A study of the impact of traffic investment on traffic fatalities in China, 2004-2020.

PURPOSE: Road traffic injuries (RTIs) have been one of the most serious public health problems in China. The purpose of this study was to investigate the extent to which traffic investment affects traffic fatalities in China as well as regional differences. METHODS: The study analyzed the correlation between traffic investment and traffic fatalities, incorporating additional factors such as economic conditions, road infrastructure, population density, and lighting. The selected variables included the number of traffic fatalities, traffic investment, urban per capita road area, urban road length, road mileage, urban road lighting, population size, and per capita gross domestic product. Relevant data between 2004 and 2020 were collected for an analysis using a fixed effect regression model. A p < 0.05 is considered statistically significant. To reduce the heterogeneity caused by regional differences, the provinces were divided into 6 groups according to administrative districts, and the clustering standard error analysis was carried out. RESULTS: Overall, there has been a significant improvement in road safety in China from 2004 to 2020, but some regions show an increase in traffic fatalities. The model reveals that traffic investment is significantly and positively correlated with the number of traffic fatalities. Holding all other factors constant, each 10,000 yuan increase in transport investment was associated with an average increase of 0.22 road traffic fatalities. In the analysis of regional differences, there was a significant positive correlation between traffic investment and traffic fatalities in the Northwest region and an increase of 10,000 yuan leads to an increase of 0.47. There was a significant negative correlation between road mileage, urban road lighting system, and population and traffic fatalities. For example, holding other factors constant, a 10,000 km reduction in road length would increase the number of traffic deaths by 45.56. The model results of urban per capita road area, urban road length, per capita gross domestic product, and the explained variables showed that p > 0.100, which was not statistically significant. CONCLUSIONS: Therefore, traffic investments are essential for governments to develop measures to enhance road safety and reduce the risk of road fatalities. Adjusting traffic road investment and other covariates is conducive to improving traffic safety and reducing the risk of road fatalities. The road safety situation in different regions of China varies greatly. Local governments should consider the actual conditions to provide better road safety configuration policies.

Daily motor vehicle traffic volume and other risk factors associated with road deaths in U.S. counties.

INTRODUCTION: Road death risk is often characterized as deaths per volume of traffic in geographic regions, the denominator in miles or kilometers supposedly indicative of the magnitude of risk exposure. This paper reports an examination of the differences in the predictive value of factors hypothesized to influence traffic volume and road death risk. METHOD: The association of 11 risk factors in U.S. counties during the first 7 months of 2020 was examined for consistency of predictions of road death and traffic volume measured by cell phone and vehicle location data. The study employed least squares regression for traffic volume and Poisson regression for deaths with the population as the offset variable. RESULTS: The directions of the regression coefficients for traffic volume and odds of road deaths per population were opposite from one another for 9 of the 11 variables in the analysis of vehicle occupant deaths. Only the coefficients for maximum daily temperature and Saturday travel were in the same direction. The confidence intervals of three risk ratios for pedestrian deaths indicated low reliability but most of the predictor variables were opposite in association with traffic volume and odds of death. Although traffic volume plunged in the first weeks of the pandemic, the results for the months before and during the COVID-19 pandemic were similar. PRACTICAL APPLICATIONS: Traffic volume is an inverse risk factor for road deaths at the local level, likely the result of lower speeds on congested roads. Without the application of countermeasures aimed at reducing speed and other risk factors, the reduction of road congestion is likely to increase deaths.

Cannabis policy bundles and traffic fatalities in the American States over time.

