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conspicuity at HWZs in Pakistan. 2 8 15 Feasibility and effectiveness of their implementation,however remains to be evaluated.ACKNOWLEDGEMENTSWe are especially thankful to Dr. Aftab Ahmed PATHAN, Deputy Inspector General ofPolice, Mr. Irshad SODHAR, Senior Patrolling Officer, and Mr. Naeemullah SHIEKH , SeniorPatrolling Officer, National Highway and Motorway Police south sector III office, Pakistanfor their support in data collection. Authors also acknowledge Engr. Ali Bin Usman SHAH,Road Safety Expert at National Highway Authority for providing traffic survey reports.Finally, we would like to thank the editor and reviewers for their suggestions to improve thecontent of this manuscript.FUNDINGFirst author is the PhD candidate at Université Victor Segalen Bordeaux 2. This position isfunded by Higher Education Commission of Pakistan. Institut National de la Santé et de laRecherche Médicale Unité 897, France, funded the logistics for data collection. Fundingbodies had no input in study design, analysis and interpretation of results.AUTHORS CONTRIBUTIONThis study is the part of PhD thesis work of JB supervised by LRS. JAR and EL providedtechnical help in study conception, design, analysis, and manuscript writing.COMPETING INTERESTSNo competing interests were identified for any of the authors.LICENSE STATEMENT:The Corresponding Author has the right to grant on behalf of all authors and does grant onbehalf of all authors, an exclusive licence (or non exclusive for government employees) on aworldwide basis to the BMJ Publishing Group Ltd and its licencees, to permit this article (ifaccepted) to be published in IP and any other BMJ Group products and to exploit allsubsidiary rights, as set out in our licence (http://ip.bmjjournals.com//ifora/licence.pdf).Important pointsWhat is already known on the subject?• Highway work zones (HWZs) lead to increased crash and fatality risk.• Risks and factors associated with such zones were rarely studied in developing countries.What this study adds:• Crash fatality risk was four times as high on HWZs as compared to other zones in Pakistan, alow-income country.• Traffic separation, harsher penalties for hazardous overtaking, and appropriate hazard signageat HWZs might reduce the risk of such crashes.Policy implications:• Exposition to HWZ will tremendously increase in coming years in developing countries likePakistan. Implementation of safety interventions at HWZs may significantly reduce roaddisease burden.REFERENCES1. Li Y, Bai Y. Highway work zone factors and their impact on crash severity. J Transp Eng2009;135:694-701.116
2. American Association of State Highway and Transportation Officials (AASHTO). Apolicy on geometric design of highways and streets. Washington, DC: AASHTO,2004.3. Li Y, Bai Y. Development of crash-severity-index models for the measurement of workzone risk levels. Accid Anal Prev 2008;40:1724-31.4. Department of Transportation (DOT). FY 2008 Budget in brief. Washington, DC: DOT,2008.5. Department of Transportation (DOT). Highway Statistics 2007: Funding For Highwaysand Disposition of Highway-User Revenues, All Units of Government, 2007.Washington, DC: DOT, 2007.6. Republic of Ghana, European Community. Country Strategy Paper and IndicativeProgramme for the period 2002–2007. Accra: European Union delegation in Ghana,2002.7. Masood H, Seetharam KC, Utami D, et al. Report and recommendation of the President tothe board of directors on proposed loans to the Islamic Republic of Pakistan for theNorth-West Frontier Province road development sector and subregional connectivityproject. Manilla: Asian Development Bank, 2004.8. American Association of State Highway and Transportation Officials (AASHTO).Summary report on work zone crashes. Standing committee on highway traffic safety.Washington, DC: AASHTO, 1987.9. Wang J, Hughes WE, Council FM, at al. Investigation of highway work zone crashes:what we know and what we do not know. J Transp Res Rec 1996;(1529):54-64.10. Li Y, Bai Y. Comparison of characterstics between fatal and injury accidents in highwaywork zones. Safety Sci 2008;46:646-60.11. Mohan SB, Gautam P. Cost of highway work zone injuries. Practical Periodical onStructural Design and Construction 2002;7:68-73.12. JICA, NTRC, Government of Pakistan. Pakistan Transport Plan Study in the IslamicRepublic of Pakistan. Islamabad: tripartite collaboration of the Japan InternationalCooperation Agency (JICA); National Transport Research Centre (NTRC), andMinistry of Communications, Government of Pakistan, 2007.13. Nishtar S, Mohamud KB, Razzak J, et al. Injury prevention and control: National ActionPlan for NCD Prevention, Control and Health Promotion in Pakistan. J Pak MedAssoc 2004;54:S57-68.14. National Transport Research Centre. Traffic Counter measures in Pakistan: NTRCpublication 85. Islamabad: National Transport Research Centre, Ministry ofCommunication, 1985.15. Ahmed A. National Road Safety Plan 2007-2012. Islamabad: National Road SafetySecretariat, Ministry of Communications, 2007.16. Hyder AA, Ghaffar AA, Sugerman DE, et al. Health and road transport in Pakistan.Public Health 2006;120:132-41.17. Salmi LR, Battista RN. Epidemiologic assessment of hazardous roadway locations.Epidemiology 1990;1:311-4.18. Lassarre S. Some Statistical Models for Road Risk Analysis. In: Tiwari G, Mohan D,Muhlrad N, editors. The Way Forward: Transportation Planning and Road Safety.New Delhi: MacMillan India Ltd., 2005.19. National Highway Authority (NHA). Traffic survey. Islamabad: NHA, 2008.20. Khoso A. Analysis of National Highways & Motorway Police Injury Surveillance Systemwith respect to WHO Injury Surveillance Guidelines. Stockholm; Kerolinska Institutet,2007.117
