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Original research
Morbidity and mortality from road injuries: results from the Global Burden of Disease Study 2017
  1. Spencer L James1,
  2. Lydia R Lucchesi1,
  3. Catherine Bisignano1,
  4. Chris D Castle1,
  5. Zachary V Dingels1,
  6. Jack T Fox1,
  7. Erin B Hamilton1,
  8. Zichen Liu1,
  9. Darrah McCracken1,
  10. Molly R Nixon1,
  11. Dillon O Sylte1,
  12. Nicholas L S Roberts1,
  13. Oladimeji M Adebayo2,
  14. Teamur Aghamolaei3,
  15. Suliman A Alghnam4,
  16. Syed Mohamed Aljunid5,6,
  17. Amir Almasi-Hashiani7,
  18. Alaa Badawi8,9,
  19. Masoud Behzadifar10,
  20. Meysam Behzadifar11,
  21. Eyasu Tamru Bekru12,
  22. Derrick A Bennett13,
  23. Jens Robert Chapman14,
  24. Kebede Deribe15,16,
  25. Bereket Duko Adema17,
  26. Yousef Fatahi18,
  27. Belayneh K Gelaw19,
  28. Eskezyiaw Agedew Getahun20,
  29. Delia Hendrie21,
  30. Andualem Henok22,
  31. Hagos de Hidru23,
  32. Mehdi Hosseinzadeh24,25,
  33. Guoqing Hu26,
  34. Mohammad Ali Jahani27,
  35. Mihajlo Jakovljevic28,
  36. Farzad Jalilian29,
  37. Nitin Joseph30,
  38. Manoochehr Karami31,
  39. Abraham Getachew Kelbore32,
  40. Md Nuruzzaman Khan33,34,
  41. Yun Jin Kim35,
  42. Parvaiz A Koul36,
  43. Carlo La Vecchia37,
  44. Shai Linn38,
  45. Reza Majdzadeh39,40,
  46. Man Mohan Mehndiratta41,42,
  47. Peter T N Memiah43,
  48. Melkamu Merid Mengesha44,
  49. Hayimro Edemealem Merie45,
  50. Ted R Miller21,46,
  51. Mehdi Mirzaei-Alavijeh29,
  52. Aso Mohammad Darwesh47,
  53. Naser Mohammad Gholi Mezerji48,
  54. Roghayeh Mohammadibakhsh49,
  55. Yoshan Moodley50,
  56. Maziar Moradi-Lakeh51,
  57. Kamarul Imran Musa52,
  58. Bruno Ramos Nascimento53,
  59. Rajan Nikbakhsh54,
  60. Peter S Nyasulu55,
  61. Ahmed Omar Bali56,
  62. Obinna E Onwujekwe57,
  63. Sanghamitra Pati58,
  64. Reza Pourmirza Kalhori59,
  65. Farkhonde Salehi60,
  66. Saeed Shahabi61,
  67. Seifadin Ahmed Shallo62,
  68. Morteza Shamsizadeh63,
  69. Zeinab Sharafi64,
  70. Sharvari Rahul Shukla65,
  71. Mohammad Reza Sobhiyeh66,67,
  72. Joan B Soriano68,69,
  73. Bryan L Sykes70,
  74. Rafael Tabarés-Seisdedos71,72,
  75. Degena Bahray Bahrey Tadesse73,74,
  76. Yonatal Mesfin Tefera75,76,
  77. Arash Tehrani-Banihashemi51,77,
  78. Boikhutso Tlou78,
  79. Roman Topor-Madry79,80,
  80. Taweewat Wiangkham81,
  81. Mehdi Yaseri82,83,
  82. Sanni Yaya84,
  83. Muluken Azage Yenesew85,
  84. Mustafa Z Younis86,87,
  85. Arash Ziapour88,
  86. Sanjay Zodpey89,
  87. David M Pigott1,90,
  88. Robert C Reiner Jr1,90,
  89. Simon I Hay1,90,
  90. Alan D Lopez1,91,
  91. Ali H Mokdad1,90
  1. 1 Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
  2. 2 College of Medicine, University College Hospital, Ibadan, Nigeria
  3. 3 Department of Health Education and Health Promotion, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
  4. 4 Department of Population Health Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
  5. 5 Department of Health Policy and Management, Kuwait University, Safat, Kuwait
  6. 6 International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
  7. 7 Department of Epidemiology, Arak University of Medical Sciences, Arak, Iran
  8. 8 Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, Ontario, Canada
  9. 9 Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
  10. 10 Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
  11. 11 Hepatitis Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
  12. 12 College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia
  13. 13 Nuffield Department of Population Health, University of Oxford, Oxford, UK
  14. 14 Swedish Neuroscience Institute, Swedish Brain and Spine Specialists, Seattle, Washington, USA
  15. 15 Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK
  16. 16 School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
  17. 17 Department of Public Health, Hawassa University, Hawassa, Ethiopia
  18. 18 Department of Pharmaceutical Nanotechnology, Tehran University of Medical Sciences, Tehran, Iran
  19. 19 School of Pharmacy, Debre Tabor University, Ambo, Ethiopia
  20. 20 Department of Public Health, Arba Minch University, Arba Minch City, Ethiopia
  21. 21 School of Public Health, Curtin University, Perth, Western Australia, Australia
  22. 22 Department of Public Health, Mizan-Tepi University, Teppi, Ethiopia
  23. 23 Department of Biostatistics and Epidemiology, Adigrat University, Adigrat, Ethiopia
  24. 24 Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
  25. 25 Computer Science Department, University of Human Development, Sulaimaniyah, Iraq
  26. 26 Department of Epidemiology and Health Statistics, Central South University, Changsha, China
  27. 27 Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
  28. 28 N.A.Semashko Department of Public Health and Healthcare, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
  29. 29 Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
  30. 30 Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, India
  31. 31 Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
