搜索结果：Traffic injury prevention

BACKGROUND: Road traffic injuries (RTIs) are a growing but neglected global health crisis, requiring effective prevention to promote sustainable safety. Low- and middle-income countries (LMICs) share a disproportionately high burden with 90% of the world's road traffic deaths, and where RTIs are escalating due to rapid urbanization and motorization. Although several studies have assessed the effectiveness of a specific intervention, no systematic reviews have been conducted summarizing the effectiveness of RTI prevention initiatives specifically performed in LMIC settings; this study will help fill this gap. METHODS: In accordance with PRISMA guidelines we searched the electronic databases MEDLINE, EMBASE, Scopus, Web of Science, TRID, Lilacs, Scielo and Global Health. Articles were eligible if they considered RTI prevention in LMICs by evaluating a prevention-related intervention with outcome measures of crash, RTI, or death. In addition, a reference and citation analysis was conducted as well as a data quality assessment. A qualitative metasummary approach was used for data analysis and effect sizes were calculated to quantify the magnitude of emerging themes. RESULTS: Of the 8560 articles from the literature search, 18 articles from 11 LMICs fit the eligibility and inclusion criteria. Of these studies, four were from Sub-Saharan Africa, ten from Latin America and the Caribbean, one from the Middle East, and three from Asia. Half of the studies focused specifically on legislation, while the others focused on speed control measures, educational interventions, enforcement, road improvement, community programs, or a multifaceted intervention. CONCLUSION: Legislation was the most common intervention evaluated with the best outcomes when combined with strong enforcement initiatives or as part of a multifaceted approach. Because speed control is crucial to crash and injury prevention, road improvement interventions in LMIC settings should carefully consider how the impact of improvements will affect speed and traffic flow. Further road traffic injury prevention interventions should be performed in LMICs with patient-centered outcomes in order to guide injury prevention in these complex settings.

Worldwide, nearly 1.2 million people are killed in road traffic crashes every year and 20 million to 50 million more are injured or disabled. These injuries account for 2.1% of global mortality and 2.6% of all disability-adjusted life years (DALYs) lost. Low- and middle-income countries account for about 85% of the deaths and 90% of the DALYs lost annually. Without appropriate action, by 2020, road traffic injuries are predicted to be the third leading contributor to the global burden of disease. The economic cost of road traffic crashes is enormous. Globally it is estimated that US$518 billion is spent on road traffic crashes with low- and middle-income countries accounting for US$65 billion--more than these countries receive in development assistance. But these costs are just the tip of the iceberg. For everyone killed, injured or disabled by a road traffic crash there are countless others deeply affected. Many families are driven into poverty by the expenses of prolonged medical care, loss of a family breadwinner or the added burden of caring for the disabled. There is an urgent need for global collaboration on road traffic injury prevention. Since 2000, WHO has stepped up its response to the road safety crisis by firstly developing a 5-year strategy for road traffic injury prevention and following this by dedicating World Health Day 2004 to road safety and launching the WHO/World Bank World Report on Road Traffic Injury Prevention at the global World Health Day event in Paris, France. This short article highlights the main messages from the World Report and the six recommendations for action on road safety at a national and international level. It goes on to briefly discuss other international achievements since World Health Day and calls for countries to take up the challenge of implementing the recommendations of the World Report.

OBJECTIVES: To evaluate the outcome of a community-based program for reducing traffic injury rates with special focus on children and to assess the impact of a Traffic Injury Report (TIR) in terms of awareness and attitudes about safety issues. SETTING: The Norwegian cities Harstad (23 000) and Trondheim (140 000), during ten years. METHODS: The outcome was evaluated using hospital-based injury recording. Sustainability of the prevention program was promoted by disseminating information on the community's traffic injury profile. Reports containing information about traffic injuries were distributed quarterly to all Harstad households, containing victim stories and statistics on medical data and the location of the accidents. The impact of the reports was evaluated, using a questionnaire mailed to persons 18-80 years old. RESULTS: From the first two years (mean rate 116.1/10,000 person years), to last two years, a significant 59% [confidence interval (CI): 42% to 71%] reduction of traffic injury rates was observed for Harstad children. Overall rates for all ages decreased 37% [CI:47% to 24%] in Harstad increased by 3% [CI:-4% to 10%] in Trondheim (reference city). Significantly higher scores were found in Harstad compared to Trondheim concerning the awareness of, and positive attitudes towards, safety issues (e.g. alcohol and driving, speeding and children's safety in traffic). 56.0% of respondents in Harstad reported having acquired information, or good advice, about traffic safety from the reports. CONCLUSIONS: Traffic injuries in children can be prevented by community-based interventions. Distributing written information may enhance the program's sustainability.

