Effect of severe weather on road traffic injuries：a meta-analysis / 公共卫生与预防医学

Objective To explore the impact of severe weather on road traffic injuries (RTIs). Methods Relevant literature on the impact of meteorology on the occurrence and resulting casualties of road traffic injuries was searched. Meta-analysis was performed on the included literature using state16.0 software. Results A total of 28 articles were included. The results of meta-analysis showed that heat wave, cloudy day, snowy day, rainy day and other severe weather such as storm had a statistically significant impact on the occurrence of road traffic injuries. Severe weather such as storms had a statistically significant impact on RTIs casualties. Conclusion Heat wave, cloudy day, snowy day, rainy day, storm and other bad weather are independent risk factors for the occurrence of RTIs. Storm is a risk factor for accident casualties. There is not enough evidence to show that low temperature, cold wave and heavy fog are the influencing factors of road traffic accidents.

Deaths Due to Road Traffic Injuries- A Forensic Autopsy Study

Background: Injuries due to road traffic injuries (RTIs) depend upon various factors that include human, vehicle and environmental factors that plays a vital role before, during and after a fatal vehicular accident. Road traffic injuries involve high human suffering and monetary costs in terms of ultimately deaths, injuries and loss of potential income. Aims and Objective: The aims and objective of study was to study the incidence of death due to road traffic injuries, demographic profile including various contributary factors of victims and vehicles and to analyse the magnitude of deaths.Material & Methods:The present retrospective and cross sectional study was conducted in Forensic Medicine & Toxicology Department, Government Medical College, Amritsar. All the autopsies conducted on road traffic injuries victims during the period from Jan, 2016 to Dec, 2020 were studied. Results:Majority of cases taken up for study were males (80%) followed by females (20%), majority cases belonged to the age group of 21 -30 years (34.72%). The majority of cases (70.61 %)that met with road traffic injury happened at evening time period. Head injury was the cause of death in 42.45% cases followed by 33.88% cases having multiple injuries.Conclusions:Motorization though has enhanced the lives in this era but that has come up with some price. High priority is demanded towards the alarming rate of human loss due to RTIs. Awareness at every level including the strict formation of policies that would prevent such RTIs in future.

Epidemiologic profile of vehicular accident patients in the largest hospital in the Philippines covering ten years

Introduction@#Globally, the number of people who die from road crashes continues to rise, reaching a high of 1.35 million in 2016. Due to this continued increase in fatalities and injuries within the road transport system, especially in low- and middle-income countries, 2011 to 2020 was declared by the United Nations General Assembly in 2010 as the Decade of Action for Road Safety. @*Objectives@#This study looked into the epidemiology of road crashes and injuries in Metro Manila over ten years, from 2008-2017, from data gathered at the Department of Surgery of the Philippine General Hospital (PGH). @*Method@#A retrospective review of patients’ clinical records was conducted to describe the epidemiology of road crash cases in the Trauma Division, Department of Surgery of the PGH. Clinical records of the road crash patients admitted to the division over the ten years, January 1, 2008, to December 31, 2017, were extracted from the Integrated Surgical Information System (ISIS). @*Results@#A total of 422 patients were admitted to the PGH Department of Surgery and recorded in the ISIS database, from 2008 to 2017, who suffered from road crashes in Metro Manila. Most of these patients (80.8%) were male. The mean age of patients was 32.4 years. The highest number of admissions (27.5%) and road crash deaths (6.9%) were in 2016; the highest number was from the city of Manila (26.7%), and most happened at nighttime (61.8%) between 6:00 PM and 5:59 AM. Throughout the years, motorcycle (52.8%) was the vehicle type involved. Among patients with helmet use information, 65.4% were not wearing helmets, 91.2% had a history of alcohol intake. The majority incurred multiple injuries (82.7%), with the external region (53.8%) as the most common. Patients who sustained injuries to their head and neck region were five times more likely to die and six times more likely to have an unchanged patient outcome than those who did not have these injuries. Patients who had a GCS of 8 and below or those who had severe brain injuries were eight times more likely to die and six times more likely to have an unchanged patient outcome. @*Conclusion@#This study looked into the epidemiology of road crash cases admitted to the Surgery Department of the PGH. Road crash injuries and deaths remain a growing concern among the citizens of Metro Manila. It is hoped that the results of this study will provide policymakers with an objective and data-driven perspective on road crashes.

