Road Safety Habits and Related Factors of the Adult Population. Summary of the Doctoral Thesis

Abstract

Introduction. Road traffic collisions and injuries are a global public health issue, not only due to high mortality rates, but also due to significant multiple injuries and subsequent disabilities. The number of deaths and injuries from road traffic collisions in Latvia is still significantly higher than in other European Union countries. Given the current paradigm that views road traffic injuries as predictable and avoidable, the development of an evidence–based and cross–sectoral understanding of individual habits and related factors is essential for the successful implementation of road safety improvement measures in the long term. The aim of the study was to describe persons killed or seriously injured in road traffic collisions and their risk factors from 2010 to 2018, to study the road safety habits of the adult population of Latvia during the same period, as well as to clarify the relationship between the habits and individual factors, health behaviour, and attitude towards road safety factors. Material and methods. The research has been carried out in parallel in two stages. In the first stage of the study, The Statistical Database of Road Traffic Collisions and Consequences was used for the analysis, including data on 57,471 persons involved in road traffic collisions. In the second stage of the study, using the data of a representative cross–sectional study of “Health Behaviour among Latvian Adult Population”, road safety habits – the use of reflectors, the use of seat belts in the front and rear seats – were analysed. The study tool was a validated, standardised questionnaire, including data from 10,731 respondents. Frequency distribution, cross–tabulation analysis, and Chi–square (?2) test were used for processing statistical data. Odds ratio, Spearman’s rank correlation coefficient, and multiple logistic regression were used to assess the associations. Results. Between 2010 and 2018, the percentage of persons killed or seriously injured in road traffic collisions has decreased on average by 0.3 percentage points per year, while the incidence rate of persons killed or seriously injured in road traffic collisions per 100,000 person–years has increased on average by 1.2% per year. Higher odds of being fatally or seriously injured in road traffic collisions are observed in males, among the elderly (55 years and older) and the youngest (18 to 24 years) persons, when the collision occurs on regional and local roads, and in other cities compared to Riga, as well as in persons with exceeded permitted blood alcohol concentration level. During the period from 2010 to 2018, the use of reflectors in Latvia has not changed significantly (p > 0.05), in general, they are almost always worn by 53.6% of respondents. The use of seat belts has increased slightly – from 93.5% to 95.6% in the front seat of the vehicle, from 52.4% to 56.3% in the rear seat of the vehicle (p < 0,001). The multifactor regression analysis shows that lower odds for road safety habits are observed in males, among the youngest age group (18–24 years), in respondents with primary education,as well as among residents of Riga, followed by other cities compared to rural areas. Better road safety habits are among respondents without excessive alcohol consumption (OR = 1,6 – 2,1 depending on the habit analysed), among nonsmokers (OR = 1,5 – 1,8) and those with families where smoking is not allowed in the car (OR = 1,3 – 1,7). The odds for safe road habits are higher among persons who have visited their family doctor during the last year (OR = 1,2 – 1,3). Individuals with a possitive attitude towards the use of seat belts (OR = 1,9 – 9,7 depending on the specific question) and penalties for traffic violations (OR = 1,3 – 1,9) have higher odds for road safety habits. Higher odds of wearing seat belts are among respondents with more responsible attitude towards driving under the influence of alcohol (OR = 1,8 – 2,8) and respect for speed limits (OR = 1,3 – 1,9). Conclusions. Road safety and individual habits are a pressing public health issue in Latvia. Although the proportion of persons killed or seriously injured in road traffic collisions is decreasing, the incidence rate of persons killed or seriously injured in road traffic collisions (per 100,000 person–years) is increasing. The use of seat belts in the front seat of the vehicle is gradually approaching the level of other European countries, while the use of seat belts in the rear seat of the vehicle and the use of reflectors is insufficient and critically low. The relationship between individual road safety habits has been demonstrated not only with demographic, socio–economic, and attitude factors but also with careless health behaviour, which highlights the need to base sectoral policies and research in the long term on an integrated approach and cross–sectoral cooperation.