Experts’ perspectives on the application of public-private partnership policy in prevention of road traffic injuries

Purpose: Successful application experiences on public-private partnership (PPP) in different countries, suggest that PPP could be an option in road traffic injury (RTI) prevention. The present study aims at investigating the applicability of PPP policy in RTI prevention in Iran based on the experts’ perspectives.Methods: This is a qualitative study with grounded theory approach which has been conducted in Tabriz University of Medical Sciences, Iran in 2018. The participants were 22 experts in the field of RTIs selected using purposive sampling method. Data were collected by semi-structured interviews and analyzed with content-analysis method.Results: The results were classified under 5 main themes (applicability, scopes and services, challenges, advantages, and strategies) for applying PPP policy and 37 sub-themes. Due to the prevalence of RTIs, the present challenges in public sector, existence of qualified private sector, and successful experiences in other areas, there are opportunities for private sector partnership in prevention of RTIs. Private sector could participate in different scopes and services regarding RTI prevention, including road construction and maintenance, maintenance and provision of vehicles safety and public education. The main challenges including legislation issues, ambiguities in collaboration, political and organizational unsustain-ability, government’s financial hardship and lack of experienced experts in the field of RTI. However, there are significant advantages including high efficiency in program implementation, covering the weaknesses of public sector, effective and efficient management on application of PPP in RTI prevention. The strategies include identifying and prioritizing the assignable activities, identifying the qualified private sector, developing PPP policies and legal frameworks, creating a common language between public and private parties, trying to meet the expectations of the private sector by public sector, developing a comprehensive and sound contract, and cultivating public culture to accept private sector in the field of RTI prevention.Conclusion: This study sought to determine whether PPP could be used as strategy to reduce the burden of RTIs in Iran. But it requires a lot of preliminary studies to provide the context and conditions for applying this policy.

Prehospital road traffic injuries among the elderly in Beijing, China： data from the Beijing Emergency Medical Center, 2004-2010

Background Road traffic injuries （RTIs） are a worldwide issue associated with increasing development and motorization. However, statistical studies do not include any analyses of Beijing＇s geriatric population. Using data from the Beijing Emergency Medical Center, we present the main characteristics of traffic injuries involving the elderly in Beijing. We also provide objective information for those concerned with the safety of traffic systems and the prevention of traffic injuries. Methods In a longitudinal, retrospective study, data were collected on 1706 victims aged 65 years and older who sustained traffic injuries in Beijing between 2004 and 2010. Personal information, time of injury event, emergency care response time, road user type, striking vehicle type, injury site, and severity of injury were analyzed using ;~2 tests and Logistic regression analysis. Results The annual rate of traffic injuries was 21.80 per 100 000 elderly people in Beijing, and the morbidity rate decreased from 2004 to 2010 （P 〈0.001）. The mean age was （72.92＋5.67） years, and 911 （53.40%） of the victims were male. The majority of victims sustained head and lower limb injuries and were classified as being of medium severity. Traffic collisions occurred most frequently in the daytime excluding rush hours; these collisions included being hit by a car （85.64%） and pedestrian victim injuries （79.19%）. Our statistical analysis found three factors for injury severity： abdominal injuries （P 〈0.001）, number of injury sites （P=0.027）, and head injuries （P=0.034）. The decline in traffic injuries is due to a decrease in victims aged 65-74 years and pedestrians; the sevedty of RTIs also decreased. Conclusions This study highlights the declining trend in traffic injuries among older adults in Beijing. However, traffic injuries remain a serious public health problem for the elderly and effective measures are required to reduce their incidence.

Evaluating the short-term effect of ambient temperature on non-fatal outdoor falls and road traffic injuries among children and adolescents in China: a time-stratified case-crossover study

studies have suggested that non-optimal temperatures may increase the risk of injury,epidemiological studies focusing on the association between temperature and non-fatal injury among children and adolescents are limited.Therefore,we investigated the short-term effect of ambient temperature on non-fatal falls and road traffic injuries(RTIs)among students across Jiangsu Province,China.Meteorological data and records of non-fatal outdoor injuries due to falls and RTIs among students aged 6–17 were collected during 2018–2020.We performed a time-stratified case-crossover analysis with a distributed lag nonlinear model to examine the effect of ambient temperature on the risk of injury.Individual meteorological exposure was estimated based on the address of the selected school.We also performed stratified analyses by sex,age,and area.A total of 57322 and 5455 cases of falls and RTIs were collected,respectively.We observed inverted U-shaped curves for temperatureinjury associations,with maximum risk temperatures at 18℃(48th of daily mean temperature distribution)for falls and 22℃(67th of daily mean temperature distribution)for RTIs.The corresponding odds ratios(95%confidence intervals)were 2.193(2.011,2.391)and 3.038(1.988,4.644)for falls and RTIs,respectively.Notably,there was a significant age-dependent trend in which the temperature effect on falls was greater in older students(P-trend<0.05).This study suggests a ignificant association between ambient temperature and students’outdoor falls and RTIs.Our findings may help advance tailored strategies to reduce the incidence of outdoor falls and RTIs in children and adolescents.

