Year: 2026
Type: article
Abstract: Introduction Road Traffic Injury (RTI) pose a significant health challenge. It represents the eighth leading cause of death globally, prompting the UN to designate 2011-2020 as the “Decade of Action for Road Safety”. This study aims to determine the global and regional burden of RTIs, and the impact of drink-driving and seatbelt-wearing on RTIs in 2017, while also assessing the UN Action Plan outcomes and forecasting the RTI rate for 2029. Methods Data on the global and regional RTI rates (2000-2019), regional seatbelt use (2017), and regional drink-driving (2017) were compiled from the Global Health Observatory Estimates. The investigated key metrics are global and regional RTI rate per 100,000 population in 2000-2019, percentage of regional seatbelt-wearing, drink-driving RTIs, and enforced seatbelt and drink-driving laws in 2017. Results This study reveals a heterogenous regional distribution of road traffic injuries in 2017. Africa sustained the highest RTI rate (27.6/100,000 population), while Europe reported the lowest rate (10.98/100,000 population). Regional variation in seatbelt laws exists, with the highest legalization in Europe (100%), and the lowest in Western Pacific (80.95%). Eastern Mediterranean (87.43%) and South-East Asia (46.8%) reported the highest and lowest driver seatbelt-wearing rates, respectively. All countries, except the Maldives, legislated drink-driving laws. Western Pacific (29.98%) and Eastern Mediterranean (1.65%) suffer from the highest and lowest burden of drink-driving RTI, respectively. Conclusion Despite a relatively stable global RTI rate from 2011-2020 and a steady decline till 2029, the future trajectoryremains uncertain in developing countries bearing the highest burden, due to slow national law enforcement,rendering the UN Action Plan insufficient in curbing the burden of RTIs. INTRODUCTION Road traffic injury (RTI) is a major global health challenge, impacting millions of individuals worldwide [1]. With approximately 20-50 million non-fatal injuries, 70 million disability-adjusted life years (DALYs), and 1.3 million deaths annually, RTI remains a neglected yet major health problem globally [1, 2]. According to the World Health Organization (WHO), RTI is ranked the 6th and 8th leading cause of DALYs and mortality globally, respectively [1, 3, 4]. The current steady RTI trends suggest that traffic fatalities are expected to become the 7th leading cause of death worldwide by 2030 [4]. RTI imposes a real threat to the health and well-being of all populations across all age groups, with a particularly heightened burden on the youth population [5]. In fact, RTI constitutes the primary cause of death for people aged 5 to 29 years; the majority of victims were among the male populations compared to their female counterparts [1, 2, 6]. Existing literature identifies multiple factors that contribute to the increased rate in RTI mortality and morbidity among the youth and the males’ population, including the tendency to violate traffic laws such as traffic signals, and the lack of seatbelts/helmets use, in addition to the potential engagement in high-risk driving behavior, including car racing and drink-driving [7-10]. Females are relatively safer drivers at all times (day/night), and in all road conditions (i.e. weather, road layout, etc.), which decreases their risk of sustaining road fatalities, with nearly 3 times less likelihood of females being killed in road traffic crashes [1, 11, 12]. Besides the health impact, RTIs inflict a serious economic and societal toll on individuals, families, and communities, incurring large direct and indirect costing reaching up to 3% of most countries’ gross domestic product (GDP) [1]. The human and economic loss associated with RTI is disproportionately more prominent in low- and middle-income countries (LMICs), where 93% of road traffic deaths (RTI) occur [1]. The latter is explained by several factors, including the high proportion of vulnerable road users, such as pedestrians and cyclists, the absence of road safety regulations, and the extensive illiteracy and defiance of laws in LMICs [8]. RTIs are expected to further rise in LMICs with the increasing motorization and urbanization [10]. In addition to environmental factors, human behavior is responsible for the majority of road crashes [13, 14]. Human observation, interpretation, and planning errors further predispose individuals to traffic crashes and impact injury severity and outcome [14]. Various factors are associated with RTIs including speeding, fatigue, poor driving skills, alcohol and substance consumption, poor vehicle conditions, violation of traffic laws (i.e. improper seatbelt/helmet/child seat use, use of mobile phone while driving, disregarding traffic signs, etc.), unsafe road environments (i.e. bad weather, poor infrastructure, poor lighting, lack of pedestrian facilities, etc.), and inadequate post-crash care (i.e. first aid care, fast access to medical personnel, rehabilitation services, etc.), amongst others, contribute to increased traffic mortalities and morbidities [2, 13]. Enforcing