  32. 32 Department of Dermatology, Wolaita Sodo University, Wolaita Sodo, Ethiopia
  33. 33 Department of Population Sciences, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
  34. 34 Department of Public Health, University of Newcastle, Newcastle, New South Wales, Australia
  35. 35 School of Medicine, Xiamen University Malaysia, Sepang, Malaysia
  36. 36 Department of Internal and Pulmonary Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, India
  37. 37 Department of Clinical Medicine and Community Health, University of Milan, Milano, Italy
  38. 38 School of Public Health, University of Haifa, Haifa, Israel
  39. 39 Community-Based Participatory-Research (CBPR) Center, Tehran University of Medical Sciences, Tehran, Iran
  40. 40 Knowledge Utilization Research Center (KURC), Tehran University of Medical Sciences, Tehran, Iran
  41. 41 Neurology Department, Janakpuri Super Specialty Hospital Society, New Delhi, India
  42. 42 Department of Neurology, New Delhi, India
  43. 43 Department of Public Health, University of West Florida, Pensacola, Florida, USA
  44. 44 Department of Epidemiology and Biostatistics, Haramaya University, Harar, Ethiopia
  45. 45 Department of Statistics, Debre Markos University, Debre Markos, Ethiopia
  46. 46 Pacific Institute for Research and Evaluation, Calverton, Maryland, United States
  47. 47 Information Technology Department, University of Human Development, Sulaimaniyah, Iraq
  48. 48 Department of Biostatistics, Hamadan University of Medical Sciences, Hamadan, Iran
  49. 49 Hamadan University of Medical Sciences, Hamadan, Iran
  50. 50 Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
  51. 51 Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
  52. 52 School of Medical Sciences, Science University of Malaysia, Kubang Kerian, Malaysia
  53. 53 Hospital of the Federal University of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
  54. 54 Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  55. 55 Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
  56. 56 Department of Diplomacy and Public Relations, University of Human Development, Sulaimaniyah, Iraq
  57. 57 Department of Pharmacology and Therapeutics, University of Nigeria Nsukka, Enugu, Nigeria
  58. 58 Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, India
  59. 59 Paramedic Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
  60. 60 Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
  61. 61 Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
  62. 62 Department of Public Health, Ambo University, Ambo, Ethiopia
  63. 63 Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
  64. 64 Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
  65. 65 Symbiosis Institute of Health Sciences, Symbiosis International University, Pune, India
  66. 66 Departments of Vascular & Endovascular Surgery, General Surgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
  67. 67 Peripheral Vascular Intervention Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
  68. 68 Hospital Universitario de la Princesa, Autonomous University of Madrid, Madrid, Spain
  69. 69 Respiratory Diseases Networking Biomedical Research Centre (CIBERES), Institute of Health Carlos III, Madrid, Spain
  70. 70 Department of Criminology, Law and Society, University of California Irvine, Irvine, California, USA
  71. 71 Department of Medicine, University of Valencia, Valencia, Spain
  72. 72 Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
  73. 73 Nursing Department, Institute of Tropical Medicine, Aksum, Ethiopia
  74. 74 Axum College of Health Science, Mekelle, Ethiopia
  75. 75 School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
  76. 76 Department of Environmental Health, Wollo University, Dessie, Ethiopia
  77. 77 Department of Community Medicine, Iran University of Medical Sciences, Tehran, Iran
  78. 78 Department of Public Health, University of KwaZulu-Natal, Durban, South Africa
  79. 79 Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
  80. 80 The Agency for Health Technology Assessment and Tariff System, Warsaw, Poland
  81. 81 Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Meung District, Thailand
  82. 82 Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
  83. 83 Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  84. 84 School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
  85. 85 School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia
  86. 86 Health Economics & Finance, Jackson State University, Jackson, Mississippi, USA
  87. 87 Research Center for Public Health, Tsinghua University, Peking, China
  88. 88 Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
  89. 89 Indian Institute of Public Health, Public Health Foundation of India, Gurugram, India
  90. 90 Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
  91. 91 School of Population and Global Health, University of Melbourne, Melbourne, Queensland, Australia
  1. Correspondence to Spencer L James, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98121, USA; spencj{at}uw.edu

