Epidemiology and Health

Original Articles

Tobacco consumption, sales, and output as monitoring indicators in the era of the tobacco endgame: a Korean example: Hana Kim, Hee-kyoung Nam, Heewon Kang; Epidemiol Health. 2023;45:e2023030. Published online February 27, 2023; DOI: https://doi.org/10.4178/epih.e2023030

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
The consumption, sales, and output of tobacco products each suggest different areas of intervention for tobacco control. In the era of the tobacco endgame, as increasingly stronger supply-side measures are implemented, multifaceted indicators that assess both supply and/or demand are required. We aimed to estimate the consumption of cigarette and heated tobacco products (HTPs) and sought agreement between the various indicators.
METHODS
The annual cigarette and HTP consumption in 2014-2020 was calculated using the frequency and intensity of cigarette use from representative surveys of adults and adolescents by sex and age. Sales and output data were acquired from governmental sources. Spearman correlation coefficients and Bland–Altman plots were used to compare the indicators.
RESULTS
Tobacco output, cigarette sales, and cigarette consumption were greatest in 2014. The HTP consumption calculated for 2020 was 292.28 million packs. Cigarette consumption and sales correlated significantly, as did tobacco output and tobacco sales. A Bland–Altman plot comparing the difference between cigarette consumption and sales showed that this difference was largest in 2014, immediately before cigarette prices increased. With the exception of a single year, all cigarette consumption values were within the limits of agreement for cigarette sales and tobacco output.
CONCLUSIONS
Our analyses showed agreement between demand-side (tobacco consumption) and supply-side (sales and output) indicators. We recommend using all indicators to monitor the impacts of tobacco control on both demand and supply sides. The systematic use of various indicators is critical to achieve the end of the tobacco epidemic.; Summary

Korean summary
공급 제한 중심의 담배 종결전 정책 채택을 고려하는 국가가 증가하고 있다. 이에 따라, 흡연율과 같은 전통적인 지표 외에 공급 측면의 지표가 필요한 상황이다. 담배 소비량, 판매량 및 반출량을 비교 분석한 결과, 지표 간 일치도가 높았으나 정책이 강화되는 시점에 지표 간 격차가 증가하는 것을 확인할 수 있었다. 담배규제 및 종결전 정책 모니터링을 위해 수요 및 공급 측면 지표 모두를 활용할 필요가 있다.

Key Message
The tobacco endgame, which aims to put an end to the tobacco epidemic once and for all, provides supply-focused measures, in addition to the traditional demand-focused measures based on MPOWER strategies. Thus, new supply-focused indicators are required to supplement the traditional demand-side indicators such as tobacco use prevalence and consumption. Our analysis showed that consumption, sales, and output were generally in good agreement. Yet, substantial gaps were identified when tobacco control measures were strengthened. Each indicator is imperfect in isolation, and we suggest to use all consumption, sales, and output indicators in the national health objectives (e.g. Health Plan 2030).

Type 2 diabetes mellitus increases the severity of non-fatal injuries, but not the risk of fatal injuries, among driver victims of motor vehicle crashes in Taiwan: I-Lin Hsu, Wen-Hsuan Hou, Ya-Hui Chang, Chung-Yi Li; Epidemiol Health. 2022;44:e2022076. Published online September 16, 2022; DOI: https://doi.org/10.4178/epih.e2022076

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Limited information is available on whether diabetes increases the severity of injuries from motor vehicle crashes (MVCs). This study aimed to investigate the association of type 2 diabetes with injury severity among driver victims of MVCs.
METHODS
This cohort study involved 75,737 adult driver victims with type 2 diabetes from Taiwan’s Police-Reported Traffic Accident Registry in 2015-2017, along with 150,911 sex-, age-, and calendar year-matched controls. The severity level of non- fatal injuries was derived from the International Classification of Diseases Programs for Injury Categorization based on the diagnostic codes of National Health Insurance claims within 3 days after an MVC. Information on fatal injuries within 3 days after an MVC was obtained from the Taiwan Death Registry. Logistic regression models were used to estimate the odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) of injury severity in association with type 2 diabetes.
RESULTS
After adjusting for potential confounders, driver victims with type 2 diabetes experienced significantly higher risks of mild and severe non-fatal injuries than their counterparts without diabetes, with covariate-adjusted ORs of 1.08 (95% CI, 1.05 to 1.11) and 1.28 (95% CI, 1.20 to 1.37), respectively. By contrast, the adjusted OR for fatal injuries was not significantly elevated, at 1.02 (95% CI, 0.89 to 1.18). Similar results were found when car and scooter driver victims were analyzed separately.
CONCLUSIONS
Type 2 diabetes was found to moderately increase the severity of non-fatal injuries from MVCs among car and scooter driver victims.; Summary

Key Message
With 75,737 driver victims with diabetes and 150,911 matched controls, this study showed an 8% and 28% increase in mild and severe non-fatal injury, respectively among driver victims with diabetes. Such increase in risk was equally applied to both car and scooter drivers. No increase in risk of 3-day mortality after crash was found.

