Akbari Maryam, Heydari Seyed Taghi, Razzaghi Alireza, Vali Mohebat, Tabrizi Reza, Bagheri Lankarani Kamran
Institute of Health, Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Research Institute for Prevention of Non-Communicable Diseases, Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
PLoS One. 2024 Dec 5;19(12):e0312428. doi: 10.1371/journal.pone.0312428. eCollection 2024.
Road traffic collisions (RTCs) are the primary cause of death, which usually occur during the most crucial years of life, resulting in significant damage to health, society, and the economy. A wide variety of strategies and policies have been implemented around the world to minimize injuries and fatalities resulting from RTCs. This study aimed to systematically evaluate the effectiveness of interventions to reduce road traffic injuries (RTIs) in low-, middle-, and high-income countries.
The researchers looked for articles in many databases (PubMed, Web of Science, Google Scholar, Scopus, Embase, PsycInfo, OpenGrey, EconLit, IMEMR, AIM, Cochrane Injuries Group's specialized register, Transport Research International Documentation (TRID), Transportation Research Information Services (TRIS) Database and the OECD's Joint Transport Research Centre's International Transport Research Documentation (ITRD)) about ways to reduce RTIs and included articles published up to December 2023. The study area did not matter; only RTI reduction methods were considered. Two people checked the articles to ensure being relevant and qualified and summarized what they found in the articles.
A total of 852 articles were included in this systematic review. Most interventions were related to legislation (26.4%) and enforcement (17.0%), and the minor interventions were related to social marketing (4.9%) and traffic user safety (2.2%). Regarding income level (based on the latest classification of the World Bank-2020), more than half of the interventions (83.7%) took place in developed and high-income countries. Regarding intervention types, legislative and road safety interventions effectively reduced road traffic crashes by 26% and 16.7%, respectively. The results indicated that interventions in high-income countries were more likely to minimize RTCs than other countries. However, this difference was not statistically significant (p-value = 0.982). Most effective interventions (36.1%) were reported during the Decade of Action for Road Safety (2011-2020).
Current road safety efforts prioritize changing how people behave on the roads (training, laws, enforcement) over making the roads safer. Focusing on fixing the entire system rather than blaming drivers ("system repair") is necessary for a complete picture.
道路交通事故（RTCs）是主要的死亡原因，通常发生在生命中最关键的年龄段，对健康、社会和经济造成重大损害。世界各地已实施了各种各样的战略和政策，以尽量减少道路交通事故造成的伤害和死亡。本研究旨在系统评估在低收入、中等收入和高收入国家减少道路交通伤害（RTIs）干预措施的有效性。
研究人员在许多数据库（PubMed、科学网、谷歌学术、Scopus、Embase、PsycInfo、OpenGrey、EconLit、IMEMR、AIM、Cochrane伤害小组的专业注册库、国际交通研究文献数据库（TRID）、交通研究信息服务（TRIS）数据库以及经合组织联合交通研究中心的国际交通研究文献数据库（ITRD））中查找有关减少道路交通伤害方法的文章，并纳入截至2023年12月发表的文章。研究区域无关紧要；仅考虑减少道路交通伤害的方法。两人检查文章以确保其相关性和合格性，并总结他们在文章中发现的内容。
本系统评价共纳入852篇文章。大多数干预措施与立法（26.4%）和执法（17.0%）相关，少数干预措施与社会营销（4.9%）和交通使用者安全（2.2%）相关。关于收入水平（基于世界银行2020年的最新分类），超过一半的干预措施（83.7%）发生在发达国家和高收入国家。关于干预类型，立法和道路安全干预措施分别有效减少了26%和16.7%的道路交通事故。结果表明，与其他国家相比，高收入国家的干预措施更有可能将道路交通事故降至最低。然而，这种差异在统计学上并不显著（p值=0.982）。大多数有效的干预措施（36.1%）是在道路安全行动十年（2011 - 2020年）期间报告的。
当前的道路安全工作优先考虑改变人们在道路上的行为方式（培训、法律、执法），而不是使道路更安全。全面了解情况需要关注修复整个系统而不是指责司机（“系统修复”）。
