Department of Public Health Sciences, University of Chicago, Chicago, IL, USA.
Department of Public Health Sciences, University of Chicago, Chicago, IL, USA.
Lancet Glob Health. 2020 Jun;8(6):e819-e828. doi: 10.1016/S2214-109X(20)30102-9.
The Sustainable Development Goals (SDGs), which aim to halve global traffic deaths by 2020, will not be met by most low-income and middle-income countries (LMICs). In Latin America and the Caribbean (LAC) region, traffic deaths have remained stable at a high-level despite strong progress in other health domains. We evaluated the effects of road safety interventions in LAC and estimated the benefits that vehicle design improvements would have in this region.
In our study done in October, 2018, we used a counterfactual analysis to assess the reduction in deaths and disability-adjusted life years (DALYs) lost if eight proven vehicle safety technologies were made more widely available in LAC countries. We estimated: (1) country-level incidence of traffic injuries, (2) the effectiveness of technologies through a systematic literature review, (3) the prevalence of car safety technologies, and (4) the lives saved and DALYs averted if all cars had these technologies. We characterised uncertainty in estimates by reporting the sensitivity of the results to alternative modelling assumptions.
Increasing availability of electronic stability control, which includes antilock-brake systems, would have the largest benefits in the LAC region, estimated at 19·4% (sensitivity analysis range 8·6-31·1) fewer deaths and 17·0% (5·7-29·2) fewer DALYs. Increasing use of seatbelts would reduce deaths by 12·1% (9·1-15·5) and DALYs by 12·6% (9·4-16·3). Optimisation for side-impacts would result in 6·3% (3·1-6·5) fewer deaths, and improvements to vehicle front-end design would result in 6·0% (2·2-10·4) fewer deaths. The overall effect of improved vehicle design in the region would be 28·1% (12·8-39·2) fewer deaths, and 29·1% (13·5-39·8) fewer DALYs. Other safety technologies modelled, including airbag (front and side), side door beam, and side structure and padding, have smaller benefits.
Regulating and encouraging the use of proven vehicle safety technologies in LMICs would have large gains and needs to be prioritised in the SDG agenda for 2030.
Inter-American Development Bank.
可持续发展目标（SDGs）旨在到 2020 年将全球交通死亡人数减半，但大多数低收入和中等收入国家（LMICs）都无法实现这一目标。在拉丁美洲和加勒比地区（LAC），尽管在其他卫生领域取得了强劲进展，但交通死亡人数仍保持在较高水平。我们评估了 LAC 地区道路安全干预措施的效果，并估计了车辆设计改进在该地区的收益。
在我们于 2018 年 10 月进行的研究中，我们使用反事实分析来评估如果在 LAC 国家更广泛地使用八项已证明的车辆安全技术，将减少多少死亡和残疾调整生命年（DALYs）。我们估计：（1）交通事故发生率；（2）通过系统文献综述评估技术的有效性；（3）汽车安全技术的流行程度；（4）如果所有汽车都配备了这些技术，将挽救多少生命并避免多少残疾调整生命年。我们通过报告对替代建模假设的结果敏感性来描述估计值的不确定性。
电子稳定控制系统（包括防抱死制动系统）的可用性增加将在 LAC 地区带来最大的收益，估计可减少 19.4%（敏感性分析范围 8.6-31.1）的死亡人数和 17.0%（5.7-29.2）的残疾调整生命年。安全带使用率的提高将减少 12.1%（9.1-15.5）的死亡人数和 12.6%（9.4-16.3）的残疾调整生命年。侧面碰撞优化将导致 6.3%（3.1-6.5）的死亡人数减少，而前端车辆设计的改进将导致 6.0%（2.2-10.4）的死亡人数减少。该地区车辆设计改进的总体效果将是减少 28.1%（12.8-39.2）的死亡人数和减少 29.1%（13.5-39.8）的残疾调整生命年。其他建模的安全技术，包括气囊（正面和侧面）、侧门梁以及侧面结构和衬垫，收益较小。
在 LMICs 中监管和鼓励使用经过验证的车辆安全技术将带来巨大收益，这需要在 2030 年的可持续发展目标议程中优先考虑。
美洲开发银行。