Are High School Students Ready to Stop the Bleed from Injuries? Needs Assessment in a Low Resource Country

Background: Life-threatening bleeding is a major cause of trauma-related deaths. Stop the Bleed—Active bleeding control (ABC) program in Hyderabad recently showed that lay first responders can be effectively trained. However, the willingness of high school students to train in bleeding control is unknown. We report Stop the Bleed training needs assessment from high schools in India and estimate the potential multiplier effect. Methods: A cross-sectional survey was conducted from 12 randomly selected schools in Hyderabad. The study was to understand current knowledge, skills and willingness to get trained and respond to life-threatening bleeding from injuries. 107 Participants (35 Teachers and 72 students) were purposively selected for telephonic interviews with a structured questionnaire. Results: Response rate was 93% overall. 80% of participants have never been trained in bleeding control. 84% reported willingness to be trained, train others and help bleeding victims. All the teachers reported that stop the bleed training would be useful in high schools. 70.6% of teachers recommended that training could start from middle school (10 to 15 years), 47% preferred the online training mode. Only 20% of participants had prior training in lifesaving first aid and 32% did not know the number of emergency medical services (EMS). Each trained participant has the potential to train 3 to 4 people at the household level and perhaps more at the community level. Conclusion: The surveyed schools in Hyderabad do not have the knowledge, skills, or training curriculum in Stop the Bleed. Students and teachers are willing to be trained and train others, with great potential for a “multiplier-effect” in the community.

Impact of social standing on traffic injury prevention in a WHO safe community

The objective of the current study was to evaluate outcomes of a program to prevent traffic injuries among the different social strata under WHO Safe Community Program. A quasi-experimental design was used, with pre- and post-implementation registrations in the program implementation area (population 41,000) and in a neighbouring control municipality (population 26,000) in ?sterg?tland County, Sweden. The traffic injury rate in the not vocationally active households was twice than employed or self-employed households in the intervention area. In the employed and not vocationally active households, males showed higher injury rates than females in both areas. In the self-employed households females exhibited higher injury rates than males in the intervention area. Males from not vocationally active households displayed the highest post-intervention injury rate in both the intervention and control areas. After 6 years of Safe Community program activity, the injury rates for males in employed category, injury rates for females in self-employed category, and males/females in non- vocationally active category displayed a decreasing trend in the intervention area. However, in the control area injury rate decreased only for males of employed households. The study indicated that there was almost no change in injury rates in the control area. Reduction of traffic injuries in the intervention area between 1983 and 1989 was likely to be attributable to the success of safety promotion program. Therefore, the current study concludes that Safe Community program seems to be successful for reducing traffic injuries in different social strata.

Epidemiological characteristics and relative factor of hospital death cases with road traffic trauma

Objective: To investigate the epidemiological characteristics and relative factor about hospital death in patients with road traffic trauma. Methods: The age, sex, road-use category, sites of injury, injury severity scale of 159 hospital death cases in 2436 cases with road traffic trauma were observed, and the relation between the causes of death and time elapsed after injury was also studied with likelihood ratio Chi-square test.

A Workable Solution for Reducing the Large Number of Vehicle and Pedestrian Accidents Occurring on a Yellow Light

