Alcohol and cannabis use in traffic-related injuries in Mexico City.

BACTERKGROUND: There is debate on whether cannabis affects road traffic injuries (RTIs) separately from the effects of alcohol. Our goals are to report the possible increase in risk of an RTI among alcohol and cannabis users by type of exposure (biological, self-reported and combined) and the possible interaction of alcohol and cannabis in patients with an RTI in an emergency department in Mexico City. METHODS: A case-crossover study with 433 cases of RTI (as a pedestrian, driver or passenger) during the period January-April 2022. A breath sample, an oral sample for cannabis detection and self-reported alcohol and cannabis use 6 hours prior to the RTI and in two control periods were used. We report ORs and 95% CIs from conditional logistic regressions for the case-crossover estimates. RESULTS: Alcohol alone increased the risk of an RTI (OR=6.02, 95% CI 3.29 to 10.99) for most RTIs, regardless of whether we used information from self-reports or a breath sample in the hazard period. Conversely, cannabis only increased the RTI when we added information in the hazard period from self-reports or oral samples. Nevertheless, this increase in risk disappeared (OR=2.06, 95% CI 0.90 to 4.70) among those who only used cannabis. We also found no evidence of interaction between alcohol and cannabis in the risk of an RTI. CONCLUSIONS: Alcohol is the most commonly used substance in Mexico and a high-risk factor for RTI in Mexico City. Although cannabis alone was not associated with an RTI, continuous monitoring of its effects is required.

Leveraging probe data to model speeding on urban limited access highway segments: Examining the impact of operational performance, roadway characteristics, and COVID-19 pandemic.

Stay-at-home orders - imposed to prevent the spread of COVID-19 - drastically changed the way highways operate. Despite lower traffic volumes during these times, the rate of fatal and serious injury crashes increased significantly across the United States due to increased speeding on roads with less traffic congestion and lower levels of speed enforcement. This paper uses a mixed effect binomial regression model to investigate the impact of stay-at-home orders on odds of speeding on urban limited access highway segments in Maine and Connecticut. This paper also establishes a link between traffic density and the odds of speeding. For this purpose, hourly speed and volume probe data were collected on limited access highway segments for the U.S. states of Maine and Connecticut to estimate the traffic density. The traffic density was then combined with the roadway geometric characteristics, speed limit, as well as dummy variables denoting the time of the week, time of the day, COVID-19 phases (before, during and after stay-at-home order), and the interactions between them. Density, represented in the model as Level of Service, was found to be associated with the odds of speeding, with better levels of service such as A, or B (low density) resulting in the higher odds that drivers would speed. We also found that narrower shoulder width could result in lower odds of speeding. Furthermore, we found that during the stay-at-home order, the odds of speeding by more than 10, 15, and 20 mph increased respectively by 54%, 71% and 85% in Connecticut, and by 15%, 36%, and 65% in Maine during evening peak hours. Additionally, one year after the onset of the pandemic, during evening peak hours, the odds of speeding greater than 10, 15, and 20 mph were still 35%, 29%, and 19% greater in Connecticut and 35% 35% and 20% greater in Maine compared to before pandemic.

Pediatric all-terrain vehicle (ATV) related head injury rates and patterns: A 10-year nationwide analysis.

