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.     

Road traffic fatalities among pedestrians, bicyclists and mo-tor vehicle occupants in Sirjan, Kerman, Iran

Objective: To analyze the crash and injury data in forensic medicine for years of 2004-2007. Methods: A sample of over 567 accident cases (9 pedestrians, 116 bicyclists, and 442 motor vehicle occupants) was considered from the Department of Foren-sic Medicine, Shahid Bahonar University of Kerman, in-volving drivers of all ages and covering a four-year period.Results: The male fatality rates were significantly higher than female ones. The groups at 15-30 years old and at 30-55 years old had the first and second highest numbers of deaths (40% and 34%, respectively). There were sub-stantial differences in distribution of injuries in motor ve-hicle occupants and pedestrians and bicyclists. Among motor vehicle occupants, there were more head injuries, such as skull fracture, brain contusion, subdural haemorrhage, and epidural haemorrhage. Nearly 77% of fatalities occurred during 08:00-22:00 in Sirjan. Internal bleeding was also higher in motor vehicle occupants. Pedestrians and bicyclists also had head injuries frequently.Conclusions: In spite of reduction of road traffic fatali-ties in Sirjan in 2007, it is still one of the cities with high road traffic fatality in the world. These results underline the im-portance of preventive strategies in transportation, sug-gesting that different methods are necessary to reduce fa-talities of various traffic participants.     

Comparison of road traffic fatalities and injuries in Iran with other countries

Objective： To compare fatalities and injuries in road traffic crashes （RTC） in Iran with other countries. Methods： Data were obtained from national health sources of Iran. These data included population number, registered motor-vehicles number, number of RTCs and consequent fatalities and injuries from 1997 to 2006. Results： RTC fatality and injury rates increased from 1997 to 2005, but decreased in 2006. The overall men/women ratio in the RTC fatalities was 4.2：1. High RTC fatality rate of 39 per 100 000 population in Iran was almost the same as some other developing countries. In Iran, RTC fatalities in recent years were almost twice as much as the highest rate among the European countries. Conclusions： This investigation shows that in spite of reduction of RTC fatality in Iran in 2006, it is still one of the highest in the world. Moreover, this paper describes the state of RTC-related parameters in a developing country in comparison with the developed countries.     

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

Objective: 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 the country. Methods: This cross-sectional study was conducted in Iran and all data regarding RTAs from March 20, 2010 to June 10, 2010 were obtained from the Traffic Police Department. We included 538 588 RTA records, which were classified to control for the main confounders: accident type, final cause of accident, time of accident and driver-related factors. Driver-related factors included sex, educational level, license type, type of injury, duration between accident and getting the driving license and driver’s error type. Results: A total of 538 588 drivers (91.83% male, sex ratio of almost 13:1) were involved in the RTAs. Among them423932 (78.71%)wereuninjured; 224818(41.74%)had a diploma degree. Grade 2 driving license represented the highest proportion of all driving licenses (290 811, 54.00%). The greatest number of accidents took place at 12:00-13:59 (75 024, 13.93%). The proportion of drivers involved in RTAs decreased from 15.90% in the first year of getting a driving license to 3.13% after 10 years’ of driving experience. Neglect of regulations was the commonest cause of traffic crashes (345 589, 64.17%). Non-observance of priority and inattention to the front were the most frequent final causes ofdeath (138175, 25.66% and129352, 24.02%, respectively). We found significant association between type of accident and sex, education, license type, time of accident, final cause of accident, driver’s error as well as duration between accident and getting the driving license (all P<0.001). Conclusion: Our results will improve the traffic law enforcement measures, which will change inappropriate behavior of drivers and protect the least experienced road users.     

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...     

Treatment of limb arterial in juries caused by traffic accidents

Objective:To analyze the features,diagonosis and treatment of limb arterial injuries caused by traffic accidents.Methods:A total of 43 patients with limb arterial injury admitted in our department over the past 30years(about50%of them happened during the last10 years)were analyzed retrospectively in this article.The popliteal,femoral and brachial arteries were mainly involved,accounting for 432%,20.5%and20.5%respectively of all the involvements.There were 35cases of open injury and9of close injury,The involved vessels were transected in 43.2%of the cases and contused in 40.9%,All the patients had various complications,such as fractures,dislocations and severe soft tissue injuries.The injured vessels were repaired by means of end-to-end anastomosis in 10cases,autogenous vein graft in 23cases and intraluminal hydraulic dilatation in 4cases.Results:Successful limb salvage was achieved in 34cases initially,whereas10amputations were carried out due to injuries to popliteal arteries in7,femoral arteries in2and humeral artery in 1and severe soft tissue damages in9 cases.Twenty-nine patients were followed up for 1-156months,with the averageof48.8months.There was good circulation in 22 cases and certain ischemia in 5cases.Two amputations were carried out in the late stage because of popliteal artery thrombosis after repair in 2cases.There was no death in this series.Conclusions:The limb arterial injuries caused by traffic accidents are severe and complicated.It is proposed that particulatr attentions should be paid to the features in diagnosis and treatment for this type of injury and special efforts should be made for both life saving and limb salvage.     