the required measures of road safety and adopting safer road behavior substantially reduce road traffic crashes and subsequently prevents RTIs [1]. Alcohol use, even in insignificant amounts, impairs the cognition, vision, and reaction time of all consumers [4, 10, 15]. Accordingly, blood alcohol concentration (BAC) above zero has been identified as a primary risk factor in the causation and severity of traffic crashes for all road users, including motorists and pedestrians [15]. Notably, drink-driving with a BAC greater than 0.04 g/dl results in severe behavior impairments associated with reckless driving, speeding, unfastening seatbelt/helmet, and disobeying traffic laws, and in turn dire traffic crashes and injuries [1, 15]. Alarmingly, approximately 20% of traffic fatalities in high-income countries and 33-69% of traffic deaths in LMICs are attributed to alcohol consumption, predominantly affecting young and novice drivers [10, 16]. Several countries including Canada, Australia, and Italy have adopted strategies to reduce RTI injuries and deaths among this high-risk group including the decrease of the BAC limit to ≤0.02 g/dl for young and/or novice drivers. This policy lead to a substantial reduction in traffic crashes by up to 24% [2, 4]. Other RTI reduction successful measures were implemented by over one hundred countries to reduce drink-driving include public awareness, random breath testing, and police sobriety checkpoints [4, 17]. Yet, given that LMICs are currently exposed to the growing use of alcohol, hardly any developing countries have enforced measures to control drink-driving [18]. Assessing the contribution of drink-driving on RTIs is crucial to develop prevention strategies, though data on drink-driving remains limited in the majority of LMICs and some high-income countries (HIC) [2, 4]. While functional seatbelt laws and increasing compliance are enacted in more countries compared to drink-driving laws, many LMICs lack mandatory safety requirements with limited law enforcement and compliance [2, 4, 19, 20]. The WHO, the FIA Foundation, and partners, have highlighted the urgent need to increase seatbelt and child restraint use, particularly in LMICs experiencing rapid motorization. Seat-belts can reduce vehicle occupant deaths by up to 50%, while child restraints can prevent up to 71% of fatalities among infants. Despite high compliance in regions such as Europe, usage remains low in other regions. Updated WHO guidelines, as noted by Dr. Khayesi, emphasize comprehensive programs combining legislation, enforcement, and public education to promote seatbelt use and convince governments and citizens of such need [23, 24]. Since the vast majority of RTIs are both predictable and preventable, global efforts have been concerted for decades to address the burden of traffic fatalities and injuries [2, 4]. Almost 123 countries, representing around six billion people, amended laws on at least one of the five key risk factors of road injuries, such as speeding, seatbelt and helmet use, child restraint use, and drink-driving [2]. HICs succeeded in reducing the toll of RTIs by relying on data-driven evidence and resources to inform strategic safety rules and regulations [2]. With the lack of adequate data on any traffic crash-related risk factor, such as alcohol consumption and seatbelt use, LMICs continued to mismanage RTIs and traffic deaths [2, 4]. Accordingly, the United Nations (UN) General Assembly launched the Decade of Action for Road Safety 2011–2020, with a target to save 5 million lives by the year 2020 [25]. This approach focused on five main pillars: road safety management, safer roads, safer vehicles, safer road user behavior, and post-crash care [25]. Evaluating the success of this plan is key to developing successful future strategies regarding traffic injuries and deaths worldwide. This study aims to describe the current burden of road injuries worldwide, for the period from 2000 to 2019, to highlight the impact of two major risk factors including alcohol consumption and seatbelt usage in 2017, and to forecast the future trends in road traffic deaths. It further assesses whether the period ranging between the years 2011 and 2020 was indeed the “Decade of Action for Road Safety” as proclaimed by the UN General Assembly. Findings from this study help to suggest reliable measurements that can be implemented globally and nationally to reduce and mitigate injuries and deaths on the roads. METHODSData Sources Data were retrieved from the Global Health Observatory Estimates generated by the WHO for Information, Evidence, and Research. Data on six regions (Americas, Africa, Europe, Eastern Mediterranean, South-East Asia, and Western Pacific) were extracted and analyzed [26]. Data posted by WHO on sea
Source: Panorama of emergency medicine.
DOI: 10.26738/poem.v4i1.2
Institution: American University of Beirut
Language: English
Topic: Traffic and Road Safety
Subfield: Safety, Risk, Reliability and Quality
Field: Engineering
Domain: Physical Sciences
Open Access status: diamond
OpenAlex ID: W7150745232
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