Abstract Background Road traffic injuries impose a substantial health burden among children. Health literacy is one of the most important determinants of non-communicable disease prevention. Parent health literacy is connected with their knowledge and behaviors regarding children road traffic injuries (CRTI) prevention. The aim of this study was to explore health literacy, knowledge and behaviors of mothers' in Croatia regarding CRTI prevention. Methods This population based cross-sectional questionnaire study was done during 2019 in convenient sample of mothers of school aged children. Sociodemographic data and data about knowledge and behaviors of mothers regarding CRTI prevention were collected by the use of specially designed questionnaire. Croatian version of the Newest Vital Sign screening test (NVS-HR) was used for heath literacy determination. Results There were 814 mothers' median age 36.0 (interquartile range 32.0. - 39.0). According to NVS-HR there were 17.7%, 26.5% and 55.8% of mothers with low, intermediate and adequate health literacy level, respectively. The higher levels of health literacy were connected with younger age of mothers (37 years old or less) (P = 0.027); urban area of settlement (P < 0.001); living with a partner (P = 0.018); higher educational level of mothers (P < 0.001) and with better self-perceived economic status (P = 0.009). The study revealed poor positive correlation between mothers' health literacy and their knowledge regarding CRTI prevention (rho=0.170; P < 0.001). The study further showed that there was no correlation between mothers' health literacy and their behavior regarding CRTI prevention (rho=0.072; P = 0.041). Finally, the study revealed poor positive correlation between mothers' knowledge and behavior regarding CRTI prevention (rho=0.193; P < 0.001). Conclusions The level of health literacy affects mothers' knowledge about CRTI prevention. Further studies are needed to better understand the underlying reasons for established association. Key messages Low parent health literacy is one of the predictors of poor parent knowledge about children road traffic injuries prevention. It is necessary to identify and to address low parent health literacy in preventive strategies directed towards children road traffic injury prevention.

PURPOSE: To investigate whether an aggressive traffic violation enforcement program could reduce motor vehicle crashes (MVCs), injury collisions, fatalities, and fatalities related to speed, and decrease injury severity in crash victims treated at the trauma center. METHODS: A vigorous enforcement program was established within Fresno, Calif, city boundaries using increased traffic patrol officers. Data on citations, collisions, fatal collisions, and fatalities related to speed, as well as injury severity from the trauma registry, were collected for the year before program onset (2002), during the first year (2003), and after full implementation (2004). U.S. Census Bureau information was used for population. Statistical analysis was performed using Fisher's exact test and independent samples t test with significance attributed to p < 0.05. RESULTS: There were significant increases in citations issued, with marked decreases in motor vehicle crashes, injury collisions, fatalities, and fatalities related to speed. There was a decrease in admissions from MVCs, a significant decrease in the number of patients with moderate injury severity (Injury Severity Score of 10-16; p < 0.01), a decrease in hospital length of stay for all MVC victims, and a decrease in hospital charges for MVC patients. These changes were not seen in the area of Fresno County outside the area of increased enforcement. CONCLUSIONS: Aggressive traffic enforcement decreased MVCs, crash fatalities, and fatalities related to speed, and it decreased injury severity. This is a simple, easily implemented injury prevention program with immediate benefit.

The objective of the current study was to evaluate outcomes of a program to prevent traffic injuries among the different social strata under WHO Safe Community Program. A quasi-experimental design was used, with pre- and post-implementation registrations in the program implementation area (population 41,000) and in a neighbouring control municipality (population 26,000) in ?sterg?tland County, Sweden. The traffic injury rate in the not vocationally active households was twice than employed or self-employed households in the intervention area. In the employed and not vocationally active households, males showed higher injury rates than females in both areas. In the self-employed households females exhibited higher injury rates than males in the intervention area. Males from not vocationally active households displayed the highest post-intervention injury rate in both the intervention and control areas. After 6 years of Safe Community program activity, the injury rates for males in employed category, injury rates for females in self-employed category, and males/females in non- vocationally active category displayed a decreasing trend in the intervention area. However, in the control area injury rate decreased only for males of employed households. The study indicated that there was almost no change in injury rates in the control area. Reduction of traffic injuries in the intervention area between 1983 and 1989 was likely to be attributable to the success of safety promotion program. Therefore, the current study concludes that Safe Community program seems to be successful for reducing traffic injuries in different social strata.