INTRODUCTION: The use of all-terrain vehicles (ATVs) carries significant risk of permanent injury and death, disproportionately affecting children. These injuries commonly affect the head and are especially severe among children as they are often unhelmeted and more likely than adults to experience rollover injuries. Many studies examining patients with ATV-related injuries are single-center cohort studies, with few focusing specifically on head injuries. In the present study, we aimed to characterize the annual incidence of ATV-related head injuries between 2012 and 2021, classify and compare head injury types, and identify descriptive characteristics of ATV-related head injury victims. METHODS: Using the US Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) database, we queried all head injuries associated with operating or riding an ATV in children under 18 years-old from over 100 emergency departments (EDs). Patient information regarding age, race, sex, location of incident, diagnoses, and sequelae were analyzed. We also collected the estimated number of ATV-related head injuries from all US EDs using the NEISS algorithm provided by the database. RESULTS: Using the NEISS algorithm we identified 67,957 (95% CI: 43,608 - 92,305) total pediatric ATV-related head injuries between 2012 and 2021. The annual incidence of ATV-related head injury was similar throughout this study period except for a 20% increase during the COVID-19 pandemic period of 2019-2021 (2019: 6382 injuries, 2020: 6757 injuries, 2021: 7600 injuries). A subset of 1890 cases from approximately 100 EDs were then analyzed. Unspecified closed head injuries were the prevailing type of injury (38%, 900/1890), followed by concussions (27%, 510/1890). More severe injuries included intracranial hemorrhages in 91 children (3.8%, 91/1890). Injuries of all types were predominantly seen in 14-17 year-old's (780/1890, 41%) and in males (64.1%, 1211/1890). In addition, ATV-associated injuries were significantly more common in those coded as white (58.0%, 1096/1890) than any other racial group. ATV-associated accidents among children younger than 9 more commonly occurred at the home compared to accidents involving children older than 9 (57% vs. 32%, p < 0.0001). CONCLUSION: ATV-related head injuries cause a significant annual burden among children, with growing incidence in recent years. Further research may wish to explore potential benefits of helmet use and supervision of younger children in possible prevention of these accidents and their associated economic and non-economic costs.

Impact of COVID-19 on traffic safety from the "Lockdown" to the "New Normal": A case study of Utah.

During the past several years, the COVID-19 pandemic has had pronounced impacts on traffic safety. Existing studies found that the crash frequency was reduced and the severity level was increased during the earlier "Lockdown" period. However, there is a lack of studies investigating its impacts on traffic safety during the later stage of the pandemic. To bridge such a gap, this study selects Salt Lake County, Utah as the study area and employs statistical methods to investigate whether the impact of COVID-19 on traffic safety differs among different stages. Negative binomial models and binary logit models were utilized to study the effects of the pandemic on the crash frequency and severity respectively while accounting for the exposure, environmental, and human factors. Welch's t-test and Pairwise t-test are employed to investigate the possible indirect effect of the pandemic by influencing other non-pandemic-related factors in the statistical models. The results show that the crash frequency is significantly less than that of the pre-pandemic during the whole course of the pandemic. However, it significantly increases during the later stage due to the relaxed restrictions. Crash severity levels were increased during the earlier pandemic due to the increased traffic speed, the prevalence of DUI, reduced use of seat belts, and increased presence of commercial vehicles. It reduced to a level comparable to the pre-pandemic later, owing to the reduction of speed and increased seat-belt-used to the pre-pandemic level. As for the incoming "New Normal" stage, stakeholders may need to take actions to deter DUI and reduce commercial-vehicle-related crashes to improve traffic safety.

Changes in the number of traffic collisions during the various waves of COVID-19 infection in Japan.

An analysis of the national traffic collision trends in Japan for the January 2018 to June 2022 period using existing statistical data indicates that the number of traffic incidents, injuries, and fatalities decreased over time. After the outbreak of COVID-19 in December 2019, traffic volume decreased. In this study, to explore how the COVID-19 pandemic correlates with traffic collisions, we used the Spearman rank correlation of non-parametric statistical test to compare the number of COVID-19 infections with the number of traffic collisions. The number of COVID-19 infections showed a significant inverse correlation with the number of traffic collisions nationwide, in some regions, and in some prefectures. When the number of COVID-19 infections increased, a State of Emergency or Semi-Emergency Spread Prevention Measures were repeatedly declared. We submit that these measures along with the restrictions on the population's autonomy and movement to prevent the spread of infection, reduces the number of traffic incidents, injuries, and fatalities owing to a decrease in traffic volume. Therefore, these lessons learned from the COVID-19 pandemic advocate that regulation of vehicle traffic volume is an effective means of reducing the occurrence of traffic collisions. These results can be applied to future policy development to support road safety improvements during unique events.