Study on characteristics of fractures from road traffic accidents in 306 cases

OBJECTIVE: To investigate the characteristics of bone fractures from road traffic accidents and analyze their injury mechanisms so as to provide reference for the research and medical care of traffic trauma. METHODS: Three hundred and six patients with fractures from road traffic accidents were included into this study. A total of 507 fractures were identified and the injury mechanism, location distribution and frequency were analyzed. RESULTS: The most common location of fractures was the lower extremities, followed by the upper extremities, skull and maxillofacial region, and the rarest was the spine. A total of 56% of the patients suffered from multiple fractures. The fractures of the patella, femur and pelvis and the fractures of the olecranon, humerus and shoulder often happened simultaneously. CONCLUSIONS: The injury mechanisms can be classified into four types: impact, incoordinate movement, stretch injury and crush and extrusion. The fractures from traffic accidents have the following characteristics: centrifugal distribution of the injuries, multiple fractures, force transmission and ipsilateral occurrence.     

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...     

Spinal cord injuries from road traffic crashes in southeastern Iran

Objective ： To analyze the data of patients with spinal cord injury （SCI） induced by road traffic crashes in southeastern Iran for better understanding the pattern of these injuries and therefore for better designing health system planning. Methods ： In this historical cohort study, the patients who had been transferred to Level I trauma center in southeastern Iran due to road traffic accidents with radiographic documented SCI were evaluated. Results： Among 64 patients with SCI, 38 patients （59.4 %, 36 males and 2 females, aged 27.42 years ± 9.44 years on average） were injured by road traffic accidents. Car and motorcycle accidents were responsible for 26 cases （68.4%） and 12 cases （31.6%）, respectively. And 31patients （81. 6%） had complete SCI. Conus medularis （T12-L2 ） was the most affected level. Conclusions： Results are discussed in terms of preventive measures, specifically those concerning the use of restraint and helmet and driving behavior. This study should be extended nationally to gain a larger case series so that the SCI risk of particular vehicle configurations, considering other crash factors, can be more precisely quantified and the characteristics for low occurrence of SCI can be more precisely identified.     

Road crash in China from 2003 to 2005

Objective： To analyze characteristics and causes of road crash and injuries in China from 2003 to 2005.
Methods： The data of road crash in 2003-2005 were collected to study the characteristics including total vehicle number, occurrence rates of traffic accidents and serious traffic accidents so as to discuss the causes and characteristics of road crash in China.
Results： From 2003 to 2005, the numbers of traffic accidents, injuries and deaths as well as the mortality rates per 100 000 persons and per 10 000 vehicles declined in China. Until 2005, the total number of traffic accidents decreased to 450 000 and deaths to 99 000, with the mortality rate per 10 000 vehicles being 7.6 persons. While the drivers and passengers accounted for 33.2 % and 26.6 % of death casualties respectively in 2005. Most traffic accidents were caused by drivers, especially those with driving experience less than 3 years. Traffic accidents occurred on suburban roads accounted for 60%. The mortality rate of the traffic accidents per 100 km on the first grade road ranked the highest. The mortality rate of the traffic accidents on expressways ranked the highest, with continual increase of death and injury.
Conclusions. At present, the increase trend of traffic accidents and casualties in China has been slowed down to some extent and shows a declining tendency, but the situation is far away from being optimistic. In order to cut down the number of traffic accidents and casualties, we should pay more attention to training and managing drivers with less than three driving years and those driving buses. Strict prevention measures should be laid on traffic accidents on first grade roads, expressways and suburban roads as well as the enhancement on improving first-aid system.     