BACKGROUND AND AIM: Since 1996, 38 US states have legalized access to cannabis (medical and/or adult-use recreational). We aimed to estimate the effect of three dimensions of state cannabis policy design - pharmaceutical, permissive and fiscal - on levels of overall, alcohol-impaired, occupant, light truck and pedestrian fatality rates. DESIGN AND SETTING: Observational study of US states' overall, alcohol-impaired, occupant, light truck and pedestrian fatalities between 1994 and 2020. CASES: The unit of analysis was at the state level, consisting of 50 states and 27 years of time series data, resulting in a total of 1350 state-year observations. MEASUREMENTS: Fatality rates associated with alcohol-impaired, pedestrian, total occupant, passenger car and light truck fatality rates were obtained from the Fatality Analysis Reporting System of the National Highway Traffic Safety Administration and normalized per 10 billion vehicle miles traveled. State cannabis policies are measured in three bundles (scales): pharmaceutical, permissive and fiscal. FINDINGS: The pharmaceutical bundle was associated with increases in all fatality rates [ß = 0.145; 95% confidence interval (CI) = 0.116-0.173; P < 0.000]. The permissive bundle was associated with lower overall fatality rates (ß = -0.319; 95% CI = -0.361 to -0.277; P < 0.000). The fiscal bundle was generally associated with higher fatality rates (ß = 0.062; 95% CI = 0.043-0.081; P < 0.000), occupant (ß = 0.070; 95% CI = 0.042-0.098; P < 0.000), light trucks (ß = 0.049; 95% CI = 0.026-0.072; P < 0.000). CONCLUSIONS: US state cannabis regulations influence traffic safety. Greater permissiveness in US state cannabis regulations does not appear to correlate with traffic fatality rate increases, but greater medicalization and fiscal operation does.

The Relationship Between the Atmospheric Environment and Road Traffic Fatalities - Shandong Province, China, 2012-2021.

Introduction: This study aims to analyze the potential impact of the meteorological environment and air pollutants on road traffic fatalities. Methods: Road traffic fatality data in Shandong Province from 2012 to 2021 were obtained from the Population Death Information Registration Management System. Meteorological and air pollutant data for the same period were collected from the U.S. National Oceanic and Atmospheric Administration and the Ecological Environment Monitoring Center of Shandong Province, China. Pearson's correlation and ridge regression were used to analyze the impact of the meteorological environment and air pollutants on road traffic fatalities. Results: From 2012 to 2021, there were 163,863 road traffic fatality cases. The results of the ridge regression analysis showed that the daily average temperature was negatively correlated with total fatalities and passengers and positively correlated with pedestrians, nonmotorized drivers, and motorized drivers. The daily minimum temperature was negatively correlated with total fatalities and positively correlated with motorized drivers. The daily maximum temperature was positively correlated with both pedestrian and nonmotorized drivers. The daily accumulated precipitation was negatively correlated with pedestrians. Sunshine duration was positively correlated with both nonmotorized and motorized drivers. Inhalable particulate matter (PM10) and nitrogen dioxide (NO2) were positively correlated with total fatalities, pedestrians, and nonmotorized drivers. Sulfur dioxide (SO2) was positively correlated with total fatalities but negatively correlated with nonmotorized drivers, passengers, and motorized drivers. Conclusions: Atmospheric factors associated with the occurrence of road traffic fatalities include air temperature, daily accumulated precipitation, sunshine duration, and air pollutants such as PM10, NO2, and SO2.

The effect of opioid use on traffic fatalities.

We use a difference-in-differences design to study the effect of opioid use on traffic fatalities. Following Alpert et al., we focus on the 1996 introduction and marketing of OxyContin, and we examine its long-term impacts on traffic fatalities involving Schedule II drugs or heroin. Based on the national fatal vehicle crash database, we find that the states heavily targeted by the initial marketing of OxyContin (i.e., non-triplicate states) experienced 2.4 times more traffic fatalities (1.6 additional deaths per million individuals) involving Schedule II drugs or heroin during 2011-2019, when overdose deaths from heroin and fentanyl became more prominent. We find no difference in traffic fatalities until after the mid-2000s between states with and without a triplicate prescription program. The effect is mainly concentrated in fatal crashes with drug involvement of drivers ages between 25 and 44. Our results highlight additional long-term detrimental consequences of the introduction and marketing of OxyContin.

Hit-and-run or hit-and-stay? Unintended effects of a stricter BAC limit.

