Road countries. The probability of reporting was found

Road traffic crashes are of global concern dueto the rising trends of deaths and disability following road traffic crashes asthey cause significant deaths, injuries and property losses.

According to theWorld Health Organisation, approximately 1.25 million people lives are cutshort every year as a result of a road traffic crash. More people between 20and 50 million suffer non-fatal injuries, with many incurring a disability as aresult of their injury 1.Road traffic injuries cause considerableeconomic losses to victims, their families, and to nations as a whole. Theselosses arise from the cost of treatment including rehabilitation and incidentinvestigation as well as reduced/lost productivity (e.

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g. in wages) for thosekilled or disabled by their injuries, and for family members who need to taketime off work (or school) to care for the injured. Road traffic accidents have a great impact not only onhuman lives but also on the economies. The global loss due to traffic injuriesis estimated to be 518 billion US dollars and is approximately equivalent to 1to 4% of the gross national products 2.

Notall reportable accidents are actually reported. About 20 yearsago, Hauer and Hakkert pointed out that not all traffic crashes were reportableand not all reportable crashes were in fact reported 3. The analysis ofunderreporting crash data leads to a biased estimate when crash predictionmodels are used, which results in ineffective treatments when the models areapplied for such purposes. These studies revealed that crashes wereunderreporting in all industrialized countries, but the unreported rate wasworse in developing countries. The probability of reporting was found to beinfluenced by the crash severity, age of the victim, role of the victim (e.g.

,whether the victim was the driver or the passenger), and the number of vehiclesinvolved 3.This underreporting can limitthe ability to manage road safety, because most of the analyses related to roadsafety are based on reported crash data. Underreportingor failure to report the road traffic injury in statistics often raised theconcern about the inaccuracy of the data analization. The information relatingto traffic accidents and victims represent an essential tool to control anddetect safety problems in transport. For example, a French regional study comparing hospitalwith road traffic police data found that only 37 percent of non-fatalhospitalized injuries were recorded by the police 4.In Australia, the use of a linked data system showed thatabout 40–45 percent of hospital records for road crash casualties did not havea corresponding police record 5. A similarfigure was estimated for child road accident injuries in Japan, through linkageof Police and Insurance Associations records 6.

Furthermore, a national underreporting study in the UK 7, revealed a considerable difference of underreportingamong different levels of injury severity; about 20 percent of injuries classifiedas serious by the Police were treated and discharged by the hospital (i.e.slight injuries), while those treated by the hospital as serious but appearingin the police record as slight accounts for about 8 percent in that country.Important differences in the degree of underreporting per road user type werealso identified in several studies. In San Francisco, United States of America,the number of injured pedestrians is underreported by approximately 20 % 8. Moreover, Amoros et al. 9found that Police underreporting of road accident injuries in France is higheramong the younger (0–17) age and lower among the older (55+ years) age groups.Cryer et al.

10 estimated increased underreportingof bicyclists and motorcyclists injuries in the United Kingdom.In the United States of America, one of the earliest suchefforts was reported by Barancik and Fife 11, drawing from aprobability sampling of emergency room visits to 42 hospitals in northeasternOhio. The authors were able to identify police crash reports for only 55percent of the patients treated for injuries received in a motor vehicle crash;among those hospitalized, 74 percent were matched. Separate information forpedestrians and bicyclists was not reported.

In a more recent study focusing onbicyclists treated in a cross section of hospital emergency rooms in NorthCarolina, Stutts et al. 12 identified police reports for 60 percent of thecases where a motor vehicle was involved and in Western Australia, 69 percentof pedestrians and 74 percent of bicyclists admitted to hospitals were linkedto official police records 13.Road safetyhas long been considered as one of the social responsibilities of the MalaysianGovernment and the people at large 14. As such, road safety have been formedwithin the government departments, private agencies and voluntaryorganisations.

The Cabinet Committee of Road Safety chaired by the PrimeMinister himself was formed by the Government. A National Road Safety Plan thenwas formulated to give attention to not only road safety research programmes,behavioural modification of road users, road engineering and vehicle safety,but also to medical treatment and safety administration. The increase in roadaccidents is closely linked to the rapid growth in the population, economicdevelopment, industrialisation and motorisation encountered by the country.