Análisis geográfico de la mortalidad de diferentes usuarios de vías de tránsito y factores de área asociados en Argentina / Geographic analysis of the mortality of different road users and associated area factors in Argentina

Resumen Introducción Las muertes por lesiones de tránsito son la principal causa de muerte por lesiones en la población de 5-64 años en Argentina. Objetivo Describir las variaciones espaciales del riesgo de mortalidad de diferentes tipos de usuarios de vías de tránsito y analizar factores de área asociados con el riesgo de mortalidad en Argentina durante los períodos 1999-2003 y 2008-2012. Método Se realizó un estudio ecológico espacial utilizando los departamentos/partidos como unidades de análisis. Se consideraron las muertes de peatones, usuarios de bicicleta, motocicleta y automóvil y usuarios no especificados de vías de tránsito. Como variables independientes se seleccionaron variables sociodemográficas y variables de patentamiento automotor. Resultados El riesgo de mortalidad de los usuarios de vías de tránsito se concentró espacialmente durante los dos períodos en Argentina. El nivel socioeconómico bajo a nivel departamental estuvo relacionado a un riesgo alto de mortalidad en peatones y usuarios de bicicleta. En áreas con mayor patentamiento de nuevos automóviles se observó un mayor riesgo de mortalidad en usuarios de bicicletas durante 1999-2003. Conclusión Las grandes disparidades en la distribución geográfica del riesgo de mortalidad de diferentes usuarios de vías de tránsito indican la adopción de políticas regionales de seguridad vial diferenciales en Argentina.

Abstract Background Traffic injury deaths are the leading cause of injury death in the 5-64-year-old population in Argentina. Objective To describe the spatial variations of the risk of mortality of different types of road users and to analyze area factors associated with the risk of mortality in Argentina during the periods 1999-2003 and 2008-2012. Method A spatial ecological study was carried out using the departments/parties as spatial units of analysis. The deaths of pedestrians, bicycle, motorcycle, and automobile users, and unspecified road users were considered. Sociodemographic characteristics of area and variables related to automotive patenting were the independent variables. Results The mortality risk of road users was spatially concentrated during the two periods in Argentina. The low socioeconomic level at the departmental level was related to a high risk of mortality in pedestrians and bicycle users. In areas with higher patenting of new cars, a higher risk of mortality was observed in bicycle users during 1999-2003. Conclusion The great disparities in the geographical distribution of the mortality risk of different road users indicated the adoption of different regional road safety policies at the national level.

Children commute to schools in Bangalore urban and rural districts: travel pattern, behaviour and perceptions

Background: Children form vulnerable road users during their regular school commute. School children safety is not taken into consideration before construction of road network. The total number of persons injured in India during 2015 near schools or colleges or educational institutions due to road traffic accidents are 13,270 in urban areas according to National Crime Records Bureau which is quite alarming. Current study is the first attempt in both rural and urban Karnataka towards understanding travel pattern, behaviour and perceptions among school children during commute to schools. The objectives of the present study were to assess travel pattern, behaviour and perception of school children in Bangalore urban and rural districts and to assess factors associated with travel pattern.Methods: A cross sectional study was conducted using a representative sample of schools selected by simple random sampling. Data was collected using a pre-tested, semi-structured questionnaire which was analysed using SPSS version 20.Results: Nearly 86% of school children travelled less than 5 kms to reach their schools. Nearly 39% of school children travelled alone to school. Most common mode of travel to school was by walk. Nearly 27.4% did not cross the main roads safely. Adherence to road safety behaviour was insufficient. Vehicular traffic was perceived as a major apprehension by children during school commute.Conclusions: Commute of children to schools in both urban and rural part of Bangalore was unsafe with least adherence to safety measures, which might increase their vulnerability to road traffic injuries.