Modeling the impact of the COVID-19 pandemic on speeding at rural roadway facilities in Maine using short-term speed and traffic count data.

The COVID-19 pandemic caused a significant change in traffic operations and safety. For instance, various U.S. states reported an increase in the rate of fatal and severe injury crashes over this duration. In April and May of 2020, comprehensive stay-at-home orders were issued across the country, including in Maine. These orders resulted in drastic reductions in traffic volume. Additionally, there is anecdotal evidence that speed enforcement had been reduced during pandemic. Drivers responded to these changes by increasing their speed. More importantly, data show that speeding continues to occur, even one year after the onset of the pandemic. This study develops statistical models to quantify the impact of the pandemic on speeding in Maine. We developed models for three rural facility types (i.e., major collectors, minor arterials, and principal arterials) using a mixed effect Binomial regression model and short duration speed and traffic count data collected at continuous count stations in Maine. Our results show that the odds of speeding by more than 15 mph increased by 34% for rural major collectors, 32% for rural minor arterials, and 51% for rural principal arterials (non-Interstates) during the stay-at-home order in April and May of 2020 compared to the same months in 2019. In addition, the odds of speeding by more than 15 mph, in April and May of 2021, one year after the order, were still 27% higher on rural major collectors and 17% higher on rural principal arterials compared to the same months in 2019.

State and city laws governing the use of child restraint systems in rideshare vehicles and taxicabs: requirements and responsibility.

OBJECTIVES: To identify, describe and critique state and local policies related to child passenger safety in for-hire motor vehicles including ridesharing and taxis. METHODS: We used standard legal research methods to collect policies governing the use of child restraint systems (CRS) in rideshare and taxi vehicles for all 50 states and the 50 largest cities in the USA. We abstracted the collected policies to determine whether the policy applies to specific vehicles, requires specific safety restraints in those vehicles, lists specific requirements for use of those safety restraints, seeks to enhance compliance and punishes noncompliance. RESULTS: All 50 states have policies that require the use of CRS for children under a certain age, weight or height. Seven states exempt rideshare vehicles and 28 states exempt taxis from their CRS requirements. Twelve cities have relevant policies with eight requiring CRS in rideshare vehicles, but not taxis, and two cities requiring CRS use in both rideshare vehicles and taxis. CONCLUSION: Most states require CRS use in rideshare vehicles, but not as many require CRS use in taxis. Though states describe penalties for drivers who fail to comply with CRS requirements, these penalties do not actually facilitate the use of CRS in rideshare or taxis. Furthermore, there is ambiguity in the laws about who is responsible for the provision and installation of the restraints. To prevent serious or fatal injuries in children, policy-makers should adopt policies that require, incentivise and facilitate the use of CRS in rideshare vehicles and taxis.

Saving lives through road safety risk factor interventions: global and national estimates.

Global road mortality is a leading cause of death in many low-income and middle-income countries. Data to support priority setting under current resource constraints are urgently needed to achieve Sustainable Development Goal (SDG) 3.6. This Series paper estimates the potential number of lives saved if each country implemented interventions to address risk factors for road injuries. We did a systematic review of all available evidence-based, preventive interventions for mortality reduction that targeted the four main risk factors for road injuries (ie, speeding, drink driving, helmet use, and use of seatbelt or child restraint). We used literature review variables and considered three key country-level variables (gross domestic product per capita, population density, and government effectiveness) to generate country-specific estimates on the potential annual attributable number of lives that would be saved by interventions focusing on these four risk factors in 185 countries. Our results suggest that the implementation of evidence-based road safety interventions that target the four main road safety risk factors could prevent between 25% and 40% of all fatal road injuries worldwide. Interventions addressing speed could save about 347 258 lives globally per year, and at least 16 304 lives would be saved through drink driving interventions. The implementation of seatbelt interventions could save about 121 083 lives, and 51 698 lives could be saved by helmet interventions. We identify country-specific estimates of the potential number of lives saved that would be attributable to these interventions. Our results show the potential effectiveness of the implementation and scaling of these interventions. This paper presents key evidence for priority setting on road safety interventions and shows a path for reaching SDG 3.6.

