High-quality data are the foundation to monitor the progress and evaluate the effects of road traffic injury prevention measures. Unfortunately, official road traffic injury statistics delivered by governments worldwide, are often believed somewhat unreliable and invalid. We summarized the reported problems concerning the road traffic injury statistics through systematically searching and reviewing the literature. The problems include absence of regular data, under-reporting, low specificity, distorted cause spectrum of road traffic injury, inconsistency, inaccessibility, and delay of data release. We also explored the mechanisms behind the problematic data and proposed the solutions to the addressed challenges for road traffic statistics.
Accidental Injuries ; epidemiology ; prevention & control ; Accidents, Traffic ; prevention & control ; statistics & numerical data ; Global Health ; Humans

PURPOSE: Motorcycle accident is a major cause of road traffic injuries and the motorcyclists are considered as vulnerable road users. The present study aimed to determine the epidemiological characteristics of fatal motorcycle crashes in Iran. METHODS: In this cross-sectional study, a total of 28,356 motorcycle traffic fatalities registered in the Legal Medicine Organization of Iran were analyzed during the period between March 2011 and March 2017. The examined variables included demographic characteristics, helmet use, crash mechanisms, crash location, position state, type of counterpart vehicle, cause of death and place of death. In the study, road traffic mortalities involving drivers and/or passenger of motorcycles were included. Cases or events registered without these conditions were excluded from the study. To analyse the data, SPSS statistics 25 and GraphPad Prism 8 softwares were used. RESULTS: Of the 122,682 fatal traffic injury cases, 28,356 (23.1%) were motorcycle users, of whom 95.3% were male and 4.7% were female. Most of the motorcycle fatalities belonged to the age group of 18-24 years (29.1%). Head trauma was the major cause of death (59.0%). Also, the overall proportion of safety helmet use among motorcycle crash victims was estimated at 37.4%. Most of the road traffic crash cases (46.8%) happened out of city and half of people (49.9%) died in hospital. About 77.4% of the victims were motorcycle riders and 21.1% were pillion passengers. The highest rate of mortality belonged to the self-employed (38.4%) and then workers (21.8%) and students (10.2%). In addition, most fatalities occurred in people with low education (77.5%) and the least occurred in university graduates (5.5%). Among 31 provinces of Iran, Fars had the highest (9.3%) occurrence rate and Kohgiluyeh and Buyer-Ahmad had the lowest (0.5%). Most of the crash mechanisms were due to motorcycle-vehicle crashes (80.2%), followed by rollover (9.8%). CONCLUSION Comprehensive public education and special rules are needed to reduce the rate of deaths in motorcycle crashes.
Accidental Injuries ; epidemiology ; mortality ; prevention & control ; Accidents, Traffic ; mortality ; prevention & control ; statistics & numerical data ; Adolescent ; Adult ; Child ; Cross-Sectional Studies ; Educational Status ; Female ; Head Protective Devices ; statistics & numerical data ; Health Education ; Humans ; Iran ; epidemiology ; Male ; Middle Aged ; Motorcycles ; Registries ; Young Adult

PURPOSE: Road traffic accidents (RTAs) are a public health issue and cost a lot to individuals, families, communities and nations. Trauma care systems in India are at a nascent stage of development. There is gross disparity between trauma services available in various parts of the country. Rural area in India has inefficient services for trauma care, due to the varied topography, financial constraints, and lack of appropriate health infrastructure. The present study is to study the trends of occurrence of RTA cases by month, week and time of accident occurrence as well as to research the types of vehicle involved in accidents and other various risk factors related to them. METHODS: During 1st January 2017 to 31st December 2017, a hospital-based and cross-sectional study of RTA victims was conducted. The patients were admitted in emergency department of Uttar Pradesh University of Medical Sciences, Saifai, Etawah, when stabilized, they were shifted to the orthopaedics and surgery ward. RESULTS: In the study, 654 road accident victims were included, of which the majority were males (77.5%) and the most of them belonged to rural (67%). RTA victims according to the month of occurrence majority were found in January (12.5%) and evening was time of a day with maximum accidents (32.1%). Mortality cases of RTA victims based on type of road user and it shows decreasing trend of mortality of motorcyclists (54.2%) followed by pedestrian (25.1%). CONCLUSION There should be control over people driving vehicles under the influence of alcohol and drivers over-speeding and rash driving on urban roads as well as rural village roads.
Accidental Injuries ; epidemiology ; mortality ; prevention & control ; Accidents, Traffic ; prevention & control ; statistics & numerical data ; Adolescent ; Adult ; Automobile Driving ; Cross-Sectional Studies ; Emergency Service, Hospital ; statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Risk Factors ; Seasons ; Tertiary Care Centers ; statistics & numerical data ; Time ; Young Adult