Geographical distribution of at fault drivers involved in fatal traffic collisions in Tehran, Iran: Amir Kavousi, Ali Moradi, Khaled Rahmani, Salahdin Zeini, Pegah Ameri; Epidemiol Health. 2020;42:e2020002. Published online January 13, 2020; DOI: https://doi.org/10.4178/epih.e2020002

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4 Web of Science
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Abstract PDF

Abstract

OBJECTIVES
According to Traffic Police, about 35% of deaths and more than 50% of injuries caused by traffic collision in the roads of Tehran are among drivers and car occupants. This study was conducted to determine areas with the highest number of traffic collisions and perform spatial analysis of traffic collisions involving drivers in Tehran during April 2014 to March 2017.

METHODS

The present study was a cross-sectional and descriptive-analytic research. In this study, all traffic collision that driver was accounted (100 percent or less) for crash occurrence which resulted in the death of at least one person (driver, pedestrian or passenger) were included in the analyses. Geographic information system software was used to show spatial distribution of events from zoning maps. Moran index was used in the mathematical analysis in order to determine the distribution pattern of the events from and Getis-Ord G statistics was applied to analyze the hot spots (high risk points).

RESULTS

A total number of 519 traffic collisions were investigated in this study. Moreover, 283 cases (54.5%) of the incidents took place in direct routes and 236 cases (45.5%) occurred at intersections. The most frequent events were in the region 4 (57 cases) and the least frequent events were reported in the region 10 (6 cases). Moran statistics show that the distribution of the studied events significantly follows the cluster pattern (p<0.001).

CONCLUSIONS

The northeastern and northwest margins of Tehran are the most prone areas for drivers involved with traffic collisions leading to death. Most traffic collisions leading to death take place at highways located at the entrance and exit points of Tehran and highways in regions 2 and 5.

Summary

Citations

Citations to this article as recorded by

Road Accident Hotspots on Jordan’s Highway Based on Geometric Designs Using Structural Equation Modeling
Shatha Aser Aldala’in, Nur Sabahiah Abdul Sukor, Mohammed Taleb Obaidat, Teh Sabariah Binti Abd Manan
Applied Sciences.2023; 13(14): 8095. CrossRef
GIS-based risk mapping of cutaneous leishmaniasis: a survey in an endemic area of Central Iran
Mohammad Reza Maracy, Fariba Jaffary, Afshin Ebrahimi, Fatemeh Sokhanvari, Asieh Heidari, Hanieh Sharifian-Koupaiee, Reza Fadaei, Javad Ramazanpour, Malihe Moazeni
Environmental Science and Pollution Research.2021; 28(41): 57470. CrossRef
Identifying and prioritizing risk factors involved in motorcyclists' traffic accidents in Tehran
Ali Moradi, Amir Kavousi, Pegah Ameri, Mohyeddin Amjadian, MohammadHossein Vaziri
Archives of Trauma Research.2021; 10(3): 153. CrossRef

Estimation of the population attributable fraction of road-related injuries due to speeding and passing in Iran: Fatemeh Khosravi Shadmani, Hamid Soori, Kamyar Mansori, Manoochehr Karami, Erfan Ayubi, Salman Khazaei; Epidemiol Health. 2016;38:e2016038. Published online August 29, 2016; DOI: https://doi.org/10.4178/epih.e2016038

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4 Crossref

Abstract PDF

Abstract

OBJECTIVES
Speeding and passing are considered to be the main human factors resulting in road traffic injuries (RTIs). This study aimed to estimate the population attributeable fraction (PAF) of speeding and passing in RTIs in rural Iran during 2012.

METHODS

The contribution of speeding and passing to RTI-related morbidity and mortality was estimated using the PAF method. The prevalence of speeding and passing was obtained from the national traffic police data registry. A logistic regression model was used to measure the association between the above risk factors and RTIs.

