Road traffic crashes are a major cause of death and injury, especially in low and middle-income countries. It is estimated that road traffic injuries will have risen from ninth to third in world disease burden rankings by 2020, accounting for 2.3 million deaths per year globally. Street lighting has been suggested as a relatively low-cost intervention with the potential to prevent traffic crashes. The objective of this study was to assess the effects of street lighting on injuries caused by road traffic crashes. The authors searched the Cochrane InjuriesGroup’s Specialised Register, CENTRAL, MEDLINE, EMBASE, TRANSPORT and the Australian Transport Index. They also searched the Internet and checked reference lists of relevant papers. The search was not restricted by language or publication status. The searches were conducted to October 2008. Selection criteria were randomised controlled trials, non-randomised controlled trials and controlled before-after studies, comparing new street lighting with unlit roads, or improved street lighting with the pre-existing lighting level. Two authors screened search results, extracted data, assessed risk of bias and analysed the data. 17 controlled before-after studies of street lighting were found, all reporting crash data, of which 15 contributed data to the meta-analysis. Seven trials included a designated control site; the other ten collected data at one site with the day-time data being used as the control. The methodological quality of the trials was generally poor. Three trials compared street lighting with an area control on total crashes; pooled rate ratio (RR) = 0.45 (95% confidence interval (CI) 0.29 to 0.69). Two trials compared street lighting with an area control on total injury crashes (all severities); RR = 0.78 (95% CI 0.63 to 0.97). No trials compared the number of fatal crashes with an area control. (Author/publisher)
Samenvatting