Road traffic injuries in Colombia

Road traffic injuries are a leading public health problem in Colombia. Pedestrians are the most vulnerable road users, especially in the main urban centers of Bogotá, Medellin and Cali. Data analyzed in this report include official statistics from the National Police and the National Institute of Legal Medicine and Forensic Sciences for 1996-2000, and results of a study conducted at the National University of Colombia in 2000. Methods from the Highway Capacity Manual were used for determining physical and technical variables, and a Geographical Information System tool was used for the location and spatial analysis of the road traffic crashes. Pedestrians accounted for close to 32% of injuries and 40% of the deaths from road traffic crashes. The problem of road traffic crashes existed predominately in urban areas. In the main urban centers, pedestrians constituted nearly 68% of road traffic crash victims. The high level of risky road use behaviors demonstrated by pedestrians and drivers, and inadequate infrastructure for safe mobility of pedestrians in some sections of the road network were the main contributing factors. Major improvements were achieved in Bogotá following enhancements to the municipal transport system and other policies introduced since 1995. In conclusion, policies and programs for improving road safety, in particular pedestrian safety, and strengthening urban planning are top priority.     

Road traffic crash injuries and fatalities in the city of Kerman,Iran

The objective of this study was to investigate road traffic crash injuries and fatalities. Cases of 3902 road traffic injuries (1709 drivers, 891 passengers, 376 pedestrians and 926 motorcyclists) and 1564 road traffic fatalities (RTFs; 1222 males and 342 females) were collected from 2005 to 2008 using the database of the police forces and Department of Forensic Medicine in Kerman, respectively. Results showed that 66% of the injuries were related to car occupants (drivers and passengers) and men/women ratio was 5:1. The highest men/women ratio was (12.2:1) for drivers, while the lowest ratio (1.8:1) was for pedestrians. Most of the injuries had taken place at 16:01–20:00 h followed by 08:01–12:00 h. Highest numbers of injuries were found in male with the age groups of 18–24 years. The highest fatality rate of 79 per 100,000 population occurred in 2007–2008. Fatality ratio indicated higher male ratio, four times higher than females. The victims were 39% male between 30 and 55 years of age. Head injuries were present in 69% of the cases. In our series of forensic autopsy cases, head injuries were more frequent in motor vehicle occupants, pedestrians and motorcyclists. On average, two people died per day in RTFs in Kerman.     

Road traffic injuries in Thailand: Trends,selected underlying determinants and status of intervention

Injuries and deaths from traffic crashes have become a major public health and socio-economic problem in Thailand. Injuries, fatalities and economic losses due to traffic crashes have increased with the rising level of motorization. This study analyzes hospital-based data compiled by the Ministry of Public Health, data compiled by the National Police Office and data compiled by the traffic engineering division of the Department of Highways, Ministry of Transport and Communications. Analysis reveals that 70% of the people injured or killed in traffic crashes are aged 10-39. Men are at four to five times higher risk of death and injury due to traffic crashes than women. The number and rate of traffic injury in Thailand swung from a record low during the economic recovery in the 1980’s to record a high during the bubble economy, then declined with the economic crisis in 1997. The economic costs were estimated at U.S.$1.6 billion in 1995. An urban-rural difference in traffic injuries has been recorded with a higher rural case-fatality rate. A number of known behavioral risk factors have been identified, i.e., drunk driving, speeding, substance abuse and failure to use helmets and seat belts. However, determinants of behavior need further investigation. Hazardous road locations have also been mapped. Trends of traffic injuries seem to follow trends of economic growth. Without effective policy and implementation programs to control the determinants, it is expected that traffic injuries will increase as the country recovers from economic crisis. A major pitfall to many current government programs is that they incorporate no systematic evaluation. The fragmented structure of road safety authorities further complicates collaboration and coordination. A broad coalition of stakeholders is needed to catalyze policy action.     

Road traffic crashes with fatal and non-fatal injuries in Arkhangelsk,Russia in 2005–2010

The study investigated trends in traffic crashes with fatal and non-fatal injuries in Arkhangelsk, Russia in 2005–2010. Data were obtained from the road police. Negative binomial regression with time regressor was used to investigate trends in monthly incidence rates (IRs) of crashes, fatalities, and non-fatal injuries. During the six-year period, the police registered 4955 crashes with fatal and non-fatal injuries, which resulted in 217 fatalities and 5964 non-fatal injury cases. The IR of crashes with fatal and non-fatal injuries per total population showed no evident change, while the IR per increasing total number of motor vehicles decreased on average by 0.6% per month. Pedestrian crashes constituted 51.8% of studied crashes, and pedestrians constituted 54.6% of fatalities and 44.5% of non-fatal injuries. The IRs of pedestrian crashes and non-fatal pedestrian injuries per total population decreased on average by 0.3% per month, and these were the major trends in the data.     