Low and middle income countries still lack proper surveillance such as registries that document traffic fatal and non-fatal injuries. Literature indicates that traffic injuries prevention can be enhanced based on rigorous documentation and reliable data. The Romanian Road Safety Plan is a national centralised program, offering little room for local initiative and evidence based approaches. The traffic injury prevention measures implemented so far involve very few health professional and disregard new technologies. An innovative pilot-project conducted in Cluj-Napoca, Romania used police reports and emergency department data to draw a map of accidents using Global Information Systems (GIS) technology. According to the Police Department Database pedestrian injuries account for 70% of traffic related injuries. More than a third of the traffic crashes occurred under normal weather and road conditions, during daylight and on dry road. GIS has been used to identify traffic injury hot spots with the primary scope of developing future injury prevention strategies in Cluj-Napoca, Romania. This local need based technologically enhanced initiative, uses GIS to assess high risk areas of the city and to allow the local Police Departments to take corrective actions. The digital map enables to locate precisely the hotspots from the city and to develop a need-based intervention plan. GIS has proved to be a successful tool, specific hotspots being detected and mapped. Further research is needed to determine environmental related causes. Furthermore, population based educational interventions are encouraged.

Traffic-related injuries have become a major public health concern worldwide. However, unlike developed or high-income countries (HICs), many developing or low-income countries (LICs) have made very little progress towards addressing this problem. Lack of the progress in LICs is attributable, in part, to their economic situation in terms of their governments' lack of resources to invest in traffic safety, cultural beliefs regarding the fatalism of injuries, competing health problems particularly with the emergence of HIV/AIDS, distinctive traffic mixes comprising a substantial number of vulnerable road users for whom less research has been done, low literacy rates precluding motorists to read and understand road signs, and peculiar political situations occasionally predominated by dictatorship and non-democratic governments. How then can LICs tackle the challenge of traffic safety from the experiences of HICs without reinventing the wheel? This paper reviews selected interventions and strategies that have been developed to counter traffic-related injuries in HICs in terms of their effectiveness and their applicability to LICs. Proven and promising interventions or strategies such as seat belt and helmet use, legislation and enforcement of seat belt use, sidewalks, roadway barriers, selected traffic-calming designs (e.g., speed ramps/bumps), pedestrian crossing signs combined with clearly marked crosswalks, and public education and behavior modification targeted at motorists are all feasible and useable in LICs as evidenced by data from many LICs. While numerous traffic-related injury policy interventions and strategies developed largely in HICs are potentially transferable to LICs, it is important to consider country-specific factors such as costs, feasibility, sustainability, and barriers, all of which must be factored into the assessment of effectiveness in specific LIC settings. Almost all interventions and strategies that have been proven effective in HICs will need to be evaluated in LICs and particular attention paid to the effectiveness of enforcement measures. It behooves LIC governments, however, to ensure that only standard, approved safety devices like helmets are imported into their countries. Additionally, LICs may need to improvise and innovate in the traffic safety technology transfer.

In order to analyse traffic injury reporting in Ghanaian newspapers and identify opportunities for improving road safety, the content of 240 articles on road traffic injury was reviewed from 2005 to 2006 editions of two state-owned and two privately owned newspapers. The articles comprised reports on vehicle crashes (37%), commentaries (33%), informational pieces (12%), reports on pedestrian injury (10%), and editorials (8%). There was little coverage of pedestrian injuries, which account for half of the traffic fatalities in Ghana, but only 22% of newspaper reports. Only two articles reported on seatbelt use. Reporting patterns were similar between public and private papers, but private papers more commonly recommended government action (50%) than did public papers (32%, p=0.006). It is concluded that Ghanaian papers provide detailed coverage of traffic injury. Areas for improvement include pedestrian injury and attention to preventable risk factors such as road risk factors, seatbelt use, speed control, and alcohol use.

