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Arch Iran Med. 2021;24(7): 512-525.
doi: 10.34172/aim.2021.74
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Original Article

Burden of Transport-Related Injuries in the Eastern Mediterranean Region: A Systematic Analysis for the Global Burden of Disease Study 2017

GBD 2017 EMR Transport Injuries Collaborators ., Saeid Safiri 1,2* ORCID logo, Mark J. M. Sullman 3,4, Timo Lajunen 5, Tetiana Hill 6, Amir Almasi-Hashiani 7, Maziar Moradi-Lakeh 8, Farshad Farzadfar 9, Sadaf G. Sepanlou 10,11, Eman Abu-Gharbieh 12, Teamur Aghamolaei 13, Tauseef Ahmad 14, Suliman A. Alghnam 15,16, Samar Al-Hajj 17,18, Vahid Alipour 19,20, Syed Mohamed Aljunid 21,22, Mina Anjomshoa 23, Alireza Ansari-Moghaddam 24, Jalal Arabloo 19, Mohsen Bayati 25, Neeraj Bedi 26,27, Salaheddine Bendak 28,29, Zulfiqar A Bhutta 30,31, Ali Bijani 32, Saad M A Dahlawi 33, Mostafa Dianatinasab 34,35, Zahra Sadat Dibaji Forooshani 36, Hala Rashad Elhabashy 37, Amir Emami Zeydi 38, Sharareh Eskandarieh 39, Mansour Ghafourifard 40, Ahmad Ghashghaee 19,41, Michal Grivna 42,43, Mohammed Ibrahim Mohialdeen Gubari 44, Randah R Hamadeh 45, Samer Hamidi 46, Khezar Hayat 47,48, Enayatollah Homaie Rad 49,50, Mehdi Hosseinzadeh 51,52, Mowafa Househ 53, Seyed Sina Naghibi Irvani 54, Mohammad Ali Jahani 32, Leila R Kalankesh 55, Rohollah Kalhor 56,57, Ibrahim Kamel 58,59, Mohammad Khammarnia 60, Maseer Khan 61, Habibolah Khazaie 62, Hamidreza Komaki 63,64, Amitis Lahimchi 65, Mohammed Madadin 66, Shokofeh Maleki 67, Navid Manafi 68,69, Fariborz Mansour-Ghanaei 70,71, Mohammad Ali Mansournia 72, Ritesh G Menezes 73, Yousef Mohammad 74, Abdollah Mohammadian-Hafshejani 75, Farnam Mohebi 9,76, Ghobad Moradi 77,78, Rahmatollah Moradzadeh 7, Seyyed Meysam Mousavi 79, Mehdi Naderi 67, Rajan Nikbakhsh 80, Keyvan Pakshir 81, Akram Pourshams 10, Navid Rabiee 82, Alireza Rafiei 83,84, Reza Rawassizadeh 85, Aziz Rezapour 19, Basema Saddik 86, Sahar Saeedi Moghaddam 9, Payman Salamati 87, Marwa Rashad Salem 88, Hosni Salem 89, Abdallah M Samy 90, Brijesh Sathian 91,92, Saeed Shahabi 93, Masood Ali Shaikh 94, Mehran Shams-Beyranvand 95, Morteza Shamsizadeh 96, Mohammad Reza Sobhiyeh 97, Amin Soheili 98, Arash Tehrani-Banihashemi 8,99, Yasir Waheed 100, Hasan Yusefzadeh 101, Telma Zahirian Moghadam 102, Leila Zaki 103, Mohammad Zamani 104, Hamed Zandian 102,105, Reza Malekzadeh 10,11, Mohsen Naghavi 106,107*