Traffic intersections are incredibly dangerous for drivers and pedestrians. Statistics from both Canada and the U.S. show a high number of fatalities and serious injuries related to crashes at intersections. In Canada, during 2019, the National Collision Database shows that 28% of traffic fatalities and 42% of serious injuries occurred at intersections. Likewise, the U.S. National Highway Traffic Administration (NHTSA) found that about 40% of the estimated 5,811,000 accidents in the U.S. during the year studied were intersection-related crashes. In fact, a major survey by the car insurance industry found that nearly 85% of drivers could not identify the correct action to take when approaching a yellow traffic light at an intersection. One major reason for these accidents is the “yellow light dilemma,” the ambiguous situation where a driver should stop or proceed forward when unexpectedly faced with a yellow light. This situation is even further exacerbated by the tendency of aggressive drivers to inappropriately speed up on the yellow just to get through the traffic light. A survey of Canadian drivers conducted by the Traffic Injury Research Foundation found that 9% of drivers admitted to speeding up to get through a traffic light. Another reason for these accidents is the increased danger of making a left-hand turn on yellow. According to the National Highway Traffic Safety Association (NHTSA), left turns occur in approximately 22.2% of collisions—as opposed to just 1.2% for right turns. Moreover, a study by CNN found left turns are three times as likely to kill pedestrians than right turns. The reason left turns are so much more likely to cause an accident is because they take a driver against traffic and in the path of oncoming cars. Additionally, most of these left turns occur at the driver’s discretion—as opposed to the distressingly brief left-hand arrow at busy intersections. Drive Safe Now proposes a workable solution for reducing the number of accidents occurring during a yellow light at intersections. We believe this fairly simple solution will save lives, prevent injuries, reduce damage to public and private property, and decrease insurance costs.

Automobile Crash Investigation Based on Vehicle System Related Causes: Systematic Literature Review

Automobile accidents are one of the leading causes of death worldwide. Every year, over 1.24 million people are killed in traffic accidents. Even though automobiles are designed to help people, they have been used to kill them in large numbers. Automobile accident research has primarily focused on past tragedies to develop and implement policies to combat this pandemic. The aim of this systematic review is to assess the different methods used to investigate the vehicle system-related cause factors of road traffic accidents. Police report reports have served as a foundation for providing historical facts about the causes of automobile accidents. It has been observed that police reports have limitations when it comes to reporting the involvement of vehicle systems in causing a traffic accident. The majority of the research was conducted on articles that investigated vehicle system risk factors using statistical data. Following articles that used statistical data to investigate vehicle system risk factors, the inclusion criteria were chosen. Articles on traffic accidents published in Cameroon were included on the condition that they studied at least one traffic accident risk factor. Two hundred twenty-five distinct records were identified, and 155 full texts were screened for inclusion, resulting in the inclusion of 25 studies in the review. According to the findings, failure to break the braking system, tyre puncture, poor driving, speeding, and overtaking are the leading causes of automobile crash reports reported by police. The majority of the study’s conclusions lamented that accusing vehicle systems was based on assumptions and the reporter’s judgment. It was determined that the use of stringent vetting procedures to investigate vehicle systems is the cause of a traffic accident. As a result, stakeholders will require accurate facts from a traffic crash investigation.

Lumbar and neck injuries of occupants in different reclining postures

Purpose:With the increasing level of automation in automobiles,the advent of autonomous vehicles hasreduced the tendency of drivers and passengers to focus on the task of driving.The increasing automation in automobiles reduced the drivers'and passengers'focus on driving,which allowed occupants tochoose a more relaxed and comfortable sitting position.Meanwhile,the occupant's sitting position wentfrom a frontal,upright position to a more relaxed and reclined one,which resulted in the existing restraint systems cannot to keep occupants safe and secure.This study aimed to determine the effects ofdifferent reclining states on occupants'lumbar and neck injuries.Methods:This is an original research on the field of automotive safety engineering.Occupants indifferent initial sitting positions(25°,35°,45°,and 55°)were adapted to changes in seat back angle andrestraint systems and placed in the same frontal impact environment.Neck injury indexes,lumbar axialcompression force and acceleration,as well as occupant dynamic response during the impact,werecompared in different sitting positions.The injury response and kinematic characteristics of occupants indifferent reclining positions were analyzed by the control variable method.Results:As the sitting angle increased,the occupant's head acceleration decreased,and the forward-leanangle decreased.Occupants in the standard sitting position had the greatest neck injury,with an Nij of0.95,and were susceptible to abbreviated injury scale 2+cervical medullary injuries.As the seatbackangle increased,the geometric position of the lumbar spine tended to be horizontal,and the impact loadtransmitted greater forces to the lumbar spine.The occupant's lumbar injury was greatest in the lyingposition,with a peak axial compression force on the lumbar region of 5.5 KN,which was 2.3 KN greaterthan in the standard sitting position.Conclusion:The study of occupant lumbar and neck injuries based on different recline states can providea theoretical basis for optimizing lumbar evaluation indexes,which is conducive to the understanding ofthe lumbar injury mechanism and the comprehensive consideration of occupant safety protection.

