Are Bus Company Regulations Associated with Crash Risk? Findings from a Retrospective Survey in Four Chinese Cities.

Bus crashes are common in urban China, and bus company regulations are hypothesized to be related to bus crash risk. We conducted a retrospective survey to examine the association in four large Chinese cities (Changsha, Shenzhen, Fuzhou, and Wuhan). Four types of bus crashes were considered: (a) passengers injured while riding the bus; (b) bus colliding with or scraping other motor vehicles; (c) bus colliding with non-motorized vehicles or pedestrians; and (d) bus damaging public facilities. Based on regulations governing the drivers' work, complete round trips per day, and their paid salary, three categories of companies were studied: type A: ≥14 h worked/day, ≥6 round trips/day, and >70% of salary based on performance; type B: 8-13 h/day, 4 or 5 round trips/day, and 36-70% of salary; and type C: <36% of salary and no other specified requirements. Of the 926 respondents, 20.7% reported one or more crashes or related risk events in the past month. Drivers from the three types of companies reported crash incidence rates of 31.9%, 8.8%, and 6.0%, respectively, in the past month. Type A crash rates were significantly higher than type C after controlling for relevant covariates (adjusted odds ratio (OR) = 7.1, 95% confidence interval (CI): 3.74-13.47). We conclude that more stringent bus company regulations, which mandate drivers to work long hours and obtain salary based on job performance in meeting demanding metrics, are associated with elevated bus-related crash risks. Local governments in China should regulate bus companies to ensure drivers work reasonable hours and are paid based on the quality of their work (e.g., safety).