OBJECTIVES: Transportation injuries are among the top ten causes of burden of disease in all age groups worldwide. The burden of transportation injuries among children and adolescents in Iran is higher than the world average and that of other developing countries. The aims of this study were to investigate the burden of transportation injuries in children and adolescents in the province of Fars in Iran from 2009 to 2013, and to report the burden of these kinds of injuries in children and adolescents in Iran from 1990 to 2010. METHODS: The number of deaths due to transportation injuries and the location of fatal injuries in the province of Fars in Iran from 2009 to 2013 were analyzed using data from the Fars Forensic Medicine Organization. The 20-year trend in the burden of transportation injuries in Iran was analyzed using data from the Institute for Health Metrics and Evaluation. RESULTS: Similarly to the long-term trend in Iran, the burden of transportation injuries among the male population of Fars province was generally higher than in females. Most fatal accident injuries occurred on roads (males: n=4151, 61.51%; females: n=1182, 65.95%) and in urban areas (males: n=1994, 29.54%; females: n=473, 26.40%). CONCLUSIONS: Considering that children and adolescents are high risk groups for transportation injuries, adopting an effective comprehensive multi-sectoral approach, including enacting and enforcing appropriate laws and regulations, developing general knowledge, and facilitating the availability of Personal protective equipment, could be helpful for reducing the burden of these injuries.
Adolescent* ; Child* ; Developing Countries ; Female ; Forensic Medicine ; Humans ; Iran ; Jurisprudence ; Male ; Social Control, Formal ; Transportation*

OBJECTIVERoad traffic accident (RTA) and its related injuries contribute to a significant portion of the burden of diseases in Iran. This paper explores the association between driver-related factors and RTA in the country.

METHODSThis cross-sectional study was conducted in Iran and all data regarding RTAs from March 20, 2010 to June 10, 2010 were obtained from the Traffic Police Department. We included 538 588 RTA records, which were classified to control for the main confounders: accident type, final cause of accident, time of accident and driver-related factors. Driver-related factors included sex, educational level, license type, type of injury, duration between accident and getting the driving license and driver's error type.

RESULTSA total of 538 588 drivers (91.83% male, sex ratio of almost 13:1) were involved in the RTAs. Among them 423 932 (78.71%) were uninjured; 224 818 (41.74%) had a diploma degree. Grade 2 driving license represented the highest proportion of all driving licenses (290 811, 54.00%). The greatest number of accidents took place at 12:00-13:59 (75 024, 13.93%). The proportion of drivers involved in RTAs decreased from 15.90% in the first year of getting a driving license to 3.13% after 10 years'of driving experience. Neglect of regulations was the commonest cause of traffic crashes (345 589, 64.17%). Non-observance of priority and inattention to the front were the most frequent final causes of death (138 175, 25.66% and 129 352, 24.02%, respectively). We found significant association between type of accident and sex, education, license type, time of accident, final cause of accident, driver's error as well as duration between accident and getting the driving license (all P less than 0.001).

CONCLUSIONOur results will improve the traffic law enforcement measures, which will change inappropriate behavior of drivers and protect the least experienced road users.

Accidents, Traffic ; statistics & numerical data ; Adult ; Automobile Driving ; statistics & numerical data ; Cross-Sectional Studies ; Female ; Humans ; Iran ; epidemiology ; Licensure ; Male ; Young Adult

OBJECTIVETo analyze the time factor in road traffic accidents (RTAs) in Fars Province of Iran.

METHODSThis study was conducted in Fars Province, Iran from November 22, 2009 to November 21, 2011. Victims'information consisted of age, sex, death toll involving dri- vers or passengers of cars, motorcycles and pedestrians, and site of injury etc. Accidents were analyzed in relation to hour of the day, season of the year, lighting condition including sunrise, sunset, daytime and nighttime.

RESULTSA total of 3 642 deaths (78.3% were males, and the ratio of males to females was about 3.6:1) were studied regarding their autopsy records. There was a steady increase in fatal accidents occurring at midnight to 15:59. The risk of being involved in a fatal traffic accident was higher for those injured between 4:00 to 7:59 than at other times (OR equal to 2.13, 95% CI 1.85-2.44). The greatest number of fatal RTAs took place in summer. Mortalities due to RTA during spring and summer were more pronounced at 20:00 to 23:59 and midnight to 3:59, whereas mortalities in fall and winter were more pronounced from 12:00 to 15:59.

CONCLUSIONThe high mortality rate of RTA is a major public health problem in Fars Province. Our results indicate that the time is an important factor which contributes to road traffic deaths.