Epidemiologic study of traffic crash mortality among motorcycle users in Iran(2011-2017)

Purpose:Motorcycle accident is a major cause of road traffic injuries and the motorcyclists are consid ered as vulnerable road users.The present study aimed to determine the epidemiological characteristics of fatal motorcycle crashes in Iran.Methods:In this cross-sectional study,a total of 28,356 motorcycle traffic fatalities registered in the Legal Medicine Organization of Iran were analyzed during the period between March 2011 and March 2017.The examined variables included demographic characteristics,helmet use,crash mechanisms,crash location,position state,type of counterpart vehicle,cause of death and place of death.In the study,road traffic mortalities involving drivers and/or passenger of motorcycles were included.Cases or events registered without these conditions were excluded from the study.To analyse the data,SPSS statistics 25 and GraphPad Prism 8 softwares were used.Results:Of the 122,682 fatal traffic injury cases,28,356(23.1%)were motorcycle users,of whom 95.3%were male and 4.7%were female.Most of the motorcycle fatalities belonged to the age group of 18-24 years(29.1%).Head trauma was the major cause of death(59.0%).Also,the overall proportion of safety helmet use among motorcycle crash victims was estimated at 37.4%.Most of the road traffic crash cases(46.8%)happened out of city and half of people(49.9%)died in hospital.About 77.4%of the victims were motorcycle riders and 21.1%were pillion passengers.The highest rate of mortality belonged to the selfemployed(38.4g)and then workers(21.8%)and students(10.2%).In addition,most fatalities occurred in people with low education(77.5%)and the least occurred in university graduates(5.5%).Among 31 provinces of Iran,Fars had the highest(9.3%)occurrence rate and Kohgiluyeh and Buyer-Ahmad had the lowest(0.5%).Most of the crash mechanisms were due to motorcycle-vehicle crashes(80.2%),followed by rollover(9.8%).Conclusion:Comprehensive public education and special rules are needed to reduce the rate of deaths in motorcycle crashes.

Comparison of pediatric pelvic fractures and associated injuries caused by different types of road traffic accidents

Purpose:To explore the clinical characteristics of pediatric pelvic fracturs caused by traffic accidents and to analyze the accompanying injuries and complications.Methods:A total of 222 cases involved traffic accidents was enrolled in this case-control study.The data of children with pelvic fractures caused by traffic accidents who were admitted to our hospital from January 2006 to December 2021 were analyzed retrospectively.Sex,age,Tile classification,abbreviated injury scale score,injury severity score,mortality,and accompanying injuries were studied.The ANOVA was used for measurement data,and the non-parametric rank sum test was used for non-normally distributed data.The Fisher's exact probability method was used for the count data.Results:Of all enrolled cases,140 are boys and 82 are girls,including 144 cases aged<6 years,65 aged between 6 and 12 years,and 13 aged>12 years.Depending on the injury mechanism,there are 15 cases involving pedestriansvs.motorcycles(PVM),91 cases involving pedestriansvs.passenger cars(PVC),78 cases involving pedestriansvs.commercial vehicles(PVV),and 38 cases involving motor vehiclesvs.motor vehicles(MVM).Associated injuries are reported in 198 cases(89.2%),primarily involving the abdomen injury in 144 cases(64.9%),and lower limb injury in 99 cases(44.6%).PVV injury involves longer hospital stay(p=0.004).Intensive care unit admission rate is significantly higher in the MVM group than in other groups(p=0.004).Head injury(p=0.001)and face injury(p=0.037)are more common in the MVM group,whereas abdominal injury(p=0.048)and lower limb injury(p=0.037)are more common in the PVV group.In the MVM group,the brain injury(p=0.004)and femoral neck injury(p=0.044)are more common.In the PVM group,the mediastinum(p=0.004),ear(p=0.009),lumbar vertebrae(p=0.008),and spinal cord(p=0.011)are the most vulnerable regions,while in the PVV group,the perineum(p<0.001),urethra(p=0.001),rectum(p=0.006),anus(p=0.004),and lower limb soft tissues(p=0.024)are the most vulnerable regions.Children aged>12 years have higher pelvic abbreviated injury scale scores(p=0.019).There are significant differences in the classification of pelvic fractures among children<6,6-12,and>12 years of age,with Tile C being more likely to occur in children>12 years of age(p=0.033).Children aged>12 years are more likely to sustain injuries to the spleen(p=0.022),kidneys(p=0.019),pancreas(p<0.001),lumbar vertebrae(p=0.013),and sacrum(p=0.024).The MVM group has the highest complication rate(p=0.003).Conclusion:PVC is the leading cause of the abdomen and lower extremities injury and has the most concomitant injuries.Different traffic injuries often lead to different associated injuries.Older children are more likely to sustain more severe pelvic fractures and peripelvic organs injuries.The MVM group has the highest extent of injury and complication rates.

