Amoros Emmanuelle, Martin Jean-Louis, Lafont Sylviane, Laumon Bernard
University of Lyon 1 (UCBL) and French Institute for Public Health Surveillance (InVS), Lyon, F-69008, France.
Eur J Public Health. 2008 Aug;18(4):360-5. doi: 10.1093/eurpub/ckn018. Epub 2008 Mar 31.
Nation-wide road casualty figures usually come from police data. In France, as in many developed countries, the reporting of fatalities is almost complete but the reporting of non-fatal casualties is rather low. It is moreover strongly biased. Valid estimates are needed.
Using the capture-recapture method on police data and on a road trauma registry covering a large county of 1.6 million inhabitants, we estimate police under-reporting correction factors that account for unregistered casualties. These correction factors are then applied to the nation-wide police data, with standardization on under-reporting bias factors.
In 2004, whereas the police report 108,727 non-fatally injured, the estimation yields 400,200. Over the 1996-2004 study period, the average annual estimated incidence is 871/100,000 for all injured (3.4 times the police incidence), 232/100,000 for hospitalized, 103/100,000 for seriously injured (2.2 times the police incidence) and 12.6/100,000 for casualties with long-term major impairment. The incidence of seriously injured (NISS 9+) is 11.3/100,000 for pedestrians, 9.5/100,000 for cyclists, 36.3/100,000 for motorized two-wheel users and 42.5/100,000 for car users.
The estimated incidences are much higher than the police-based ones. This changes the scale of the road injuries issue. The risk of suffering a major impairment from a road crash is equal to the risk of being killed. Motorized two-wheel users experience a large burden of traffic casualties, much larger than that indicated by police data. The approach used can be reproduced in other countries, if an additional medical registration exists.
全国道路伤亡数据通常来自警方记录。在法国,与许多发达国家一样,死亡人数的报告几乎完整,但非致命伤亡的报告率较低,而且存在严重偏差,因此需要进行有效估计。
我们采用捕获再捕获法,基于警方数据以及一个涵盖160万居民的大县的道路创伤登记处的数据,估算警方漏报校正因子,以计入未登记的伤亡情况。然后将这些校正因子应用于全国警方数据,并对漏报偏差因子进行标准化处理。
2004年,警方报告的非致命受伤人数为108,727人,而估算结果为400,200人。在1996 - 2004年研究期间,所有受伤者的年平均估算发病率为871/10万(是警方发病率的3.4倍),住院患者为232/10万,重伤者为103/10万(是警方发病率的2.2倍),长期严重致残伤亡者为12.6/10万。行人重伤(简明损伤定级9+)的发病率为11.3/10万,骑自行车者为9.5/10万,两轮机动车使用者为36.3/10万,汽车使用者为42.5/10万。
估算的发病率远高于基于警方数据的发病率,这改变了道路伤害问题的规模。道路交通事故造成严重损伤的风险与死亡风险相当。两轮机动车使用者承受着巨大的交通伤亡负担,远大于警方数据所显示的情况。如果存在额外的医疗登记,本文所采用的方法可在其他国家推广。