Pandemic effects to autonomous vehicles test operations in California.

Companies developing automated driving system (ADS) technologies have spent heavily in recent years to conduct live testing of autonomous vehicles operating in real world environments to ensure their reliable and safe operations. However, the unexpected onset and ongoing resurgent effects of the Covid-19 pandemic starting in March 2020 has serve to halt, change, or delay the achievement of these new product development test objectives. This study draws on data obtained from the California automated vehicle test program to determine the extent that testing trends, test resumptions, and test environments have been affected by the pandemic. The importance of government policies to support and enable autonomous vehicles development during pandemic conditions is highlighted.

Safety analytics at a granular level using a Gaussian process modulated renewal model: A case study of the COVID-19 pandemic.

With the advance of intelligent transportation system technologies, contributing factors to crashes can be obtained in real time. Analyzing these factors can be critical in improving traffic safety. Despite many crash models having been successfully developed for safety analytics, most models associate crash observations and contributing factors at the aggregate level, resulting in potential information loss. This study proposes an efficient Gaussian process modulated renewal process model for safety analytics that does not suffer from information loss due to data aggregations. The proposed model can infer crash intensities in the continuous-time dimension so that they can be better associated with contributing factors that change over time. Moreover, the model can infer non-homogeneous intensities by relaxing the independent and identically distributed (i.i.d.) exponential assumption of the crash intervals. To demonstrate the validity and advantages of this proposed model, an empirical study examining the impacts of the COVID-19 pandemic on traffic safety at six interstate highway sections is performed. The accuracy of our proposed renewal model is verified by comparing the areas under the curve (AUC) of the inferred crash intensity function with the actual crash counts. Residual box plot shows that our proposed models have lower biases and variances compared with Poisson and Negative binomial models. Counterfactual crash intensities are then predicted conditioned on exogenous variables at the crash time. Time-varying safety impacts such as bimodal, unimodal, and parabolic patterns are observed at the selected highways. The case study shows the proposed model enables safety analytics at a granular level and provides a more detailed insight into the time-varying safety risk in a changing environment.

Identifying research priorities for road safety in Nepal: a Delphi study.

OBJECTIVE: To identify and prioritise the research needed to help Nepali agencies develop an improved road safety system. DESIGN: Delphi study. SETTING: Nepal. PARTICIPANTS: Stakeholders from government institutions, academia, engineering, healthcare and civil society were interviewed to identify knowledge gaps and research questions. Participants then completed two rounds of ranking and a workshop. RESULTS: A total of 93 participants took part in interviews and two rounds of ranking. Participants were grouped with others sharing expertise relating to each of the five WHO 'pillars' of road safety: (1) road safety management; (2) safer roads; (3) safer vehicles; (4) safer road users and (5) effective postcrash response. Interviews yielded 1019 research suggestions across the five pillars. Two rounds of ranking within expert groups yielded consensus on the important questions for each pillar. A workshop involving all participants then led to the selection of 6 questions considered the most urgent: (1) How can implementing agencies be made more accountable? (2) How should different types of roads, and roads in different geographical locations, be designed to make them safer for all road users? (3) What vehicle fitness factors lead to road traffic crashes? (4) How can the driver licensing system be improved to ensure safer drivers? (5) What factors lead to public vehicle crashes and how can they be addressed? and (6) What factors affect emergency response services getting to the patient and then getting them to the right hospital in the best possible time? CONCLUSIONS: The application of the Delphi approach is useful to enable participants representing a range of institutions and expertise to contribute to the identification of road safety research priorities. Outcomes from this study provide Nepali researchers with a greater understanding of the necessary focus for future road safety research.