Risk factors of mortality in road traffic injury patients with acute respiratory distress syndrome

Background Among the deaths due to trauma, about one half of the patients suffer from road traffic injury （RTI）. Most of RTI patients complicate acute respiratory distress syndrome （ARDS） and severe multiple injuries. ARDS is a major contributor to morbidity and mortality in trauma patients. Although many injuries and conditions are believed to be associated with ARDS independent risk factors in trauma patients, their relative importance in development of the syndrome are undefined. We hypothesize that not all of the traditional risk factors impacting mortality are independently associated with patients strictly identified by traffic injury. This study aimed to sieve distinctive risk factors in our RTI population, meanwhile, we also hypothesize that there may exist significantly different risk factors in these patients.Methods This was a retrospective cohort study regarding RTI as a single cause for emergency intensive care unit （EICU） admission. Patients identified as severe RTI with post-traumatic ARDS were enrolled in a prospectively maintained database between May 2002 and April 2007 and observed. Twenty-three items of potential risk impacting mortality were calculated by univariate and multivariate Logistic analyses in order to find distinctive items in these severe RTI patients. Results There were 247 RTI patients with post-traumatic ARDS admitted to EICU during the study period. The unadjusted odds ratio （OR） and 95% confidence intervals （CI） of mortality were associated with six risk factors out of 23： APACHE II score, duration of trauma factor, pulmonary contusion, aspiration of gastric contents, sepsis and duration of mechanical ventilation. The adjusted ORs with 95% Cl were denoted with respect to surviving beyond 96 hours EICU admission （APACHE II score, duration of trauma factor, aspiration of gastric contents）, APACHE II score beyond 20 EICU admission （duration of trauma factor, sepsis, duration of mechanical ventilation） and mechanical ventilation beyond 7 days EICU admission （duration of trauma factor and sepsis）. Conclusions We have retrospectively demonstrated an adverse effect of six different risk factors out of 23 items in mortality of post-traumatic ARDS within severe RTI patients and, moreover, gained distinct outcomes in stratified patients under real emergency trauma circumstance. An impact of APACHE II score and pulmonary contusion contributing to prediction of mortality may exist in prophase after traffic injury. Sepsis is still a vital risk factor referring to systemic inflammatory response syndrome, infection, and secondary multiple organs dysfunction. Eliminating trauma factors as early as possible becomes the critical therapeutic measure. Aspiration of gastric contents could lead to incremental mortality due to severe ventilation associated pneumonia. Long-standing mechanical ventilation should be constrained on account of severe refractory complications.

Road traffic injury mortality and morbidity by country development status, 2011- 2017

Purpose:This research examined road traffic injury mortality and morbidity disparities across of country development status,and discussed the possibility of reducing country disparities by various actions to accelerate the pace of achieving Sustainable Development Goals target 3.6 e to halve the number of global deaths and injuries from road traffic accidents by 2020.Methods:Data for road traffic mortality,morbidity,and socio-demographic index(SDI)were extracted by country from the estimates of the Global Burden of Disease study,and the implementation of the three types of national actions(legislation,prioritized vehicle safety standards,and trauma-related post-crash care service)were extracted from the Global Status Report on Road Safety byWorld Health Organization.We fitted joinpoint regression analysis to identify and quantify the significant rate changes from 2011 to 2017.Results:Age-adjusted road traffic mortality decreased substantially for all the five SDI categories from 2011 to 2017(by 7.52%e16.08%).Age-adjusted road traffic mortality decreased significantly as SDI increased in the study time period,while age-adjusted morbidity generally increased as SDI increased.Subgroup analysis by road user yielded similar results,but with two major differences during the study period of 2011 to 2017:(1)pedestrians in the high SDI countries experienced the lowest mortality(1.68e1.90 per 100,000 population)and morbidity(110.45e112.72 per 100,000 population for incidence and 487.48e491.24 per 100,000 population for prevalence),and(2)motor vehicle occupants in the high SDI countries had the lowest mortality(4.07e4.50 per 100,000 population)but the highest morbidity(428.74e467.78 per 100,000 population for incidence and 1025.70e1116.60 per 100,000 population for prevalence).Implementation of the three types of national actions remained nearly unchanged in all five SDI categories from 2011 to 2017 and was consistently stronger in the higher SDI countries than in the lower SDI countries.Lower income nations comprise the heaviest burden of global road traffic injuries and deaths.Conclusion:Global road traffic deaths would decrease substantially if the large mortality disparities across country development status were reduced through full implementation of proven national actions including legislation and law enforcement,prioritized vehicle safety standards and trauma-related postcrash care services.