PURPOSE: Trauma is a major health concern. Length of hospital stay (LOS) has been targeted as an important metric to assess trauma care. This study aims to evaluate the risk factors that affect LOS among trauma patients in a trauma center in Southwestern Iran. METHODS: This cross-sectional study was conducted on patients admitted to Rajaee Trauma Center, Shiraz, Iran between January 1, 2018 and December 30, 2018. The inclusion criteria were age above 15 years and having traffic accident injuries, including car, motorcycle and pedestrian injury mechanisms. The exclusion criteria were existing diseases including cardiovascular, cerebral, renal, and pulmonary diseases prior to this study, dead upon arrival or within 48 h after admission, and stay at the hospital for less than 6 h. The risk variables analyzed for prolonged LOS were age, gender, mechanism of traffic accident injury, infection during hospital stay, type of injury, injury severity score, surgery during hospitalization, and survival. Poisson regression was performed to evaluate the partial effects of each covariate on trauma hospitalization (≥3 days as longer stay). RESULTS: This study was conducted on 14,054 patients with traffic accident injury and the mean age was (33.89 ± 15.78) years. Additionally, 74.35% of the patients were male, with male to female ratio of 2.90. The result of Poisson regression indicated that male patients, higher age, combination of thoracic injuries, onset of infected sites, and surgery patients were more susceptible to have a longer LOS. Considering the site of injury, patients with face injuries followed by those with thorax injuries had the highest means of LOS (3.74 days and 3.36 days, respectively). Simultaneous existence of surgical intervention and infection in a patient had the greatest impact on prolonged LOS. CONCLUSION This study identified that age, gender, mechanism of injury, infection, type of injury, survival, and ISS could lead to prolongation of LOS, but the affect can be reduced by eliminating modifiable risk factors.
Accidental Injuries ; Accidents, Traffic ; Adult ; Age Factors ; Facial Injuries ; Female ; Humans ; Iran ; Length of Stay ; statistics & numerical data ; Male ; Middle Aged ; Risk Factors ; Sex Factors ; Thoracic Injuries ; Wound Infection ; Young Adult

