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简介：Objective:Thereisnosaferwaytotransportachildthanaschoolbus.FatalcrashesinvolvingoccupantsareextremelyrareeventsintheUS.Inrecentyears,schoolbustransportationbegantodevelopinChina.WewanttobringadvancedexperienceonschoolbussafetyinWesterncountriessuchastheUStodevelopingcountries.Methods:WesearchedthepapersrelatedtoschoolbussafetyfromMedline,ChineseScientificJournalsDatabaseandtheWeboftheNationalHighwayTrafficSafetyAdministration(NHTSA).Results:Therewereonly9papersrelatedtoschoolbussafety,whichshowedthathigherlevelsofsafetystandardsonschoolbuses,schoolbus-relatedtransportationandenvironmentallawsandinjurypreventionweretheprimaryreasonsforthedesiredoutcome.Fewschoolbusisrelatedtodeathsandinjuriesinthedevelopedcountries.Conclusions:Thedevelopingcountriesshouldmakestrictenvironmentallawsandstandardsonschoolbussafetytopreventchildren'sinjuryanddeath.

简介：Objective:Toevaluatetheepidemiologiccharacteristicsofexpresswaytraffictraumain2040casesinZhejiangProvince.Methods:Thedataof2040casesofexpresswaytraffictraumatakenfromZhejiangProvincialExpresswayTrafficBureauwereanalyzedwithcomputertechniques.Results:Atotalof2040personswereinjuredin7963expresswaytrafficaccidentsinZhejiangProvincefromJanuary1999toDecember2001.Amongthem,435personsdied(mortality,21.3%)and1605wereinjured.Theeconomiclosseswereover170millionyuanRMB.Theaccidentscausedbyhumanfactorsaccountedfor84.9%(vehicledriversaccountingfor79.2%),whichmainlyincludedimpropermeasures(20.4%),steeringfailure(17.7%),insufficientlongitudinalspace(15.9%),overspeeddrive(12.5%),fatiguedrive(6.4%),loadingviolation(5.9%)andcarelessdrive(6.3%).Mechanicaltroublesandotherfactorstookup15.1%.Thereexistedobviousunevendistributionamongvariousregions.JiaxingandShaoxingwerethesectionswithhighincidenceofaccidents.Theaccidentsmostlyhappenedat12:00-18:00,butthecausing-deadonesmostconcentratedat0:00-6:00.Themainvictimswereyoungandmiddle-agedpeople(accountingfor72.3%),butaccident-strickenchildrenandelderlypersons(over70yearsold)tookuphighermortalities(30.2%and40.7%,respectively).Conclusions:Thenumberofexpresswaytrafficaccidentsandtheeconomiclossesareincreasingyearbyyear,withobviousunevendistributionatdifferentplaces,differenttimeandunderdifferentweatherconditions.Toreducetheaccidentfrequency,itisimportanttostrengthentheenforcementoftrafficregulation,tobalancethesystemof'person-vehicle-road',andtoimprovethesafetyconsciousnessofpeople.

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简介：AbstractHigh-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.

简介：Objective:Tostudytheepidemiologicfeaturesofhighwaytrafficaccidentsbyanalyzingtheclinicaldataofthepatientsdiedofheadinjury.Methods:Thereaturesofthecases'age,occupation,statusofheadinjuryandcomplications.andtherescueprocedureswereretrospectivelyanalyzedbasedonthedataof214patientsdiedofheadinjury.Results:Themainvictimewereadults(78%)andpeasants(52.8%).Andtheostcommonheadinjurieswereseverecerebralcontusionwithintracranialhematomas(73.4%).Themeanarrivaltimefromtheaccidentspotstohospitalswas(2.2±1.9)h.Andthemeanintervaltimebetweenthearrivalandoperationwas(1.9±0.9)h.Primaryandsecondarybrainstemdamagewerethemaincausesofearlydeath.Yetpulmonaryinfectionandmultipleorgansfailurewerethecommonreasonsforlatedeath.Conclusions:Enhancingthepropagandafortrafficregulations,establishingperfectpre-hospitalandin-hospitalEMS(emergencymedicalservice)system,catchingtheopportunityofoperation,andpreventingcomplicationsareessentialtoreducethemortalityoftrafficaccidentsinducedheadtrauma.

