| Background and Objective:Road traffic injuries(RTIs)have become a public health concern that needs to be coped with urgently worldwide.It is a significant challenge for world countries,especially for low-and middle-income countries.RTIs is a heavy economic burden,as with high mortality and morbidity.Therefore,the purpose of this study is to retrospectively analyze the data including the injuries,the death caused by highway motor vehicle crashes as well as the accident-related information in China from 2004 to 2015,to discuss the epidemiological characteristics of highway motor vehicle crashes and the risk factors to the lethal accidents by analyzing the parameters including the human-related,crashed related and environment related factors that were compared with those of roadway MVCs.Methods:The crash-related information was pulled out from the annual national reports of motor vehicle crashes released by Traffic Safety Administration Bureau between 2004 and 2015(except Tibet and Chongqing),including 4 general parameters(fatal cases toll,the total number of the fatalities and the injured,the direct economic loss),the crash by the hour of occurrence,the years of valid driver’s licenses as well as the road surface conditions and weather conditions.The quantitative data were analyzed by descriptive analysis,the comparisons between h MVCs and rMVCs were analyzed by Independent-Samples T-test,different weather conditions,road conditions,driving between groups using one-way ANOVA;highway traffic injury risk factors analysis Using univariate logistic regression analysis.The degree of risk is expressed by relative risk(RR).The difference in distribution of weather conditions,road surface conditions,the year of valid driver’s licenses was assessed by Chi-squared test.P<0.05 was considered with statistical difference;P<0.01 was considered with significantly statistical difference.Results:1.The mileage death rate of highway traffic injuries(HTIs)was dropped by 75.99%,the mileage injury rate was dropped by 61.99%.The death rate per 100 accidents was increased 1.6 times,the injury rate per 100 crashes was ascended 1.24 times.Compared with the road traffic injuries(RTIs),The mileage mortality rate of HTIs was about 4.51 times higher(97.06±44.49 vs 21.51±13.75 persons per 100 accidents,p<0.01),the crash mortality was around 2.21 times higher(56.55±14.55 vs 25.60±3.60 persons per 100 accidents,p<0.01),the mortality rate was 1.64 tims higher(31.31±2.12% vs 19.11±1.71%,p<0.01),the direct economic loss was about 10 times higher(33.6±5.4 vs 3.4±0.6 thousand yuan,p<0.01).The mileage crash rate and death rate of HTIs was decreasing year by year.However,the crash death rate and the mortality was ascending gradually.The relative risk of the fatal crash in HTIs s was 1.97(RR:1.97,95%CI:1.96-1.99)times higher than in RTIs.2.There are significant difference in 24 h distribution between HTIs and RTIs(Z=-5.939,P<0.01).The accidents by the hour of occurrence showed two peaks: 4:00-6:00 and 15:00-17:00 in HTIs,whereas 24 h distribution in RTIs was at a high-level from 8:00 to 24:00.There is no significant high risk period in RTIs.The crash mortality rate of HTIs at night was significantly higher than during the daytime(61.95±3.53 vs 50.23±2.69 persons per 100 accidents,p<0.05)3.There are significant differences in weather condition distribution and road surface condition distribution between HTIs and RTIs(Z=-2.193,P=0.032 and Z=-2.000,P=0.046,respectively).The fatal crashes often occurred on sunny weather and dry road surface in HTIs,RR were 1.17(95%CI:1.15-1.19)and 1.23(95%CI:1.21-1.26)respectively.The crash mortality rate in HTIs on icy and snowy road surface,windy,foggy and dusty weather was highest(61.17±20.12 and 73.84±21.51 persons per 100 accidents,respectively).4.There was a significant difference in the years of driver license distribution between HTIs and RTIs(Z=-2.611,P<0.01).The crash death rate in the years of driver license groups in HTIs was significantly higher than in RTIs.The crash mortality in the years of driver license beyond 10 years was notably higher than that of shorter than 5 years in HTIs(58.07±1.83 vs 50.38±14.56 persons per 100 accidents,P<0.05).The crash mortality in the yeas of driver license between 16 and 20 was highest,60.04±17.62 person per 100 accidents.Besides,the accident composition ratio of the shorter years of driver license is highest.5.The illegal ratio of pedestrians and passengers was gradually increased,the crash death rate was 70.39±16.91 persons per 100 accidents,was significantly higher than others causes.The crash mortality rate between human and motor vehicle was 74.32±7.34 persons per 100 accidents and notably higher than other crash types.6.The cluster analysis results: The Provinces which had the highest mileage death rate included Guizhou,Beijing,Yunnan and so on.The Provinces which had the highest crash mortality rate included Guizhou,Yunnan,Gungxi and Tianjin.The Provinces which had the highest mortality rate included Jiangsu,Shanghai.Univariate Logistic regression show that the risk of death by pedestrian entered into highway illegally was 8.7 times higher than driving a bus.The risk of death by driving with driver license was 1.84 times higher than without.The risk of death of crash between human and motor vehicle was higher than a car accident.Windy,foggy and dusty weather was 1.1 times higher than sunny weather,The risk of death in pedetrians and passgners breaking the law was 5.08 times higher than motor cehicle breaking the law.The death risk in the years of driver license beyond 20 years was 1.09 times higher than the years shorter than 5 years.Conclusions:1.Although the total number of deaths,injuries,injuries and direct property losses in HTIs is reduced in China,the composition ratio have increased year by year.The severity of HTIs is getting worse and is significantly higher than RTIs.2.The specific risk factors of HTIs are the years of driver license > 20 years,undocumented driving,foggy,windy and dusty weather,dry road surface condition,human-motor vehicle accident,pedestrian and passenger illegal,and pedestrian entering into highway illegally.Therefore,in the development of the preventive measures of highway motor vehicle crashes to be targeted to consider these risk factors in order to avoid the occurrence of traffic accidents,reduce the severity of traffic injuries.3.The national crash death rate and mortality rate of traffic injuries in highway rouse inconsistent trend,the results show that the trauma care system and the response ability may be one of the important factors that determine the outcome of highway traffic injury. |
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