Severity of injuries in different modes of transport, expressed with disability-adjusted life years (DALYs)

BMC Public Health

Mark J Nieuwenhuijsen²  Audrey de Nazelle⁵  Grzegorz Teresiński¹  Dorota Olkowicz³  Marko Tainio⁴ 

[1]Department of Forensic Medicine, Medical University of Lublin, ul. Jaczewskiego 8, Lublin 20-090, Poland

[2]Center for Research in Environmental Epidemiology (CREAL), Parc de Recerca Biomèdica de Barcelona – PRBB, C. Doctor Aiguader, 88, Barcelona 08003, Spain

[3]The Faculty of Power and Aeronautical Engineering, Warsaw University of Technology, ul. Nowowiejska 24, Warsaw 00-665, Poland

[4]UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK

[5]Centre for Environmental Policy, Imperial College London, 13 G7 Princes Gardens, London SW7 1NA, UK

关键词: HIA;    AIS;    YLL;    YLD;    DALY;    Injury;    Crash;    Fatality;    Transport;    Traffic;   

Others  :  1128868
DOI  :  10.1186/1471-2458-14-765

 received in 2014-04-10, accepted in 2014-06-26,  发布年份 2014

【 摘 要 】

Background

Health impact assessment (HIA) studies are increasingly predicting the health effects of mode shifts in traffic. The challenge for such studies is to combine the health effects, caused by injuries, with the disease driven health effects, and to express the change in the health with a common health indicator. Disability-adjusted life year (DALY) combines years lived disabled or injured (YLD) and years of life lost (YLL) providing practical indicator to combine injuries with diseases. In this study, we estimate the average YLDs for one person injured in a transport crash to allow easy to use methods to predict health effects of transport injuries.

Methods

We calculated YLDs and YLLs for transport fatalities and injuries based on the data from the Swedish Traffic Accident Data Acquisition (STRADA). In STRADA, all the fatalities and most of the injuries in Sweden for 2007–2011 were recorded. The type of injury was recorded with the Abbreviated Injury Scale (AIS) codes. In this study these AIS codes were aggregated to injury types, and YLDs were calculated for each victim by multiplying the type of injury with the disability weight and the average duration of that injury. YLLs were calculated by multiplying the age of the victim with life expectancy of that age and gender. YLDs and YLLs were estimated separately for different gender, mode of transport and location of the crash.

Results

The average YLDs for injured person was 14.7 for lifelong injuries and 0.012 for temporal injuries. The average YLDs per injured person for lifelong injuries for pedestrians, cyclists and car occupants were 9.4, 12.8 and 18.4, YLDs, respectively. Lifelong injuries sustained in rural areas were on average 31% more serious than injuries in urban areas.

Conclusions

The results show that shifting modes of transport will not only change the likelihood of injuries but also the severity of injuries sustained, if injured. The results of this study can be used to predict DALY changes in HIA studies that take into account mode shifts between different transport modes, and in other studies predicting the health effects of traffic injuries.