Mortality due to injuries in Maputo City, Mozambique

Records of all registered deaths due to injuries maintained by the Legal Medicine Department in Maputo City for the period 1 January to 31 December 2000 were reviewed. Among the 1135 registered deaths, road traffic injuries accounted for the most common underlying cause of death (43.7%), followed by firearm discharge (8.7%) and burns (7.8%). For all deaths, skull fracture (21.9%), organ system injury (17.2%) and brain tissue injury (9.3%) were the most important intermediate causes of death and among the immediate causes of death acute anaemia (21.9%) was the most common followed by asphyxia (14.4%) and traumatic shock (12.0%). Overall, most cases were seen in the age group 20-29 years (27.0%) and comprising mainly males (male/female ratio 3.1). The most commonly reported cause for the victims to sustain injuries leading to death were accidents (59.4%), followed by homicides (19.8%), unknown causes (16.1%) and suicides (4.2%). Prevention of road traffic injuries and improved emergency care and health facility-based treatment is needed to reduce injury-related mortality.     

How socioeconomic status influences road traffic injuries and home injuries in Rome

Road traffic injuries (RTI) and home injuries (HI) are a relevant public health problem, especially among people living in deprived areas. The objective of this study was to explore the relationship between morbidity, hospitalisation, mortality from RTI and HI, and socioeconomic status (SES) of the area of residence. RTI and HI surveillance based on the Emergency Information System, the Hospital Information System and the Mortality Registry of Lazio region are the three sources of this study to create a unique surveillance system. For each subject, the SES index (5 levels) of its census tract of residence was obtained. The study population included emergency department admissions (year 2005) of residents in Rome, Italy. Incidence Rate Ratios (IRRs) have been estimated using Poisson Regression. The rates of RTI and HI emergency department visits were higher among the most deprived level of SES (IRR = 1.27, 95% CI: 1.24–1.30; IRR = 1.33, 95% CI: 1.29–1.37, respectively) compared to the most privileged ones; a similar result was found for hospitalisation (IRR = 1.19, 95% CI: 1.08–1.32; IRR = 1.11, 95% CI: 1.01–1.22). A strong relation was found between RTI mortality rates and poor level of SES. The study concluded that RTI and HI incidence were associated to sociodemographic factors.     

National burden of road traffic injuries in Argentina

More than 1.2 million people die and as many as 50 million people are injured or disabled due to road traffic injuries (RTIs) every year worldwide. The lack of reliable data hinders efforts to describe the characteristics of the issue and prioritise prevention activities. The objective was to provide a snapshot of fatal and non-fatal RTI in Argentina. We used the methodology proposed by the Global Burden of Disease Injury Expert group. External causes of deaths with unknown codes were proportionately redistributed over the known categories. In 2007 in Argentina, we estimated 5915 RTI deaths, compared with 3983 RTI deaths reported previously by the Ministry of Health, accounting for 1931 additional cases. The highest number of deaths occurred in young men (15-29 years old), although the highest RTI death rates were in the age group of 55 years and older. Four-wheeled vehicle occupants were the most common road user type killed (59.1%); vulnerable road users represented one third (29.5%) of deaths and 64% of non-fatal RTI. The national and regional estimates of RTI in Argentina should help policy makers and public-health researchers to understand the importance of RTI prevention and design specific interventions to further reduce these preventable deaths and injuries.     

Road traffic accidents and policy interventions in Korea

The high rate of road traffic crashes, in conjunction with the absence of order on the road, has long been considered a critical social problem in Korea. The Korean public seems to agree that high priority ought to be placed on policies for improving road safety. Using data from government sources, this study describes what has happened in the area of road traffic crashes since 1970, the causes of traffic crashes, and the relative importance of traffic injuries as a cause of death in Korea. Road traffic crashes in Korea increased nearly eightfold, from 37,000 in 1970 to 290,481 in 2000. The fatalities increased three-fold and injuries ten-fold over the same period. Road traffic injuries were the leading cause of death for people under 29. However, through multiple policy interventions, partly in response to the 2002 FIFA World Cup, about two thousand road traffic deaths and nine thousand traffic-related disabilities were averted in 2001 alone. The policy interventions included enforcement of penalties for seven risky driving behaviours, including drunk driving and speeding, installation of traffic-monitoring cameras, financial rewards for citizens who reported traffic violations, introduction of a road safety evaluation system, correction of accident black spots in existing roads, and road safety education programs. Through multiple policy interventions, road traffic crashes in Korea were reduced in a relatively short time period, along with their associated injuries and fatalities. However, road traffic crashes still pose a major public health problem, threatening the quality of life of the Korean people.     

