Hotspots and causes of motor vehicle crashes in Baltimore,Maryland: A geospatial analysis of five years of police crash and census data

IntroductionRoad traffic injuries are a leading killer of youth (aged 15–29) and are projected to be the 7th leading cause of death by 2030. To better understand road traffic crash locations and characteristics in the city of Baltimore, we used police and census data, to describe the epidemiology, hotspots, and modifiable risk factors involved to guide further interventions.Materials and methodsData on all crashes in Baltimore City from 2009 to 2013 were made available from the Maryland Automated Accident Reporting System. Socioeconomic data collected by the US CENSUS 2010 were obtained. A time series analysis was conducted using an ARIMA model. We analyzed the geographical distribution of traffic crashes and hotspots using exploratory spatial data analysis and spatial autocorrelation. Spatial regression was performed to evaluate the impact of socioeconomic indicators on hotspots.ResultsIn Baltimore City, between 2009 and 2013, there were a total of 100,110 crashes reported, with 1% of crashes considered severe. Of all crashes, 7% involved vulnerable road users and 12% had elderly or youth involvement. Reasons for crashes included: distracted driving (31%), speeding (6%), and alcohol or drug use (5%). After 2010, we observed an increasing trend in all crashes especially from March to June. Distracted driving then youth and elderly drivers were consistently the highest risk factors over time. Multivariate spatial regression model including socioeconomic indicators and controlling for age, gender and population size did not show a distinct predictor of crashes explaining only 20% of the road crash variability, indicating crashes are not geographically explained by socioeconomic indicators alone.ConclusionIn Baltimore City, road traffic crashes occurred predominantly in the high density center of the city, involved distracted driving and extremes of age with an increase in crashes from March to June. There was no association between socioeconomic variables where crashes occurred and hotspots. In depth analysis of how modifiable risk factors are impacted by geospatial characteristics and the built environment is warranted in Baltimore to tailor interventions.     

Epidemiology of road traffic mortality and injuries in Yazd, Iran during 2003-2008

Objective: Road traffic crashes (RTCs) are considered to be the second highest cause of mortality in Iran. The purpose of this study was to describe the morbidity and mortality of RTC during 2003-2008.Methods: Data were got from national health sources of Iran. These data included population, the number of RTCs,consequent fatalities, cause and place of death from 2003 to 2008.Results: RTC incidence rate increased from 868.5 per 100 000 population in the year 2003 to 1 643.6 in 2008. A total of 2 565 deaths from RTC were recorded in Yazd from 2003 to 2008. RTC mortality rate increased from 46.1 per 100 000 population in 2003 to 46.9 in 2006, then declined to 38.8 in 2008. During this time period, overall traffic injury incidence per 100 000 population increased from 368.8 in 2003 to 647.9 in 2006, then declined to 527.9 in 2008. Head injuries were the most common cause of road traffic-related mortality from 2003 to 2008. Following road traffic accidents, most of the deaths occurred before arriving hospital.Conclusions: Road traffic crash-related mortality and morbidity in Yazd in the recent six years are increased, but decreased in the last two years. This decline is most probably the result of a variety of interventions, including laws,police enforcement, improvements in traffic and transport,health care resources and media and public education.     

Verkehrsunfälle in Entwicklungsländern

Road traffic crashes pose a major threat to individuals and national health systems. Developing countries account for 48% of motorized vehicles, but for 91% of the 1.3 million fatalities per annum. While ranked ninth among the causes of disabilities adjusted life years lost in 2004, crash injuries are projected to rise to third position by 2030. This article reviews current prognoses of deaths and disabilities, the characteristics of crashes in low and middle income countries and evidence-based road safety interventions. This article is considered a wake-up call for trauma, orthopaedic, and emergency surgeons in high-income countries to join the global community in fighting the neglected yet potentially curable epidemic named road traffic injuries.     