Global road traffic injury statistics:Challenges,mechanisms and solutions

High-quality data are the foundation to monitor the progress and evaluate the effects of road traffic injury prevention measures.Unfortunately,official road traffic injury statistics delivered by governments worldwide,are often believed somewhat unreliable and invalid.We summarized the reported problems concerning the road traffic injury statistics through systematically searching and reviewing the literature.The problems include absence of regular data,under-reporting,low specificity,distorted cause spectrum of road traffic injury,inconsistency,inaccessibility,and delay of data release.We also explored the mechanisms behind the problematic data and proposed the solutions to the addressed challenges for road traffic statistics.

Driver sleepiness,fatigue,careless behavior and risk of motor vehicle crash and injury:Population based case and control study

Background： A few studies have been conducted to determine the relationship between road motor vehicle crashes （MVC） and serious injuries related to tiredness, fatigues and sleeping. Aim： To determine the effects of aggressive behaviour, driver sleepiness and fatigue on MVC and related injuries among Turkish population. Design and setting： Population-based case and control study conducted at the accident emergency departments of hospitals and roads. Subjects： 515 car drivers involved in crashes with injury were admitted to hospital and 1030 car drivers involved while driving on public roads as control group during the study period. Methods： The Manchester driver behaviour questionnaire （DBQ） measured the aberrant driving behaviours leading to accidents. Participants completed a fatigue severity scale （FSS） and Stanford Sleeping questionnaire an epworth scale with items related to socio-demographic information, driving experiences, adherence to traffic laws （such as speed limits and seat belt）, and drivers＇ driving records. Results： In a representative sampling, participant＇s age ranged from 25 to 65 and the mean and standard deviation were 36.5 _＋ 7.8 for cases and 37.0 4- 8.0 for controls. There was a significant difference in both group of drivers regarding BMI, level of education, marital status, driving experience, seat belt use, excessive speed limits, physical activity number of sleeping hours, mobile phone use, and cigarette smoking habit （p = 0.017）. Also, there was a significant higher mean score on all the DBQ violation questions among case group in comparison with the control group （p 〈 0.001）. Further, cases had higher prevalence of Epworth sleeping disorders （p 〈 0.001） and fatigue severity （p - 0.003） compared to control drivers. Multivariate logistic regression revealed that excessive speed, fatigue, lapses, errors, Stanford sleepiness score, violations, mobile phone use and Epworth sleepiness scale were significantly associated with injury involvement in vehicle crash, after adjusting for driving experience and annual mileage. Conclusion： The current study confirmed that drivers with chronic fatigue, acute sleepiness, and careless driver behavior may significantly increases the risk of road crash which can be lead to serious injury.

The common road safety approaches:A scoping review and thematic analysis

Purpose:Comparison of effective road safety approaches with those of relatively similar countries can be used to identify possibilities for safety improvement.Since there is no clear and comprehensive study of countries'current and successful approaches to road safety in the world,the aim of this study was to identifying common road safety approaches in the world.Methods:This study was performed using scoping review and thematic analysis.The study followed the approach proposed by Arksey and O'Malley.In this study all articles were selected without time limit by searching in the following databases:Web of Science,PubMed,Scopus,ProQuest,and Embase.An initial search of 5612 papers was found and finally,20 papers met the inclusion criteria and were analyzed.Results:There were different road safety approaches in different countries around the world,which were classified in three themes:traditional approach,systemic approach,and vision zero.The traditional approach includes the sub-theme of the road-user approach,and the causal approach.The systemic approach also includes sub-themes of sustainable safety,safety system,and the United Nations plan for decade of action,Conclusion:A systemic approach to road safety seems to be welcomed by most developed and developing countries,and a paradigm shift towards a safe system has taken place.Also,given the successful results of implementing vision zero in leading countries,most countries are trying to design and implement this approach.Finally,the choice and implementation of road safety approaches varies according to the principles,priorities and infrastructure of each country.