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more cost-effective than redesigning a junction or installing a pedestrian bridge. Similarly, aUgandan study observed the influence of overhead pedestrian bridge installation onpedestrian crashes on the Kampala-Jinja highway [37]. No significant differences wereobserved in pedestrian crash count between the two periods. Females and children used thebridge more than men and adults. A convenient sample of 123 pedestrians reported that52.0% of them used it. A majority of those not using it reported extra walking distance andtime and high stairs as causes of their non-use.Traffic enforcement with increased fines and a rigid penalty scoring on Brazilian highwayssystem decreased fatalities by 24.7%, hospital admissions 33.2%, and RTCs by 21.3%.Stricter penalties almost halved the tickets issued to drivers [40]. Similar results wereobserved on four sub-urban road sections in Uganda, when more resources were provided tothe highway police. Adequately equipped traffic police facilitated a drop in road fatalities by27.3% (95% confidence interval (95% CI)= 6.0; 48.9].[23]. Considering average age ofperson dying due to crash and life expectancy, traffic enforcement could save up to USD 27(95% CI=15-118] per disability adjusted life year saved year at 3% discount rate. Trafficenforcement appeared to be one of the most cost-effective behavioural interventions andoverall system improvement approach.Two separate studies showed that road environmental improvements lead to significantreductions in injury crash rates. For instance, multi-sector intervention involving removal ofhard metal bars and installation of road furniture, luminous traffic signs, and security fencedecreased injuries from 2.1 to 1.4 per 10 000 vehicles adjusted on seat-belt use on a Mexicanhighway [32]. Similarly, security fence installation on a mountainous Chinese highwaydecreased overall traffic crashes by 43.8% and severe crashes by 70.8% [48]. Overall designimprovement on the same highway led to a decrease in crashes by 37.2% and traffic fatalitiesby 47.1% as compared to the other highways adjusted on traffic counts.78
Table 17. Analytical studies of traffic crash and injury risk on interurban road sections in developing countries.Author (year) Objective Study design Setting Data Outcome ResultsAlmeida, et al Factors associated with Cross-sectionalHighway police data for year 2004(2009)injury crashesHijar, et al (1996)Hijar, et al (1998)Hijar, et al (2000)Liu, et al (2003)Majdzadeh, et al(2008)Rey de Castro, etal (2004)Souza, et al (2005)Viegas et al (2005)Association of non-use ofseat belt with injuryseverityAssociation of alcoholintake with injury crashesFactors associated withhighway crashesDriver sleepiness and riskof crashFactors associated withinjuries in drivers &motorcyclistsAssociation of fatigue anddrowsiness with reportedcrashes in bus driversAssociation of sleepinesswith crashesPrevalence of risk factorsfor sleep apnoeasyndrome in commercialbus driversOR: adjusted odds ratio95% CI: 95% confidence intervalNISS: New Injury Severity ScoreCross-sectionalFederalhighway163, BrazilMexico–Cuernavacahighway,MexicoSeven-month ambulance data (1994)Injury crash inwhich at leastone person hasbeen injured ordiedCrash requiringhospitaltreatmentCross-sectional As above As above Crash requiringhospitaltreatmentCase-control As above Three-month ambulance data (1996:Cases, involved in crash & transportedby ambulance; controls, not involved ina crash, recruited from two points.Case-controlCase-controlCross-sectionalCross-sectionalCross-sectionalHighways inHuanggudistrict,ChinaQazvin-LoshanRoad, IranNorthern PanAmericanhighway,PeruFederalhighways,BrazilFederalhighways,BrazilNine-month traffic & police data (2001-02): Cases, drivers involved in a trafficcrash; controls, randomly selected withpolice officers from 28 road locationsFour-month traffic & police data(2005): Cases, injured drivers &motorcyclists involved in a crash;controls, uninjured drivers &motorcyclists on the same road involvedin a crash.Bus drivers operating at bus-stand onkm 10 of the highway. Interviews wereconducted with 238 out of 400 driversworking on the bus stand.Interviews conducted with 260 truckdriversInterviews conducted with 262 maleinterstate bus driversCrashPolice reportedcrashMild trafficinjury (NISS ≤15) and moderatetraffic injury(NISS > 15)Crash or nearcrashAssociations were assessed for three different set of independent variables:Surface condition: Substandard pavement OR=1.89; 95%CI=1.32-2.70 (Reference: unpaved)Crash types: Frontal (OR=14.14; 95%CI=8.96-22.32) and pedestrian (OR=35.95; 95%CI=8.10-159.92) collisions (reference: rear collisions)Contributory factors: Highway maintenance problems (OR=4.35; 95%CI=1.94-9.75) anddisobeying traffic signs (OR=5.69; 95%CI=2.01-16.12) (reference: not keeping safe distance)Not wearing a seat-belt (OR=2.94; 95% CI=1.13-7.66) was significantly associated with injurycrashAlcohol intake (OR=6.09; 95%CI=1.55-24.00) was significantly associated with injury crashesAge 10 (OR=2.07; 95%CI=1.30-3.29) and night or shift work (OR=2.14; 95%CI=1.50-3.05) were significantly associated withpolice reported crash. Associations remained significant even after removing those with alcoholintake determined by breath-analyzers applied to both case and control groups.Female sex (OR=7.78; 95%CI=2.77-21.85), safety equipment use (OR=0.44; 95%CI=0.23-0.84),and motorcycle involvement (OR=5.06; 95%CI=1.42-18.02) were significantly associated withmild injury crashes.Female sex (OR=4.78; 95%CI=1.36-16.80) and adverse weather condition (OR=4.32,95%CI=1.13-16.50) were significantly associated with moderate injury crashes.Forty five percent drivers reported having a crash or near crash in a precedent period. Drivinghours per day was significantly higher in drivers who reported a crash or near crash than driversnot reporting such event (7.9 vs. 6.9 hours, P=0.003). Similarly, 35% drivers reported drivingwhile sleepy, which was significantly higher in those reporting a crash or near crash than driversnot reporting such event (P
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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
Page 28 and 29: Injury outcome patternsMost of inju
Page 30 and 31: MethodsThe study setting was 196-km
Page 32 and 33: patients. In the ED, those with NIS
Page 34 and 35: Table 6. Traffic injuries reported
Page 36 and 37: 5. Analytical StudiesPrevious liter
Page 38 and 39: under supervision of Dr. Sobngwi-Ta
Page 40 and 41: Table 9. Situational variables at c
Page 42 and 43: MethodsStudy design and settingStud
Page 44 and 45: to Dec 08 were retrieved and photoc
Page 46 and 47: normal zones. However, this associa
Page 48 and 49: MethodsStudy design and settingsThe
Page 50 and 51: Figure 14. Picture extracted of a h
Page 52 and 53: located in built-up area in Pakista
Page 54 and 55: Table 15. Differences in hazard per
Page 56 and 57: 6. Discussion6.1 Originality of stu
Page 58 and 59: Although adjustments are possible,
Page 60 and 61: observational studies on how the de
Page 62 and 63: to understand the deficiencies in t
Page 64 and 65: [24] Damsere-Derry J, Afukaar FK, D
Page 66 and 67: [69] Central Intelligence Agency. T
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
Page 74 and 75: Appendix 1: Literature review on in
Page 76 and 77: they identified a cluster of long b
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
Page 104 and 105: 104
Page 106 and 107: 106
Page 108 and 109: 108
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 116 and 117: conspicuity at HWZs in Pakistan. 2
Page 118 and 119: 21. Sobngwi-Tambekou J, Bhatti J, K
Page 120 and 121: Table 2. Highway work zone crash fa
Page 122 and 123: 122
Page 124 and 125: ABSTRACTObjectives: Interurban road
Page 126 and 127: oad). A matched strategy was used t
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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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