Although they comprise a relatively small subset of all traffic deaths, hit-and-run (HR) fatalities are both contemptible and preventable. We analyze longitudinal data from 1982 to 2008 to examine the effects of blood alcohol concentration (BAC) laws on HR traffic fatalities. Our results suggest that lower BAC limits may have an unintended consequence of increasing HR fatalities, whereas a similar effect is absent for non-HR fatalities. Specifically, we find that the adoption of a 0.08 BAC limit is associated to an 8.3% increase in HR fatalities. This unintended effect is more pronounced in urban areas and during weekends, which are typical settings for HR incidents.

Road traffic mortality in Iran: longitudinal trend and seasonal analysis, March 2011-February 2020.

Road traffic mortalities (RTMs) and injuries are among the leading causes of human fatalities worldwide, particularly in low-and middle-income countries like Iran. Using an interrupted time series analysis, we investigated three interventional points (two government-mandated fuel price increases and increased traffic ticket fines) for their potential relation to RTMs. Our findings showed that while the overall trend of RTMs was decreasing during the study period, multiple individual provinces showed smaller reductions in RTMs. We also found that both waves of government-mandated fuel price increases coincided with decreases in RTMs. However, the second wave coincided with RTM decreases in a smaller number of provinces than the first wave suggesting that the same type of intervention may not be as effective when repeated. Also, increased traffic ticket fines were only effective in a small number of provinces. Potential reasons and solutions for the findings are discussed in light of Iran's Road Safety Strategic Plan.

Revisiting the effect of recreational marijuana on traffic fatalities.

BACKGROUND: This study examines the effect of retail recreational marijuana legalization on traffic fatalities using the most current data available and recent advancements in difference-in-difference estimation methods proposed by Callaway and Sant'Anna, (2021). METHOD: A modified difference-in-difference (CS-DID) is used to estimate the effect of recreational marijuana legalization on traffic fatalities reported in the Fatality Analysis Reporting System (FARS). Difference-in-difference regression models are run at the state-year level, using data from 2007 through 2020, and compared to estimates using traditional two-way-fixed-effects (TWFE) models. RESULTS: Consistent with past studies, results from conventional TWFE suggest traffic fatalities increase at a rate of 1.2 per billion vehicle miles traveled (BVMT) after retail of recreational marijuana begins. However, using the CS-DID model, we find slightly larger average total treatment effects (∼2.2 fatalities per BVMT). Moreover, the size of the effect changes across time, where cohorts "treated" earlier have substantially higher increases than those who more recently legalized. CONCLUSION: Traffic fatalities increase by 2.2 per billion miles driven after retail legalization, which may account for as many as 1400 traffic fatalities annually. States who legalized earlier experienced larger traffic fatality increases. TWFE methods are inadequate for policy evaluation and do not capture heterogeneous effects across time.

Investigating the trend of road traffic fatalities in Malawi using Mann-Kendall statistic.

Fatalities due to road accidents remain a major challenge worldwide. In the recent years, Malawi, one of the developing African countries with a total population of about 19 million has also been witnessing a very high fatality rate [of about 31 crash deaths per 100,000 population in 2016] compared to most of its neighbours in the region. This seems to be continuously increasing even with several intervention measures, such as, speed and alcohol impairment laws, and laws for mandatory seatbelt and helmet use. In view of this, the study attempted to investigate the trend of road fatalities in Malawi, such that effectiveness of the existing measures can be established. For this, archived crash data of road fatalities between years 2000-2021 were used to undertake intervention and trend analyses. The method of Cumulative Summation was used to identify intervention points in the series, followed by the Mann-Kendall statistic (τ) to determine the trend during the intervened period using the non-parametric Rank-Sum test to support the findings. The results showed that the trend has been decreasing in the early years of legislating policy measures [2000-2012] and, thereafter [2013-2021], increased significantly [τ = 0.8333]. This suggests that there was acceptance of the measures by the motorists/public in the early years of implementation [2000-2012], which might have been overshadowed by vehicle population growth and weak enforcement mechanism that have seen the trend increasing lately. The study therefore suggests that there is still a scope to review the intervention measures in their effective implementation as well as regular monitoring.

Autopsy study of alcohol-associated unnatural deaths in Thailand, 2007-2019.