An epidemiologic survey of road traffic accidents in Iran:analysis of driver-related factors

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

Pedestrian traffic injury in Victoria,Australia

IntroductionRoad traffic injuries are the fifth leading cause of years of life lost, with pedestrians comprising 39% of all road deaths (Global Burden of Disease Mortality and Causes of Death Collaborators [1]). Programs that use injury surveillance data to identify high-risk targets for intervention are known to be effective for reducing injury. This study aims to identify trends in the population incidence of pedestrian traffic injury (PTI) in Victoria, Australia.MethodA retrospective review of data from the Victorian Emergency Minimum Dataset, the Victorian Admitted Episodes Dataset, the Victorian State Trauma Registry and the National Coronial Information System was conducted of patients with a PTI who present to a public hospital emergency department, were admitted to hospital, sustained major trauma or who died of their injuries from January 1st 2009 to December 31st 2013. The primary outcome measure was population incidence of pedestrian traffic-related emergency presentations, hospital admissions, major trauma and deaths.ResultsOver the study period, 1838 cases presented to a public hospital emergency department and were discharged without admission to hospital and an additional 3241 cases were admitted to hospital. Of these, 628 cases were classified as major trauma including 90 in-hospital deaths. From January 1st 2008 to December 31st 2011, a total of 216 deaths occurred. A decrease in the population incidence of emergency presentations for PTI was observed over the study period. No significant change was observed in the population incidence of hospital admissions, major trauma cases or deaths from PTI. The demographics of PTI were observed more commonly to be young, intoxicated males and pedestrians aged over 65 years.ConclusionsAlthough the population-adjusted incidence of emergency presentations for PTI in Victoria has decreased from 2009 to 2013, no change was observed in the incidence of hospital admissions, major trauma or pedestrian fatalities. Novel programs designed to address high-risk groups should be considered to achieve further reductions in PTI and severity of 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 eight-fold, 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.     

Road traffic deaths in Kashan region, Iran: An eight-year study (2006e2013)

Purpose

The aim of this study was to analyze the trend of road traffic fatalities in Kashan Region, Iran, in a period of eight years.

A contemporary analysis of road traffic crashes,fatalities and injuries in Trinidad and Tobago

Road safety, in particular pedestrian safety, is a problem in Trinidad and Tobago. Data were derived from the database of the Traffic and Highway Patrol Unit of the Trinidad and Tobago Police Service. Road traffic crashes in Trinidad and Tobago are largely an urban problem. Four urban areas accounted for nearly three-quarters of reported road traffic crashes, fatalities and injuries. Pedestrians, passengers and drivers accounted for 93% of fatalities and 95% of injuries due to road traffic crashes in 2000. Pedestrians alone accounted for 42% of fatalities and 34% of injuries in 2000. Trends over time show that there has been a decline in fatality rates from 17 deaths per 100,000 population in 1960 to 10 deaths per 100,000 population in 2000, despite rapid motorization. Motorization increased four-fold from 63 registered vehicles per 1000 population in 1960 to 250 vehicles per 1000 population in 2000. In conclusion, effort should be intensified to ensure safety for all road users and, in particular, pedestrians, passengers and drivers. Improved data collection and operational research would improve monitoring and evaluation of policy interventions.     

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.     

Road traffic injuries in Tanzanian children and adolescents: A cross-sectional household survey

ObjectiveTo measure annual rates of road traffic injuries (RTI) and to describe the characteristics of road traffic crashes experienced by children and adolescents in Tanga, Tanzania.MethodsWe conducted a cross-sectional household survey using geospatial population-weighted sampling in the city of Tanga in northern Tanzania. Data were collected in February and March of 2022. We report 12-month rates of road traffic crashes and RTI (reported by adult caregivers) among children and adolescents <18 years of age.ResultsA total of 2,794 adult respondents reported data on 6563 children and adolescents, among whom, 180 were reported to have experienced road traffic crashes in the past 12 months (crash incidence: 27.4 per 1,000 children, 95%CI 23.5-31.4) and 158 sustained injuries (RTI incidence: 24.1 per 1000 children, 95%CI 20.4-27.8). Almost a quarter of RTI (23%) were reported to be major (resulting in ≥30 days of missed activities). RTI was higher among adolescents (13-17 years) than children <5 years (21.5 vs. 14.1 per 1,000, p=0.039). Few children always or sometimes wore helmets when riding on motorcycles/motorbikes (12.8%) or wore safety restraints/seat belts in cars or other vehicles (11.9%).ConclusionThe high rate of road traffic crashes and RTI observed among children and adolescents in a medium-sized city in Tanzania underscores the urgent need to improve road safety and increase use of safety equipment in low resource settings.     

