs involving victims in the target age range are more likely to occur as a result of driver distraction, speeding, not giving way, or rapid turning. As compared with the logistic regression model, the CART model was more convenient and accurate for understanding the trends and predicting the involvement probability of the target age group in RTCs; however, this model requires a higher processing time for its development. [ABSTRACT FROM AUTHOR]

Background: Road traffic crashes are a common cause of preventable injury and death worldwide including in Nigeria. Objective: This study assessed the determinants of road traffic crashes among intercity commercial drivers in Ile-Ife, Nigeria. Methods: This was a descriptive cross-sectional study design. Three hundred and fifty commercial drivers completed an interviewer-administered questionnaire on the occurrence and determinants of road traffic crashes. Data were analysed using descriptive and inferential statistics. Results: The respondents were male, with a mean age of 45.6 (10.6) years, married (88.9%), had secondary education (57.4%) and earned above $5/month (94.3%). Only 28.3% attended driving school, 26.9% started driving <10 years and 65.4% drove more than 8 h daily with morning hours considered the busiest (63.4%). Over one-third (36.7%) of the respondents had experienced road traffic crashes with 86.7% driving when crashes occurred. The identified causes of road traffic crashes include bad roads (37.5%), burst tyre (18.8%), over-speeding (18%) and brake failure (16.4%). Other causes include driving fatigue/sleeping while driving (14.1%), driving at night (14.1%) and environmental factors (13.3%). The outcome of road traffic crashes includes vehicular damage (75%), injury to the passenger (45.3%) and driver (38.3%) with fatal (13.3%). The determinants of road traffic crashes include young age (adjusted odd ratio [AOR] = 8.17; 95% confidence interval [CI] = 4.15--17.7; P = 0.001), using sedatives (AOR = 6.49; 95% CI = 2.91--14.46; P = 0.001), alcohol use (AOR = 17.76; 95% CI = 8.72--36.16; P = 0.001), night driving (AOR = 3.10; 95% CI = 1.41--6.78; P = 0.005) and driving over 8 h per day (AOR = 2.78; 95% CI = 1.40--5.53; P = 0.004). Conclusion: Road traffic crashes were common among young commercial intercity drivers with causes varying from human, mechanical and environmental factors. Strategy to reduce these factors will improve road safety among commercial drivers. [ABSTRACT FROM AUTHOR]

Abstract Background Road traffic crashes related (RTCR) chest traumas remain important global public health challenge. The impact of boosting market of automobile vehicles in China during last decade on thoracic injury needs to be defined. This study aimed to review and analyze the demographic and clinical characteristics of RTCR thoracic injuries in China. Methods Clinical records of patients with thoracic trauma admitted to thoracic surgery department between January 2003 and June 2020 were retrospectively retrieved and reviewed. Patients’ profiles and clinical characteristics were comparatively analyzed between road traffic crashes caused injury and other injury mechanisms, and in RTCR chest trauma patients before January 2011 (2003 group), and after January 2011 (2011 group), when is considered as the beginning year of Chinese household vehicle era. Results The study included 5095 thoracic trauma patients with mean age of 50.2 years, of whom 79.4% were male. Most of the patients (70.3%, n = 3583) had rib fractures. Associated injuries were present in 52.0% of the patients, of them 78.5% (n = 2080) were extremity fractures. Road traffic crashes accounted for 41.4% (n = 2108) of the injuries, most of them (98.0%) were related to motor vehicles. In comparison with other chest trauma mechanisms, RTCR chest injuries affected females and older males more frequently, with a higher incidence of rib fractures and sternum fractures, and higher injury severity scores (ISS) (all p