BACKGROUND: To date, there have been no major studies of alcohol-associated unnatural deaths in Thailand or South East Asia. Thailand leads South East Asia in per capita alcohol consumption. The objectives of this study were to determine the incidence of alcohol-associated unnatural deaths in Thailand and their relation to post-mortem blood alcohol concentration (BAC); to investigate correlations between BAC and selected demographic variables; and to evaluate the incidence of co-use of alcohol and illicit substances. METHODS: We conducted a retrospective register-based study of alcohol-investigated unnatural deaths in Thailand for the period 2007-2019. The core study sample (n = 77,006) was derived from a Thai government computerized database of unnatural-death autopsies. RESULTS: Of the total autopsy sample 32.49% was alcohol positive (BAC ≥0.20 g/L). The rate at which male autopsy cases were alcohol positive (35.52%) was approximately twice that of female autopsy cases (16.62%), with males having significantly higher median BAC levels, 1.64 and 1.31 g/L, respectively. The incidence of female alcohol-positive cases with extremely high BACs (≥3.50 g/L) was comparable to that of male alcohol-positive autopsies. The rates at which victims of accidents, homicides, and suicides were alcohol positive were 42.44%, 38.81%, and 33.25%, respectively. Drowning fatalities had the highest rate of alcohol detection (49.12%) and the highest median BAC (2.47 g/L). The next highest rate (48.47%) was among road traffic fatalities (RTFs, BAC 1.92 g/L), which accounted for about one-half of all RTFs and one-third of all alcohol-positive autopsies. Of the total alcohol-positive population, 8.33% tested positive for illicit substances, most commonly methamphetamine/amphetamine. CONCLUSIONS: BAC results for the majority of male and female alcohol-positive victims exceeded the generally accepted threshold for Heavy Episodic Drinking (0.8 g/L) and provided a rare BAC-documented (≥3.50 g/L) example of gender parity in the incidence of heavy alcohol consumption. The median BAC value for alcohol-positive RTFs (1.92 g/L) was about 10% higher than in studies in most other countries and about four times greater the Thai legal limit for motor-vehicle operation (0.50 g/L).

Ride-hailing services: Competition or complement to public transport to reduce accident rates. The case of Madrid.

Introduction: The transport and mobility sector is experiencing profound transformations. These changes are mainly due to: environmental awareness, the increase in the population of large urban areas and the size of cities, the aging of the population and the emergence of relevant technological innovations that have changed consumption habits, such as electronic commerce or the sharing economy. The introduction of new services such as Uber or Cabify is transforming urban and metropolitan mobility, which has to adapt to this new scenario and the very concept of mobility. Objective: Thus, the purpose of this study was to evaluate whether ride-hailing platforms substitute or complement public transport to reduce accident rates, considering the two basic transport zones of Madrid: "The Central Almond" and the periphery. Methods: The data were collected from the 21 districts of Madrid for the period 2013-2019, and they were analyzed by a Random Effects Negative Binominal model. Results: The results obtained in this study suggest that since the arrival of Uber and Cabify to the municipality of Madrid the number of fatalities and serious injuries in traffic accidents has been reduced. Traffic accidents on weekends and holidays, with at least one serious injury or death, have also been reduced. However, the number of minor injuries has increased in the central districts of Madrid. Conclusion: Overall, what was found in this study supports the hypothesis that these services replace the urban buses. However, these services improve the supply to users with greater difficulties to access taxis or public transport, constituting an alternative mode of transport for high-risk drivers. Therefore, such findings may be quite useful for policy makers to better define regulatory policies for these services.

Proximity to fatal accidents predicts police citation rates on urban and rural roads.