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Université Victor Segalen Bordeaux
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Publications (peer-reviewed).......
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Index of figuresFigure 1. Traffic f
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AbbreviationsAKUAVCIBMIEASESSDALYDW
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AbstractBackground: Interurban traf
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L'objectif de cette thèse était d
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2. Background2.1 Road injury burden
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2.4 Multiple factors involved in tr
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Figure 4. Percentage difference of
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2.7 Interurban road safety research
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ObjectivesThe objectives of this fi
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ResultsCrash burdenA total of 935 R
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Figure 7. Monthly trend of traffic
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Injury outcome patternsMost of inju
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MethodsThe study setting was 196-km
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patients. In the ED, those with NIS
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Table 6. Traffic injuries reported
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5. Analytical StudiesPrevious liter
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under supervision of Dr. Sobngwi-Ta
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Table 9. Situational variables at c
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MethodsStudy design and settingStud
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to Dec 08 were retrieved and photoc
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normal zones. However, this associa
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MethodsStudy design and settingsThe
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Figure 14. Picture extracted of a h
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located in built-up area in Pakista
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Table 15. Differences in hazard per
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6. Discussion6.1 Originality of stu
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Although adjustments are possible,
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observational studies on how the de
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to understand the deficiencies in t
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[24] Damsere-Derry J, Afukaar FK, D
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Page 68 and 69: [111] Geurts K, Wets G, Brijs T, Va
Page 70 and 71: [154] Rosenbloom T, Shahar A, Elhar
Page 72 and 73: 4. Farooq U, Bhatti JA, Siddiq M, M
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Page 76 and 77: they identified a cluster of long b
Page 78 and 79: more cost-effective than redesignin
Page 80 and 81: Table 18. Traffic injury interventi
Page 86 and 87: Appendix 3: Study I supplementary r
Page 88 and 89: Appendix 4: Manuscript in preparati
Page 90 and 91: BACKGROUNDPakistan, located at the
Page 92 and 93: patients were recorded during their
Page 94 and 95: This might motivate police officers
Page 96 and 97: 12. Peden M, Scurfiled R, Sleet D,
Page 98 and 99: Table 1. Traffic injuries reported
Page 100 and 101: Table 3. Ascertainment of police, a
Page 102 and 103: Appendix 5: Article published - Stu
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Page 110 and 111: Appendix 6: Article under review -
Page 112 and 113: 1. INTRODUCTIONWith the aging of hi
Page 114 and 115: A total of 180 crashes were identif
Page 118 and 119: 21. Sobngwi-Tambekou J, Bhatti J, K
Page 120 and 121: Table 2. Highway work zone crash fa
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Page 124 and 125: ABSTRACTObjectives: Interurban road
Page 126 and 127: oad). A matched strategy was used t
Page 128 and 129: SitesOut of 131 crash sites identif
Page 130 and 131: Similarly, it was shown previously
Page 132 and 133: Majdzadeh, R., Khalagi, K., Naraghi
Page 134 and 135: Table 2. Characteristics of Pakista
Page 136 and 137: Table 4. Factors associated with ha
Page 138 and 139: Table 21. Situational factors at hi
Page 140 and 141: Table 23. Situational factors assoc
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