【 授权许可】

   
2014 Tainio et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Rojas-Rueda D, de Nazelle A, Tainio M, Nieuwenhuijsen MJ: The health risks and benefits of cycling in urban environments compared with car use: health impact assessment study. British Medical Journal 2011, 343:1-8.
• [2]Woodcock J, Edwards P, Tonne C, Armstrong BG, Ashiru O, Banister D, Beevers S, Chalabi Z, Chowdhury Z, Cohen A, Franco OH, Haines A, Hickman R, Lindsay G, Mittal I, Mohan D, Tiwari G, Woodward A, Roberts I: Health and Climate Change 2 Public health benefits of strategies to reduce greenhouse-gas emissions: urban land transport. Lancet 2009, 374:1930-1943.
• [3]De Hartog JJ, Boogaard H, Nijland H, Hoek G: Do the Health Benefits of Cycling Outweigh the Risks? Environ Health Perspect 2010, 118:1109-1116.
• [4]De Nazelle A, Nieuwenhuijsen MJ, Anto JM, Brauer M, Briggs D, Braun-Fahrlander C, Cavill N, Cooper AR, Desqueyroux H, Fruin S, Hoek G, Panis LI, Janssen N, Jerrett M, Joffe M, Andersen ZJ, van Kempen E, Kingham S, Kubesch N, Leyden KM, Marshall JD, Matamala J, Mellios G, Mendez M, Nassif H, Ogilvie D, Peiro R, Perez K, Rabl A, Ragettli M, et al.: Improving health through policies that promote active travel: A review of evidence to support integrated health impact assessment. Environ Int 2011, 37:766-777.
• [5]Woodcock J, Tainio M, Cheshire J, O’Brien O, Goodman A: Health effects of the London bicycle sharing system: health impact modelling study. BMJ 2014, 348:1-14.
• [6]United States Environmental Protection Agency (US EPA): The Benefits and Costs of the Clean Air Act 1990 to 2010: EPA Report to Congress. Washington D.C: United States Environmental Protection Agency (US EPA); 1999:1-654.
• [7]Hänninen O, Knol A: European Perspectives on Environmental Burden of Disease Estimates for Nine Stressors in Six European Countries. Helsinki, Finland: National Institute for Health and Welfare (THL), Finland; 2011:1-99.
• [8]Harvard School of Public Health, World Health Organization, World Bank: The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020. Cambridge, MA: Published by the Harvard School of Public Health on behalf of the World Health Organization and the World Bank; Distributed by Harvard University Press; 1996. Global Burden of Disease and Injury Series, v. 1
• [9]Murray CJL, Lopez AD: Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet 1997, 349:1436-1442.
• [10]Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, Abraham J, Ackerman I, Aggarwal R, Ahn SY, Ali MK, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Bahalim AN, Barker-Collo S, Barrero LH, Bartels DH, Basanez M-G, Baxter A, Bell ML, Benjamin EJ, et al.: Disability-adjusted life years (DALYs) for 291 diseases and injuries in. Lancet 2012, 380:2197-2223.
• [11]Holm AL, Glumer C, Diderichsen F: Health Impact Assessment of increased cycling to place of work or education in Copenhagen. Bmj Open 2012, 2:1-9.
• [12]Dhondt S, Pirdavani A, Macharis C, Bellemans T, Putman K: Translating road safety into health outcomes using a quantitative impact assessment model. Injury Prevention 2012, 18:413-420.
• [13]Haagsma JA, Polinder S, Lyons RA, Lund J, Ditsuwan V, Prinsloo M, Veerman JL, van Beeck EF: Improved and standardized method for assessing years lived with disability after injury. Bull World Health Organ 2012, 90:513-521.
• [14]McClure RJ, Douglas RM: The public health impact of minor injury. Accid Anal Prev 1996, 28:443-451.
• [15]Holtslag HR, van Beeck EF, Lichtveld RA, Leenen LPH, Lindeman E, van der Werken C: Individual and population burdens of major trauma in the Netherlands. Bull World Health Organ 2008, 86:111-117.
• [16]Lapostolle A, Gadegbeku B, Ndiaye A, Amoros E, Chiron M, Spira A, Laumon B: The burden of road traffic accidents in a French Departement: the description of the injuries and recent changes. Bmc Public Health 2009, 9:1-10.
