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thèse doctorat de l'université bordeaux 2 - ISPED-Enseignement à ...

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ABSTRACTObjective: To assess the bur<strong>de</strong>n and factors associated with highway work-zone (HWZ)crashes.Design: Historical cohort.Setting: Karachi-Hala road-section, Pakistan (196 km).Data: Police reported crashes and traffic statistics from Jan 06 to Dec 08.Analysis: Crash and fatality risk between HWZ and other zones for a 50-km-long sectionwere compared. Crash locations were <strong>de</strong>scribed for a further 146-km-long section on whichfactors associated with HWZ crashes were assessed.Results: HWZs accounted for 15.0% of traffic crashes (N=180) and 30.8% of road fatalities(N=91) on the 196-km-long section. Rates were higher in HWZ compared to other zones forcrash (rate ratio (RR) = 2.35, 95% confi<strong>de</strong>nce interval (95%CI) = 1.17-4.70) and fatality (RR= 4.70, 95%CI = 2.11-10.46). Opposite-direction (adjusted odds ratio (aOR)=10.65, 95%CI=3.22-35.25) and traffic crashes involving pe<strong>de</strong>strians (aOR=6.03, 95%CI=1.39-26.20) andon wet surfaces (aOR=7.26, 95%CI=4.15-48.89) were significantly associated with HWZs.Conclusion: These results orient toward prevention measures such as strict trafficenforcement, traffic separation, improving pe<strong>de</strong>strians’ conspicuity, and hazard signage atHWZs in Pakistan. Feasibility and effectiveness of these measures remains to be evaluated.Keywords: Developing country; road/traffic acci<strong>de</strong>nts; severity; trauma.Abbreviations: HWZ, highway work zones; km, kilometre; LMIC, low and middle-incomecountries; NHA, National Highway Authority; NHMP, National Highway & MotorwayPolice; PKR, Pakistani rupee; USA, United States of America.111

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