The level and trend of road traffic injuries attributable mortality rate in Iran, 1990–2015: a story of successful regulations and a roadmap to design future policies
Abstract Background Road-Traffic-Injuries (RTIs) are predicted to rise up to the fifth leading cause of worldwide death by 2030 and Iran has the third highest RTIs mortality among higher-middle income countries. Although the high mortality of RTI in Iran is a warning, it provides the opportunity to...
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2021-09-01
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Online Access: | https://doi.org/10.1186/s12889-021-11721-9 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mehran Shams Farnam Mohebi Kimiya Gohari Masoud Masinaei Bahram Mohajer Nazila Rezaei Ali Sheidaei Sara Khademioureh Moein Yoosefi Milad Hasan Bahman Damerchilu Ayyoob Jafari Farshad Farzadfar |
spellingShingle |
Mehran Shams Farnam Mohebi Kimiya Gohari Masoud Masinaei Bahram Mohajer Nazila Rezaei Ali Sheidaei Sara Khademioureh Moein Yoosefi Milad Hasan Bahman Damerchilu Ayyoob Jafari Farshad Farzadfar The level and trend of road traffic injuries attributable mortality rate in Iran, 1990–2015: a story of successful regulations and a roadmap to design future policies BMC Public Health Road traffic injuries Iran Trend Mortality Sustainable development goal |
author_facet |
Mehran Shams Farnam Mohebi Kimiya Gohari Masoud Masinaei Bahram Mohajer Nazila Rezaei Ali Sheidaei Sara Khademioureh Moein Yoosefi Milad Hasan Bahman Damerchilu Ayyoob Jafari Farshad Farzadfar |
author_sort |
Mehran Shams |
title |
The level and trend of road traffic injuries attributable mortality rate in Iran, 1990–2015: a story of successful regulations and a roadmap to design future policies |
title_short |
The level and trend of road traffic injuries attributable mortality rate in Iran, 1990–2015: a story of successful regulations and a roadmap to design future policies |
title_full |
The level and trend of road traffic injuries attributable mortality rate in Iran, 1990–2015: a story of successful regulations and a roadmap to design future policies |
title_fullStr |
The level and trend of road traffic injuries attributable mortality rate in Iran, 1990–2015: a story of successful regulations and a roadmap to design future policies |
title_full_unstemmed |
The level and trend of road traffic injuries attributable mortality rate in Iran, 1990–2015: a story of successful regulations and a roadmap to design future policies |
title_sort |
level and trend of road traffic injuries attributable mortality rate in iran, 1990–2015: a story of successful regulations and a roadmap to design future policies |
publisher |
BMC |
series |
BMC Public Health |
issn |
1471-2458 |
publishDate |
2021-09-01 |
description |
Abstract Background Road-Traffic-Injuries (RTIs) are predicted to rise up to the fifth leading cause of worldwide death by 2030 and Iran has the third highest RTIs mortality among higher-middle income countries. Although the high mortality of RTI in Iran is a warning, it provides the opportunity to indirectly assess the implemented RTI-related regulations’ effectiveness via high-resolution relevant statistics and, hence, Iran could serve as a guide for countries with similar context. In order to do so, we utilized this study to report the time and spatial trends of RTIs-related mortality in different age and sex groups and road user classes in Iran. Methods Based on the national death-registration-system (DRS), cemeteries data, and the demographic characteristics, and after addressing incompleteness, we estimated mortality rates using spatiotemporal and Gaussian process regression models. We assessed Pearson seatbelt and helmet use and RTIs-attributable Age-Standardized-Morality-Rate (ASMR) associations. We also predicted RTIs-death-numbers, 2012–2020, by fitting a Generalized Additive Model to assess the status of achieving relevant sustainable development goal (SDG), namely reducing the number of RTIs-related deaths by half. Results Overall RTIs-attributable death and ASMR at the national level increased from 12.64 [95% UI, 9.52–16.86] to 29.1 [22.76–37.14] per 100,000 people in the time period of 1990–2015. The trend consisted of an increasing segment in 1990–2003 followed by a decreasing part till 2015. The highest percentage of death belonged to the three-or-more-wheels motorized vehicles. Pedestrian injuries percentage increased significantly and the highest mortality rate occurred in 85 