Experts' perspectives on the application of public-private partnership policy in prevention of road traffic injuries / 中华创伤杂志(英文版)

PURPOSE@#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 unsustainability, 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.

Epidemiologic study of traffic crash mortality among motorcycle users in Iran (2011-2017) / 中华创伤杂志(英文版)

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 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.

Analysis of the status and influence factors of road traffic injuries in children of Shashi District, Jingzhou City / 公共卫生与预防医学

Objective To investigate the status and influencing factors of road traffic injuries among children aged 0-17 in Shashi District, Jingzhou City, and to provide a basis for formulating strategies and measures to prevent road traffic injuries in children. Methods A staged random sampling method was used to select preschool children from 8 communities, and students from 8 primary schools, 8 junior high schools and 4 senior high schools, respectively, in Shashi District of Jingzhou. A questionnaire survey was conducted on the children on road traffic safety, and the incidence of children's traffic injuries and their cognition and behavior were analyzed.  Results A total of 8 299 children completed the survey. The incidence rate of non-fatal road traffic injuries was 1.07%. Children aged 11-15 years had the highest incidence of road traffic injuries among all age groups, accounting for 66.29% of the total injuries, followed by the 16-20 years old group. The main risk factors of road traffic injuries in children were not taking the special lane when riding a bicycle, running red lights, using mobile phones when walking, and not wearing a helmet when riding a motorcycle. Walking was the main way for students to have road traffic injuries.  Conclusion Children's road traffic injuries became a social problem that should not be ignored. Students above fourth grade were the key population for children's road traffic injury intervention in Shashi District. Road traffic safety publicity and intervention should be carried out for children of different ages and genders.

Austerity policies in Brazil may affect violence related outcomes / Políticas de austeridade no Brasil podem afetar os desfechos relacionados à violência

Abstract Economic crisis is often managed with austerity policies. These measures seem to burden the population disproportionately, with the poorer being more affected. This paper aims to investigate health outcomes performance after the recent Brazilian crisis and gauge whether that pattern also emerged. Public domain data from 2010 to 2017 was used, and it was found that suicide and homicide rates increased after 2014, while mortality by road traffic injuries decreased at the same time. Furthermore, these trends were exacerbated in the North and Northeast regions and in the municipalities with the poorest quintiles of Human Development Index (HDI). The austerity policies followed by the Brazilian economic crisis may have influenced the mortality trends due to external causes, with a possible stronger impact in the North and Northeast regions and among less developed municipalities.

Resumo Crises econômicas são comumente administradas com políticas de austeridade. Estas medidas atingem a população de modo desproporcional, sendo os mais pobres os mais afetados. Este artigo pretende investigar a performance dos desfechos de saúde após a crise econômica recente e avaliar se o padrão de desproporcionalidade também ocorreu no Brasil. Dados públicos de 2010 a 2017 foram utilizados e encontramos que suicídios e taxas de homicídios aumentaram depois de 2014, enquanto mortalidade por acidentes de trânsito diminuíram. Além disto, estas tendências foram exacerbadas no Norte e no Nordeste e em municípios no quintil mais pobre em termos de Índice de Desenvolvimento Humano (IDH). As políticas de austeridade que se seguiram à crise econômica brasileira podem ter influenciado a tendência de mortalidade por causas externas, com um possível maior impacto no Norte e no Nordeste e em municípios menos desenvolvidos.