OBJECTIVES: This study assessed whether the quality of the available road traffic injury (RTI) data was sufficient for determining the burden of RTIs in the Western Cape Province and for implementing and monitoring road safety interventions. METHODOLOGY: Underreporting was assessed by comparing data reported by the South African Police Services (SAPS) in 2008 with data from 18 provincial mortuaries. Completeness of the driver death subset of all RTIs was assessed using the capture-recapture method. RESULTS: The mortuary and police data sets comprised 1696 and 860 fatalities respectively for the year 2008. The corresponding provincial road traffic mortality rates were as follows: 32.2 deaths/100,000 population per year (95% confidence interval [CI]: 30.7-33.8) and 16.3 deaths/100,000 population per year (95% CI: 15.3-17.5). The police data set contained 820,960 crashes, involving 196,889 persons, indicating substantial duplication of crash events. There were varying proportions of missing data for demographic and other identifying variables, with age missing in nearly half of the cases in the police data set. The estimated total number of driver deaths/year was 588.6 (95% CI: 544.4-632.8), yielding estimated completeness of the mortuary and police data sets of 57.6 and 46.4 percent separately and 77.3 percent combined. CONCLUSION: This study found extensive data quality problems, including missing data, duplication, and significant underreporting of traffic injury deaths in the police data. Not all assumptions underlying the use of capture-recapture method were met in this study; hence, the estimates provided by this analysis should be interpreted with caution. There is a need to address the problems highlighted by this study in order to improve data utility for informing road safety policies. Supplemental materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention to view the supplemental file.

<h3>Background</h3> Multinational corporations (MNCs) can contribute to their employees’ wellness through global interventions aimed at road traffic injury prevention, particularly in high risk settings. The purpose of this study was to understand the road use experiences of employees of a large U.S. MNC in India to inform a globally enacted and locally relevant employee road safety platform. <h3>Methods</h3> Surveys and focus group interviews were used to elicit road safety perceptions, attitudes and behaviours of employees in MNC offices in the cities of Bangalore and Pune. Survey responses were analysed to describe demographic, vehicular, and behavioural features of a representative sample of employees. Focus group transcripts were coded to develop a thematic framework that described the road traffic experiences of employees in their local environment and perceptions of interventions that would enhance their safety. <h3>Results</h3> Seventy-five employees completed surveys and participated in one of six focus group interviews. Participants considered daily road use to be a dangerous and stressful experience. Roadway danger was attributed to vehicle mix, non-adherence to traffic laws, and transportation infrastructure unequipped for the rate of population and commercial growth. Focus groups identified inconsistencies between employee knowledge of safety strategies and their road use behaviours, and policy-level actions that could be instituted. <h3>Conclusions</h3> This study uncovered that an employee road safety intervention for MNC employees in the context of urban India should focus on behaviour change and structural interventions that take into account roadway infrastructure, traffic patterns, and enforcement of traffic policies. It further demonstrates how simple strategies can be used to elicit important contextual road safety factors amoung MNC employees globally in order to identify locally relevant interventions for employee injury prevention.

Traumatic brain injury (TBI) is among the most devastating of injuries leading to death and disability among young people today. The major cause of TBI is motor vehicle crashes. One way to reduce the rates of such crashes and thus TBI is through prevention programs. This article analyzes a study conducted for assessing a 1-day educational traffic injury prevention program for young traffic offenders with speeding violations. The obtained data include information about traffic convictions for speeding violations on a group of 16- to 23-year-old drivers. A common method for analyzing such studies is to use simple two-sample rank tests on summary statistics. But this approach ignores the detailed conviction process information and can assess only the long-term overall effect of the program. In this article, we treat the data as recurrent event data and apply a novel approach based on counting processes to evaluate the program. Our approach makes use of the information ignored by the rank tests and allows the assessment of both short- and long-term effects of the program. The analysis results indicate that the prevention program has an effect for a short period and suggest that a long-term effect could be gained if the program is repeated.

Road traffic injury prevention training manual , Road traffic injury prevention training manual , کتابخانه دیجیتال جندی شاپور اهواز

Road traffic related death and injury continues to be a major challenge globally. Unsafe road use is particularly evident in low- and middle-income countries while also being a growing concern for private sector organisations. The Safe System approach is recognized internationally as the leading approach to improving road safety and previous work has codified the essential management functions and interventions evident in its successful implementation. Tracking the development of Safe System adoption within the public and private sectors is of interest for several reasons. This paper presents recent development and use of road safety maturity frameworks and discusses the utility of these approaches for road safety practitioners and researchers.