RESULTS

Speeding accounted for 20.96% and 16.61% of rural road-related deaths and injuries, respectively. The corresponding values for passing were 13.50% and 13.44%, respectively. Jointly, the PAF of these factors was 31.63% for road-related deaths and 27.81% for injuries.

CONCLUSIONS

This study illustrates the importance of controlling speeding and passing as a high-priority aspect of public-health approaches to RTIs in Iran. It is recommended that laws restricting speeding and passing be enforced more strictly.

Summary

Citations

Citations to this article as recorded by

Human Risk Factors for Severity of Injuries in Urban and Suburban Traffic Accidents in Southern Iran: An Insight from Police Data
Meisam Abolvardi, Nader Sharifi, Karamatollah Rahmanian, Vahid Rahmanian
International Journal of High Risk Behaviors and Addiction.2023;[Epub] CrossRef
Evaluation of the effect of fixed speed cameras on speeding behavior among Iranian taxi drivers through telematics monitoring
Hamed Tavolinejad, Mohammad-Reza Malekpour, Nazila Rezaei, Ayyoob Jafari, Naser Ahmadi, Ali Nematollahi, Elham Abdolhamidi, Elmira Foroutan Mehr, Milad Hasan, Farshad Farzadfar
Traffic Injury Prevention.2021; 22(7): 559. CrossRef
Spousal violence against women and its association with sociodemographic factors and husbands’ controlling behaviour: the findings of Myanmar Demographic and Health Survey (2015–2016)
Tayzar Tun, Per-Olof Ostergren
Global Health Action.2020; 13(1): 1844975. CrossRef
Time Series Analysis of Mortalities Resulting from Car Accidents in the Injured Individuals Hospitalized in Shiraz Shahid Rajaee Hospital During 2010 - 2016
Haleh Ghaem, Mahmoud Hajipour, Hamid Reza Tababataee, Mahnaz Yadollahi, Fatemeh Izanloo
Trauma Monthly.2017;[Epub] CrossRef

A study on epidemiologic characteristics and factors associated with excess hospitalization of the patients injured by traffic accident.: Mi Woon Kim, Joung Soon Kim, Min Kyung Lim; Korean J Epidemiol. 1998;20(2):279-287.

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Abstract PDF: Abstract
The occurrence of injuries and death caused by traffic accidents have been increasing during last few decades in Korea, which resulted in enormous personal, social and economic loss in terms of death, disability, labour days and medical costs incurred for treatment. Generally, it is well known and even became an hot sociopolitical issue that the duration of hospital stay for traffic accident patients are much longer than that of other patients with the similar condition. The objective of the study is to find out epidemiologic characreristics and management pattern of traffic accident patients in a general hospital of medium-sized, industrialized town. This study was carried out on 177 cases injured by motor vehicle accidents, who were admitted and treated in a general hospital from Feb. 1, 1997 to Sept. 30, 1997. The results obtained are as followings: The most of the patients(44%) were 20-30 years old age group although the occurrence of injuries was more frequent among older ages, 50's for male and 60's for female being 2.1 times more frequent among male. The traffic accidents occurred most frequently(14.1%) in the morning(06:00-08:00) and afternoon(14:00-16:00), and on Saturdays(20.3%); the (14.1% traffic accidents were frequent during weekends for passengers whereas it was more frequent during weekdays for pedestrian. Old and child pedestrians were most vulnerable subjects to traffic accidents. The most common site injured was head(19.9%) and the injury types were fracture of lower extremity(9.3%), skull fracture(8.6%) and rib fracture(8.6%) for both sexes; rib fractures/thoracic spine fractures(12.0%) for female and tibia/ fibula fractures(11.6%) for male. Mean days of hospital stay presumptively judged by the doctor who examined, made diagnosis and admitted the patient was 43.8 days compare to 38.4 days of actual mean days of hospitalixation. On the other hand, the optimal mean days of hospital stay for the patients determined by two doctors independently was estimated to be 26.6 days. Thus the difference between actual days of hospitalization and optimal days of hospitalization was 11.7 days, which can be regarded as excess hospitalization days. It consists 30.5% of actual hospitalization days, an enormous waste of resources. The only factor associated with this excess hospitalization was payment responsibility for the hospital cost; when the hospitalization expenses are to be paid by the person inflicted the injury there were always excess days of hospitalization regardless of insurance status.; Summary

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