1 Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
2 Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
3 Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
4 Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
5 Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
6 Hertfordshire Business School, University of Hertfordshire, Hatfield, UK
7 Department of Epidemiology, Arak University of Medical Sciences, Arak, Iran
8 Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
9 Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
10 Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
11 Non-communicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
12 Department of Clinical Sciences, University of Sharjah, Sharjah, United Arab Emirates
13 Department of Health Education and Health Promotion, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
14 Department of Epidemiology and Health Statistics, Southeast University, Nanjing, China
15 Population Health Research Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
16 King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
17 Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
18 British Columbia Injury Research Prevention Unit, British Columbia Children’s Hospital Research Institute, Vancouver, BC, Canada
19 Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
20 Department of Health Economics, Iran University of Medical Sciences, Tehran, Iran
21 Department of Health Policy and Management, Kuwait University, Kuwait City, Kuwait
22 International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
23 Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
24 Department of Epidemiology and Biostatistics, Zahedan University of Medical Sciences, Zahedan, Iran
25 Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
26 Department of Community Medicine, Gandhi Medical College Bhopal, Bhopal, India
27 Jazan University, Jazan, Saudi Arabia
28 Department of Industrial Engineering and Engineering Management, University of Sharjah, Sharjah, United Arab Emirates
29 Department of Epidemiology, University of Sharjah, Sharjah, United Arab Emirates
30 Centre for Global Child Health, University of Toronto, Toronto, ON, Canada
31 Centre of Excellence in Women & Child Health, Aga Khan University, Karachi, Pakistan
32 Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
33 Environmental Health Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
34 Department of Epidemiology and Biostatistics, Shahroud University of Medical Sciences, Shahroud, Iran
35 Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
36 Tehran University of Medical Sciences, Tehran, Iran
37 Neurophysiology Department, Cairo University, Cairo, Egypt
38 Department of Medical-Surgical Nursing, Mazandaran University of Medical Sciences, Sari, Iran
39 Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
40 Department of Medical Surgical Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
41 Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
42 Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
43 Department of Public Health and Preventive Medicine, Charles University, Prague, Czech Republic
44 Department of Family and Community Medicine, University of Sulaimani, Sulaimani, Iraq
45 Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
46 School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
47 Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
48 Department of Pharmacy Administration and Clinical Pharmacy, Xian Jiaotong University, Xian, China
49 Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
50 Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
51 Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
52 Department of Computer Science, University of Human Development, Sulaymaniyah, Iraq
53 College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
54 Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
55 Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
56 Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
57 Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
58 University of La Verne, La Verne, CA, USA
59 Department of Medicine, October 6 University, Giza, Egypt
60 Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
61 Epidemiology Department, Jazan University, Jazan, Saudi Arabia
62 Department of Psychiatry, Kermanshah University of Medical Sciences, Kermanshah, Iran
63 Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
64 Brain Engineering Research Center, Institute for Research in Fundamental Sciences, Tehran, Iran
65 First Faculty of Medicine, Charles University, Prague, Czech Republic
66 Pathology Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
67 Clinical Research Development Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
68 School of Medicine, Iran University of Medical Sciences, Tehran, Iran
69 School of Medicine, University of Manitoba, Winnipeg, MB, Canada
70 Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
71 Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
72 Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
73 Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
74 Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
75 Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran
76 National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran, Iran
77 Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
78 Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran
79 Department of Health Policy, Management, and Economics, Tehran University of Medical Sciences, Tehran, Iran
80 Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
81 Department of Parasitology and Mycology, Shiraz University of Medical Sciences, Shiraz, Iran
82 Department of Chemistry, Sharif University of Technology, Tehran, Iran
83 Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran
84 Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
85 Department of Computer Science, Boston University, Boston, MA, USA
86 Department of Family and Community Medicine, University of Sharjah, Sharjah, United Arab Emirates
87 Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
88 Public Health and Community Medicine Department, Cairo University, Giza, Egypt
89 Urology Department, Cairo University, Cairo, Egypt
90 Department of Entomology, Ain Shams University, Cairo, Egypt
91 Department of Geriatrics and Long Term Care, Hamad Medical Corporation, Doha, Qatar
92 Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
93 Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
94 Independent Consultant, Karachi, Pakistan
95 School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
96 Faculty of Caring Science, Work Life, and Social Welfare, University of Borås, Borås, Sweden
97 Department of Vascular and Endovascular Surgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
98 Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran
99 Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
100 Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan
101 Department of Health Care Management and Economics, Urmia University of Medical Science, Urmia, Iran
102 Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran
103 Department of Parasitology and Entomology, Tarbiat Modares University, Tehran, Iran
104 Student Research Committee, Babol University of Medical Sciences, Babol, Iran
105 Department of Community Medicine, Ardabil University of Medical Science, Ardabil, Iran
106 Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
107 Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
*Corresponding Authors: *Corresponding Author: Saeid Safiri, PhD, Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Tel: 0098-4133364673; Email: , Email: safiris@tbzmed.ac.ir; Mohsen Naghavi, MD, PhD; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA. Tel: 001- 2068972800; Emails: , Email: nagham@uw.edu

Abstract

Background: Transport-related injuries (TIs) are a substantial public health concern for all regions of the world. The present study quantified the burden of TIs and deaths in the Eastern Mediterranean region (EMR) in 2017 by sex and age.

Methods: TIs and deaths were estimated by age, sex, country, and year using Cause of Death Ensemble modelling (CODEm) and DisMod-MR 2.1. Disability-adjusted life years (DALYs), which quantify the total burden of years lost due to premature death or disability, were also estimated per 100000 population. All estimates were reported along with their corresponding 95% uncertainty intervals (UIs).

Results: In 2017, there were 5.5 million (UI 4.9–6.2) transport-related incident cases in the EMR – a substantial increase from 1990 (2.8 million; UI 2.5–3.1). The age-standardized incidence rate for the EMR in 2017 was 787 (UI 705.5–876.2) per 100000, which has not changed significantly since 1990 (-0.9%; UI -4.7 to 3). These rates differed remarkably between countries, such that Oman (1303.9; UI 1167.3–1441.5) and Palestine (486.5; UI 434.5-545.9) had the highest and lowest age-standardized incidence rates per 100000, respectively. In 2017, there were 185.3 thousand (UI 170.8–200.6) transport-related fatalities in the EMR – a substantial increase since 1990 (140.4 thousand; UI 118.7–156.9). The age-standardized death rate for the EMR in 2017 was 29.5 (UI 27.1–31.9) per 100000, which was 30.5% lower than that found in 1990 (42.5; UI 36.8–47.3). In 2017, Somalia (54; UI 30–77.4) and Lebanon (7.1; UI 4.8–8.6) had the highest and lowest age-standardized death rates per 100,000, respectively. The age-standardised DALY rate for the EMR in 2017 was 1,528.8 (UI 1412.5–1651.3) per 100000, which was 34.4% lower than that found in 1990 (2,331.3; UI 1,993.1–2,589.9). In 2017, the highest DALY rate was found in Pakistan (3454121; UI 2297890- 4342908) and the lowest was found in Bahrain (8616; UI 7670-9751).

Conclusion: The present study shows that while road traffic has become relatively safer (measured by deaths and DALYs per 100000 population), the number of transport-related fatalities in the EMR is growing and needs to be addressed urgently.


Cite this article as: GBD 2017 EMR Transport Injuries Collaborators, Safiri S, Sullman MJM, Lajunen T, Hill T, Almasi-Hashiani A, et al. Burden of Transport-related Injuries in the Eastern Mediterranean Region: A Systematic Analysis for the Global Burden of Disease Study 2017. Arch Iran Med. 2021;24(7):512-525. doi: 10.34172/aim.2021.74
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Submitted: 13 Sep 2020
Accepted: 13 Jan 2021
ePublished: 01 Jul 2021
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