Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Level 4, Ambulatory Care Centre (ACC) Building, Jalan Raja Ashman Shah, Ipoh, Perak, 30450, Malaysia.
Clinical Research Centre, Hospital Seri Manjung, Ministry of Health, Seri Manjung, Perak, 32040, Malaysia.
BMC Public Health. 2024 Jun 6;24(1):1520. doi: 10.1186/s12889-024-19027-2.
This study addresses the persistent global burden of road traffic fatalities, particularly in middle-income countries like Malaysia, by exploring the impact of the COVID-19 pandemic on Road Traffic Accident (RTA) fatalities in Perak state, Malaysia, with a secondary focus on applying Years of Life Lost (YLL) to understand the implications of these premature deaths.
The cross-sectional study retrospectively reviewed certified RTA fatalities from 2018 to 2021, individually counting fatalities in accidents and excluding cases with incomplete death profiles. Data were collected from all Forensic Departments in the government hospitals in Perak. RTA fatalities were confirmed by medical officers/physicians following established procedures during routine procedures. A total of 2517 fatal accident and victim profiles were transcribed into data collection form after reviewing death registration records and post-mortem reports. Inferential analyses were used for comparison between pre- and during COVID-19 pandemic. The standard expected YLL was calculated by comparing the age of death to the external standard life expectancy curve taking into consideration of age and gender in Malaysia.
This study included 2207 (87.7%) of the RTA fatalities in Perak State. The analysis revealed a decreasing trend in RTA deaths from 2018 to 2021, with a remarkable Annual Percent Change (APC) of -25.1% in 2020 compared to the pre-pandemic year in 2019 and remained stable with lower APC in 2021. Comparison between pre-pandemic (2018-2019) and pandemic years (2020-2021) revealed a difference in the fatality distribution with a median age rise during the pandemic (37.7 (IQR: 22.96, 58.08) vs. 41.0 (IQR: 25.08, 61.00), p = 0.002). Vehicle profiles remained consistent, yet changes were observed in the involvement of various road users, where more motorcycle riders and pedestrian were killed during pandemic (p = 0.049). During pandemic, there was a decline in vehicle collisions, but slight increase of the non-collision accidents and incidents involving pedestrians/animals (p = 0.015). A shift in accident from noon till midnight were also notable during the pandemic (p = 0.028). YLL revealed differences by age and gender, indicating a higher YLL for females aged 30-34 during the pandemic.
The decline in RTA fatalities during COVID-19 pandemic underscores the influence of pandemic-induced restrictions and reduced traffic. However, demographic shifts, increased accident severity due to risky behaviors and gender-specific impacts on YLL, stress the necessity for improved safety interventions amidst evolving dynamics.
本研究旨在探讨 COVID-19 大流行对马来西亚霹雳州道路交通伤亡事故（RTA）死亡人数的影响，该研究针对的是全球道路交通死亡人数持续存在的问题，特别是在马来西亚等中等收入国家。本研究的另一个重点是应用寿命损失年（YLL）来理解这些过早死亡的影响。
本横断面研究回顾性分析了 2018 年至 2021 年期间霹雳州经认证的 RTA 死亡人数，单独计算了事故中的死亡人数，并排除了死亡记录不完整的病例。数据来自霹雳州政府医院的所有法医部门。RTA 死亡人数由医疗官员/医生根据常规程序中确定的程序确认。在审查死亡登记记录和尸检报告后，将总共 2517 份致命事故和受害者档案转录到数据收集表中。使用推断分析比较了大流行前和大流行期间的数据。通过将死亡年龄与考虑到马来西亚年龄和性别的外部标准预期寿命曲线进行比较，计算出标准预期 YLL。
本研究纳入了霹雳州 2207 例（87.7%）RTA 死亡病例。分析显示，2018 年至 2021 年期间 RTA 死亡人数呈下降趋势，2020 年与 2019 年大流行前相比，年度百分比变化（APC）显著下降了 25.1%，2021 年 APC 保持稳定，但略有下降。大流行前（2018-2019 年）和大流行年（2020-2021 年）之间的比较显示，死亡率分布存在差异，大流行期间的中位数年龄上升（37.7（IQR：22.96，58.08）vs. 41.0（IQR：25.08，61.00），p=0.002）。车辆类型保持不变，但各种道路使用者的参与情况发生了变化，大流行期间更多的摩托车骑手和行人死亡（p=0.049）。大流行期间，车辆碰撞事故有所减少，但非碰撞事故和涉及行人和动物的事故略有增加（p=0.015）。大流行期间，中午至午夜的事故发生时间也发生了显著变化（p=0.028）。YLL 因年龄和性别而异，表明大流行期间 30-34 岁女性的 YLL 更高。
COVID-19 大流行期间 RTA 死亡人数的下降突显了大流行引起的限制和交通减少的影响。然而，人口结构的变化、由于危险行为导致的事故严重程度增加以及性别对 YLL 的特定影响，强调了在不断变化的动态环境中需要加强安全干预措施。
