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Publication date: 
May 1, 2009


Iran has the highest death rate resulting from road traffic accidents of any country in the world, according to a study conducted by IHME researchers. The study, "Adverse health outcomes of road traffic injuries in Iran after rapid motorization," utilized national fatality data as well as hospital records to estimate the total burden of road traffic injuries in Iran.

Research findings

The rate of road accident deaths in Iran is climbing, from 30 deaths per 100,000 in 2000 to 44 deaths per 100,000 in 2006. Four times as many males (28,135) as females (6,390) died in road traffic accidents in Iran in 2005, and car occupants accounted for the greatest number of deaths (12,753), followed by pedestrians (9,804), and motorcyclists (5,398), although motorcyclists dominated inpatient admissions and outpatient visits.

In 2002, the mortality rate for road traffic injuries in Iran was 44 per 100,000 population, the highest death rate of any country for which reliable estimates were made. In comparison, the average death rate for road traffic injuries is 19 deaths per 100,000 worldwide, 26 per 100,000 in the Eastern Mediterranean, 29 in sub-Saharan Africa, 19 in the United States, nine in Canada, and six in Germany.

Researchers found that the mortality rate in Iran told only part of the story when analyzing the impact of road traffic injuries on the population and the health care system. Nonfatal injuries as a result of traffic accidents can result in reduced function, disability, or premature death, represented as disability-adjusted life years (DALYs). Iranians lost 1.3 million DALYs due to road traffic injuries in 2005, making road traffic injuries the second leading cause of DALYs after cardiovascular diseases.

The researchers explore possible reasons for these high death rates, such as the increasing number of non-standard cars and motorcycles, low gas prices, increasing preference and use of private vehicles over public transportation, and lack of enforcement of road and vehicle safety laws.

Analytical approach

Researchers evaluated data from the death registration system in Iran to identify the number of deaths reported due to road traffic injuries. Data on deaths and injuries were also collected from hospital records from all medical facilities in 12 provinces and from household interviews with the victims or their relatives. 

Research objective

This study was conducted to explain the public health burden of road traffic injuries in Iran and provide details on the sociopolitical environment that led to the rise of road traffic injuries over the last few decades. It is part of ongoing work by IHME to provide timely, accurate, and comparable health measurements.

Recommendations for future work

The study researchers outline a number of policy changes to minimize the burden of road traffic injuries and fatalities in Iran. For example, they suggest that Iran needs to take a systems approach to road safety that addresses all aspects of the transportation system that result in injuries, including reinforcing traffic safety regulations, building more public health infrastructure, making safer cars and motorcycles, increasing access to health services, and controlling the growth of motorized vehicles.

Additionally, the authors encourage researchers in other countries, where official government estimates of road traffic deaths are based primarily on crime statistics, to also investigate road traffic injury and fatality incidence using health sector data in order to gain a more comprehensive picture of the impact of these injuries and deaths.


Naghavi M, Shahraz S, Bhalla K, Jafari N, Pourmalek F, Bartels D, Puthenpurakal JA, Motlagh ME. Adverse health outcomes of road traffic injuries in Iran after rapid motorization. Archives of Iranian Medicine. 2009 May; 12(3):284–294.