Exposure to air pollutants may elevate the injury severity scores (ISSs) for road traffic injuries (RTIs). This multicenter cross-sectional study aimed to investigate the associations between air pollution, weather conditions, and RTI severity. This retrospective study was performed in Taiwan in 2018. The location of each road traffic accident (RTA) was used to determine the nearest air quality monitoring and weather station, and the time of each RTA was matched to the corresponding hourly air pollutant concentration and weather factors. Five multiple logistic regression models were used to compute the risk of sustaining severe injury (ISS ≥ 9). Of the 14,973 patients with RTIs, 2853 sustained severe injury. Moderate or unhealthy air quality index, higher exposure to particulate matter ≤2.5 μm in diameter, bicyclists or pedestrians, greater road width, nighttime, and higher temperature and relative humidity were significant risk factors for severe injury. Exposure to nitrogen oxide and ozone did not increase the risk. Auto occupants and scene-to-hospital time were the protective factors. Sensitivity analyses showed consistent results between air pollutants and the risk of severe injury. Poor air quality and hot and humid weather conditions were associated with severe RTIs. Active commuters were at higher risk of sustaining severe RTI.
Keywords: active commuters; air quality index; fine particulate matter; injury severity; road traffic injury.