Abstract Background Road traffic crashes (RTCs) are a global public health burden whose resulting morbidity and mortality disproportionately impact low‐ and middle‐income countries with stressed health systems. There is a paucity of published studies that evaluate the sociodemographic distribution of RTCs using nationally representative samples from the African region. Aim To examine population‐wide associations between sociodemographic factors and involvement in RTCs in Kenya. Methods Data were obtained from the 2014 Kenyan Demographic Health Survey, representing all 47 counties in Kenya, from May to October of 2014. We estimated the prevalence of RTCs and utilized logistic regression for bivariate and multivariable analyses to determine the sociodemographic factors associated with RTCs. Study variables included age, place of residence, household wealth index, educational attainment, and history of alcohol consumption. We computed odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Results A higher prevalence was reported among men (8.76%) versus women (3.22%). The risk factors among men included being 20−34 years of age, living in a rural area (OR 1.38, 95% CI 1.09, 1.74), drinking alcohol (OR 1.33, 95% CI 1.11, 1.59), and having not higher than a primary (OR 1.90, 95% CI 1.19, 3.03) or secondary (OR 1.68, 95% CI 1.04, 2.71) education. The strongest risk factors for women included the being aged 45−49 (OR 2.30, 95% CI 1.44, 3.67) and 20−24 years (OR 1.81, 95% 1.17, 2.79) as well as being in the fourth wealth quintile (OR 1.83, 95% CI 1.15, 2.91). Conclusion Men and the most economically productive age groups were more likely to report being involved in RTCs. Strategies to reduce the occurrences of RTCs should prioritize the most vulnerable sociodemographic groups.

• Injured RTC survivors had high levels of PTSD symptoms, relative to non-injured individuals. • Decreased perceptions of self-efficacy, greater rumination about the RTC, and social isolation were observed among injured participants. • Results could inform specific efforts to target early development of PTSD among injured RTC survivors. The current paper reports a field study of 132 Argentinian individuals who experienced a road traffic crash (RTC), focusing on the role of physical injury in the early aftermath of the crash. Three groups of participants were studied: 1) individuals who were <1 month post-RTC who were not injured (<1 mo, Not Injured, n = 89), 2) individuals who were <1 month post-RTC who were injured (<1 mo, Injured, n = 15), and 3) individuals who were 1–3 months post-RTC who were injured (1–3 mo, Injured, n = 28). Examination of PTSD symptoms indicated that with several exceptions, most PTSD symptoms were endorsed at higher levels by the two injured groups, relative to the not injured group. Consideration of post-RTC cognitive and interpersonal factors indicated that the two injured groups reported lower self-efficacy and higher levels of rumination, relative to the Not Injured group. Additionally, the 1–3 mo Injured group reported being more socially isolated, relative to the two other groups. Results are discussed in light of related literature, with elaboration of potential public health interventions designed to target injured survivors of RTCs. [ABSTRACT FROM AUTHOR]

Abstract Background Driving is a visually intensive task. In Cameroon, where the burden of road traffic deaths is high, visual assessment is not universally performed before the issuance of driver licenses. This study aims to assess the visual status of commercial drivers (CDs) in the southwestern region of Cameroon, and to find its relation to road traffic crashes (RTCs). Methods This work was a cross-sectional community-based study on CDs in Limbe and Buea. Questionnaires were used to assess sociodemographic parameters, the incidence of RTCs, and self-reported visual status. Visual acuity (VA) was measured using a standard Snellen chart at 6 m. Statistical analysis was performed using descriptive methods: frequencies, the paired Student’s t-test, and the chi-square test. Results Two hundred seven CDs were enrolled in this study, all of which were male, with a mean age of 41.8 ± 12.1 years. A total of 15.0% had undergone an eye exam prior to licensure, and 3.4% had undergone an eye exam within the past 10 years. The VA in the better-seeing eye of participants was less than 6/9 and 6/12 in 14.1 and 10.6% of CDs, respectively. Seventy-five percent of CDs with self-reported poor vision and 95% of CDs with VA

• Machine learning methods for road traffic crashes injury severity prediction. • More than 25 different machine learning techniques compared. • Random Forest is a good approach for road traffic crash injury severity prediction. • Support Vector Machine, Decision Tree and K-Nearest Neighbor are also relevant. • First review study on this topic. Introduction: Road traffic crashes represent a major public health concern, so it is of significant importance to understand the factors associated with the increase of injury severity of its interveners when involved in a road crash. Determining such factors is essential to help decision making in road safety management, improving road safety, and reducing the severity of future crashes. Method: This paper presents a recent literature review of the methods that have been applied to road crash injury severity modeling. It includes 56 studies from 2001 to 2021 that consider more than 20 different statistical or machine learning techniques. Results: Random Forest was the algorithm with the best results, achieving the best performance in 70% of the times that it was applied and in 29% of all studies. Support Vector Machine and Decision Tree achieved the best performance in 53% and 31% of the times and in 16% and 14% of all studies, respectively. Bayesian Networks and K-Nearest Neighbors achieved the best performance in 67% and 40% of the times that were used but only achieved the best performance in 4% and 7% of all the studies analyzed, respectively. Conclusions: At this point, Random Forest revealed to be a good approach for road traffic crash injury severity prediction followed by Support Vector Machine, Decision Tree, and K-Nearest Neighbor. However, there is still a lot of room in this area to explore other techniques that can best suit this purpose as not only the model's performance should be considered but also causality issues, unobserved heterogeneity, and temporal instability. Practical Applications: This review enables researchers to understand the recent techniques applied in the analysis of injury severity modeling, and the ones that achieved the best performance results. Based on the reviewed studies, challenges and future research directions are presented. [ABSTRACT FROM AUTHOR]

