title: Factors associated with RTCs among for-hire three-wheeler drivers in Sri Lanka: a case-control study.
abstract: OBJECTIVE
  For-hire three-wheeler crashes are a growing burden in Sri Lanka. We conducted this study to examine the factors associated with road traffic crashes (RTCs) among for-hire three-wheeler drivers in Sri Lanka.
  
  
  METHODS
  We conducted a case-control study in Kandy, Sri Lanka between August 2008 and March 2009. Cases were all the for-hire three-wheeler drivers involved in crashes in Kandy between 1 January and 31 December 2007 (n=88). Controls were non-crash-involved for-hire three-wheeler drivers in Kandy, matched to the ages of the cases (n=88). We examined participants' sociodemographic characteristics, job characteristics, driving behaviours and the characteristics of their three wheelers. We used conditional logistic regression analysis to examine the factors associated with for-hire three-wheeler crashes.
  
  
  RESULTS
  Three factors were positively associated with for-hire three-wheeler crashes. They were as follows: taking more than three passengers in the passenger seat (adjusted OR (AOR)=8.03, 95% CI 1.16 to 55.71), higher age of the three wheelers (AOR=1.38, 95% CI 1.04 to 1.84), and being convicted by police for traffic law violations during the past 12 months (AOR=1.74, 95% CI 1.16 to 2.58).
  
  
  CONCLUSIONS
  We identified three factors that might lead to for-hire three-wheeler crashes in Sri Lanka. They were as follows: carrying excessive passengers, higher three-wheeler age and drivers' traffic law violations. To prevent three-wheeler crashes, laws should prevent three wheelers carrying more than three passengers. Yearly examinations should be mandated to ensure proper driving conditions of for-hire three wheelers. Police should enforce traffic laws to prevent traffic law violations by three-wheeler drivers.
authors.affiliation: Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka Institute of Violence and Injury Prevention, Colombo, Sri Lanka.
authors.forename: Achala Upendra
authors.initials: AU
authors.lastname: Jayatilleke
authors.affiliation: Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA.
authors.forename: Krishna C
authors.initials: KC
authors.lastname: Poudel
authors.affiliation: Department of Community Medicine, Faculty of Medicine, Peradeniya, Sri Lanka Institute for Health Metrics and Evaluation, Department of Global Health, School of Public Health, University of Washington, Seattle, Washington, USA.
authors.forename: Samath D
authors.initials: SD
authors.lastname: Dharmaratne
authors.affiliation: Institute of Violence and Injury Prevention, Colombo, Sri Lanka Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Achini C
authors.initials: AC
authors.lastname: Jayatilleke
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Masamine
authors.initials: M
authors.lastname: Jimba
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D017677:Age Distribution; D001336:Automobiles / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013188:Sri Lanka / Q000453:epidemiology; D055815:Young Adult