PURPOSE: Injury continues to be an important cause of morbidity and mortality in both developed and developing countries. Globally, it is responsible for approximately 5.8 million deaths per year and 91% of these deaths occur in developing countries. Road traffic collision, suicides and homicides are the leading cause of traumatic deaths. Despite the fact that traumatic chest injury is being responsible for 10% of all trauma-related hospital admissions and 25% of trauma-related deaths across the world including in Ethiopia, only few published studies showed the burden of traumatic chest injury in Ethiopia. So, this study aims at assessing the characteristics and outcome of traumatic chest injury patients visited Tikur Anbesa Specialized Hospital (TASH) over one year period. METHODS: A single center based retrospective study was done. We collected data from patients' records to assess characteristics and outcome of traumatic chest injury at TASH over one year period. All patients diagnosed with traumatic chest injury and received treatment at the hospital from January 1 to December 31, 2016 regardless of its types and severity levels were included in the study. Patients with incomplete medical records for at least 20% of the study variables and without detailed medical history, or patients died before receiving any health care were excluded from the study. The collected data were cleaned and entered into Epidata version 3.1 and exported to SPSS Version 21.0 for analysis. Bivariate and multivariate logistic regression models were used to examine factors associated with outcome of traumatic chest injury patients. RESULTS: A total of 192 chest injury patients were included in the study and about one-fourth of chest injury victims were died during treatment period in TASH. Road traffic collision (RTC) was the leading cause of morbidity and mortality among traumatic chest injury victims. Age of the victims (adjusted odds ratio (AOR) 8.9, 95% confidence interval (CI) 1.51-53.24), time elapsed between the occurrence of traumatic chest injury and admission to health care facilities (AOR 4.6, 95% CI 1.19-18.00), length of stay in hospital (AOR 0.12, 95% CI 0.02-0.58), presence of multiple extra-thoracic injury (AOR 25, 95% CI 4.18-150.02) and development of complications (AOR 23, 95% CI 10-550) were factors associated with death among traumatic chest injury patients in this study. CONCLUSION RTC contributed for a considerable number of traumatic chest injuries in this study. Old age, delay in delivering the victim to health care facilities, length of stay in hospital, and development of atelectasis and pneumonia were associated with death among traumatic chest injury patients. Road safety interventions, establishment of organized pre-hospital services, and early recognition and prompt management of traumatic chest injury related complications are urgently needed to overcome the underlying problems in the study setting.
Accidents, Traffic ; prevention & control ; Adult ; Age Factors ; Ethiopia ; epidemiology ; Female ; Hospitals, Special ; statistics & numerical data ; Humans ; Length of Stay ; Male ; Middle Aged ; Pneumonia ; etiology ; mortality ; Pulmonary Atelectasis ; etiology ; mortality ; Retrospective Studies ; Thoracic Injuries ; complications ; epidemiology ; mortality ; Time Factors ; Transportation of Patients

PURPOSE: Traffic accidents are one of the major health problems in the world, being the first cause of burden of illness and the second leading cause of death in Iran. The Sistan-Baluchestan province is one of the most accidental provinces of Iran with the highest rate of accidents-caused deaths. This study was conducted to determine the risk factors associated with traffic accidents in Zahedan through 2013 to 2016. METHODS: This analytical cross-sectional study was carried out on 223 drivers from Zahedan who were traumatized by traffic accident and sent to Zahedan hospitals. The data were obtained through interviews taken by the trained interviewers via refereeing to the medical records and collected in the researcher-made checklist. Census was obtained from the study subjects. For data analysis, independent t-test, one-way ANOVA, Chi-square and logistic regression were used with the Stata software version 11.0. RESULTS: In this study, 223 male subjects with the mean age of (32.54 ± 12.95) years, 39.8% single and 60.2% married, entered for investigation. Most accidents (38.8%) occurred between 12:00 to 17:59. While driving, 47.1% of the study subjects were using cell phones, 89.1% had manual use of mobile phones, 21.9% had a habit of sending short message service (SMS) and 23.4% had sent SMS within 10 min before the accident. The one way analysis of variance showed that the mean age of individuals with marital status, driving experience, education and accident with motorcycle were significantly different (p < 0.05). Also, the multivariate logistic regression test indicated a significant relationship of smoking, ethnicity, insurance and SMS typing while driving with motorcycle accident (p < 0.05). CONCLUSION In this study, SMS and smoking while driving had the highest risk among the variables studied in the motorcycle accidents. Therefore, effective education attempting to enhance people's awareness about the consequences of using cell phone and smoking during driving to reduce traffic accidents seems necessary.
Accidents, Traffic/statistics & numerical data* ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Automobile Driving ; Cause of Death ; Cell Phone Use/adverse effects* ; Cross-Sectional Studies ; Female ; Health Education ; Humans ; Iran/epidemiology* ; Male ; Marital Status ; Middle Aged ; Risk ; Smoking/adverse effects* ; Young Adult

