Analysis On Causes, Features And Trend Of Road Traffic Crashes And Traffic Injuries In China

Background and objective: Fast economic development and increased investment in infrastructure construction accelerate road construction in China, with road mileage in 2008 up to 3.15 times of that in 1996. At the same time, the vehicle population in China shows a significant increase with higher GDP, for instance, the vehicle population in 2008 was up to 4.71 times of that in 1996. In the 21st Century, road traffic crash (RTC) and road traffic injury (RTI) in China manifest some new characteristics. The annual traffic report shows that both the number of RTC and the total death toll have been descended, indicating an improvement of traffic situation in China. In the meantime, some researchers predict that the number of RTC and the death toll will increase continuously. There reported that the average amount of death caused by RTC excelled 273.9 thousands each year, which was markedly higher than that reported by the annual data. Investigaton and analysis of RTC and the casualty caused by RTC will be helpful for understanding the causes, features and regulations of RTC and RTI in China, which will further lay a good foundation for prevention of RTC and RTI.Methods: 1 We made a set of scientific and standard RTC and RTI survey form and developed a software for collection of data on RTC and RTI.Then, we established a"Road Traffic Crashes and Road Traffic Injuries Database"("RTC&RTIDB"). 2 The annual reports were obtained from the official department of road traffic administration. The whole data were analyzed to find the epidemiologic features, causes and prevention of RTC and RTI. 3 Sampling data of RTC and RTI were taken from some typical districts in Chongqing from 2000-2006 and recorded into"RTC&IDB"database. The data were analyzed to explore the causes, features and differences of RTC and RTI in different regions and different personnel in Chonqgqing. Results:1 We successfully developed Regional Annual Road Traffic Crash Survey Form and Road Traffic Crash Case Survey Form, with 384 items. The general items included the regional population, road construction, regional economy, and whole TRC&RTI; the general information, road traffic condition, causes, vehicle&driver, casualty of RTC cases. In the meantime, Road Rraffic Crash Survey Database Software V1.0 was developed and the copyright of this software was protected by National Copyright Bureau, with registry number of 2008SR05320. The total data of RTC and casualty in 13 years since 1996 in China as well as 3398 RTCs and 52369 casualties of 4 districts in Chongqing from 2000-2006 were collected in detail. The"RTC&IDB"was established.2 The national data of RTC and RTI of China were analyzed to reveal the features and patterns of RTC and RTI in China. The main results are as follows:1) The tendency of RTC and RTI: Before 2003, the number of RTC and casualties increased yearly, reached the peak (773.1 thousands cases and 109.4 thousands death) in 2002 and then descended year by year. The traffic safety level got continual improvement, with the mortality rate per 10000 vehicles for 4.33 in 2008. The mortality rate per 100,000 persons reached the peak (8.79) in 2002 and then decreased to 5.66 in 2008.2) The causes of RTC: The driver was the major factor leading to RTCs, which increased gradually and accounted for 83.20% in 1996 and 94.90% in 2008. The five leading causes of RTCs for drivers were illegal giving a way, overspeed, faulty operation, carelessness and keeping unsafe distance. The RTCs caused by pedestrian and passengers were decreased gradually from 5.00% in 1996 to 1.37% in 2008. The RTCs due to road and environmtental factors accounted for rather low proportion.3) Injury features: The injured drivers accounted for 38.70% and the passengers for 30.56%. The death of drivers and pedestrians ranked the first two places, ie, 32.05% and 25.76% respectively. The mortality and intensity of the pedestrians were significantly higher than that of the drivers and passengers. Most of the death were among the injured at age of 26-40 years. The persons over 65 years had the highest mortality than others.4) Regional distribution of RTC&RTI: The developed districts in eastern China had higher number of RTCs&RTI than that of underdeveloped districts in western China. But the severity of RTC of the latter was higher than that of the former. The mortality rate per 100 RTCs and intensity in the underdeveloped districts were higher or stronger, with a tendency of increase in aspect of the severity of RTC.5) Highway distribution of RTC: Over 60% of RTCs and casualties occurred on the second and third class highways, which accounted for 27% of total highway mileage. But the first class highway had leading incidence