Impact of night travel ban on road traffic crashes and fatalities in Zambia: an interrupted time series analysis.

BACKGROUND: The burden of road traffic crashes (RTCs) and road traffic fatalities (RTFs) has been increasing in low-income and middle-income countries (LMICs). Most RTCs and RTFs happen at night. Although few countries, including Zambia, have implemented night travel bans, there is no evidence on the extent to which such policies may reduce crashes and fatalities. METHODS: We exploit the quasi-experimental set up afforded by the banning of night travel of public service vehicles in Zambia in 2016 and interrupted time series analysis to assess whether the ban had an impact on both levels and trends in RTCs and RTFs. We use annual administrative data for the period 2006-2020, with 10 pre-intervention and 4 post-intervention data points. In an alternative specification, we restrict the analysis to the period 2012-2020 so that the number of data points are the same pre-interventions and post-interventions. We also carry out robustness checks to rule out other possible explanation of the results including COVID-19. RESULTS: The night travel ban was associated with a reduction in the level of RTCs by 4131.3 (annual average RTCs before the policy=17 668) and a reduction in the annual trend in RTCs by 2485.5. These effects were significant at below 1%, and they amount to an overall reduction in RTCs by 24%. The policy was also associated with a 57.5% reduction in RTFs. In absolute terms, the trend in RTFs reduced by 477.5 (Annual average RTFs before the policy=1124.7), which is significant at below 1% level. Our results were broadly unchanged in alternative specifications. CONCLUSION: We conclude that a night travel ban may be an effective way of reducing the burden of RTCs and RTFs in Zambia and other LMICs. However, complementary policies are needed to achieve more gains.

Global impact of COVID-19 pandemic on road traffic collisions.

BACKGROUND: Various strategies to reduce the spread of COVID-19 including lockdown and stay-at-home order are expected to reduce road traffic characteristics and consequently road traffic collisions (RTCs). We aimed to review the effects of the COVID-19 pandemic on the incidence, patterns, and severity of the injury, management, and outcomes of RTCs and give recommendations on improving road safety during this pandemic. METHODS: We conducted a narrative review on the effects of COVID-19 pandemic on RTCs published in English language using PubMed, Scopus, and Google Scholar with no date restriction. Google search engine and websites were also used to retrieve relevant published literature, including discussion papers, reports, and media news. Papers were critically read and data were summarized and combined. RESULTS: Traffic volume dropped sharply during the COVID-19 pandemic which was associated with significant drop in RTCs globally and a reduction of road deaths in 32 out of 36 countries in April 2020 compared with April 2019, with a decrease of 50% or more in 12 countries, 25 to 49% in 14 countries, and by less than 25% in six countries. Similarly, there was a decrease in annual road death in 33 out of 42 countries in 2020 compared with 2019, with a reduction of 25% or more in 5 countries, 15-24% in 13 countries, and by less than 15% in 15 countries. In contrast, the opposite occurred in four and nine countries during the periods, respectively. There was also a drop in the number of admitted patients in trauma centers related to RTCs during both periods. This has been attributed to an increase in speeding, emptier traffic lanes, reduced law enforcement, not wearing seat belts, and alcohol and drug abuse. CONCLUSIONS: The COVID-19 pandemic has generally reduced the overall absolute numbers of RTCs, and their deaths and injuries despite the relative increase of severity of injury and death. The most important factors that affected the RTCs are decreased mobility with empty lines, reduced crowding, and increased speeding. Our findings serve as a baseline for injury prevention in the current and future pandemics.

Associations between vision impairment and driving and the effectiveness of vision-related interventions: protocol for a systematic review and meta-analysis.

