No abstract

No abstract

Background. Road traffic accidents are the fourth leading cause of death in the entire population, and the first among the youth (ages 15-19 years) in Thailand. The situation in Thailand is worse than in neighboring low- to middle-income countries in the Southeast Asia region. Seventy-three percent of the deaths in the country are motorcycle drivers or passengers. Although motorcyclists (both drivers and passengers) have been obligated to wear helmets by law, the prevalence of helmet use nationwide is not high (43.7% in 2010). Methods. We performed a systematic review to examine potential social determinants of helmet use behavior (observational studies) and to summarize previous intervention studies to promote helmet use (interventional studies) in the country. Studies were identified in PubMed and Web of Science, and by additional review of Thai-written literature. Results. We identified 16 relevant studies for social determinants of helmet use and 5 relevant studies for promoting helmet use in Thailand. Our review shows that several factors such as teens and children (age), women (gender), rural areas (geography), and alcohol drinking (interaction with another behavior) are associated with non-helmet use. We also identified 4 interventional studies implemented in Thailand: 1 law enforcement program and 4 community-based educational programs. Although all the studies improved the prevalence of helmet use after the interventions, only 2 studies exceeded 50%. Conclusion. There is consistent evidence that being younger, being a woman, living in non-Bangkok areas, and drinking alcohol are associated with non-helmet use among motorcycle users in Thailand. We also observed that the effect of past intervention programs is limited.

Bus accidents are a serious issue, with high rates of injury and fatality in Thailand. However, no studies have been conducted on the factors affecting bus accident severity in Thailand. A cross-sectional study was conducted by the Department of Highways, Thailand over the 2010–2019 period. A multinomial logit model was used to evaluate the factors associated with bus accident severity. This model divided accidents into three categories: non-injury, injury, and fatality. The risk factors consisted of three major categories: the bus driver, characteristics of the crash, and environmental characteristics. The results showed that characteristics of the bus driver, the crash, and the environment where the crash occurred all increased the probability of bus accidents causing injury. These three main factors included driving on sloped roads (relative risk ratio [RRR] 3.03, 95% confidence level [CI] 1.73 to 5.30), drowsy driving (RRR 2.60, 95% CI 1.71 to 3.96), and driving in the wrong direction (RRR 2.37, 95% CI 1.77 to 3.19). Moreover, the factors that increased the probability of the accidents causing fatality were drowsy driving (RRR 3.40, 95% CI 2.07 to 5.57) and drivers not obeying or following traffic rules (RRR 3.02, 95% CI 1.95 to 4.67), especially in the northern part of Thailand (RRR 3.01, 95% CI 1.98 to 4.62). The results can provide a valuable resource to help road authorities in development targeting road safety programs at sloped roads in the northern part of Thailand. Stakeholders should increase road safety efforts and implement campaigns, such as raising public awareness of the risks of not obeying or following traffic rules and drowsy driving which could possibly reduce the risk of both injury and fatality.