Road-Traffic-Injuries (RTIs) are predicted to rise up to the fifth leading cause of worldwide death by 2030 and Iran has the third highest RTIs mortality among higher-middle income countries. Although the high mortality of RTI in Iran is a warning, it provides the opportunity to indirectly assess the implemented RTI-related regulations’ effectiveness via high-resolution relevant statistics and, hence, Iran could serve as a guide for countries with similar context. In order to do so, we utilized this study to report the time and spatial trends of RTIs-related mortality in different age and sex groups and road user classes in Iran. Based on the national death-registration-system (DRS), cemeteries data, and the demographic characteristics, and after addressing incompleteness, we estimated mortality rates using spatiotemporal and Gaussian process regression models. We assessed Pearson seatbelt and helmet use and RTIs-attributable Age-Standardized-Morality-Rate (ASMR) associations. We also predicted RTIs-death-numbers, 2012–2020, by fitting a Generalized Additive Model to assess the status of achieving relevant sustainable development goal (SDG), namely reducing the number of RTIs-related deaths by half. Overall RTIs-attributable death and ASMR at the national level increased from 12.64 [95% UI, 9.52–16.86] to 29.1 [22.76–37.14] per 100,000 people in the time period of 1990–2015. The trend consisted of an increasing segment in 1990–2003 followed by a decreasing part till 2015. The highest percentage of death belonged to the three-or-more-wheels motorized vehicles. Pedestrian injuries percentage increased significantly and the highest mortality rate occurred in 85 years and older individuals. Low prevalence of seatbelt and helmet use were observed in provinces with higher than the median ASMR due to the relevant cause of each. RTIs-attributable death number is expected to reduce by 15.99% till 2020 which is lower than the established SDG goal. Despite the observed substantial moderation in the RTI-ASMR, Iran is till among the leading countries in terms of the highest mortality rates in the world. The enforced regulations including speed limitations (particularly for elder pedestrians) and mandatory use of seatbelt and helmet (for young adult and male drivers) had a considerable effect on ASMR, nevertheless, the RTI burden reduction needs to be sustained and enhanced.

中文翻译：

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1990-2015 年伊朗道路交通伤害死亡率的水平和趋势：成功法规的故事和设计未来政策的路线图


预计到 2030 年，道路交通伤害 (RTI) 将上升至全球第五大死亡原因，而伊朗的道路交通伤害死亡率在中高收入国家中排名第三。尽管伊朗 RTI 的高死亡率是一个警告，但它提供了通过高分辨率相关统计数据间接评估实施的 RTI 相关法规有效性的机会，因此，伊朗可以为具有类似情况的国家提供指导。为此，我们利用这项研究报告了伊朗不同年龄、性别组和道路使用者类别的 RTI 相关死亡率的时间和空间趋势。根据国家死亡登记系统（DRS）、墓地数据和人口特征，在解决不完整性问题后，我们使用时空和高斯过程回归模型估算了死亡率。我们评估了 Pearson 安全带和头盔的使用情况以及 RTI 归因的年龄标准化道德率 (ASMR) 关联。我们还预测了 2012 年至 2020 年的 RTI 死亡人数，通过拟合广义加性模型来评估实现相关可持续发展目标 (SDG) 的状况，即将 RTI 相关死亡人数减少一半。 1990 年至 2015 年期间，全国 RTI 所致死亡和 ASMR 从每 10 万人 12.64 例 [95% UI，9.52–16.86] 增加到 29.1 例 [22.76–37.14]。其趋势是1990-2003年呈上升趋势，随后到2015年呈下降趋势。死亡率最高的是三轮及以上机动车辆。行人受伤比例显着上升，死亡率最高的是85岁及以上人群。 在 ASMR 高于中位数的省份，由于各自的相关原因，安全带和头盔的使用率较低。到2020年，RTI归因的死亡人数预计将减少15.99%，低于既定的可持续发展目标。尽管观察到 RTI-ASMR 大幅放缓，但伊朗仍是世界上死亡率最高的国家之一。包括速度限制（特别是针对老年行人）和强制使用安全带和头盔（针对年轻成年和男性驾驶员）在内的强制法规对 ASMR 产生了相当大的影响，然而，RTI 负担的减轻需要持续和加强。