INTRODUCTION: Driving is one of the main modes of transport with safe driving requiring a combination of visual, cognitive and physical skills. With population ageing, the number of people living with vision impairment is set to increase in the decades ahead. Vision impairment may negatively impact an individual's ability to safely drive. The association between vision impairment and motor vehicle crash involvement or driving participation has yet to be systematically investigated. Further, the evidence for the effectiveness of vision-related interventions aimed at decreasing crashes and driving errors has not been synthesised. METHODS AND ANALYSIS: A search will be conducted for relevant studies on Medline (Ovid), EMBASE and Global Health from their inception to March 2020 without date or geographical restrictions. Two investigators will independently screen abstracts and full texts using Covidence software with conflicts resolved by a third investigator. Data extraction will be conducted on all included studies, and their quality assessed to determine the risk of bias using the Joanna Briggs Institute Critical Appraisal Tools. Outcome measures include crash risk, driving cessation and surrogate measures of driving safety (eg, driving errors and performance). The results of this review will be reported using the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. Meta-analysis will be undertaken for outcomes with sufficient data and reported following the Meta-analyses of Observational Studies in Epidemiology guideline. Where statistical pooling is not feasible or appropriate, narrative summaries will be presented following the Synthesis Without Meta-analysis in systematic reviews guideline. ETHICS AND DISSEMINATION: This review will only report on published data thus no ethics approval is required. Results will be included in the Lancet Global Health Commission on Global Eye Health, published in a peer-reviewed journal and presented at relevant conferences. PROSPERO REGISTRATION NUMBER: CRD42020172153.

Balancing safety on the road with risk from COVID-19: A content analysis of policy adaptations by Divisions of Motor Vehicles.

PURPOSE: The COVID-19 pandemic significantly altered people's daily lives, including driving. However, how state Divisions of Motor Vehicles (DMV) adapted their operation policies in response to COVID-19 remains unknown. This study analyzed adaptations to the content of state DMV operation policies during the COVID-19 pandemic across 50 US states and assessed the relationships between these policy adoptions and their state-level COVID-19 restriction orders. METHODS: We merged data on policy adaptations due to COVID-19 obtained from DMV websites for all 50 states with data on state-level restrictions obtained from the National Academy for State Health Policy (NASHP). We created a codebook and analyzed the DMV policy adaptations in the following three areas: (1) road testing, (2) licensure extension and renewals, and (3) facility reopening. Two trained coders independently reviewed and coded the adaptations of policy content related to precaution to spread of COVID-19 and ease of obtaining licensure. We calculated summary scores for policy adaptations and ease of licensure and compared these scores across three categories of state-level COVID-19 restrictions using ANOVA. RESULTS: DMVs in all 50 states adapted their policies to slow the spread of COVID-19. The ease of licensure summary scores increased in some states but decreased in others. Extensions for licensure renewals was the most common change. Adoption of COVID-19 precautions during the road test was the most common road test adaptation, while road test waivers were the most controversial. Requiring appointments, social distancing, and/or face coverings/personal protective equipment [PPE] were common adaptations during facility reopening. However, variations in level of policy adaptations and ease of licensure were not associated with the state's COVID-19 restrictions. CONCLUSIONS: Our findings provide insight into policy adaptations made by state DMVs to reduce the spread of COVID-19 and may inform future policy adaptations in DMVs and other government agencies during public health emergencies.

The impact of COVID-19 on road safety in Canada and the United States.