To Assess the Frequency of Common Fractures Secondary to Motorcycle Accident in Patients Admitted to the Orthopedic Department of a Tertiary Care Hospital, Pakistan

Objective: To assess the frequency of common fractures secondary to a bike accident in patients admitted to the orthopedic department of a tertiary care hospital, urban center. Methods: This cross-sectional study embrace 240 patients with the bike out of action for 6-months from September 2017 to March 2018 in Department of Orthopedic Unit I and II, Dow University of Health Sciences/Civil Hospital urban center. Temporary history concerning the time of accident and age of the patients was taken. Examination and relevant X-Rays were done. All the knowledge was noted in proforma. Results: The common age of the patients was 32 years (0.92 ± 7.30). There have been 200 (83.33%) male and 40 (16.67%) female. Out of 240 patients, femoris fracture was found in 68 (28.33%), leg bone fractures 134 (55.83%), there have been 19 (7.92%) arm bone fractures, and radius-ulna fractures were determined in 19 (7.92%). Conclusion: Majority of the accidents are preventable by an academic campaign of the general public, social control of traffic rules, provision of facilities for passengers and upgraded observance system for transportation and drivers. Preventive programs and actions should be launched by policy manufacturers of involved departments and stakeholders at the national level.

Safety awareness and use of child safety seats among parents after the legislation in Shanghai / 中华创伤杂志(英文版)

PURPOSE@#To investigate the changes and underlying mechanisms in parents' safety awareness and the use of child safety seats after the mandatory legislation in Shanghai city, China.@*METHODS@#This study was carried out by Shanghai Key Laboratory of Environment and Children's Health using a multi-stage, simple random sampling method. Volunteers with children aged 0-12 months were recruited. Child safety seats were sent to each volunteer's family. Telephone encounters and/or on-site visits were used to collect data from parents using a phased survey on children's safety during car use.@*RESULTS@#Among all respondents, 91.2% had heard of motor vehicle accidents involving children, and 97.2% could describe the appropriate use of a safety seat to minimize the risk of child injury in a collision. Among 1078 families with newborns, awareness of child safety seats was 91.9%. There were 86% patients aware that new laws and regulations have been released regarding the use of child safety seats, and 98.5% of them plan to comply with the new laws. Moreover, 61% patients think that taxis should be routinely equipped with child safety seats.@*CONCLUSION@#The parents in Shanghai obtained a high level of awareness of children's traffic safety after the introduction of child safety seats legislation, and had a positive experience related to the use of child safety seats. Taxi may be an important area of focus for implementation of child traffic safety. Traffic safety laws and regulations with further impact should be continuously studied.

Retrospective analysis of 1 115 cases of maxillofacial fracture in the Kashgar Prefecture / 口腔疾病防治

Objective@#To explore the clinical epidemiological characteristics and treatment methods of maxillofacial fracture patients in the Kashgar Prefecture to provide a reference for clinical diagnosis and treatment.Methods The medical records of 1 115 patients with maxillofacial fracture admitted to the First People's Hospital of Kashgar from November 2011 to November 2016 were retrospectively analyzed by age composition, sex ratio, cause of trauma, time of injury, site of injury and systemic complications.@*Methods@#The medical records of 1 115 patients with maxillofacial fracture admitted to the First People's Hospital of Kashgar from November 2011 to November 2016 were retrospectively analyzed by age composition, sex ratio, cause of trauma, time of injury, site of injury and systemic complications.@*Results @#Among the 1 115 patients, the ratio of males to females was 4.7∶1, and those aged 21 to 30 years accounted for the majority of patients, with most injuries occurring in the summer (31.38%) and spring (29.69%). The most common cause of trauma was falling (38.57%), followed by traffic accidents (36.95%). Midfacial fractures were the most frequently observed (65.38%), followed by mandibular fractures(30.26%). In all, 42.15% of cases were complicated with systemic injuries, the majority being ocular injuries (35.55%), followed by limb injuries (21.67%). The majority of patients (50.04%) chose treatment by open reduction and internal fixation. Logistic regression analysis showed that males were more prone to midfacial fractures than females. The occurrence of midfacial fracture became more likely with increasing age.@*Conclusion @# In the Kashgar Prefecture, the majority of patients with maxillofacial fracture are male and young or middle-aged. Most maxillofacial fractures occur in the spring or summer and are mainly caused by falling or traffic accidents. Fractures in the middle part of the face are more common. Ocular injury is the most common complication, and in most cases, the fracture is treated by open reduction and internal fixation. The occurrence of midfacial fracture is closely related to age, sex and cause of trauma.

