Unaddressed Vision Problems Linked to Many Bus Crashes in Bangladesh

The new research from eye care nonprofit Orbis International is among the first to look at vision and road safety among public transportation workers in low- and middle-income countries

Orbis announces new research demonstrating that correctable vision problems among commercial bus drivers are a significant contributor to the high rate of road crash fatalities in Bangladesh. The study is published in a special issue of the Asia Pacific Journal of Ophthalmology on the prevalence and impact of near- and farsightedness in the Asia Pacific and globally.

Dr. Munir Ahmed


Many of us rely on pub­lic trans­porta­tion to go about our dai­ly lives, but there are very few stud­ies that pro­vide data on vision and traf­fic safe­ty among the sector’s dri­vers. While our study showed high rates of unad­dressed visu­al impair­ment among bus dri­vers, in the vast major­i­ty of cas­es, it could be eas­i­ly and inex­pen­sive­ly cor­rect­ed. This has sig­nif­i­cant impli­ca­tions for reduc­ing traf­fic fatal­i­ties not only in Bangladesh, but also in oth­er low- and mid­­dle-income coun­tries, where 93% of road traf­fic deaths occur.

New Orbis research reveals unaddressed vision problems are linked to bus crashes in Bangladesh

Findings of the Study

The road crash fatality rate per capita in Bangladesh is three times higher than that of the South Asia region, with bus crashes being a notable contributor to that trend. In a recent three-year period, approximately 50% of fatal crashes in the Dhaka metro area involved buses, compared to less than 1% in the US and the UK.

The clarity of one’s vision is a key parameter commonly measured when applying for a driver's license, but studies suggest that uncorrected vision problems are common among commercial drivers in low- and middle-income countries. Orbis set out to determine how common such vision problems were among bus drivers in Bangladesh and whether their presence was associated with a history of motor vehicle crashes reported by drivers.

To do so, Orbis Bangladesh worked together with local partner the Grameen GC Eye Hospital to carry out free eye health screenings at 10 bus terminals in seven districts across Bangladesh during a three-month period in 2019.

A majority of bus drivers screened were found to be near- or farsighted. Additionally, nearly 1 in 5 bus drivers did not meet the standard of clarity for distance vision that is required to obtain a commercial driver's license in Bangladesh; nearly 90% of these cases could be improved with readily available treatments, such as glasses.

These findings underscore important recommendations for policymakers, including ensuring that specific vision standards are not only set for licensure, but also enforced by rigorous testing of all applicants, particularly those responsible for the safety of numerous other road users. Additionally, given the very high proportion of drivers with vision impairment due to readily treatable causes, referral for affordable and accessible care must be made for all those failing screening.

Road Traffic Safety Trends

Road traffic injuries are the leading global cause of death for people between 5 and 29 years old, making traffic safety a major public health concern, particularly in low- and middle-income countries, where the number of road traffic deaths is increasing and disproportionately higher than in high-income countries. While 60% of the world's motor vehicles are in low- and middle-income countries, all but 7% of road traffic deaths occur there.

The types of individuals affected by road traffic crashes are also notably different between high-income countries, where the automobile driver is the most common fatality, and low- and middle-income countries, where pedestrians, cyclists and passengers are more likely to die.

Given these implications, road traffic safety improvement is highlighted in targets within two of the United Nations Sustainable Development Goals (SDGs). One calls to halve the number of global deaths and injuries from road traffic crashes by 2030, while the other calls for improved road safety by expanding public transport, with special attention to the needs of vulnerable users, including women, children, persons with disabilities and the elderly.

Orbis’s study shows an important link between improved access to vision screening and quality eye care and the ability to improve road traffic safety concerns in the areas most affected by them and to meet the SDGs. Besides benefits at the individual level from a reduced burden of road traffic crashes, a reduction in crashes in low- and middle-income countries has also been shown to be associated with increases in gross domestic product.

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