Population incidence of pedestrian traffic injury in high-income countries: A systematic review

BackgroundRoad traffic injuries are the fifth leading cause of years of life lost, with pedestrians comprising 39% of all road deaths. International recognition of this public health issue has led to a reduction in road traffic deaths in many high-income countries. However data on non-motorised road users such as pedestrians is incomplete. Additionally, non-fatal injuries are poorly documented. The aim of this study was to identify the incidence of pedestrian traffic injury reported from high-income countries.MethodsA systematic review of the literature was conducted using MEDLINE, Scopus, PubMed and the Cochrane library. Studies were eligible for inclusion if they reported the incidence of pedestrian injury in a defined population from a high-income country defined using the World Bank atlas method for the 2016 fiscal year. A meta-analysis was performed on the population incidence of pedestrian traffic injury by world region.ResultsSeventeen studies were identified from eight high-income countries that satisfied the inclusion criteria. The pooled incidence of PTI in the European region was 68.8 per 100,000 population (95%CI 50–87.7, p < 0.01) and 89.3 per 100,000 (95%CI 47.2–131.4, p < 0.01) in the American region. The incidence of pedestrian traffic injury varied from 20 per 100,000 in Victoria, Australia to 203 per 100,000 in New York City, United States of America. Pedestrian mortality ranged from 0.9 to 14 per 100,000 population. Wide variation in population size, location and demographics was observed between studies.ConclusionsThis review concluded a high burden of pedestrian trauma in HICs with individual reports reporting from rates of 20 to 203 per 100,000 population. Recommended interventions directed at reducing the burden of pedestrian trauma were not universally present in the reported high-income countries. Implementation of such safety strategies and demonstration of improvement in pedestrian trauma rates and outcomes present directions for further research.     

Epidemiology of traffic crash mortality in west of Iran in a 9 year period

Purpose: In Iran, the most common cause of injuries and the second leading cause of deaths are traffic accidents, and those problems impose a substantial financial burden on the society. This study aims to determine traffic accident mortality trends and their epidemiologic characteristics in the Kermanshah province, west of Iran. Methods: In a cross sectional study, road traffic fatality data from 2004 to 2013 were analyzed to determine the epidemiological pattern of traffic accident mortality. Trend assessment was performed to ascertain the decreasing or increasing status. Chi-square and one-way analysis of variance (ANOVA) tests, as well as Poisson regression were used to determine the significance of the data in time. Data were analyzed using Excel and statistical package of SPSS version 19. Results: Out of 5110 people that died in traffic accidents, 4024 (78.7%) were males. The state of accidents indicated that 404 (43.8%) female pedestrians died as a result of car crashes, and 1330 (41.4%) males died because of car collisions. 1554 (31.9%) deaths happened to pedestrians and 1556 (32.1%) to vehicle drivers, and the rest belonged to vehicle passengers. Head trauma was the cause of death for as much as 3400 (69.9%) cases. Fatal crashes in which pedestrians were involved mostly occurred between the hours 13:00 to 15:00, while the time for vehicle drivers was between 16:00 to 18:00. 2882 people (59.1%) died before reaching to health care facilities. Traffic crash mortality trend for pedestrians follows a linear pattern with a gentle downward slope, but the trend shows various swings when it comes to vehicle drivers. Conclusion: The number of traffic crash deaths from 2004 to 2013 indicates a decreasing trend in two groups of road users: vehicle drivers and car occupants. This can be due to some interventions such as modification of traffic rules and enhancement of police control which has been implemented in recent years. Moreover, more attention should be paid to promote the optimal health care services to save the lives of the injured from traffic accidents.     

