Analysis and future trend prediction of disease burden of road traffic injuries in China and several Asian countries from 1990 to 2021

Fang Lanxi; Li Yiyang; Deng Qi; Han Yude; Yang Zhijin

doi:10.3969/j.issn.1009-4237.2025.12.011

Abstract：To analyze and compare the disease burden and risk factors of road traffic injuries(RTI)in Chi-na and several Asian countries from 1990 to 2021,and to predict future trends.Methods Data from the Global Burden of Disease(GBD)2021 database on the prevalence,incidence,and disability-adjusted life years(DALY)of RTI were extracted for the global population,China,India,Pakistan,and Malaysia,stratified by gender.The esti-mated annual percentage change(EAPC)was used to assess trends.Joinpoint regression and Bayesian age-period-cohort(BAPC)models were employed for analysis and prediction.Results From 1990 to 2021,the incidence and DALY of global RTI were decreasing.The EAPC in the incidence rate was-1.6(95%CI:-1.61 to-1.51),and in the DALY rate was-1.4(95%CI:-1.56 to-1.29),both indicating a downward trend.At the national level,China and Malaysia showed a general decline in overall burden.In India,the age-standardized incidence rate(ASIR)re-bounded between 2015 and 2021(APC=0.22%,P<0.001),while Pakistan exhibited significant increases in the incidence rate and DALY rate,with the EAPCs being 0.41%and 1.16%,respectively.In terms of gender differ-ences,the ASIR and age-standardized disability-adjusted life year rate(ASDR)of males were generally 2-3 times higher than those of females across different countries.In India,cultural factors led to lower early exposure risks for females,but the gender gap has been gradually narrowed since 2015.The Bayesian model predicts that by 2030,the burden of RTI will continue to decline in most regions globally.However,India is expected to see a short-term in-crease in ASIR(with a 2.7%increase in males),and Malaysia may experience a 22.6%rise in ASDR due to popu-lation aging.The analysis of risk factors indicated that occupational injuries were the primary risk,with Pakistan ex-hibiting a high attributable DALY rate of 519.75 per 100,000 population.Exposure to low temperatures was identi-fied as a protective factor,while exposure to high temperatures was considered a risk factor.Conclusion The over-all burden of global RTI declined year by year,but in some areas,the burden of RTI still needs to be continuously monitored due to economic,policy and demographic factors.China should summarize and learn from the experience and lessons of various countries,promote the transformation of public transport models,pay attention to the allocation of safety while the economy is growing rapidly,and pay attention to policy interventions for gender specificity and population aging,so as to further reduce the burden of future RTI.