Accidents, Traffic ; mortality ; Adult ; Aged ; Female ; Humans ; Iran ; epidemiology ; Male ; Middle Aged ; Time Factors

PURPOSEThe aim of this present study is to investigate the prevalence of alcohol and substance abuse (ASA) and its relationship with other risky driving behaviors among motorcycle drivers.

METHODSThis is a cross sectional study which is performed at Shiraz city of Iran. Data from motorcycle drivers were collected using a standard questionnaire in eight major streets at different times of the day. The data includes consumption of alcohol and other substances two hours before driving and some of the risky behaviors during driving.

RESULTSA total of 414 drivers with a mean ± SD age of (27.0 ± 9.3) years participated in the study. Alcohol or substance consumptions two hours before driving was significantly associated with risky driving behaviors such as using mobile phone during driving, poor maneuvering, and driving over the speed limit (both p < 0.001). It was also associated with carelessness about safety such as driving with technical defects (p < 0.001) and not wearing a crash helmet (p=0.008).

CONCLUSIONScreening for alcohol and substance consumption among motorcycle drivers is an efficient way to identify drivers that are at a greater risk for road traffic accidents.

Accidents, Traffic ; mortality ; statistics & numerical data ; Adult ; Age Distribution ; Alcoholism ; complications ; epidemiology ; Chi-Square Distribution ; Confidence Intervals ; Cross-Sectional Studies ; Developing Countries ; Humans ; Iran ; Male ; Middle Aged ; Motorcycles ; statistics & numerical data ; Odds Ratio ; Prevalence ; Risk Factors ; Risk-Taking ; Substance-Related Disorders ; complications ; epidemiology ; Survival Rate ; Urban Population ; Young Adult

OBJECTIVETo evaluate the efficacy of a first aid training course for a group of drivers.

METHODSThis study comprised 500 drivers, randomly selected from the road transport companies. They underwent a course of first aid training and the results were evaluated at 0-3 and 4-6 months after training.

RESULTSBoth quantitative and qualitative improvements were observed in the drivers'efficacy in giving first aid. Also the rate of correct interventions was higher at 4-6 months than at 0-3 months. The exception was airway management which was not favorably improved after training.

CONCLUSIONThe first aid training course for drivers is beneficial and helpful for prehospital care system in road traffic accidents.

Accidents, Traffic ; Adult ; Aged ; Automobile Driving ; Community Participation ; Emergency Medicine ; education ; First Aid ; Humans ; Inservice Training ; Iran ; Male ; Middle Aged ; Surveys and Questionnaires

OBJECTIVEThis research analyzes data on road traffic accidents (RTA) in Fars province, whose roads are among the highly dangerous ones in Iran. It investigates educational level and age involved in RTA in order to discover patterns that can prevent or decrease accidents.

METHODSThis research made use of data visualization techniques to find hidden patterns. The data included mortality rate related to RTA in Fars province and were obtained from Fars Forensic Medicine Registry covering a period of 1 year from March 21, 2010 to March 21, 2011. All data were analyzed using SPSS 11.5. The results were reported as descriptive indices such as frequency (percentage). The Chi-square test was applied to the data concerning educational level and age. P value less than 0.05 was considered significant.

RESULTSIn the mentioned period, 1 831 people were killed, out of whom un/lowly educated people (69.6%) accounted for the highest mortality rate. The significant relationship between educational level and mortality rate was found (X2 equal to 275.98, P less than 0.0001).Also three was a significant association between age and mortality rate (X2 equal to 371.20, P less than 0.0001). Young people (age between 20 and 29 years) contribute to higher RTA mortality rate compared with other age groups.

CONCLUSIONThe educational level and age are significantly correlated to mortality rate. The youth and un/lowly educated people suffer more fatal RTA.

Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Age Factors ; Aged ; Child ; Educational Status ; Humans ; Iran ; Male ; Middle Aged

OBJECTIVETo determine the epidemiological characteristics of fatal pedestrian accidents in Fars Province of Iran.

METHODSThis cross-sectional study was conducted in Fars Province of Iran during a 29-month period from March 2009 to July 2011. The data were from the Fars Forensic Medicine Registry. In 4 923 recorded road traffic accident fatalities, 971 deaths were due to pedestrian accidents. The demographic and accident-related information were analyzed by SPSS version 11.5. P value less than 0.05 was considered significant.

RESULTSThe mean age of decedents was (47.2+/-26.2) years, ranging from 6 months to 103 years old. Males accounted for 69.8% of all deaths. Fatal accidents were most common in September; 56.1% of the fatal injuries occurred on intracity roads and 33.1% on extracity roads. Fatal head injuries were present in 60.54% of cases. Evaluation of the injury site and the cause of death found that they were significantly associated with age, interval between injury and death. Besides, the type of roads played an important role in mortality.