简介：AbstractPurpose:The increasing number of deaths due to road traffic accidents (RTAs) has attracted global attention. However, the influence of road types is rarely considered in the study of RTAs. This study evaluates the influence of different road types in RTAs in northern Guizhou to provide a basis for the formulation of evidence-based policies and measures.Methods:We obtained the data from the Zunyi Traffic Management Data Platform for the years 2009-2018. The mortality rates of RTAs were calculated. Descriptive methods and Chi-square tests were used to analyze the characteristics of road traffic collisions on different road types. We also examined the associations between the mortality rate per 10,000 vehicles and the growth of per capital gross domestic product (GDP) with Spearman's rank correlation analysis. According to the passing volume and the infrastructure, we defined different types of roads, like administrative road, functional road, general urban road and urban expressway.Results:In 2012, the traffic mortality rate of administrative roads was 8.9 per 100,000 people, and the mortality rate of functional roads was 7.4 per 100,000 people, which decreased in 2018 to 6.1 deaths per 100,000 people and 5.2 deaths per 100,000 people, respectively. The mortality rate per 10,000 vehicles reached the highest level in 2011 (28.8 per 10,000 vehicles and 22.5 per 10,000 vehicles on administrative and functional roads, respectively). The death rate of county roads was the highest among administrative roads (χ2= 17.389, p < 0.05) and that of fourth-class roads was the highest among functional roads (χ2= 21.785, p < 0.05). The mortality rate per 10,000 vehicles was negatively correlated with per capital GDP.Conclusion:Although our research shows that RTAs in northern Guizhou have steadily declined in recent years, the range of decline is relatively small. Many measures and sustainable efforts are needed to control road traffic death and accelerate the progress in road traffic safety in northern Guizhou.

简介：Objective:TostudytheepidemiologicalcharacteristicsandpreventivemethodsofroadtrafficcrashesinamountaincityinwesternChinathroughsamplinginvestigationoftrafficcrashesindifferentregionsofChongqingcityinrecentyears.Methods:Twopoliceteamsoftrafficmanagementindowntown,twoteamsinsuburb,oneteamincountyandonefreewayteamwererandomlyselected,androadtrafficcrashesbetween1988and1997wereinvestigatedandanalyzed.Results:Atotalof13121roadtrafficcrasheswith6201crasheswithcasualtieswereanalyzed.TheincidenceofcrasheswashigherinMay,JuneandJuly,andonFridayandWednesdayandat8:00-12:00and14:00-18:00withinaday.Casualtieswere44.0%inpedestriansand42.5%inpassengersoftotalcasualties.Thedeathsandsevereinjuriesinpedestrianswere59.1%oftotaldeathsand56.4%oftotalsevereinjuries.Theageofdriversandpassengersweremainlyat18-30years,followedby31-40years.Peopleover60yearsoldaccountedfor24.1%oftotalpedestriancasualty.Headinjurywasthemostcommonreasonfordeaths.Themainreasonsforthesecrasheswereimproperdrivingandviolatingtrafficlaws.Violatingtrafficlawsbypedestrianwasoneofthemainreasonsforpedestriancasualty.Conclusions:Thecrashesarerelatedtothecharacteristicsofgeography,climate,societyactivityofpeople,andthesenseoftrafficsafety,thebasictrafficconstructionandmanagementinChongqing.ThetrafficcasualtyofpedestrianisabigprobleminChongqing.Topreventanddecreaseroadtrafficinjurieseffectivemethodsshouldbeworkedoutandpropagandaontrafficsafetyandtrafficmanagementshouldbestrengthenedaccordingtodifferentcharacteristicsofdifferentregions.Tostrengthenthefirstaidandtreatmentofcranium-braininjuryandchest-backinjuryisalsohelpfulindecreasingtrafficdeaths.

简介：ObjectiveRoad交通碰撞(RTC)被认为是在这研究的Iran.The目的死亡的第二个最高的原因是在2003-2008.MethodData期间描述RTC的病态和死亡从伊朗的国家healthsources被得到。从2003to2008.ResultsRTC发生的死亡的包括的人口，数字ofRTCs，作为结果的死亡，原因和地方评估的这些数据在一年2003～1每100000人口从868.5增加了643.6在2008。全部的of2从RTC的565死亡在Yazdfrom2003被记录到2008。在2006在2003～46.9每100000人口从46.1增加的RTC死亡率，然后在2008衰退了到38.8。在期间这次时期，全面交通损害发生在2006在2003～647.9从368.8每100000人口增加了，然后在2008衰退了到527.9。头损害是道路的最普通的原因从2003～2008的交通相关的死亡。后面的道路交通事故，大多数死亡发生在到达hospital.ConclusionRoad交通前在Yazd在的碰撞相关的死亡和病态最近六年在最后二年里被增加，但是减少。这衰落最可能是许多干预的结果，包括法律，警察实施，在交通和运输的改进，护理资源和媒介和公共教育。