• The effects of the German zero tolerance law were studied over a period of a decade. • Alcohol-related crashes and offences were analysed and a survey was conducted. • Current novice drivers were less involved in alcohol-related crashes or offences. • The effect associated with the measure can even be observed for former novice drivers. • The acceptance of the measure is high among current and former novice drivers. In 2007, the German legislature introduced a zero tolerance law (ZTL) for novice drivers to reduce the number of alcohol-related crashes. The purpose of our study was to evaluate the long-term effects of this law on current and former novice drivers. Method: Our approach was threefold: first, we used individual data of police records from 2003-2018 and conducted a cohort analysis to examine how the first cohort affected by the law responded in the long-term. Second, we analyzed the influence of the ZTL on alcohol-related traffic offenses by current novice drivers. Third, we conducted a survey to examine if the acceptance, knowledge, and behavior regarding the ZTL have changed compared to a decade ago. Results: The number of alcohol-related crashes was significantly lower in the first affected cohort than in earlier cohorts. Moreover, current novice drivers had lower levels of alcohol-related crashes and alcohol-related traffic offenses than did novice drivers before the ZTL became effective. The survey showed a high level of acceptance and knowledge in both current and first cohort and a decreased importance of drinking and driving. Conclusion: The ZTL is associated with a long-term increase of traffic safety in Germany. Former novice drivers appear to have retained learned behavior toward drinking and driving. Thus, the ZTL might have an impact on perceived norms resulting in less acceptance of drinking and driving. Changes in society, like lower alcohol consumption and decreased importance of passenger cars among young people, further accelerated these effects. Practical applications: ZTL for novice drivers are an effective way to improve traffic safety. It is associated with a positive effect on traffic safety even when drivers were no longer directly affected by the measure. These findings suggest that policies are an effective tool to improve traffic safety and help towards achieving Vision Zero. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol and illicit drugs impair cognitive and psychomotor skills and may thereby increase the risk of involvement in a road traffic crash and other types of injuries. However, the knowledge on the use of psychoactive substances among injured patients presenting to emergency departments in low and middle-income countries remains limited.Aims: To estimate the prevalence of alcohol and illicit drug use among patients with traumatic injuries admitted to an emergency department in Sao Paulo, Brazil.Methods: Blood samples from injured patients requiring hospitalization for more than 24 h due to road traffic crashes, falls, or violence, were collected from July 2018 to June 2019. The samples were analyzed for alcohol and illicit drugs.Results: A total of 376 patients were included in this study; the median age was 36 years and 80% of patients were male. The majority (56%) of injuries resulted from road traffic crashes, with approximately half of them being motorcyclists. Alcohol, drugs, or both were detected in 32% of samples. The proportion that tested positive was highest for males (35%), for the age group 18-39 years (41%), for singles (43%), and for patients injured at nighttime (44%). Patients injured due to violence had the highest prevalence of alcohol or drugs in their blood samples (44%). Alcohol was most prevalent (23%), followed by cocaine (12%) and cannabis (5%).Conclusion: The use of alcohol and illicit drugs was common among injured patients in Sao Paulo; it was likely a contributing factor in a third of the injurious accidents. Alcohol was the most prevalent substance followed by cocaine and cannabis. [ABSTRACT FROM AUTHOR]