Objectives: Police enforcement can effectively deter risky driving behaviors and reduce traffic fatalities, including speed-related fatalities. Unlike other areas of data-driven policing, spatial methods to improve road safety are not well-described. The objectives of this study were as follows: (1) determine if proximity to a prior roadway fatality increases the risk of a traffic citation being issued after adjusting for relevant roadway variables; (2) determine if this effect varies between rural and urban roads.Methods: The study region included a rural county and adjacent small city (City of Charlottesville, Albemarle County, Virginia). Fatality locations were obtained from the Fatality Analysis Reporting System (FARS) from 2008 to 2018. Police citation data were obtained from the State of Virginia for 2020. Data on fatalities and roadway features were used to create a model to predict traffic citation density. Traffic stop locations were analyzed as a point pattern on a linear network, assuming a Poisson process with varying intensity. The model adjusted for average traffic volume, distance to the nearest fatal crash along the road network, rural vs urban roadway, posted speed limit, and interstate vs non-interstate road. To account for over-dispersion, quasi-Poisson model was used.Results: There were 138 fatalities and 651 traffic citations during the time periods examined. After adjusting for other covariates, the expected number of citations/km was higher with increasing proximity to prior fatal crashes, RR = 1.34 (95% CI: 1.04, 1.72) per km. The effect of proximity did not vary significantly between urban and rural roads (p = 0.2707). However, citation intensity was significantly higher on urban roads vs. rural roads, RR = 2.65 (1.09, 6.45). Predicted citation intensity reflected anticipated enforcement clusters inside the city limits and on major county roads, suggesting satisfactory model fit.Conclusions: This study demonstrated a novel approach to quantify the impact of road fatalities on police activity, measured by traffic citations. Proximity to fatal crashes was found to affect police citation rates, and this effect is consistent between urban and rural areas. Future work will aim to identify areas of under enforcement based on proximity to fatal crashes and other roadway variables.

Demographics of road injuries and micromobility injuries among China, India, Japan, and the United States population: evidence from an age-period-cohort analysis.

BACKGROUND: Micromobility sharing platforms have involved skyrocketing numbers of users in multiple countries since 2010. However, few studies have examined the overall impact of the growing micromobility market on road injuries. METHOD: We use road injury data from the Global Burden of Disease Study database to examine the effect of age, period, and cohort on micromobility injury-related deaths and incidence. We compared four countries that vary in demographic background and road infrastructure. By comparing the countries, we analyzed the relationship between the trends in road injuries and these factors. RESULTS: We found an overall upward trend in micromobility injuries. A higher risk of micromobility-related injuries was witnessed in China and the US in 2015-2019, and people older than 45 showed a growing micromobility-related mortality and incidence rate in China, India, and the US. Cohorts after 1960 showed higher micromobility injury incidence risks in China and India, but the population born after 1990 in India showed a slightly lower risk compared to those before it. CONCLUSIONS: The boosted usage of micromobility devices explains these increasing trends. Road infrastructure and separated traffic ease the collisions from micromobility devices. The overall situation calls for improvement in legislation as well as road infrastructure.

The Car Cushion Hypothesis: Bigger Cars Lead to More Risk Taking-Evidence from Behavioural Data.

Car traffic and accidents involving cars create an enormous societal cost, particularly in terms of negative consequences for public health. Mitigating these effects is a daily concern for public and private institutions and people around the world. At least a subset of accidents is attributable to the amount of risk drivers allow in their driving and in related behaviour like mobile phone use or substance abuse. Our study looks at the effect of car size on risk taking. While literature highlights several behavioural effects of car size, the direction of causality of these effects is not always clear, and empirical evidence is lacking. Two behavioural and consequential studies support that car size affects risk taking in driving and that this increase in risk taking generalizes to other domains as well. Based on these results and in line with literature showing that social stability and security can affect financial risk taking, we propose the "car cushion hypothesis." This hypothesis suggests that bigger cars make people feel more secure, which affects their behaviour in terms of generalized risk taking. We discuss policy implications aimed at contributing to reducing the societal and public health cost of car traffic.

Alcohol-related traffic laws and drunk-driving fatal accidents.

In the United States, about 28 lives are lost daily in motor vehicle accidents that involve an alcohol-impaired driver. While most states have enacted various traffic laws to address this phenomenon, little consensus exists on the causal impact of these laws in reducing alcohol-induced fatalities. This paper exploits quasi-random variation in state-level laws to estimate the causal effect of alcohol-related traffic laws on the frequency of fatal accidents. This is identified from the discontinuities in traffic laws among contiguous counties that are separated by a shared state border. We present robust evidence that the conventional approaches that are typically utilized in the literature may erroneously estimate the effectiveness of several alcohol-related laws.

