Road Traffic Injuries among Middle School Students in a Rural Area of China

Abstract

Objective: Injuries resulting from road traffic crashes are a major and growing public health problem worldwide, disproportionately affecting vulnerable road users in developing countries. However, research on road traffic injuries in developing countries has been limited. We studied road traffic injuries among middle school students in a rural area of China.

Methods: We surveyed 1551 students in Hunan province using a hard-copy survey questionnaire. The survey was conducted at two middle schools with the cooperation of teachers and school officials. The questionnaire gathered data including sociodemographics, school activities, and sleep patterns along with road traffic injuries among middle students during a 3-month recall period in 2006. Road traffic injuries were defined as injuries incurred as a result of a road traffic collision involving at least one vehicle in motion on a public or private road that resulted in at least one person being injured.

Results: There were 56 road traffic injuries reported by the surveyed students yielding a rate of 3.6 percent over the 3-month period. The greatest percentage of those injuries involved a motorcycle (80%). Nearly two fifths of injuries resulted in a period of activity restriction lasting one day or more (39%). The multivariable logistic regression analysis indicated that there were statistically significant associations between the assignment of extra homework by parents (odds ratio [OR] = 3.78, 95% confidence intervals [CI] = 1.49–9.60, p-value < 0.01) and parents' treatment for poor academic performance (OR = 2.18, 95% CI = 1.18–4.02, p-value < 0.05) with road traffic injuries and difficulty falling asleep was a marginally a significant risk factor (OR = 2.03, 95% CI = 0.78–5.28, p-value = 0.06).

Conclusion: School-related stress and sleep disturbance were identified as possible risk factors for road traffic injuries among students in a rural area of China. Further research is warranted in order to develop prevention strategies to address these preventable injuries.

Keywords:

• Adolescents
• Students
• Road traffic injuries
• Sleep
• Rural
• China

ACKNOWLEDGEMENTS

We thank Dr. Guanmin Chen and our colleagues at the Wuhan University School of Public Health for their help with data collection. This study was funded by the Colorado Injury Control Research Center (Grant #: R49/CCR811509, PI: Huiyun Xiang). Data analysis and manuscript writing were partially supported by a grant from the National Institutes of Health Fogarty International Center (Grant #: 1D43TW007257-01A2, PIs: Lorann Stallones and Huiyun Xiang).

Notes

∗One subject was injured by multiple vehicles.

^tp-value from Cochran-Armitage trend analysis of injury percentage.

^ap-value from regular χ² significance test.

^bUnknown/refused response not included in trend or χ² significance test.

^t p-value from Cochran-Armitage trend analysis of injury percentage.

^a p-value from regular χ² significance test.

^bUnknown/refused responses not included in trend or χ² significance test.

∗p-value < 0.05,

∗∗p-value < 0.01 from x² significance test.