Road Traffic Accidents In India: An Overview

Road traffic accidents claim over a million lives every year in the world. As per World Health Organization (WHO) it is one of the leading cause of death. India, being a rapidly developing country with expanding economy has its own issues as regarding road traffic accidents due to rapid proliferation of motorization. Road traffic accidents causes enormous morbidity and mortality and at the same time, the toll on the economy of the country as a result of it is quite heavy. Road traffic accident is a result of an interaction among different factors which include the environ-ment, vehicle and the human being. Traditionally it is considered that road traffic accidents are accidents which are unpredictable, inevitable and not preventable. But road traffic accidents are indeed predictable and preventable in majority of the cases. This require the knowledge of factors contributing and leading to road traffic accidents. There are certain preventive measures which if adopted can lead to decrease in morbidity and mortality resulting from RTA. Hence, it is the responsibility of all to contribute in reducing road traffic accidents.

Urban health: Needs urgent attention

Urban population in our country has increased at an annual rate of 2.7% during the last decade and it is estimated that by 2031, there would be about 600 million people living in urban India. The fast pace of urbanization has come to stay with increasing proportion of urban poor and vulnerable with health indicators much worse than their rural counterparts. The need to provide health care to urban poor has been emphasized in the past in various health committees' reports and National 5-year Development Plans, but no significant dent was made to improve the urban health scenario of the country. The National Urban Health Mission launched in May 2013 provides us a concrete mechanism to address special health needs of urban population with focus on urban poor. There is a strong need to set up primary healthcare system in urban areas and systematically deal with urban health challenges in terms of vector-borne diseases, rising incidence of noncommunicable diseases, air pollution and acute respiratory infections, road traffic accidents, trauma, and injuries. The initiatives to address these challenges do not remain confined to health sector alone but also need to be supported by sectors other than health such as social welfare, women and child development, road transport and highways, school education, drinking water, and sanitation. We really need to address wider and social determinants of health to effectively improve the urban health scenario.

Estimating the social and economic burden of road traffic injuries in the Philippines

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Road traffic injuries (RTI) are a leading cause of morbidity and mortality globally. Despite underreporting, the scarce Philippine data suggest that RTI pose a significant health problem in the country. It is imperative, therefore, to accurately quantify the burden of RTI in the Philippines.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> This study aimed to provide the first comprehensive baseline estimation of the socioeconomic burden of RTI in the Philippines for year 2014.</p><p style="text-align: justify;"><strong>METHODS:</strong> The study was a mixed method study design that utilized both primary and secondary data. These data were used to construct parameters needed for the modeling estimates. Measure of socioeconomic burden estimated were (1) economic costs, (2) disability-adjusted life years (DALYs), and (3) healthy life years (HeaLY).</p><p style="text-align: justify;"><strong>RESULT:</strong> Estimated deaths due to RTI in 2014 were 12,336 translating to 454,650 years life lost due to premature death. Injury episodes from RTI were estimated to be 2,798,088 in 2014 with 186,174 leading to admissions, translating to 56,224 years life lost to disability. The total DALY loss due to RTI in 2014 was estimated at 510, 874, while healthy life years lost were estimated to be 76,215,477.4. The estimated deaths and injuries for that year equaled to direct medical cost of PhP 1.213 B, productivity loss due to premature death of PhP 24.620 B, and productivity loss due to illness of PhP 685 M resulting to a total economic cost of PhP 26.519 B to the society.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> The findings indicate that RTI is an important public health concern in the Philippines with substantial economic and health burden. Investing in preventive measures will likely yield significant economic and health gains for the Philippines.</p>

