Fatal accident distribution by age, gender and head injury, and death probability at accident scene in Mashhad, Iran, 2006-2009.

Several studies have investigated road traffic deaths, but few have compared by road user type. Iran, with an estimated 44 road traffic deaths per 100,000 population in 2002 had higher road traffic deaths than any other country for which reliable estimates can be made. So, the present study was conducted on road death data and identified fatal accident distribution by age, gender and head injury as well as the influences of age and gender on deaths at accident scenes for all road user groups. Data used in this study are on fatal road accidents recorded by forensic medicine experts of the Khorasan Razavi province in Mashhad, the capital of the province, the second largest city and the largest place of pilgrimage, immigration and tourism in Iran. Chi-square test and odds ratio were used to identify the relation of death place with age and gender in 2495 fatal road accidents from 2006 to 2009. The t-test and analysis of variance were employed for continues variable, age, to compare males' and females' mean age for all road user categories. For two genders, all three groups of fatalities (pedestrian, motorcyclist and motor vehicle occupant) had a peak at the ages of 21-30. The youngest were male motorcyclists (mean age = 28). Old pedestrians were included in road deaths very much, too. Male/female overall ratio was 3.41 and the highest male/female ratio was related to motorcyclists (14). The overall ratio of head injury to other organ injuries (torso and underbody) was 2.51 and pedestrians had the largest amount of head injury (38.2%). Regarding death at accident scene, for all road users, gender did not have any significant relation with death at the scene (P-value > 0.1); on the contrary, age had significant relation (P-value < 0.05). Females were more vulnerable at accident scenes (male/female ratio at accident sense < 1). Pedestrians aged 21-30, motorcyclists 41-50 and motor vehicle occupants 31-40 died the most at accident scenes. Identifying the most endangered groups of road accident fatalities, which was conducted in this study, is invaluable for the appropriate design of prevention strategies and allocation of financial resources for each group of road user fatalities - since in developing nations, there are insufficient financial resources to traffic safety and we should consider superiorities, i.e. the most risky groups. Steps which may contribute to safety promotion for local conditions include suitable facilities for old pedestrians, a training course before obtaining motorcycle license for motorcyclists, informing young road users by provincial media about death risk of road users and improving management of the head-injured patients. Finally, suggestions for future researches were made.