| ObjectivesThrough questionnaire survey of key populations and field observations on central roads,the basic demographic characteristics,awareness of road traffic safety regulations,riding behavior characteristics,personality characteristics and injury status of electric bicycle(EB)riders in Shantou were mastered,and the current situation and influencing factors of E-bike road traffic injury(ERTI)were analyzed and discussed,clarifying its injury patterns and epidemiological characteristics,and providing scientific basis for preventing and controlling ERTIs in Shantou.MethodsDescriptive study:including cross-sectional study and roadside observation study.The cross-sectional study adopted a multi-stage stratified cluster random sampling method to select the distributed(Jinping District,Longhu District)and non-distributed(Chaoyang District,Chaonan District,Chenghai District)areas of shared e-bikes in Shantou City,Guangdong Province.for investigation.Parents of elementary school students,as well as junior high school students,high school students,and college students were the subjects of the survey.In the roadside observation study,six road intersections in the urban area of Shantou city(Jinping District and Longhu District)were selected,and the EB riders at the intersections were observed by researchers trained in uniform standards for a week during four time periods:8:00～9:00,11:30～12:30,14:00～15:00,and 17:30～18:30,respectively.Analytical research:including case-control research and case-cross research.Case-control study selected orthopedic inpatient departments of three comprehensive 3A hospitals in Shantou City(First Affiliated Hospital of Shantou University,Second Affiliated Hospital of Shantou University and Shantou Central Hospital)for investigation,screened and confirmed that newly admitted EB cyclists were included in the case group,and nurses or doctors in the inpatient department conducted investigation.A 1:1 matched case-control study method was adopted,and the subjects of the same sex,same age(5 years old),same occupation,same administrative area in cross-sectional investigation and who had not suffered ERTI in the 12 months before the investigation were taken as the control group.The specific time period before the injury of the same individual in the case group was defined as the risk period,and the three months from the day before the injury was defined as the control period.The exposure of some risk factors(such as helmet wearing,mobile phone use,etc.)in the two periods was cross-studied.Epi Data V.3.1 was used to double-enter data and verify cleaning,and SPSS V.25.0(IBM)as well as R V.4.0.3 were used for statistical analysis.Statistical description of measurement data and enumeration data were performed by means and standard deviations,frequency and composition ratios respectively;t-test,χ~2 test and one-way logistic regression were used for comparison between groups;stepwise forward multi-factor conditional logistic regression or cox regression was used to identify risk factors for ERTI.P<0.05 on both sides was regarded as the difference with statistical significance.Results1.Cross-sectional study:A total of 2444 EB riders in Shantou were investigated,and 2412valid questionnaires were collected.The effective rate was 98.69%,and the accident rate was4.81%(116/2412).The injury rate of males(7.62%)was higher than that of females(3.37%),and middle school students who were under the legal riding age(16 years old)The awareness rate of EB riders on relevant road traffic safety laws and regulations in Shantou is low,and dangerous riding behaviors such as not wearing safety helmets,running red lights,using mobile phones when riding,riding on motor vehicle lanes,and riding in reverse are common.ERTI mainly occurred in October(17.24%)and July(16.38%),with the most injuries(9.48%)from17:00 to 18:00.The main injury sites were lower limbs(57.76%)and upper limbs(28.45%),and the main methods of treatment are private clinics(40.52%)and outpatient clinics(27.59%).The main cause of injury accidents is that the road design is imperfect and unreasonable,and the road traffic injuries caused by it account for over 30%(35.34%)of all injury accidents.2.Roadside observation study:A total of 14,144 private EB riders and 20,410 shared EB riders were observed.The incidence of retrograde movement was 4.52%,the incidence of red light running was 5.58%,the riding rate on pedestrian walkways was 28.01%,and the rates of answering phone calls and reading mobile phone information were 3.37%and 7.61%,respectively.The incidence of the above-mentioned dangerous riding behaviors of private EB cyclists is higher than that of shared EB cyclists,and the occurrence of the above-mentioned dangerous riding behaviors at traffic intersections without traffic police on duty is significantly higher than those with traffic police on duty,with statistical significance(P<0.001).The helmet wearing rate of private EB is 58.17%,which is higher for women than for men.There is a significant difference in helmet wearing rate among private EB riders in different time periods(χ~2=220.81,P<0.001),among which the helmet wearing rate is the highest from 08:00 to 09:00(morning rush hour)and the lowest from 11:30 to 12:30(morning rush hour).The wearing rate of helmets at intersections with traffic police on duty(70.98%)was higher than that at intersections without traffic police on duty(53.64%).The overall incidence of illegally carrying adults(11.37%)is higher than that of children(5.33%),and the incidence of illegally carrying passengers on non-working days is higher than that on working days,with statistical significance(χ~2=4.67,P<0.05).Adults(13.30%)are mainly carried in business districts,while the incidence of children(5.34%)in non-business districts is slightly higher than adults(5.32%).3.Case-control study:Astigmatism is the protective factor of ERTI(OR=0.05,95%CI:0.007～0.331).Compared with urban road sections,the frequent cycling road sections are suburbs and towns(OR=8.19,95%CI:2.344～28.601),which are more prone to injury accidents.Dangerous riding behaviors include reverse riding(OR=5.01,95%CI:1.523～16.449),chasing and fighting with other vehicles or pedestrians(OR=25.57,95%CI:5.624～116.240),and finding EB malfunction but continuing to ride(OR=12.52,95%CI:2.087～75.138)were risk factors for heavy ERTI.4.Cross-case study:Wearing helmets is the protective factor of heavy ERTI,and the EB cyclists who don’t wear a helmet have an increased risk of injury by 3.63 times(OR=4.63,95%CI:1.041～16.260)compared to those wearing a helmet.Using mobile phones to make calls or read information increased the ERTI risk by 23.94 times(OR=24.94,95%CI:4.266～27.793).However,riding on motor vehicle lanes(OR=0.35,95%CI:0.162～0.765)and riding on sidewalks(OR=0.08,95%CI:0.023～0.272)are the protective factors of heavy ERTI.Conclusions1.The incidence of light ERTI in Shantou is 4.81%.Cyclists lack correct understanding of relevant road traffic safety laws and regulations,and the implementation rate of dangerous riding behavior is high.Junior high school students are the key group of injury prevention and control.2.The helmet wearing rate of electric bicycles in Shantou is 58.17%,and the incidence of other traffic violations is about 5%.Traffic police enforcement is a powerful control measure to reduce dangerous riding behavior.3.Road sections with high incidence of heavy ERTI are mixed lanes,mainly suburban and township sections.Some serious ERTI caused severe clinical symptoms and poor prognosis.Wearing helmets can reduce the risk of ERTI,while the behavior of using cell phones is an important risk factor for ERTI.Also,reverse riding,chasing and jostling with other vehicles or pedestrians,and continuing to ride after vehicle failure are closely related to injury.Therefore,the traffic control department should earnestly implement the propaganda and enforcement of the"One Helmet and One Belt"policy,improve the helmet wearing rate of EB cyclists,and resolutely put an end to illegal activities such as cycling after drinking,running red lights,and using mobile phones while riding;Urban construction planning and governance departments should focus on improving the road construction and riding environment,improving the separation facilities of non-motor vehicles and motor vehicles,and maximizing the social and economic benefits and public health benefits of electric bicycles. |
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