Improving hospital-based trauma care for road traffic injuries in Malawi / 世界急诊医学杂志（英文）

@#BACKGROUND:The mortality rate from road traffic injuries has increased in sub-Saharan Africa as the number of motor vehicles increase. This study examined the capacity of hospitals along Malawi's main north-south highway to provide emergency trauma care. METHODS:Structured interviews and checklists were used to evaluate the infrastructure, personnel, supplies, and equipment at all four of Malawi's central hospitals, ten district hospitals, and one mission hospital in 2014. Most of these facilities are along the main north-south highway that spans the country. RESULTS:Between July 2013 and March 2014, more than 9200 road traffic injuries (RTIs) and 100 RTI deaths were recorded by the participating hospitals. All of the hospitals reported staff shortages, especially during nights and weekends. Few clinicians had completed formal training in emergency trauma management, and healthcare workers reported gaps in knowledge and skills, especially at district hospitals. Most central hospitals had access to the critical supplies and medications necessary for trauma care, but district hospitals lacked some of the supplies and equipment needed for diagnosis, treatment, and personal protection. CONCLUSION:The mortality and disability burden from road traffic injuries in Malawi (and other low-income countries in sub-Saharan Africa) can be reduced by ensuring that every central and district hospital has a dedicated trauma unit with qualified staff who have completed primary trauma care courses and have access to the equipment necessary to save lives.

Subestimación de la mortalidad causada por el tránsito en México: análisis subnacional / Underestimation of mortality caused by traffic in Mexico: an analysis at the subnational level

Resumen: Objetivo: Estimar la potencial subestimación de la mortalidad por lesiones de tránsito en las entidades federativas de México para un periodo de 15 años. Se buscó identificar variables sociales y económicas de cada entidad federativa que pudieran estar potencialmente asociadas con la calidad de la clasificación estadística de las defunciones. Material y métodos: Análisis secundario de bases de mortalidad, periodo 1999-2013. Mediante modelos de imputación múltiple, se identificaron los registros que pudieran ser muertes atribuidas al tránsito y se realizó un análisis de correlación simple. Resultados: La subestimación de defunciones por lesiones de tránsito durante el periodo fue de 18.85%, con importantes variaciones por entidad federativa. No hubo evidencia de que existiera asociación de alguna variable con el porcentaje de subestimación de la mortalidad. Conclusiones: La clasificación de la mortalidad es diferente en las entidades federativas. Esta información es de gran utilidad para focalizar intervenciones que permitan mejorar el registro de las defunciones en el país.

Abstract: Objective: To estimate the potential underestimation of mortality from traffic injuries at the subnational level in Mexico for a period of 15 years and to identify social and economic variables at the state level that could potentially be associated with the quality of statistical classification of deaths. Materials and methods: Secondary analysis of validated mortality databases for the period 1999-2013 was conducted. Using multiple imputation models, registries that could potentially be attributed to road traffic deaths were estimated and the potential underestimation of mortality due to this external cause was quantified. A simple correlation analysis was carried out. Results: The potential underestimation of deaths from traffic injuries during the period was 18.85% at the national level, with significant variations by state. From the data analyzed, there was no statistical evidence of any association of the percentage of road traffic deaths underestimation with the variables analyzed. Conclusions: Performance in terms of mortality classification is different at the state level in Mexico. This information is useful for targeting interventions to improve the recording of deaths in the country.