rate per 100 km and mortality rate per 100 km, next with the express way. The second class road had the leading mortality rate per 100RTCs and the express way had the leading mortality rate of RTC and strongest intensity.3. The data of RTC and RTI of sampling regions in Chongqing were comparatively analyzed and the main results are as follows:1) The overviews of RTC&RTI: The sampling regions had higher mortality rate per 10000 vehicles and mortality rate per 100000 persons than overall national data. The severity of RTC was higher than average national level. There showed no obvious decrease in RTC&RTI in sampling regions and nationwide. The number of RTCs and deaths were increased in countryside areas.2) The causes of RTC: The illegal behavior and fault of drivers were the major causes for RTCs. The RTCs caused by diver account for 84%, followed by pedestrians (11%) and other factors (5%). The percentage of RTCs in downtown was significantly higher than that in suburban area and countryside areas.3) Regional distribution of RTC: The RTCs in downtown and suburban area were significantly more than that in countryside areas. The number of deaths in suburban area and countryside areas was significantly higher than that in downtown. The mortality rate per 100RTCs and intensity in downtown were higher or stronger than that in other two areas, in a tendency of increase. The RTCs mainly took place in downtown road, and the RTCs and casualties mainly occurred on highway in countryside areas. Installation of central isolation belt was useful for reducing the number of RTCs, without influence on the severity of RTC. The number of RTCs caused by cars ranked the highest. The vehicle types causing highest rate of deaths in downtown and suburban areas were middle or small trucks, but that in countryside areas was motorcycles. The number of RTCs and casualties caused by motorcycles were under an increasing tendency.4)Age distribution of casualties: Most of the injured were at age of 21-50 years. The highest percentage of injuries were at 31-35 years. Most of the deaths were at age of 26-55 years and over 65 years. The highest mortality rate was 20% in persons at over 65 years, next those at 36-40 years. The persons at over 65 years old had highest mortality (16.12%) and strongest intensity (5.74) than others.5)Injury features: The severe injuries of pedestrians accounted for 52.46%, which was higher than those with slight and moderate injuries (38.00%). Most types of RTI were brain injuries, especially the injuries with AIS5,6 (accounting for over 80%). The percentage of pedestrians with brain injuries was higher than that of drivers and passengers. The percentage of drivers and passengers with facial injuries was higher than that of pedestrians. The percentage of passengers with thoracic and spine injuries was higher than that of drivers and pedestrians.Conclusions:1. RTC safety in China is developing from the II stage, when the level of traffic safety (LTS) is improving but level of personal safety (LPS) is unfavorable, to the III stage, when LTS and LPS are all improving. But in some regions especially some countryside areas, the RTC safety is still under a poor situation, where we should pay special attention,2. In China, the driver of vehicle is the major cause leading to RTCs, next by pedestrians. The rate of RTCs caused by pedestrians in Chongqing is higher than that of national overall level, with a tendency of increase in the downtown.3. In China, more than 60% of RTC&RTI occurred on the second and third calss highways. But RTCs occurred on expressway and first class highway usually cause the most serious results.4. Drivers of vehicle have highest death rate in China but pedestrians in Chongqing. The motorcyclists have higher death rate in countryside areas. The persons at over 65 years have the highest severity of RTI. The pedestrians had higher rate of severe RTI. Most RTI are brain injuries that are the main causes of death. There is significant difference in aspect of injury locations between passenger and the pedestrians5. To decrease RTCs, it is necessary to improve infrastructure construction and traffic management of the third and second class roads in countryside areas,and strengthen education and management on pedestrians and motorcyclists. We should establish an efficient medical first aid system, emphasizing emergency care of the elderly and brain injury persons, which is effective measures for prevention injuries caused by RTCs and reduction of mortality.6. In addition, when we treating RTCs and RTI,we should pay attention to scientific and complete preservation of the records of RTC&RTI, as will be helpful for further carrying out epidemiological study and effectively promoting development of prevention of RTC and treatment of RTI in China..