Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, United States.
Shanghai Municipal Center for Disease Control and Prevention, China.
Accid Anal Prev. 2018 Dec;121:279-284. doi: 10.1016/j.aap.2018.09.027. Epub 2018 Oct 4.
Road traffic crashes impose a heavy burden in China's most populous city, Shanghai. Since early 2016, Shanghai police have started deploying high-resolution cameras and an object-detection algorithm in seatbelt enforcement. Around the same time, an international consortium on road safety launched a series of capacity trainings for law enforcement accompanied by infrastructure renovation and social marketing campaigns in Shanghai. Our objective is to assess the level and trend of seatbelt use in Shanghai over 2015-2017.
Ongoing observational studies evaluate seatbelt use within the city. Data are collected at eight randomly selected locations throughout the city, stratified by road type and geographic locations. Data collection covers most times of the day on both business days and weekends, providing a full representation of varying traffic models during both rush hours and non-rush hours. At each site, trained field workers observe seatbelt use of occupants in all passing motorized vehicles. A multivariate logistic regression model was developed to analyze the data.
From October 2015 to December 2017, six rounds of data collection were completed with a total sample size of 77,641 drivers and passengers of motor vehicles. The seatbelt use rate has steadily increased over time, from 60.8% (95% CI: 59.9%-61.7%) in round 1 to 84.9% (84.3%-85.4%) in round 6 (p-value < 0.01). The increase is substantial and statistically significant for both drivers and passengers (p-value < 0.01). Results from the multivariate logistic regression show an annual growth rate of seatbelt use of 8.8% (8.4%-9.1%); the wearing rate was 49.8% (49.0%-50.5%) lower among passengers than drivers; 3.5% (2.9%-4.1%) lower in peri-urban areas than central urban areas; 16.3% (14.3%-18.4%) higher among 18-24-year and 18.9% (17.0%-20.9%) higher among 25-59-year olds than other age groups.
Seatbelt use in Shanghai has been boosted during a short period of time through a combined strategy that includes training of police, social marketing campaign, and the deployment of computer vision assisted enforcement. Large cities in China and other countries facing similar challenges with seatbelt wearing may learn from Shanghai's experience.
道路交通碰撞在中国人口最多的城市上海造成了沉重的负担。自 2016 年初以来，上海警方开始在安全带执法中部署高分辨率摄像头和目标检测算法。与此同时，一个国际道路安全联合会在上海开展了一系列执法能力培训，同时进行基础设施改造和社会营销活动。我们的目标是评估 2015-2017 年上海的安全带使用水平和趋势。
正在进行的观察性研究评估了该市的安全带使用情况。数据在全市 8 个随机选定的地点收集，按道路类型和地理位置分层。数据采集涵盖了工作日和周末的大部分时间，全天 24 小时，充分代表了高峰和非高峰时段不同的交通模式。在每个地点，经过培训的现场工作人员观察过往机动车辆中所有乘客的安全带使用情况。开发了一个多变量逻辑回归模型来分析数据。
从 2015 年 10 月至 2017 年 12 月，共完成了六轮数据收集，总样本量为 77641 名机动车驾驶员和乘客。安全带使用率随着时间的推移稳步上升，从第 1 轮的 60.8%（95%CI：59.9%-61.7%）上升到第 6 轮的 84.9%（84.3%-85.4%）（p 值<0.01）。无论是驾驶员还是乘客，这一增长都是显著且具有统计学意义的（p 值<0.01）。多变量逻辑回归结果显示，安全带使用率的年增长率为 8.8%（8.4%-9.1%）；乘客的安全带使用率比驾驶员低 49.8%（49.0%-50.5%）；城市周边地区比市中心地区低 3.5%（2.9%-4.1%）；18-24 岁年龄组和 25-59 岁年龄组的安全带使用率分别比其他年龄组高 16.3%（14.3%-18.4%）和 18.9%（17.0%-20.9%）。
上海通过培训警察、开展社会营销活动和部署计算机视觉辅助执法的综合战略，在短时间内提高了安全带的使用。中国和其他面临类似安全带佩戴挑战的大城市可以借鉴上海的经验。