The effects of false identification laws on underage alcohol-related traffic fatalities.

We examine the effects of policies aimed at restricting the use of false identification to purchase alcohol on traffic fatalities involving alcohol-impaired underage drivers. We find that the implementation of policies that incentivize alcohol retailers to adopt ID scanners reduces traffic fatalities from accidents involving 16-18 year old drivers with a BAC >0, but we do not find that similar policies like vertical ID laws lead to statistically significant changes in traffic fatalities involving underage impaired drivers. A back-of-the-envelope calculation suggests that if all remaining states passed ID scanner laws, the reduction in underage alcohol-related fatal accidents would generate over $400 million in annual economic benefits.

Death on the job: The Great Recession and work-related traffic fatalities.

In light of recent discussions about shifting employees from traditional workplaces to virtual employment, we are motivated by the question of whether this phenomenon will end up saving lives even in the absence of an infectious disease outbreak. Motor vehicle incidents are the leading cause of work-related fatalities in the US, killing more than 1200 workers each year, which make up about a quarter of all work-related deaths. Not only are motor vehicle crashes the top killer at work, but economic expansions can further increase occupational and traffic deaths as they both tend to be procyclical. In this paper, we examine the effects of business cycles on traffic fatalities in the US with a special focus on work-related deaths. Specifically, we implement a longitudinal design across all 50 states by compiling quarterly data for 2004-2012 and consider macroeconomic fluctuations around the Great Recession. Our findings show that traffic deaths during prosperous times are not solely due to an increase in risky behaviors such as drunk driving, but directly related to work. Given the highly preventable nature of traffic crashes, policy makers, public health advocates, and employers can develop effective strategies, including remote work arrangements, to improve both occupational and traffic safety.

Safer spaces: The impact of a reduction in road fatalities on the life expectancy of South Africans.

In this paper we determine the burden on society of fatalities resulting from road traffic injuries (RTIs) in South Africa. We express the burden in terms of reduced life expectancy and years of potential life lost (YPLL). Our main data source is the Injury Mortality Survey (IMS), a retrospective descriptive study carried out in South Africa. Using the mortality rates by sex and age from the IMS we calculate actual life expectancy at birth. In our counterfactual analysis we assume a 15 % reduction in road fatalities per year over a period of 10 years. A comparison of the estimated actual and counterfactual life expectancies suggests that the average gain in life expectancy at birth would be 0.58 years. Since the overwhelming majority of road traffic fatalities are male (75.7 %), there is a considerable gender difference. Men would gain on average 0.85 years while women would gain 0.30 years in life expectancy, closing the gender gap in life expectancy by about 14 %. We then discuss how a reduction in RTIs could be achieved. South Africa's legislation addresses several of the important aspects of road safety (e.g. seat belt use, drink driving restrictions, speed limits, infrastructure improvements), however, enforcement is relatively weak and should be improved. There are a raft of measures that have been well researched in other countries, most interventions aim to modify the behaviour of road users and have been found to be cost effective. In addition to stricter enforcement, evidence from social science suggests that compliance could be increased through a change in social norms regarding road usage.

Preventable deaths following road traffic collisions in Botswana: A retrospective review.

Road traffic collisions (RTC) are a major cause of mortality and morbidity in Botswana. To our knowledge no research has been conducted in Botswana to investigate preventable deaths that occur as a result of RTCs. The aim of this study is to establish the rate of preventable deaths from RTCs in the greater Gaborone area in Botswana. This was a 5-year retrospective study conducted at the forensic pathology department for the greater Gaborone area, in Botswana. Nine hundred and nine (909) forensic pathology reports were retrieved. Sixty-eight percent (68.2%) of RTC deaths were considered preventable. Head injury in isolation and in combination with other injuries accounted for 87.6% (796/909) of deaths. Haemorrhagic shock was present in 70.2% (638) of all documented injuries. Another documented injury contributing to fatal RTCs was high spinal cord injury. This injury was documented in 13.1% (119/909) of all deaths. We recommend the implementation of a comprehensive trauma system in Botswana to reduce the number of deaths from RTCs.