• [17]Polinder S, Meerding WJ, Mulder S, Petridou E, van Beeck E: Assessing the burden of injury in six European countries. Bull World Health Organ 2007, 85:27-34.
• [18]Begg S, Tomijima N: Global Burden of Injury in the Year 2000: An Overview of Methods. Geneva: World Health Organization (WHO); 2006:1-22. http://www.who.int/healthinfo/statistics/bod_injuries.pdf webcite
• [19]Swedish Transport Administration: Nytt nationellt informationssystem för skador och olyckor inom hela vägtransportsystemet [New national information system for injuries and accidents throughout the road transport system]. Vägverket [Swedish Transport Administration]; 2007:1-110. Sjöö B, Ungerbäck A-C (Series editors) https://www.transportstyrelsen.se/Global/Publikationer/Vag/STRADA/2007_147_nytt_nationellt_informationssystem_for_skador_och_olyckor_inom_hela_vagtransportsystemet.pdf webcite
• [20]Azhar A-M, Svante B: Signal Control of Roundabouts. In 6th International Symposium on Highway Capacity and Quality of Service, Volume 16 Edited by Koutsopoulos HN, Bang KL. 2011.
• [21]Strandroth J, Rizzi M, Sternlund S, Lie A, Tingvall C: The Correlation Between Pedestrian Injury Severity in Real-Life Crashes and Euro NCAP Pedestrian Test Results. Traffic Inj Prev 2011, 12:604-613.
• [22]Gennarelli TA, Wodzin E: AIS 2005: A contemporary injury scale. Injury-Int J Care Inj 2006, 37:1083-1091.
• [23]Owczarczyk W: The development of a software tool for classification of injuries in the Abbreviated Injury Scale. In Proceeding of the 2008 International IRCOP conference on the biomechanics of injury. Bern, Switzerland: International Research Council on the Biomechanics of Injury; 2008.
• [24]Murray CJL: Quantifying the Burden of Disease – The technical basis for disability-adjusted life years. Bull World Health Organ 1994, 72:429-445.
• [25]KOM The National Communications Survey: Swedish Institute for Transport and Communications Analysis. 2006, 74. http://trafa.se/PageDocuments/KOM_eng.pdf webcite
• [26]EU Road safety Statistics – Accidents data http://ec.europa.eu/transport/road_safety/specialist/statistics/ webcite
• [27]Turner C, McClure R: Age and gender differences in risk-taking behaviour as an explanation for high incidence of motor vehicle crashes as a driver in young males. Inj Contr Saf Promot 2003, 10:123-30.
• [28]Pawlowski B, Atwal R, Dunbar RIM: Sex Differences in Everyday Risk-Taking Behavior in Humans. Evol Psychol 2008, 6:29-42.
• [29]Pucher J, Dijkstra L: Promoting safe walking and cycling to improve public health: Lessons from the Netherlands and Germany. Am J Publ Health 2003, 93:1509-1516.
• [30]De Geus B, Vandenbulcke G, Panis LI, Thomas I, Degraeuwe B, Cumps E, Aertsens J, Torfs R, Meeusen R: A prospective cohort study on minor accidents involving commuter cyclists in Belgium. Accid Anal Prev 2012, 45:683-693.
• [31]Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, Abraham J, Ackerman I, Aggarwal R, Ahn SY, Ali MK, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Bahalim AN, Barker-Collo S, Barrero LH, Bartels DH, Basanez M-G, Baxter A, Bell ML, Benjamin EJ, Bennett D, et al.: Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012, 380:2163-2196.
• [32]Salomon JA, Vos T, Hogan DR, Gagnon M, Naghavi M, Mokdad A, Begum N, Shah R, Karyana M, Kosen S, Farje MR, Moncada G, Dutta A, Sazawal S, Dyer A, Seiler J, Aboyans V, Baker L, Baxter A, Benjamin EJ, Bhalla K, Bin Abdulhak A, Blyth F, Bourne R, Braithwaite T, Brooks P, Brugha TS, Bryan-Hancock C, Buchbinder R, Burney P, et al.: Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010. Lancet 2012, 380:2129-2143.
• [33]Mindell JS, Leslie D, Wardlaw M: Exposure-Based, “Like-for-Like” Assessment of Road Safety by Travel Mode Using Routine Health Data. Plos One 7(12):e50606.
• [34]Dhondt S, Macharis C, Terryn N, Van Malderen F, Putman K: Health burden of road traffic accidents, an analysis of clinical data on disability and mortality exposure rates in Flanders and Brussels. Accid Anal Prev 2013, 50:659-666.