Epidemiologic study of traffic crash mortality among motorcycle users in Iran(2011e2017)

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 selfemployed (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.     

Head injury‐related road crash mortality in rural Western Australia

Background: The aim of the present paper was to assess the incidence of, and identify factors associated with road crash (RC)‐related fatal head injuries in rural and metropolitan Western Australia. Methods: Examination of demographics, driving behaviour and RC characteristics for RC fatalities involving a head injury (Abbreviated Injury Scale (AIS) ≥ 2) between 1 January 1998 and 31 December 1999 was carried out using the State Coronial ­Database. Results: There were 328 deaths. The median age was 28 years and 74.1% of cases were male. Seventy per cent died at the scene. Of scene survivors, 89% were transferred to a metropolitan hospital before dying. Sixty per cent of total RC and 65% of at‐scene deaths occurred in rural areas. Single‐vehicle crashes comprised 45% of total crashes, of which 72.8% occurred in rural locations. Poor driver behaviour was identified in 53% of deaths. Ethanol was implicated in 29.8% of deaths, other intoxicating drugs were implicated in 19.2%, speeding was implicated in 19.5%, and lack of safety restraints/devices was implicated in 22%. Poor driver behaviour was identified in 72% of single‐vehicle deaths, compared with 38% of multivehicle crashes (P < 0.001). Rural people comprised 61% of rural crash victims. Ninety‐one per cent of rural victims died in rural crashes. The incidence of RC death associated with head injury in the rural population is 13.4 deaths/100 000 per year, more than double that for the metropolitan population (6.4 deaths/100 000 per year; P < 0.001). Conclusion: The rural population of Western Australia is overrepresented in head injury‐related RC deaths. Single‐vehicle crashes where unsafe driving behaviour is implicated comprise a large proportion of these. Strategies to reduce unsafe driving practices aimed at rural drivers are necessary.     

Secular trends in rates of unintentional injury deaths among adult Finns

This study assessed the current secular trends in unintentional injury deaths among persons 15 years of age or older in Finland. For this purpose, we obtained from the Finnish Official Cause-of-Death Statistics (OCDS) the data for persons aged 15 years or older whose deaths occurred in 1971--2003 due to an unintentional injury. Among Finnish men, the most drastic change occurred in road traffic crashes. The age-standardised death rate (per 100,000 person-years) of men's road traffic crashes was 47 in 1971 but only 11 in 2003. In contrast, the rate of fall-induced deaths among Finnish men gradually rose, from 18 in 1971 to 24 in 2003, by which time falls became the leading category of men's unintentional injury death. Also alcohol poisonings seemed to bypass road traffic crashes as the cause of men's injury death. Among Finnish women, the age-standardised rate of fall-induced deaths decreased till 1975, after which the curve was rather flat. The death rate (per 100,000 person-years) of women's falls was 30 in 1971 and 18 in 2003. During the entire period of 1971--2003, traffic caused fewer deaths in women than men, but the declining trend in women's death rates was also clear, from 17 in 1971 to 5 in 2003. Other unintentional causes accounted for few deaths in women during 1971--2003, although it was of interest that the rate of women's deaths due to alcohol poisoning rose from 1 in 1971 to 4 in 2003. In conclusion, during 1971--2003 falls replaced road traffic crashes as the leading cause of unintentional injury death in adult Finns. The rise in men's fall-induced deaths occurred even with a rate that cannot be explained merely by demographic changes, and therefore, systematic fall prevention measures are needed to control the development. The rising incidence of women's deaths due to alcohol poisoning needs close follow-up.     

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 injury mortality and morbidity by country development status, 2011-2017

Purpose: 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 Reporton 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%e16.08%). 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 postcrash care services.     

Time analysis of fatal traffic accidents in Fars Province of Iran

Objective:To analyze the time factor in road traffic accidents (RTAs) in Fars Province of Iran.Methods:This study was conducted in Fars Province,Iran from November 22,2009 to November 21,2011.Victims'i...