years and older individuals. Low prevalence of seatbelt and helmet use were observed in provinces with higher than the median ASMR due to the relevant cause of each. RTIs-attributable death number is expected to reduce by 15.99% till 2020 which is lower than the established SDG goal. Conclusions Despite the observed substantial moderation in the RTI-ASMR, Iran is till among the leading countries in terms of the highest mortality rates in the world. The enforced regulations including speed limitations (particularly for elder pedestrians) and mandatory use of seatbelt and helmet (for young adult and male drivers) had a considerable effect on ASMR, nevertheless, the RTI burden reduction needs to be sustained and enhanced. |
topic |
Road traffic injuries Iran Trend Mortality Sustainable development goal |
url |
https://doi.org/10.1186/s12889-021-11721-9 |
work_keys_str_mv |
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doaj-13915ffd12614170a66b1a009277f68e2021-09-26T11:17:29ZengBMCBMC Public Health1471-24582021-09-0121111210.1186/s12889-021-11721-9The level and trend of road traffic injuries attributable mortality rate in Iran, 1990–2015: a story of successful regulations and a roadmap to design future policiesMehran Shams0Farnam Mohebi1Kimiya Gohari2Masoud Masinaei3Bahram Mohajer4Nazila Rezaei5Ali Sheidaei6Sara Khademioureh7Moein Yoosefi8Milad Hasan9Bahman Damerchilu10Ayyoob Jafari11Farshad Farzadfar12Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesHaas School of Business, University of CaliforniaDepartment of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares UniversityNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesDepartment of Epidemiology and Biostatistics, Tehran University of Medical SciencesNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesFaculty of Electrical, Biomedical and Mechatronics Engineering, Qazvin Branch, Islamic Azad UniversityNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesAbstract Background Road-Traffic-Injuries (RTIs) are predicted to rise up to the fifth leading cause of worldwide death by 2030 and Iran has the third highest RTIs mortality among higher-middle income countries. Although the high mortality of RTI in Iran is a warning, it provides the opportunity to indirectly assess the implemented RTI-related regulations’ effectiveness via high-resolution relevant statistics and, hence, Iran could serve as a guide for countries with similar context. In order to do so, we utilized this study to report the time and spatial trends of RTIs-related mortality in different age and sex groups and road user classes in Iran. Methods Based on the national death-registration-system (DRS), cemeteries data, and the demographic characteristics, and after addressing incompleteness, we estimated mortality rates using spatiotemporal and Gaussian process regression models. We assessed Pearson seatbelt and helmet use and RTIs-attributable Age-Standardized-Morality-Rate (ASMR) associations. We also predicted RTIs-death-numbers, 2012–2020, by fitting a Generalized Additive Model to assess the status of achieving relevant sustainable development goal (SDG), namely reducing the number of RTIs-related deaths by half. Results Overall RTIs-attributable death and ASMR at the national level increased from 12.64 [95% UI, 9.52–16.86] to 29.1 [22.76–37.14] per 100,000 people in the time period of 1990–2015. The trend consisted of an increasing segment in 1990–2003 followed by a decreasing part till 2015. The highest percentage of death belonged to the three-or-more-wheels motorized vehicles. Pedestrian injuries percentage increased significantly and the highest mortality rate occurred in 85 years and older individuals. Low prevalence of seatbelt and helmet use were observed in provinces with higher than the median ASMR due to the relevant cause of each. RTIs-attributable death number is expected to reduce by 15.99% till 2020 which is lower than the established SDG goal. Conclusions Despite the observed substantial moderation in the RTI-ASMR, Iran is till among the leading countries in terms of the highest mortality rates in the world. The enforced regulations including speed limitations (particularly for elder pedestrians) and mandatory use of seatbelt and helmet (for young adult and male drivers) had a considerable effect on ASMR, nevertheless, the RTI burden reduction needs to be sustained and enhanced.https://doi.org/10.1186/s12889-021-11721-9Road traffic injuriesIranTrendMortalitySustainable development goal |