Abstract

Background The global burden of road injuries is known to follow complex geographical, temporal and demographic patterns. While health loss from road injuries is a major topic of global importance, there has been no recent comprehensive assessment that includes estimates for every age group, sex and country over recent years.

Methods We used results from the Global Burden of Disease (GBD) 2017 study to report incidence, prevalence, years lived with disability, deaths, years of life lost and disability-adjusted life years for all locations in the GBD 2017 hierarchy from 1990 to 2017 for road injuries. Second, we measured mortality-to-incidence ratios by location. Third, we assessed the distribution of the natures of injury (eg, traumatic brain injury) that result from each road injury.

Results Globally, 1 243 068 (95% uncertainty interval 1 191 889 to 1 276 940) people died from road injuries in 2017 out of 54 192 330 (47 381 583 to 61 645 891) new cases of road injuries. Age-standardised incidence rates of road injuries increased between 1990 and 2017, while mortality rates decreased. Regionally, age-standardised mortality rates decreased in all but two regions, South Asia and Southern Latin America, where rates did not change significantly. Nine of 21 GBD regions experienced significant increases in age-standardised incidence rates, while 10 experienced significant decreases and two experienced no significant change.

Conclusions While road injury mortality has improved in recent decades, there are worsening rates of incidence and significant geographical heterogeneity. These findings indicate that more research is needed to better understand how road injuries can be prevented.

  • burden of disease
  • motorcycle
  • descriptive epidemiology
  • road traffic accident
  • road injuries, pedestrian injuries
  • traumatic brain injury
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/injuryprev-2019-043302

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    Footnotes

    • Correction notice The article has been corrected since it is published. The affiliation of Mihajlo Jakovljevic has been updated.

    • Funding This study was funded by the Bill & Melinda Gates Foundation.

    • Map disclaimer The depiction of boundaries on the map(s) in this article do not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

    • Competing interests SLJ reports grants from Sanofi Pasteur outside the submitted work. TRM reports a contract to evaluate AB InBev Foundation’s efforts to, among other things, reduce impaired driving in 6 cities using GBD road safety data in calculating baseline harm.

    • Patient consent for publication Not required.

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

    • Data availability statement Data are available in a public, open access repository. Data are available on reasonable request. Data may be obtained from a third party and are not publicly available.

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