The analysis of epidemiological characteristics of road traffic crashes in a mountain city in western China

Objective: To study the epidemiological characteristics and preventive methods of road traffic crashes in a mountain city in western China through sampling investigation of traffic crashes in different regions of Chongqing city in recent years. Methods： Two police teams of traffic management in downtown, two teams in suburb, one team in county and one freeway team were randomly selected, and road traffic crashes between 1988 and 1997 were investigated and analyzed. Results: A total of 13121 road traffic crashes with 6201 crashes with casualties were analyzed. The incidence of crashes was higher in May, June and July, and on Friday and Wednesday and at 8:00-12:00 and 14:00-18:00 within a day. Casualties were 44.0% in pedestrians and 42.5% in passengers of total casualties. The deaths and severe injuries in pedestrians were 59.1% of total deaths and 56.4% of total severe injuries. The age of drivers and passengers were mainly at 18-30 years, followed by 31-40 years. People over 60 years old accounted for 24.1% of total pedestrian casualty. Head injury was the most common reason for deaths. The main reasons for these crashes were improper driving and violating traffic laws.Violating traffic laws by pedestrian was one of the main reasons for pedestrian casualty. Conclusions: The crashes are related to the characteristics of geography, climate, society activity of people, and the sense of traffic safety, the basic traffic construction and management in Chongqing. The traffic casualty of pedestrian is a big problem in Chongqing. To prevent and decrease road traffic injuries effective methods should be worked out and propaganda on traffic safety and traffic management should be strengthened according to different characteristics of different regions. To strengthen the first aid and treatment of cranium-brain injury and chest-back injury is also helpful in decreasing traffic deaths.     

Statistical analysis on 2213 inpatients with traffic injuries from January 2003 to September 2005 in Ningbo city

Objective: To analyze the epidemiological conditions and characteristics of inpatients with traffic trauma in order to provide objective data for basic research and clinical application of traffic trauma. Methods: The data of 2213 inpatients with traffic trauma admitted to Lihuili Hospital, Ningbo Medical Centre, Ningbo, China, from January 2003 to September 2005 were studied retrospectively. According to the transportation ways, the patients were divided into four groups; pedestrians, bicyclists, motorcyclists, and automobilists. And the data of injured regions, combined injuries and causes of death were analyzed statistically. Results: Among the 2213 patients, there were 550 pedestrians (23. 5%), 521 bicyclists (24.9%), 738 motorcyclists (33.3%), and 404 automobilists (18.3%). Male patients were more than female ones, with the ratio of male to female of 2.8:1. Single region injury was found in 1663 patients (75.15%) and multiple injuries in 550 patients (24.85%). In total, 2849 regions were injured. Fracture of extremities (53.3%) occurred most often, craniocerebral trauma (19.4%) next, then followed in turn by thoraco-abdominal visceral injury (6.56%), spine fracture (5.37%), fracture of ribs (4.88%), and pelvic fracture (4.18 %). The percentage of multiple injuries (33.2%) was highest and the percentage of thoraco-abdominal injury (18.0%) was higher in motorcyclists. The percentages of craniocerebral trauma in pedestrians and bicyclists were 27.8% and 28.2%, respectively. The incidence of fracture of extremities in motorcyclists reached 73.8%, but with the lowest case-fatality ratio of 1.4%. The incidence of traffic accidents caused by motorcyclists themselves (32.8%) was highest. A total of 56 patients died, with the case-fatality ratio of 2.53%. Among the deaths, 47 died from craniocerebral injury, 6 from multiple fractures combined with hemorrhagic shock, 2 from combined injury in the thoraco-abdominal region, and 1 from cervical cord injury. Conclusions: Nowadays, the patients with traffic trauma are mainly pedestrians, bicyclists and motorcyclists, and they suffer generally from fracture of extremities and craniocerebral injury. The main cause of death is craniocerebral injury. Another characteristic of traffic trauma is that the ratio of multiple injuries is higher.     

Fatal motorcycle accidents in Fars Province, Iran: a community-based survey

Objective: To identify the main characteristics of victims of motorcycle accidents in Fars Province, Iran. Methods: This cross-sectional study was conducted in Fars Province which has the fourth largest population of all 31 provinces in Iran from March 2009 to June 2010. We included data from all 542 recorded cases of fatalities due to motor vehicle accidents. Data were recorded from the forensic medicine registry consisting of demographic and accident-related information. Demographic information consisted of name, age, sex, status of fatal victim (motorcycle driver vs passenger) and educational level. Results: Of the 2 345 autopsy records from the forensic medicine archives, 542 (23.1%) gave the cause of death as motor vehicle accidents. Mean age of these victims was (31.4+/-6.5) years, and the male to female ratio was 28. Head injury was the most common cause of death in these victims, and overall they tended to have a low level of education. Motorcycle accidents frequently involved younger age groups (15-35 years), and head trauma related with non-use of a helmet was the most common cause of death. Conclusions: Head injury is frequent among victims in the province we studied. This situation may be related to the victims' low socioeconomic status and little education regarding traffic laws leading to speeding and disregard of these laws along with their weak enforcement.     

Analysis of 86 fatal motorcycle frontal crashes in Chongqing, China

Objective: To analyze the injuries of motorcyclists involved in fatal motorcycle frontal crashes.Methods: A survey group involving multi-discipline experts was built to randomly collect data on fatal m...     