Epidemiological characteristics of hospital reported road traffic injuries case in Tianjin, 2013 / 中华流行病学杂志

Objective To understand the distribution of reported road traffic injuries case in Tianjin from January to December 2013.Methods The injury data was collected from the disease surveillance system which covered all the areas in Tianjin.All the reported injury cases were at their first medical care seeking in sentinel hospitals from 1 January 2013 to 31 December 2013.Results A total of 26 405 injury cases were reported,including 103 deaths (0.4％),during this period with the incidence of 263.01/100 000.The male to female ratio of the cases was 1.68 ∶ 1 and average age of the cases was (40.24 ± 17.58) years.The injuries caused by motor vehicle traffic accident accounted for 74.0％ (19 547 cases) and the non-motor vehicle traffic accident caused cases accounted for 26.0％ (6 858).The first four areas with higher incidence were Binhai (684.86/100 000),Dongli (634.03/100 000),Xiqing (519.83/100 000) and Jinnan (504.12/100 000) districts.The three districts with lower incidence were Heping (44.69/100 000),Nankai (52.36/100 000) and Hedong (64.34/100 000) districts.The mild,moderate and serious cases accounted for 59.7％ (15 771 cases),33.1％ (8 747 cases) and 6.8％ (1 783 cases) respectively.The differences in incidence among different districts and age groups were statistical significant (P＜0.005).The death number in Tanggu district was highest,accounting for (26.21％) of the total,and age specific death number was highest in age group 45-64 years,accounting for 46.60％ of the total.Conclusion The case number and severity of road traffic accident caused injury varied with area and age group in Tianjin.It is necessary to develop targeted prevention and control measures to reduce the incidence of road traffic accident related injuries.

The Role of Graduated Drivers' Licensing on Incidence and Severity of Road Traffic Injuries In Iran.

Aims: This study investigated the role of graduated drivers licensing, implemented by the Traffic Police of Iran, on reducing the severity and incidence of road traffic injuries. Study Design: It was an evaluation of the effectiveness of intervention by looking at the data before and after intervention. Place and Duration of Study: Data on road traffic crashes and injuries from one year before, one year after and two years after the implementation of educated drivers licensing were obtained from Iran Traffic Police database in 2010. Methodology: In this study the effectiveness of provisional license intervention by looking at the data before and after intervention was evaluated. After data cleaning and stratification of traffic injuries and mortalities, the post-education records of drivers, in their early years of driving experience, were compared against their pre-education driving experience. Results: Drivers under 23 years of age were involved in 22.8% of total road traffic injuries (RTIs) in the year prior to the implementation of graduated drivers licensing. This measure fell to 15.5% and 16.1% in the first and second years following the intervention among the holders of provisional B1 type driving license (p<0.001). Conclusion: Intervention is an effective way of reducing the number and severity of traffic injuries, particularly among the young and novice drivers are at a greater risk of RTIs. Such drivers can particularly benefit from graduated drivers licensing program which is proven to reduce the incidence and severity of road traffic injuries .

Health behaviours & problems among young people in India: Cause for concern & call for action.

the young people in the age group of 10-24 yr in India constitutes one of the precious resources of India characterized by growth and development and is a phase of vulnerability often influenced by several intrinsic and extrinsic factors that affect their health and safety. Nearly 10-30 per cent of young people suffer from health impacting behaviours and conditions that need urgent attention of policy makers and public health professionals. Nutritional disorders (both malnutrition and over-nutrition), tobacco use, harmful alcohol use, other substance use, high risk sexual behaviours, stress, common mental disorders, and injuries (road traffic injuries, suicides, violence of different types) specifically affect this population and have long lasting impact. Multiple behaviours and conditions often coexist in the same individual adding a cumulative risk for their poor health. Many of these being precursors and determinants of non communicable diseases (NCDs) including mental and neurological disorders and injuries place a heavy burden on Indian society in terms of mortality, morbidity, disability and socio-economic losses. Many health policies and programmes have focused on prioritized individual health problems and integrated (both vertical and horizontal) coordinated approaches are found lacking. Healthy life-style and health promotion policies and programmes that are central for health of youth, driven by robust population-based studies are required in India which will also address the growing tide of NCDs and injuries.