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Hazard perception at high- and low-risk road sites: a pilot study of interurban roads in Pakistan and Cameroon
  1. Junaid A Bhatti1,2,3,4,
  2. Junaid A Razzak3,
  3. Emmanuel Lagarde1,2,
  4. Jöelle Sobngwi-Tambekou1,
  5. Ahmadou Alioum1,2,
  6. L Rachid Salmi1,2,5
  1. 1Institut National de la Santé et de la Recherche Médicale Unité 897 (INSERM U897), Bordeaux, France
  2. 2Université Bordeaux Segalen, Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED), Bordeaux, France
  3. 3Department of Emergency Medicine, Aga Khan University, Karachi, Pakistan
  4. 4Douglas Hospital Research Centre, McGill University, Montreal, Canada
  5. 5Centre Hospitalier Universitaire de Bordeaux, Service d'information médicale, Bordeaux, France
  1. Correspondence to Dr Junaid A Bhatti, Équipe « Prévention et Prise en Charge des Traumatismes », Institut National de la Santé et de la Recherche Médicale Unité 897 (INSERM U897), 146 rue Léo Saignat, 33076 Bordeaux cedex, France; junaid.bhatti{at}


Objectives Interurban roads account for a significant proportion of traffic deaths in developing countries. In this pilot study, hazard perceptions of interurban road sites involved in ≥3 injury road traffic crashes were compared with those not involved in road traffic crashes on the same road sections.

Settings Karachi–Hala (Pakistan) and Yaoundé–Douala (Cameroon) road sections were the main study settings.

Data Videos of 26 high-risk sites and 26 low-risk sites from Karachi–Hala (Pakistan) and Yaoundé–Douala (Cameroon) roads, matched for the road section, were shown to 100 voluntary Pakistani drivers. Variations in perceived site hazardousness and preferred speed for each site pair were assessed.

Analyses Factors associated with incorrect hazard perception of high-risk sites (perceived as safe) were assessed by multinomial logistic regression analyses.

Results Drivers reported a higher hazard perception and a lower preferred speed for high-risk sites than for their matched low-risk sites in less than half of pairs (n=12, p≤0.02). Factors associated with increased likelihood of identifying a high-risk site as safe were as follows: flat road profile (adjusted OR=2.00, 95% CI 1.55 to 2.57), intersections (OR=1.96, 95% CI 1.43 to 2.68), irregular road surface (OR=3.56, 95% CI 2.68 to 4.71), nearby road obstacles (OR=2.57, 95% CI 1.96 to 3.39) and visible rain (OR=1.85, 95% CI 1.48 to 2.32).

Conclusion The methods used in this study might be useful in prioritising cost-effective improvements at high-risk sites.

  • Black spots
  • developing countries
  • epidemiology
  • risk factors
  • road traffic accidents
  • engineering
  • public health
  • trauma systems
  • low- to middle-income country
  • alcohol
  • helmet
  • suicide
  • behavioural
  • homeostasis
  • head injury
  • developing nations
  • violence
  • firearm
  • bicycle
  • international
  • methods
  • MVTC
  • systematic review

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  • J A B and L R S contributed equally to this work.

  • Funding The first author completed his PhD at Université Victor Segalen Bordeaux 2. This position was funded by the Higher Education Commission of Pakistan. Institute National de la Santé et de la Recherche Médicale Unité 897, France, funded the logistics for data collection. Funding bodies had no input in study design, analysis and interpretation of results.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Obtained from the review committee of the Aga Khan University.

  • Provenance and peer review Not commissioned; externally peer reviewed.