Differences in police, ambulance, and emergency department reporting of traffic injuries on Karachi-Hala road, Pakistan

<p>Abstract</p> <p>Background</p> <p>Research undertaken in developing countries has assessed discrepancies in police reporting of Road Traffic Injury (RTI) for urban settings only. The objective of this study was to assess differences in RTI reporting across police, ambulance, and hospital Emergency Department (ED) datasets on an interurban road section in Pakistan.</p> <p>Methods</p> <p>The study setting was the 196-km long Karachi-Hala road section. RTIs reported to the police, Edhi Ambulance Service (EAS), and five hospital EDs in Karachi during 2008 (Jan to Dec) were compared in terms of road user involved (pedestrians, motorcyclists, four-wheeled vehicle occupants) and outcome (died or injured). Further, records from these data were matched to assess ascertainment of traffic injuries and deaths by the three datasets.</p> <p>Results</p> <p>A total of 143 RTIs were reported to the police, 531 to EAS, and 661 to hospital EDs. Fatality per hundred traffic injuries was twice as high in police records (19 per 100 RTIs) than in ambulance (10 per 100 RTIs) and hospital ED records (9 per 100 RTIs). Pedestrian and motorcyclist involvement per hundred traffic injuries was lower in police records (8 per 100 RTIs) than in ambulance (17 per 100 RTIs) and hospital ED records (43 per 100 RTIs). Of the 119 deaths independently identified after matching, police recorded 22.6%, EAS 46.2%, and hospital ED 50.4%. Similarly, police data accounted for 10.6%, EAS 43.5%, and hospital ED 54.9% of the 1 095 independently identified injured patients.</p> <p>Conclusions</p> <p>Police reporting, particularly of non-fatal RTIs and those involving vulnerable road users, should be improved in Pakistan.</p

Did Ontario's Zero Tolerance & Graduated Licensing Law reduce youth drunk driving?

On April 1, 1994, Ontario, Canada, instituted a new graduated driver license (GDL) system that effectively set the legal blood alcohol content (BAC) threshold at zero for the first few years of a youth's driving eligibility. I use data from the 1983-2001 Ontario Student Drug Use Surveys (OSDUS) to examine whether the Zero Tolerance (ZT) policy reduced self-reported drinking and alcohol-involved driving among youth. I find that rates of drunk driving reported by 16- to 17-year-olds-who faced new, lower legal limits after adoption of the ZT policy-were about 5 percentage points lower after the law was implemented. Visual inspection of the data, however, shows that the estimated reduction is an artifact of a pre-existing trend: Drunk driving rates in this age group were falling steadily throughout the 1980s and into the 1990s. Estimates that account for this pre-existing trend or that consider shorter windows around the 1994 implementation date return effects on alcohol-involved driving that are either small and statistically insignificant or large and implausibly signed (positive). These null findings are robust to using the associated change in outcomes for slightly younger (14-15) or slightly older (19-20) youths as controls in a difference-in-differences framework. I similarly find no robust effect on drinking participation. This suggests that Ontario's age-targeted drunk driving law-despite being harsher than similar policies in the United States-was not responsible for reductions in Canadian youth road fatalities over the past two decades. © 2006 by the Association for Public Policy Analysis and Management