简介：AbstractPurpose:This research examined road traffic injury mortality and morbidity disparities across of country development status, and discussed the possibility of reducing country disparities by various actions to accelerate the pace of achieving Sustainable Development Goals target 3.6 - to halve the number of global deaths and injuries from road traffic accidents by 2020.Methods:Data for road traffic mortality, morbidity, and socio-demographic index (SDI) were extracted by country from the estimates of the Global Burden of Disease study, and the implementation of the three types of national actions (legislation, prioritized vehicle safety standards, and trauma-related post-crash care service) were extracted from the Global Status Report on Road Safety by World Health Organization. We fitted joinpoint regression analysis to identify and quantify the significant rate changes from 2011 to 2017.Results:Age-adjusted road traffic mortality decreased substantially for all the five SDI categories from 2011 to 2017 (by 7.52%-16.08%). Age-adjusted road traffic mortality decreased significantly as SDI increased in the study time period, while age-adjusted morbidity generally increased as SDI increased. Subgroup analysis by road user yielded similar results, but with two major differences during the study period of 2011 to 2017: (1) pedestrians in the high SDI countries experienced the lowest mortality (1.68-1.90 per 100,000 population) and morbidity (110.45-112.72 per 100,000 population for incidence and 487.48-491.24 per 100,000 population for prevalence), and (2) motor vehicle occupants in the high SDI countries had the lowest mortality (4.07-4.50 per 100,000 population) but the highest morbidity (428.74-467.78 per 100,000 population for incidence and 1025.70-1116.60 per 100,000 population for prevalence). Implementation of the three types of national actions remained nearly unchanged in all five SDI categories from 2011 to 2017 and was consistently stronger in the higher SDI countries than in the lower SDI countries. Lower income nations comprise the heaviest burden of global road traffic injuries and deaths.Conclusion:Global road traffic deaths would decrease substantially if the large mortality disparities across country development status were reduced through full implementation of proven national actions including legislation and law enforcement, prioritized vehicle safety standards and trauma-related post-crash care services.

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简介：AbstractPurpose:Successful application experiences on public-private partnership (PPP) in different countries, suggest that PPP could be an option in road traffic injury (RTI) prevention. The present study aims at investigating the applicability of PPP policy in RTI prevention in Iran based on the experts’ perspectives.Methods:This is a qualitative study with grounded theory approach which has been conducted in Tabriz University of Medical Sciences, Iran in 2018. The participants were 22 experts in the field of RTIs selected using purposive sampling method. Data were collected by semi-structured interviews and analyzed with content-analysis method.Results:The results were classified under 5 main themes (applicability, scopes and services, challenges, advantages, and strategies) for applying PPP policy and 37 sub-themes. Due to the prevalence of RTIs, the present challenges in public sector, existence of qualified private sector, and successful experiences in other areas, there are opportunities for private sector partnership in prevention of RTIs. Private sector could participate in different scopes and services regarding RTI prevention, including road construction and maintenance, maintenance and provision of vehicles safety and public education. The main challenges including legislation issues, ambiguities in collaboration, political and organizational unsustain-ability, government's financial hardship and lack of experienced experts in the field of RTI. However, there are significant advantages including high efficiency in program implementation, covering the weaknesses of public sector, effective and efficient management on application of PPP in RTI prevention. The strategies include identifying and prioritizing the assignable activities, identifying the qualified private sector, developing PPP policies and legal frameworks, creating a common language between public and private parties, trying to meet the expectations of the private sector by public sector, developing a comprehensive and sound contract, and cultivating public culture to accept private sector in the field of RTI prevention.Conclusion:This study sought to determine whether PPP could be used as strategy to reduce the burden of RTIs in Iran. But it requires a lot of preliminary studies to provide the context and conditions for applying this policy.

简介：AbstractPurpose: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.

简介：AbstractPurpose: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 motor-cyclists (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.

简介：AbstractBackground:Air pollution and poor ambient air quality are significantly related to multiple health risks. One associated disease is chronic obstructive pulmonary disease (COPD), a preventable disease with several contributing factors and one of the leading causes of morbidity/mortality locally and globally. A potentially high-risk population are traffic enforcers who are constantly exposed to air pollution. In the Philippines, the MMDA has the widest coverage in traffic management. The study determined the risk of COPD among Metro Manila Development Authority (MMDA) traffic enforcers in relation to ambient air quality level, as well as identified other factors that increase the risk of developing COPD.Methods:Fifty-two MMDA traffic enforcers deployed in PM2.5 air quality sensor areas in Metro Manila from 2016 to 2018 were recruited through stratified sampling. The International Primary Airways Guidelines (IPAG) questionnaire was utilized to measure risk of COPD. Respiratory health and working history were obtained through questionnaires. Department of environment and natural resources provided PM2.5 ambient air quality data which aided in the construction of the Exposure-Month Index. Ordinal logistic regression was used to examine the association of PM2.5 together with the relevant factors and the risk of COPD.Results:We found statistically significant associations between PM2.5 and COPD among high risk category [odds risk (OR): 1.24, 95% confidence interval (CI): 1.07-1.44]. Age (Moderate, OR: 1.16, 95% CI: 0.98-1.38 and High, OR: 10.06, 95% CI: 4.02-25.17) and chest pain (Moderate, OR: 68.65, 95% CI: 1.71-2.75 × 103) were potential risk factors, whereas body mass index (BMI) (OR: 0.05, 95% CI: 0.01-0.53) exhibited protective effect.Conclusions:Exposure to PM2.5 was associated with an increased risk of COPD among high-risk category MMDA traffic enforcers. Age and chest pain were potential risk factors to risk of COPD, whereas BMI exhibited a potential protective effect. Results of this study can be used for clinical management of high-risk populations, such that of MMDA traffic enforcers.