Pedestrian traffic injuries in Mexico: A country update

Road traffic injuries in general and pedestrian injuries in particular are a major public health problem in Mexico, especially in large urban areas. Analysis of mortality and road crashes at the national level was done using routine data recorded on death certificates. Fatality rates for different age groups were estimated by region for the year 2000. These data were supplemented by a cross-sectional study of pedestrian injuries in Mexico City based on death certificates information for pedestrians who lived and died in Mexico City between 1994 and 1997. Participant observation of physical spaces where crashes occurred was carried out. The spaces were filmed and in-depth interviews of survivors conducted. Road traffic crashes were responsible for approximately 17,500 deaths in Mexico during 2000. The mean age of the victims was 37 years. Mexico lost an average of 30 years of productive life for each individual who died in a traffic crash – 525,000 years in 2000. An estimated 9500 (54.3%) of all fatalities were pedestrians, and for every pedestrian death there were 13 others who sustained nonfatal injuries requiring medical care. The overall crude mortality rate for pedestrian injuries in Mexico City was 7.14 per 100,000 (CI 6.85-7.42). A concentration of deaths was observed in 10 neighborhoods at specific types of street environments. The underlying factors included dangerous crossings and the absence or inadequacy of pedestrian bridges, as well as negative perceptions of road safety by pedestrians. In conclusion, this study demonstrates the importance of elucidating the underlying contextual determinants of pedestrian injuries.     

Patterns of injuries and motor-vehicle traffic accidents in Athens

The extremely high cost of motor-vehicle accidents in public health leads to the necessity of a better injury data collection in the Accident and Emergency Hospital Departments. The ‘Asclepeion’ of Voula Hospital covers the southeastern suburban areas of the greater Athens area (1 000 000 population). The aim of this study is to present information on the pattern of injuries in Athens, in order to understand the magnitude of the problem and develop rational prevention programmes. Specially trained health visitors of the Emergency Department Injury Surveillance System (EDISS) interviewed in person every injured victim who was brought into the Emergency Service of the ‘Asclepeion’ of Voula Hospital. The study was performed during a 3-year period, from 1996 to 1998; 4564 persons were interviewed. Traffic accidents were more frequent on weekdays with a seasonal peak in July and among young Greeks (aged 25 – 34 years). The usual type of injuries seen in vehicle-accident victims were cerebral contusion and concussion, while in motorcycle-accident victims, head contusion and fractures. The most common reasons for the accident were excessive speed, poor condition of road, inattention, abstraction or drowsiness and drug effects. A total of 29.8% of motorcycle drivers and 5.7% of motorcycle passengers wore a helmet and 26.3% of car drivers and 14.1% of car passengers were using seatbelts. The identification of road traffic injury patterns can contribute to the development of injury prevention measures and guide rational preventive interventions that can reduce the incidence of these injuries. The EDISS system established at ‘Asclepeion’ of Voula Emergency Service can provide useful and accurate information about this serious and multidimensional problem of Greek Public Health.     

Patterns of injuries and motor-vehicle traffic accidents in Athens

The extremely high cost of motor-vehicle accidents in public health leads to the necessity of a better injury data collection in the Accident and Emergency Hospital Departments. The 'Asclepeion' of Voula Hospital covers the southeastern suburban areas of the greater Athens area (1,000,000 population). The aim of this study is to present information on the pattern of injuries in Athens, in order to understand the magnitude of the problem and develop rational prevention programmes. Specially trained health visitors of the Emergency Department Injury Surveillance System (EDISS) interviewed in person every injured victim who was brought into the Emergency Service of the 'Asclepeion' of Voula Hospital. The study was performed during a 3-year period, from 1996 to 1998; 4564 persons were interviewed. Traffic accidents were more frequent on weekdays with a seasonal peak in July and among young Greeks (aged 25 - 34 years). The usual type of injuries seen in vehicle-accident victims were cerebral contusion and concussion, while in motorcycle-accident victims, head contusion and fractures. The most common reasons for the accident were excessive speed, poor condition of road, inattention, abstraction or drowsiness and drug effects. A total of 29.8% of motorcycle drivers and 5.7% of motorcycle passengers wore a helmet and 26.3% of car drivers and 14.1% of car passengers were using seatbelts. The identification of road traffic injury patterns can contribute to the development of injury prevention measures and guide rational preventive interventions that can reduce the incidence of these injuries. The EDISS system established at 'Asclepeion' of Voula Emergency Service can provide useful and accurate information about this serious and multidimensional problem of Greek Public Health.     