CONCLUSIONAlthough the clinical management of trauma patients has been improved in our country in the recent decade, decreasing the burden of injuries needs coordination among trauma system organizations.

Accidents, Traffic ; Cross-Sectional Studies ; Humans ; Iran ; Pedestrians ; Surveys and Questionnaires ; Wounds and Injuries

OBJECTIVETo identify the main characteristics of victims of motorcycle accidents in Fars Province, Iran.

METHODSThis cross-sectional study was conducted in Fars Province which has the fourth largest population of all 31 provinces in Iran from March 2009 to June 2010. We included data from all 542 recorded cases of fatalities due to motor vehicle accidents. Data were recorded from the forensic medicine registry consisting of demographic and accident-related information. Demographic information consisted of name, age, sex, status of fatal victim (motorcycle driver vs passenger) and educational level.

RESULTSOf the 2 345 autopsy records from the forensic medicine archives, 542 (23.1%) gave the cause of death as motor vehicle accidents. Mean age of these victims was (31.4+/-6.5) years, and the male to female ratio was 28. Head injury was the most common cause of death in these victims, and overall they tended to have a low level of education. Motorcycle accidents frequently involved younger age groups (15-35 years), and head trauma related with non-use of a helmet was the most common cause of death.

CONCLUSIONSHead injury is frequent among victims in the province we studied. This situation may be related to the victims' low socioeconomic status and little education regarding traffic laws leading to speeding and disregard of these laws along with their weak enforcement.

Accidents, Traffic ; Cross-Sectional Studies ; Humans ; Iran ; epidemiology ; Motorcycles ; Surveys and Questionnaires

OBJECTIVEThere is increasing interest in complementary and alternative medicine generally, and especially by those affected by chronic diseases, such as diabetes mellitus. We aimed to determine the prevalence and pattern of complementary and alternative medicine use among patients suffering from diabetes mellitus in Shiraz, southern Iran. Another objective was to explore associated factors for use of complementary and alternative medicine among patients with diabetes mellitus.

METHODSA 19-item semi-structured questionnaire (open- and close-ended) was administered to 239 patients with diabetes mellitus in this cross-sectional study. It was carried out in two outpatient diabetes clinics affiliated with the Shiraz University of Medical Sciences, Shiraz, Iran.

RESULTSOne hundred and eighty patients (75.3%) used at least one type of complementary and alternative medicine in the last year prior to the interview. Patients with diabetes mellitus who were living in a large family (≥5 members), not taking insulin, and believed that complementary and alternative medicine have synergistic effects with conventional medicine, were independently and significantly (P values: 0.02, 0.04, and 0.01, respectively) more likely to use complementary and alternative medicine. Most of the users (97.7%) reported use of herbal preparations, and 89.4% of users did not change their medication, neither in medication schedule nor its dosage.

CONCLUSIONThe use of complementary and alternative medicine, especially herbal remedies, is popular among diabetes patients in Shiraz, Iran. This use is associated with patients' family size, type of conventional medications and their view about concomitant use of complementary and conventional medicine.

Adult ; Aged ; Complementary Therapies ; Cross-Sectional Studies ; Diabetes Mellitus ; therapy ; Female ; Humans ; Iran ; Male ; Middle Aged ; Phytotherapy

PURPOSETraffic injuries are among the leading causes of mortality and morbidity worldwide. Pedestrians have been considered as a high-risk group among road users, especially in middle- or low-income communities. This study attempted to determine the burden of pedestrians' fatalities in Fars, the southern province of Iran using years of life lost (YLL) approach.

METHODSThe data used in this study were retrieved from Fars Forensic Medicine Organization database on pedestrian traffic accidents. The YLL from 2009 to 2013 was estimated using the method presented by World Health organization. Some epidemiological characteristics of pedestrians' fatalities were analyzed by SPSS.

RESULTSAlthough YLL among 1000 male pedestrians decreased from 2.5 in 2009 to 1.5 in 2013, it increased from 0.9 to 2.1 among 1000 females during the same period. Higher proportion of death was found in female, illiterate, and married pedestrians (p < 0.001). In addition, mortality was higher in pedestrians living the cities, during daytime, at home, and in hospitals (p < 0.001).

CONCLUSIONConsistent with the global trends, burden of pedestrian accidents in Fars was also exceptionally high. Considering the national and cultural aspects of different countries, improving the safety of pedestrians demands a multi-dimensional approach with interventional factors concerning policies, rules, pedestrians, motor vehicles and environmental conditions taken into consideration.