Epidemiology of patients admitted to a major trauma centre in northern India

Objective： Trauma in India is an increasingly significant problem, particularly in light of rapid development and increasing motorization. Social changes are resulting in alterations in the epidemiology of trauma. The aim of the study was to assess the various epidemiological parameters that influence the cause of injury in the patients admitted to a major trauma centre in northem India. Methods： An observational study of 748 patients chosen by random assortment was carried out over a peri- od of 1 year （August 2008 to July 2009）. Age, sex, injury type and pattern were noted. Injury mode of upper and lower limbs was also noted. Results： Injuries occur predominately in the age group of 15-30 years. Males incurred more injury with male to female ratio of 6：1. The most vulnerable group was motorcycle users. Among the injured, farmers were the most commonly involved. Blunt injuries （94.92%） were much more common than penetrating injuries. Among patients with head injury, two wheelers related accidents were the most common （40.3%）. Most spinal cord injuries were caused by falls from height （51.09%）. Most lower limb fractures were simple type. Compound fractures of the lower limb were more common than up- per limb fractures. Conclusion： Strict enforcement of traffic rules, combined with improved infrastructure and behavior change can decrease the burden of road traffic accidents in India and other developing countries. This study could assist in raising the profile of road traffic accidents as a public health problem which needs to be addressed as a preventable cause of mortality and morbidity, and plan- ning appropriate interventions for this major challenge. Preventive strategies should be made on the basis of these epidemiological trends.     

Road traffic crashes in rural setting: an experience of a middle-income country

Objective： To date, there has been little information published on the death of rural road accident deaths. This study uses burden of injury method to explore a more accurate estimate of years of life lost due to road traffic crashes occurring over a four-year period in Guilan province, northern Iran. Methods： Rural road accident deaths from 2009 to 2013 were extracted from Iran＇s Forensic Medicine System, Death Registry System and Road Trauma Research center database. Results： During the study period, the average years of life lost due to motor vehicle crashes was 13.8 per 1 000 persons, ranging from 11.9 during March 2011- 2012 to 15.8 per 1 000 persons during March 2012-2013. Conclusion： Road accident deaths in 2013 remained at the same high level as in 2009. The information obtained from this study provides a new perspective on fatal road traffic crash victims in rural settings and show us that more attention is needed in this area.     

Simultaneous anterior and posterior dislocation of hips:a case report and review of literature

The presence of anterior hip dislocation along with contralateral posterior hip dislocation in the absence of other major traumas is a distinctly rare injury pattern.We report such a case,along with a ...     

Epidemiology of livestock-related injuries in a major trauma center in Kashan, Iran

Objective:Livestock-related injuries are one of the important factors causing morbidity and mortality in patients admitted to hospital.Treatment of these patients is still a major problem in health car...     

Traffic crash accidents in Tehran, Iran: Its relation with circadian rhythm of sleepiness

Purpose: Road traffic accidents are one of main problems in Iran. Multiple factors cause traffic accidents and the most important one is sleepiness. This factor, however, is given less attention in our country. Road traffic accidents relevant to sleepiness are studied. Methods: In this cross-sectional study, all road traffic accidents relevant to sleepiness, which were reported by police, were studied in Tehran province in 2009. Results: The risk of road traffic accidents due to sleepiness was increased by more than sevenfold (odds ratio=7.33) in low alertness hours (0:00-6:00) compared to other time of day. The risk of road traffic accidents due to sleepiness was decreased by 0.15-fold (odds ratio=0.15) in hours with maximum of alertness (18:00-22:00) of circadian rhythm compared to other time of day. Conclusion: The occurrence of road traffic accidents due to sleepiness has significant statistical relations with driving during lowest point of alertness of circadian rhythm.     

交通伤致颈椎挥鞭样损伤的急诊诊治

目的 总结交通伤致颈椎挥鞭样损伤的临床特点,为急诊诊治提供参考.方法 对2002年1月至2008年12月急诊收治的交通伤所致的263例颈椎挥鞭样损伤患者的临床表现、影像学检查结果和急诊早期处理方法进行回顾性分析总结.结果 该损伤临床表现呈多样性,以颈肩枕部疼痛不适和压痛最常见,多数患者伤后数小时内出现症状,但约1/3患者症状迟发;影像学检查中,X线片阳性结果最低,CT和MRI阳性结果高;222例保守治疗和41例手术治疗的患者,经平均7.2个月随访总体治疗效果满意.结论 根据交通事故中驾乘人员易出现颈椎挥鞭样损伤的创伤条件,结合临床表现可以对其进行早期诊断、及时治疗,多数预后较好,综合应用影像学检查町避免漏诊,CT检查可以作为诊断的重要手段.