Global burden of road injuries and their attributable risk factors from 1990 to 2021: A systematic analysis for the global burden of disease study 2021

<i>Objective:</i> To systematically estimate the burden of road injuries and associated risk factors. <i>Methods:</i> Data on incidence, deaths, and disability-adjusted life years (DALYs) with 95 % uncertainty intervals, by age, sex, sociodemographic index, region, and country, from 1990 to 2021, were obtained from the Global Burden of Disease Study 2021. In addition, we obtained the numbers of DALYs and deaths attributed to risk factors. Joinpoint regression analysis was used to calculate the average annual percentage changes and 95 % confidence intervals (CIs). <i>Results:</i> In 2021, the incident cases of road injuries were 50.3 million (95 % uncertainty interval: 45.7 to 55.2) globally, with an age-standardized incidence (ASIR) of 627.8 per 100,000 population (95 % uncertainty interval: 570.6 to 688.1). From 1990 to 2021, the ASIR was decreased by an average of 1.52 (95 % CI: -1.55 to -1.49) per year. Substantial heterogeneity was observed, particularly among youth aged 25-29 years, males, and high-income North America. Road injuries caused 65.1 million (95 % uncertainty interval: 60.7 to 69.9) DALYs and 1195.7 thousand (95 % uncertainty interval: 1118.2 to 1275.7) deaths in 2021. High burden was observed in older people, males, Central Sub-Saharan Africa, and countries with low income. Motor vehicles (36.6 %) and pedestrians (36.8 %) were the main causes of death. In particular, 72.2 % of road injuries were attributable to occupational injuries for males, while 57.7 % were attributable to low bone mineral density for females. <i>Conclusion:</i> This study suggests a decreasing global burden of road injuries. Nonetheless, road safety remains a significant global public health issue.