PURPOSE: One of the consequences of trauma-related injuries is disability. There are more than one billion people with disabilities worldwide. Disability in people reduces their quality of life. The goal of this study was to determine the rate of post-trauma stress and disability related to trauma in the population over 15 years old in Kashan during a solar year of 2018-2019. METHODS: This is a cross-sectional population-based study. A cluster sampling method was used in the city of Kashan, and 3880 persons were interviewed with individuals randomly selected in each household. If a person had trauma during one year ago, the World Health Organization Disability Assessment Schedule 2.0 and Post Trauma Stress Disorder (PTSD) Checklist were applied for further interview. Data were analyzed using Chi-square test or t-test. RESULTS: Among the 3880 participants residing in Kashan, 274 (7.1%) reported a history of traumatic injury during one year ago in 2018-2019. Incidence of all injuries was estimated to be 70.61 (62.60-78.70) per 1000 people. For the trauma population, 213 (77.7%) were male and 75.1% were married. About half of them (50.3%, 138/274) aged 21-39 years. The most common cause of injuries was related to traffic accidents: 140 (51.1%). Of the 274 trauma participants, 47 (17.2%) reported PTSD; 244 (89.1%) had a mild disability, and 30 (10.9%) reported moderate disability. CONCLUSION One of the main causes of disability in the human community is the traumatic injuries. According to the results of this study, 89.1% of trauma participants have sustained at last mild disability following trauma. These people require follow-up and post-treatment support. It should be noted that psychological complications such as PTSD are as significant as physical symptoms.
Accidents, Traffic ; Adult ; Age Factors ; Cross-Sectional Studies ; Disability Evaluation ; Disabled Persons/statistics & numerical data* ; Female ; Humans ; Iran/epidemiology* ; Male ; Stress Disorders, Post-Traumatic/psychology* ; Time Factors ; Young Adult

BACKGROUND: Road traffic injury is one of the persistent public health challenges in most regions of the world, representing substantial human and economic losses. Annually, about 1.25 million lives are lost, whereas 50 million suffer from road traffic injuries globally. It has been shown that over 60% of the reasons for traffic injuries are a risky driving behavior (RDB). Despite the problem's pervasiveness, there is a paucity of information about level and factors influencing RDB among professional car drivers in Bahirdar city, northwest Ethiopia. METHODS: An institution-based cross-sectional study was conducted from February to March 2016. A systematic random sampling technique was used to select 376 participants. A self-administered driver behavior questionnaire (DBQ) was used for data collection. We performed a binary logistic regression analysis to investigate the associations of variables. Potential confounders were controlled using a multivariable logistic regression model. We ascertained the significance at < 0.05 p value and evaluated strength of associations using crude odds ratios (COR) and adjusted odds ratios (AOR) with 95% confidence intervals (CI). RESULTS: A total of 361 drivers participated (response rate, 96%). The mean age was 34 (standard deviations ± 7.97) years. The majority, 98.9% (N = 357), were males. The level of risky driving behavior and road traffic crashes were 79.4% (95% CI 75.92, 83.97) and 16.3% (95% CI 15.91, 24.84), respectively. Average monthly salary [AOR 2.04; 95% CI (1.23, 2.74)], driving experience [AOR 2.72; 95% CI (1.07, 6.89)], distance driven per year [AOR 2.06; 95% CI (1.13, 4.10)], and previous history of involvement in traffic crashes [AOR 2.30; 95% CI (1.15, 7.35)] were significantly associated with risky driving behavior. CONCLUSIONS The study shows that risky driving behavior is common among professional car drivers in the study setting. Therefore, it is strongly advisable for policy makers and other stake holders to devise strategies that consider working conditions, like monthly salary and driving experiences. The study also suggests that it is often advisable to reduce the distance driven per year and learn from implications of previous history of involvement in traffic crashes.
Accidents, Occupational ; statistics & numerical data ; Accidents, Traffic ; statistics & numerical data ; Adult ; Automobile Driving ; psychology ; statistics & numerical data ; Cities ; Cross-Sectional Studies ; Ethiopia ; Female ; Humans ; Male ; Odds Ratio ; Risk Factors ; Risk-Taking ; Surveys and Questionnaires