Motor vehicle accidents are the leading cause of death in adolescents and young adults worldwide. Nearly three-quarters of road deaths occur in developing countries and men comprise a mean 80% of casualties. The rate of road traffic accidents caused by four-wheeled vehicles is the highest globally reported road traffic accidents statistic. In Saudi Arabia, the motor vehicle is the main means of transportation with one person killed and four injured every hour. Over 65% of accidents occur because of vehicles travelling at excess speed and/or drivers disobeying traffic signals. Road traffic injuries cause considerable economic losses to victims, their families, and to nations as a whole. Strategic prevention plans should be implemented soon by various sectors (health, police, transport, and education) to decrease the mortality and morbidity among adolescent and young age group. Strong and effective coordination between ministry of health and other ministries together with World Health Organization and other related organisations will be an important step towards implementing the international Decade of Action for Road Safety (2011-2020). The aim of this review article is to highlight some aspects of the health impacts of road traffic accidents.

Road traffic injuries (RTIs) are a major public health problem worldwide, especially in low- and middle-income countries (LMICs)and require concerted efforts for effective and sustainable prevention. A variety of measures need to be considered when planning activities. This is particularly true in LMICs. Iran, for example, despite its enormous efforts in recent years in both pre-crash and post crash measures as well as social policy changes, continues to be challenged by the sheer magnitude of this major public health problem. Accordingly, stakeholders’ perceptions, the approach and the kind of preventive activities are crucial. On the whole, there are two different approaches in RTI prevention: the individual approach and the system approach.In the individual approach, there is a tendency for researchers and particularly practitioners to identify only one or a few elements, which usually can be found in many LMICs. Traditionally, in such countries many studies have focused on factors relating to driver errors, poor vehicles and the road environment instead of finding the reason for injury outcome. In many LMICs, the majority of preventive activities target road-user behaviors, which are usually tackled by means of education and enforcement. Hence the primary responsibility is assigned to the road user. However, while safe road-user behavior is one important component, changing such behavior should not simply be focused on education and enforcement. When WHO launched its call to action, it invited members of the public to be part of the solution. The initiative focused on five important courses of action for the general public including: not speeding; wearing a seat-belt; being visible on the road; wearing a helmet; and never drinking and driving. Studies on public education efficiency have revealed that a decrease in crashes due to such campaigns can occur only if they clearly target specific forms of behavior, like seat belt use or helmet wearing.In contrast, a system approach, tends to be mainly directed toward the crashworthiness of the road transport system. Sweden has been rather successful in this area and one major national policy is a long-term vision for road safety, “Vision Zero”. It was a revolutionary way of thinking about traffic user safety that helped Sweden to significantly reduce the number of deaths and serious injuries due to road traffic crashes. This is a road safety policy that puts the protection of the most vulnerable road-users at its centre. The system designer has the primary responsibility and as a result changes within the environment are given more emphasis than human factors. The road transport system should be able to take human failings into account and absorb errors in the system, in order to avoid serious RTIs and deaths. The amount of energy in the system must be kept below critical limits by ensuring that speed is restricted1. Now the Vision Zero policy has been embraced in the other countries, and the Swedish national policy with its powerful emphasis on safety is saving lives around the world. It is interesting to note that the “Vision Zero” is not just applicable to high-income countries. It could easily be transferred to LMICs. Accordingly, in such countries, if the inherent safety of the system (road and vehicle safety design) cannot be changed, then the only way to reduce RTIs is to lower speeds1. The basic principles of Vision Zero can be used in any type of road transport system, at any stage of development.

By virtue of their variability, mass and speed have important roles in transferring energies during a crash incidence (kinetic energy). The sum of kinetic energy is important in determining an injury severity and that is equal to one half of the vehicle mass multiplied by the square of the vehicle speed. To meet the Vision Zero policy (a traffic safety policy) prevention activities should be focused on vehicle speed management. Understanding the role of kinetic energy will help to develop measures to reduce the generation, distribution, and effects of this energy during a road traffic crash. Road traffic injury preventive activities necessitate Kinetic energy management to improve road user safety.