Pattern of traffic injuries in Shanghai: implications for control

In China, traffic-related injuries are often treated as transportation issues, called 'accidents'. The objectives of the research are to analyse traffic injury patterns, estimate costs of traffic injuries and provide evidence to develop effective prevention strategies. There were over 1 500 deaths due to traffic-related injuries annually in Shanghai from 1987 to 2003, and it is rising year by year with the rate of growth in motorization. The rates of annual increase are 3.59% in fatalities (from 7.78 to 14.18 per 100000 population) and 10.46% in non-fatalities (from 53.93 to 264.98 per 100000 population) respectively during the period. The analysis of the geographic information system showed that the geographic distribution of traffic injuries in the countryside regions of Shanghai had the highest rates. Labour force groups represented the majority of fatalities (70.97%) and serious traffic injuries (90.51%). The mortality rates were 18.40 per 100000 population and 10.02 per 100000 population in 45-65 year age group and 15-44 year age group respectively; the morbidity rates of serious traffic injuries were 121.60 per 100000 population and 70.46 per 100000 population in the same groups respectively. And females generally showed a lower incidence than males. In general, fatalities and injuries were higher for drivers, bicyclists and pedestrians. Among road traffic injury-related fatalities, 66.8% were attributed to head injuries. Of those with fatal head injuries, bicyclists accounted for 29.8% of the total; pedestrians accounted for 28.3%; motorcyclists accounted for 25.5%. Total traffic injury cost was estimated at least US $645989580 in Shanghai in 2003. Good injury intervention programmes need to be done as soon as possible to effectively reduce traffic injury burden in Shanghai, China.     

Pattern of road traffic injuries in Ghana: Implications for control

Road traffic injuries and fatalities are increasing in Ghana. Police-collected crash and injury data for the period 1994-1998 were aggregated and analyzed using the MAAP5 accident analysis package developed by the Transport Research Laboratory, U.K. Published results of recent transport-related epidemiological and other surveys provided an additional data source. According to the 1994-1998 police data, road traffic crashes were a leading cause of death and injuries in Ghana. The other leading causes of death and injuries are occupational injuries which involve nonmechanized farming and tribal conflicts. The majority of road traffic fatalities (61.2%) and injuries (52.3%) occurred on roads in rural areas. About 58% more people died on roads in the rural areas than in urban areas, and generally more severe crashes occurred on rural roads compared with urban areas. Pedestrians accounted for 46.2% of all road traffic fatalities. The majority of these (66.8%) occurred in urban areas. The second leading population of road users affected was riders in passenger-ferrying buses, minibuses and trucks. The majority of these (42.8%) were killed on roads that pass through rural areas. Pedestrian casualties were overrepresented (nearly 90%) in five regions located in the southern half of the country. Efforts to tackle pedestrian safety should focus on the five regions of the country where most pedestrian fatalities occur in urban areas. Policies are also needed to protect passengers in commercially operated passenger-ferrying buses, minibuses and trucks because these vehicles carry a higher risk of being involved in fatal crashes.     

Equity dimensions of road traffic injuries in low- and middle-income countries

Globally, poorer population groups bear a disproportionate burden of avoidable morbidity and mortality from road traffic injuries. The distribution of road traffic injuries is generally influenced by socioeconomic factors. Poor countries bear a disproportionate burden of injuries and fatalities, and within countries, poor people account for a disproportionate portion of the ill health due to road traffic injuries. The main source of data for this paper was the road traffic injury database of the WHO World Health Report for 1999 supplemented by the WHO Global Burden of Disease Study 2000 report, and published and unpublished works. Fatality rates for 0-4 and 5-14 year olds in low- and middle-income regions, measured as deaths per 100,000 population, were six times the rates for high-income regions, while within low- and middle-income regions the rates varied widely. Within poor countries, poor people – represented by pedestrians, passengers in buses and trucks, and cyclists – suffer a higher burden of morbidity and mortality from traffic injuries. In rich countries, children from poor socioeconomic classes suffer more injuries and deaths from road crashes than their counterparts from highincome groups. The disproportionate burden of morbidity and mortality in low- and middle-income countries, and among low socioeconomic groups in those countries, illustrates problems of global inequities in health. The problems can be addressed through policies that focus on the road safety of vulnerable groups.     

Road accidents involving bicycles: configurations and injuries

This study analyzed the most common types of accident involving bicycles and compared the frequency of injuries. The data source was the database of German In-Depth Accident Study (GIDAS). Cases consist of bicycles and their riders involved in accidents between 2000 and 2010. In most collisions, the bicycle impacted with a car. The percentage of injured bicyclists was higher in collisions with a heavy vehicle and decreased when the bicycle impacted with lighter vehicles. A high percentage of injured bicyclists in single accidents was observed; the most severe injury was more frequently to head and extremities. Accidents involving a car and a bicycle with the right of way in a bicycle path represented about 20% of involved and injured bicyclists. The ten most frequent configurations represented about 60% of involved and injured bicyclists. These results contribute to understand the dangerous scenarios for bicyclists and to suggest preventive actions.