PURPOSE: Traffic accidents are one of the main causes of death and disability, causing annual deaths of 1.23 million and tens of millions injured people worldwide. Meanwhile, a significant proportion of the deaths and injuries caused by traffic accidents occur among motorcyclists. According to the world health organization's 2015 report, about 25% of deaths from traffic accidents occur in motorists. In Iran, a significant proportion of deaths and injuries result from traffic accidents among motorcyclists, especially in passages within the cities. According to traffic police, about 25% of deaths and 50% of injuries in traffic accidents of Tehran are reported among motorcyclists. Therefore, due to the importance of this issue, the spatial factors influencing the incidence of motorcycle-related accidents in Tehran were investigated using the geographic information system. METHODS: The present work was a cross-sectional and descriptive analysis study. The data necessary for the study were extracted from Tehran traffic police as well as municipality databases. Zoning maps were used to display the distribution of events. In the analytical investigation, Moran index was used to determine the distribution pattern of the events, while Getis-Ord G * statistics were applied to analyze hot spots. To investigate the role of regional and environmental factors in the frequency of traffic accidents related to motorcyclists in geographic units (Tehran 22 districts), Poisson regression and negative binomial models were used. The geographically weighted regression (GWR) model was used to analyze the relationship between environmental factors and the location of these events. Statistical analyses were performed using SPSS, STATA, ARC-GIS and GWR software. RESULTS: The southern and eastern margins of Tehran are the most vulnerable areas in terms of deaths related to traffic accidents of motorcyclists. Highways are considered the location of most traffic accidents which lead to death of motorcyclists. Getis-Ord General G * (p < 0.04) indicates that the distribution of high-risk points is statistically significant. The final model showed that in Tehran, the association of different variables including demographic characteristics, pathways network and type of land use with the number of accidents in geographic units was statistically significant. The spatial distribution of traffic accidents leading to deaths of motorcyclists in the center of Tehran varies considerably with changes in population density, length of highways, volume of traffic, and land use in different parts. CONCLUSION Most of the traffic accidents leading to deaths of motorcyclists occur in highways. Various environmental variables play a role in determining the distribution pattern of these types of events. Through proper traffic management, controlling environmental risk factors and training people the safety of motorcyclists in Tehran can be improved.
Accidents, Traffic ; prevention & control ; statistics & numerical data ; Automobile Driving ; statistics & numerical data ; Cross-Sectional Studies ; Environment ; Geographic Information Systems ; Geography ; Humans ; Incidence ; Iran ; epidemiology ; Motorcycles ; statistics & numerical data ; Regression Analysis ; Risk Factors ; Wounds and Injuries ; epidemiology ; etiology ; mortality ; prevention & control

PURPOSE: Pelvic fractures are severe injuries and are often associated with multiple system injuries, exacerbating the overall outcome. In India, the incidence of pelvic fractures is on a rise due to suboptimal roads and traffics but related literature regarding the overall epidemiology of these injuries is scarce and scanty. Our aim was to study the epidemiology of patients admitted with pelvic fractures at a level 1 trauma centre in India. METHODS: A 16-month (between September 2015 and December 2016) prospective observational study was carried out on trauma patients with pelvic fractures at a level 1 trauma centre of a tertiary care hospital. Demography of patients, mechanism of injuries and complications were recorded prospectively. RESULTS: We observed 75 patients who presented with pelvic fractures, where 56 were males and 19 were females. Mean age of the study population was 37.57 years. Road traffic accidents were the most common mode of injuries. Lateral compression injuries were the most common pattern. Associated injuries frequently encountered were lower extremities and acetabulum fractures, blunt abdominal trauma, urogenital injuries and head injuries. Out of the 75 patients, 52 were treated surgically and 23 were managed by conservative methods. Associated injuries of the extremities, head, abdomen and urogenital system indicated a longer hospital stay. CONCLUSION Pelvic fractures, although belong to a relatively rare trauma subset, cause a high morbidity and mortality with considerable burden on the economy. Proper road safety training and driving etiquettes along with its strict implementation in true sense and spirit are the need of the hour.
Accidents, Traffic ; prevention & control ; statistics & numerical data ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Cost of Illness ; Female ; Fractures, Bone ; economics ; epidemiology ; mortality ; Humans ; Incidence ; Length of Stay ; statistics & numerical data ; Male ; Middle Aged ; Pelvic Bones ; injuries ; Prospective Studies ; Tertiary Care Centers ; statistics & numerical data ; Time Factors ; Young Adult