Wilson C, Willis C, Hendrikz J K, Bellamy N
University of Queensland, Level 3, Mayne Medical School, Herston Road, Herston, Brisbane, Australia, Qld 4006.
Cochrane Database Syst Rev. 2006 Apr 19(2):CD004607. doi: 10.1002/14651858.CD004607.pub2.
It is estimated that by 2020, road traffic crashes will have moved from ninth to third in the world ranking of burden of disease, as measured in disability adjusted life years. The identification of effective strategies for the prevention of road traffic injuries is of global public health importance. Measures aimed at reducing traffic speed are considered essential to preventing road injuries; the use of speed enforcement detection devices (including speed cameras and radar and laser devices) is one such measure.
To assess whether the use of speed enforcement detection devices (SEDs) reduces the incidence of speeding, road traffic crashes, injuries and deaths.
We searched the Cochrane Injuries Group's Specialised Register, CENTRAL, MEDLINE, EMBASE, Science (and Social Science) Citation Index, TRANSPORT, PsycINFO, CINAHL, EconLit. We searched the websites of road safety and motoring associations, as well as general internet searches. We handsearched selected journals and conference proceedings, and contacted experts in the field. The searches were conducted during May to November 2004.
Randomised controlled trials and controlled before-after studies that assessed the impact of speed enforcement detection devices on speeding, road crashes, injuries and deaths were eligible for inclusion. For studies involving co-interventions, SEDs had to be the major intervention focus of the study to be eligible.
We independently screened search results, assessed studies for inclusion, extracted data and assessed methodological quality. Due to variability between and within included studies, a pooled analysis was not appropriate.
No randomised controlled trials were identified. Twenty-six studies met the inclusion criteria, of which 22 were controlled before-after trials incorporating a distinct control or comparison group(s) and four were interrupted time series designs with a comparison group(s). Fourteen studies reported speed and crash outcomes, seven reported crash outcomes only and five reported speed outcomes only. All but one study reported an absolute reduction in pre/post average speeds. A pre/post reduction in the proportion of speeding vehicles ranged across studies from 5% to 70% depending on the speed threshold set. Pre/post reductions of 50% to 65% were reported in the proportion of speeding vehicles travelling >15 km/h over the speed limit. Compared with controls, the relative improvement was from 1% to 15% for average speed and from 14% to 65% for percent speeding. All studies reporting crash outcomes reported an absolute pre/post reduction in all crashes and injury related crashes. In the vicinity of camera sites these pre/post reductions ranged from 14% to 72% for all crashes, 8% to 46% for injury crashes, and 40% to 45% for crashes resulting in fatalities or serious injuries. More generalised effects over wider areas showed an absolute pre/post crash reduction ranging from 9% to 35%, 7% to 30% for all injury crashes and 13% to 58% for crashes resulting in fatalities alone, or in combination with serious injuries. The studies of longer duration showed that these positive trends were either maintained or improved with time. Compared with controls, the relative improvement in pre/post crash numbers resulting in any type of injury ranged from 5% to 36%.
AUTHORS' CONCLUSIONS: Despite the methodological limitations of the studies reviewed, the consistency of reported positive reductions in speed and crash outcomes across all studies suggest that SEDs are a promising intervention for reducing the number of road traffic injuries and deaths. More studies of a scientifically rigorous nature are necessary to provide a stronger evidence base that these interventions are worthwhile. There is a need for international harmonisation of data collection methods, including standards on how best to measure speeds and collect crash data, over lengthy intervention and follow-up periods, as well as some consensus as to the expression of outcomes in studies, so that studies can be compared.
据估计，到2020年，道路交通碰撞在按伤残调整生命年衡量的疾病负担全球排名中将从第九位升至第三位。确定预防道路交通伤害的有效策略具有全球公共卫生重要性。旨在降低交通速度的措施被认为对预防道路伤害至关重要；使用速度执法检测设备（包括测速摄像头、雷达和激光设备）就是这样一种措施。
评估使用速度执法检测设备（SEDs）是否能降低超速、道路交通碰撞、伤害和死亡的发生率。
我们检索了Cochrane伤害组专业注册库、Cochrane系统评价数据库、医学期刊数据库、荷兰医学文摘数据库、科学（及社会科学）引文索引、交通运输数据库、心理学文摘数据库、护理学与健康领域数据库、经济学文献数据库。我们检索了道路安全和驾驶协会的网站，以及进行了一般的互联网搜索。我们手工检索了选定的期刊和会议论文集，并联系了该领域的专家。检索于2004年5月至11月进行。
评估速度执法检测设备对超速、道路碰撞、伤害和死亡影响的随机对照试验和前后对照研究符合纳入标准。对于涉及联合干预的研究，SEDs必须是研究的主要干预重点才有资格纳入。
我们独立筛选检索结果，评估研究是否纳入，提取数据并评估方法学质量。由于纳入研究之间和内部存在差异，不适合进行汇总分析。
未检索到随机对照试验。26项研究符合纳入标准，其中22项是纳入了不同对照组的前后对照试验，4项是带有对照组的中断时间序列设计。14项研究报告了速度和碰撞结果，7项仅报告了碰撞结果，5项仅报告了速度结果。除一项研究外，所有研究均报告前后平均速度有绝对降低。根据设定的速度阈值，不同研究中超速车辆比例的前后降低幅度为5%至70%。报告显示，超过限速15公里/小时行驶的超速车辆比例前后降低了50%至65%。与对照组相比，平均速度的相对改善为1%至15%，超速百分比的相对改善为14%至65%。所有报告碰撞结果的研究均报告所有碰撞及与伤害相关碰撞的前后绝对减少。在摄像头安装地点附近，所有碰撞的前后减少幅度为14%至72%，伤害碰撞为8%至46%，导致死亡或重伤的碰撞为40%至45%。在更广泛区域的更普遍影响显示，所有碰撞前后绝对减少幅度为9%至35%，所有伤害碰撞为7%至30%，仅导致死亡或与重伤合并的碰撞为13%至58%。持续时间较长的研究表明，这些积极趋势随时间得以维持或改善。与对照组相比，导致任何类型伤害的碰撞数量前后相对改善幅度为5%至36%。
尽管所审查的研究存在方法学局限性，但所有研究报告的速度和碰撞结果均呈积极下降趋势，这表明SEDs是减少道路交通伤害和死亡数量的一种有前景的干预措施。需要更多科学严谨的研究来提供更强有力的证据基础，证明这些干预措施是值得的。需要对数据收集方法进行国际协调，包括关于如何在长时间干预和随访期间最佳测量速度和收集碰撞数据的标准，以及在研究结果表达方面达成一些共识，以便能够对研究进行比较。