Background: This study aimed to determine the rates of road traffic injuries and deaths as well as the factors affecting their levels in the Al-Najaf governorate for 3 years (2017-2019). Materials and Methods: Data were collected and analysed from the annual report of traffic crashes statistics of the Iraqi Ministry of Planning/Central Statistical Organisation. Al-Najaf governorate was selected as the study model for the period between 2017 and 2019. This selection was based on its urban growth, important location and standing for religious tourism. Results: Of the 8824, 9852 and 10,753 crashes reported in Iraq in 2017, 2018, and 2019, Al-Najaf governorate recorded 1057 (12%), 1041 (10.6%) and 1148 (10.7%), respectively. The percentage of injuries in Al-Najaf governorate to the total of injuries in Iraq decreased as follows: (11.9%), (10.2%) and (9.9%) for 2017, 2018 and 2019 respectively, while the mortality rate decreased as follows: (8.4%), (7.7%) and (7.1%), respectively. The number of deaths and injuries on main roads and highways was higher. Besides, the rates of injuries and deaths among males were higher than in females. Driving at excessive speed was the most statistically significant factor leading to a high proportion of deaths and injuries. Conclusion: This study showed a decrease in the deaths and injuries caused by road traffic crashes during the 3 years 2017-2019 in the Al-Najaf Governorate, Iraq. It seems that driving rules and regulations need to be revised so that they can have more deterrent power in preventing injuries and deaths from driving accidents. [ABSTRACT FROM AUTHOR]

Introduction: A national road safety strategic plan (NRSSP) is considered as one of the main road safety management issues in different countries. Such a plan not only determines the vision and relevant strategies but also causes the implementation of appropriate interventions to be coordinated and strengthened to achieve the goals set by partner organizations. The present study mainly aims to report Iran's NRSSP 2021–2031 development protocol. Methods: According to a schedule, the study protocol consists of ten sections: (1) Determining a core planning center, (2) Establishment of a steering committee, (3) Stakeholder identification, (4) Identification and development of Goals and Strategies, (5) Vision development, (6) Establishment of committees, (7) Integration of Goals and Strategies, (8) Goals and Strategies assessment, (9) Action plans development, (10) Monitoring and evaluation. An appropriate study method is performed for each of the concerned steps. Conclusion: The road safety strategy plan is a critical component to promote the effectiveness of activities and achieve the goals determined for road safety purposes. The Decade of Action for Road Safety is just being closed to its end; hence, reviewing and drawing up a road safety document concerning authentic scientific models and evidence is of paramount importance in Iran. The present study takes over the mission to address this gap.

Background: Trauma, a major public health concern in remote highlands of Nepal, has led to considerable morbidity and mortality. The study elucidates the pattern and characteristics of trauma at the only tertiary care hospital in the Karnali province, Nepal. Materials and Methods: Case records of all injured patients who presented to the emergency department from January to December 2018 were analyzed for demographic data, types of injuries, body parts injured, the outcome of the treatment, and distribution of injuries with respect to age and sex. Results: A total of 460 injured patients (age: 26.5 ± 19.67 years, range: 0.5–84) were studied consisting of 282 (61.3%) males and 178 (38.7%) females, with a male-to-female ratio being 1.58:1 (P = 0.001). Unintentional injuries were the predominant form of trauma (n = 383, 84.1%), with fall (n = 194, 42.2%), road traffic crashes (RTC) (n = 161, 35%), and physical assaults (n = 73, 15.9%) being the top three leading causes in order. Fall injury and RTC were most prevalent in children, accounting 12.8% (59) and 9.3% (43) of the total injuries, respectively. The physical assaults were predominant (n = 23, 5%) in adults (20–29 years). Male patients significantly outnumbered females for all types of injuries. Soft tissue followed by head and extremities was the most common site of injuries. Conclusion: Trauma in Karnali is a predominantly early age male occurrence, with fall injury being the leading etiological factor, followed by injuries due to RTC and physical assaults. Soft tissue, head, and extremities were the major sites of injuries. Reducing fall injuries, RTC, and physical assaults will likely reduce mortality and morbidity due to trauma in this province.

1.3 million people die each year as a result of Road traffic crashes. Road Traffic Injuries are a global health crisis with 90% of global deaths affecting LMICs. Sustainable Development Goal 3.6 focuses on reducing road injury and death. The global plan is based on the Safe Systems approach. In South Africa, the burden of crashes on the health system and society is particularly high with a population death rate of 20.7 per 100 000 population. Understanding local context and culture is critical. Rurality, distorted urban planning, higher travel exposure and alcohol usage disproportionately impact racial and ethnic minorities. Pedestrian safety is a key priority. There is a critical need for the global health community to take an active role in advocacy in order to achieve SDG 3.6 by 2030., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2024 The Author(s).)