Since the 1970’s, Malaysia has been experiencing a remarkable growth in thesesectors. According to a press releasein the New Straits Times, the Transport Minister reported that 7152 people haddied in road accidents in the year 2016. He also quoted that the painfulreality is that the accident rate keeps increasing every year 15.A keyingredient for a successful road safety improvement program are theavailability and the knowledge of basic facts about road accidents. Inparticular, essential pieces of information concerning the where, when, why andwho of road traffic accidents are necessary before any effective solution plancan be implemented 16.Underreportingor failure to report the road traffic accidents has often raised the concernabout the inaccuracy of statistics and its effect on road safety policy-makingand planning. The World Health Report emphasises the need for good and completedata and scientific approaches in the prevention and control of road trafficinjuries 17. Elvick and Mysen 18 stated that the true number of roadtraffic crashes is unknown, and virtually all studies of road crashes includingmore than one type of data compare just two sources, most commonly police andhospital records, and the level of completeness of these datasets is limited.

These two sources do not capture those who do not go to the hospital or to thepolice, resulting in a further underestimation of under reporting. It is saidthat accurate death and injury rates would best be generated through community-basedstudies 19.Recentstudies by Samuel et al 20 showed the underreporting of road traffic injuriesand fatalities in Malawi. They analized using capture-recapture analysis whichwas the tool to estimate the incidence of road traffic deaths using two incompletedata sources.

However, they suggested using spatial analyses or third datasource to refine such estimates. Besides that, another study by Abegaz et al21 also utilised the capture-recapture method. The method was applied usingdata from traffic police and hospital injury surveillance. Neither ofthe two sources independently provided accurate coverage of road trafficincident related to deaths and injuries. Strengthening both systems isnecessary to obtain accurate information on road accidents and human casualitiesconducted in Ethiopia. Periyasamyet al 22 conducted a community survey to estimate the road traffic injuriesthat were underreported and to compare the degree to which road trafficinjuries are underreported and to compare the characteristics reported to thepolice to those not reported in district of Kandy, Sri Lanka. Based on theirfindings, underreporting between 33 percent and 56 percent in the districtof Kandy demonstrated that the real burden of traffic injury wasunderestimated.

Under reporting was most pronounced among non-fatal, non-severeinjuries and among the high-income group and middle-aged vulnerable road users.Underreporting was most likely influenced by the human tendency to avoid legalprocedures and to avoid wasting time or money by reporting the event. Thisstudy highlighted the need to increase population education on the importanceof reporting, and to create a favourable environment to improve reporting inorder to have complete and reliable data for effective and efficient policyplanning.

In Hong Kong, Tsui et al 23 did a study on misclassificationof injury severity among road casualties in police reports. The results oflogistic regression indicate that age, the injury severity scale and positionof the victim significantly determine the likelihood of police injurymisclassification. It is recommended that the more precise and completeinformation on injury characteristics that is available in trauma records beapplied for the identification and quantification of biases in injury severitygrading. In Malaysia, Manan & Varhelyi 24 had studiedon motorcycle fatalities since Malaysia has the highest road fatality risk (per100,000 population) among the ASEAN countries and the fact that more than 50percent of the road accident fatalities involved motorcyclists. However, only fatality data are useddue to the severe underreporting of severe injuries (up to 600%) and slightinjuries (up to 1400%).

Hence, accident reporting must be improved in Malaysia byestablishing an injury recording system and database based on hospital recordsto complement police records in order to obtain more accurate results oninjuries.Since the survey rely on memory based data of the human,Schacter 25 warned that the human memory is fallible. Someresearchers reject use of self-reported data due to its alleged poor quality.However, Chan 26 argued that the so-called poor quality of self-reported datais nothing more than an urban legend.  Driven by social desirability,respondents might provide the researchers with inaccurate data on someoccasions, but it does not happen all the time.

For example, it is unlikelythat the respondents would lie about their demographics, such as gender andethnicity. Second, while it is true that respondents tend to fake their answersin experimental studies, this issue is less serious in measures used in fieldstudies and naturalistic settings. Further, there are numerous well-establishedself-reported measures of different psychological constructs, which haveobtained construct validity evidence through both convergent and discriminantvalidation. For example, Big-five personality traits, proactive personality,affectivity disposition, self-efficacy, goal orientations, perceivedorganizational support, and many others.The specific aims of this research study are to provide answers tothe following questions:a) what are the characteristics of Malaysiandrivers and their unreported road accidents?b) what influences do drivers’ variables haveon their reporting or unreported of road traffic accidents?c) what are the reasons for unreported roadaccidents?

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