The COVID-19 pandemic has led to the implementation of unprecedented public health measures. The effect of these lockdown measures on road safety remain to be fully understood, however preliminary data shows reductions in traffic volume and increases in risky driving behaviors. The objective of the present study is to compare self-reported risky driving behaviors (speeding, distracted driving, drinking and driving, and drugged driving) during the pandemic in Canada and the U.S. to determine what differences exist between these two countries. Data was collected using the Road Safety Monitor (RSM), an annual online public opinion survey that investigates key road safety issues, administered to a representative sample of N = 1,500 Canadian drivers and N = 1,501 U.S. drivers. Respondents were asked about the likelihood of engaging in risky driving during the pandemic as compared to before COVID-19. Results show the majority of respondents indicated their behavior did not change, and most positively, a small proportion reported they were less likely to engage in these risky driving behaviors. However, notable proportions indicated they were more likely to engage in risky driving behaviors during the pandemic, as compared to before COVID-19. Of those who indicated this, U.S. drivers had significantly higher percentages compared to their Canadian counterparts. Behaviors most often reported by this sub-section of drivers who admit to being more likely to engage in risky driving during the pandemic were speeding (7.6%) and drinking and driving (7.6%) in the U.S., and speeding (5.5%) and distracted driving (4.2%) in Canada. Logistic regression results confirm that country was a significant factor, as U.S. drivers had greater odds of reporting they were more likely to engage in these risky driving behaviors, with the exception of speeding. Age also had a significant effect, as increasing age was associated with lower odds of reporting that these risky driving behaviors were more likely during the pandemic. Conversely, sex did not have a significant effect. Overall, the current findings suggest that a small proportion of drivers reported being more likely to engage in risky driving behaviors and the pandemic may have led to changes in the profiles of those drivers engaging in risky driving behaviors during lockdown measures. These results have important implications for policies and can inform how to manage road safety during future lockdowns.

Compliance, practices, and attitudes towards VTIs (Vehicle Technical Inspections) in Spain: What prevents Spanish drivers from checking up their cars?

OBJECTIVE: Mechanical conditions of vehicles may play a determinant role in driving safety, the reason why vehicle periodical technical inspections (VTIs) are mandatory in many countries. However, the high number of drivers sanctioned for not complying with this regulation is surprisingly high, and there is not much evidence on what kind(s) of motives may explain this concerning panorama. This study aimed to identify the aspects that modulate the relationship between complying (or not) with VTI's standards in a nationwide sample of Spanish drivers. The study design also addressed the drivers' awareness regarding different risky behaviors while driving, depending on their sex and their crash record. METHODS: 1,100 Spanish drivers completed a survey on the aforementioned issues. An analysis of variance (ANOVA) with Bonferroni post-hoc adjustment was conducted to assess significant differences (p<0.05) in the study variables. RESULTS: Most of the surveyed drivers (99.18%) reported that they always comply with VTI's requirements. The main reasons to comply were related to compliance with traffic regulation and fear of penalties, while the reasons attributed to its incompliance are, instead, stated as involuntary. CONCLUSION: The findings of this study support the idea that more actions are needed to increase drivers' awareness of the relevance of VTIs for road safety, as well as warning them about the dangers of neglecting vehicle checking beyond merely punishing measures. For this reason and given the greater prevalence of the issue among younger segments of the driving population, it is suggested that more emphasis on the matter could be made during novice driver's training.

Media coverage and framing of road traffic safety in India.

BACKGROUND: Media coverage of road traffic collisions (RTCs) may influence preventative action. India experiences some of the highest RTC mortality and morbidity rates globally, but advocacy and effective action to mitigate this has been limited. We conducted an analysis of Indian media in English to assess whether coverage met the WHO's Reporting on Road Safety guidelines for evidence-based reporting of RTCs. METHODS: English-language articles published online between March 2018 and February 2019 were assessed against the seven recommended story angles and seven recommended key elements in the WHO guidelines. RESULTS: 458 articles were included in the analysis. The most common story angle was descriptions of single collisions, which was not a WHO-recommended story angle. These included limited key elements such as use of human story or linking to road safety risks or evidence-based solutions. However, some articles did follow the WHO-recommended story angles, with 22.1% discussing specific road safety solutions and a further 6.3% discussing vulnerable groups. Almost all articles avoided the use of technical language, but only 2.0% explicitly stated that RTCs were preventable. More than half identified at least one evidence-based solution. Very few articles discussed economic or health impacts of RTCs, including the burden they present to the public health system. CONCLUSION: Indian media in English can improve reporting by focusing on human stories and documenting experiences of those injured in RTCs. Coverage should also focus more on evidence-based solutions, emphasising the systems approach which encourages government action rather than changes to individual behaviour.