traffic injuries are a leading cause of death and disability in many countries , and they are major public health problems ( 14 ) . it is anticipated that the traffic accident rate could increase by 50% by the end of 2020 if appropriate actions are not taken to reduce global deaths due to traffic accidents ( 1 ) .
some epidemiological studies have reported that the incidence rates of fatal traffic injuries are about 26.4 , 17.4 , and 19 per 100,000 people in the eastern mediterranean region , in the european region , and worldwide , respectively ( 5 ) . in 2007 ,
27,567 deaths and 276,762 injuries as the result of traffic accidents were reported in iran ( 1 ) .
the knowledge , attitudes , and practice of drivers towards traffic regulations have been thought to be key factors in decreasing traffic injuries and deaths .
the issue of human factors , such as drivers errors , seems to be a significant contributor to the rate of traffic injuries and deaths .
the results of a study that was conducted in saudi arabia indicated that speed and non - compliance with rules were the main reasons for the high rate of injuries and deaths ( 6 ) .
a study of the knowledge , attitudes , and practices of 2200 drivers toward traffic regulations in tehran and zahedan indicated that the rate of road traffic crashes can be decreased by increasing the levels of knowledge of drivers and by changing their attitudes and practices .
a significant association was found between safer attitudes and decreases in the rate of traffic crashes ( or = 0.76 , p = 0.007 ) ( 7 ) .
many observers have mentioned the importance of determining the relationships between personality and demographic variables ( such as age , gender , and education levels ) and drivers behaviors . in low - income countries , driving attitudes and behaviors
intention to commit driving violations , high - speed driving , and poor decision making are important risk factors for traffic accidents ( 9 ) .
some previous studies have reported a weak association between knowledge , attitudes toward driving , and driving behavior ( 10 ) .
various surveys , such as the one conducted by yunesian and moradi , have shown that 67.7 , 56.4 , and 47.7% of drivers had adequate knowledge , positive attitudes , and safe practice towards traffic regulations , respectively .
their findings suggested that the type of automobile , education levels , occupation , and marital status had significant effects on drivers practices .
the researchers conclude that drivers in teheran city had risky practices towards traffic regulations ( 11 ) .
although , there has been considerable debate concerning whether attitudes predict behavior , several research studies have indicated that attitudes do , in fact , affect behavior .
changing people s attitudes towards traffic regulations has been considered to be a key element in the prevention of traffic crashes ( 12 ) . developing a culture of safety is the most effective strategy to prevent breaking the rules ( 13 ) .
some studies have shown that the use of seat belts by drivers reduces the risk of fatal injuries and reduces the severity of the effects of accidents on the occupants of vehicles .
the most common causes of car accidents in malaysia were high - speed driving , dangerous driving , and the careless overtaking of other vehicles , i.e. , with these causes contributing to 32.8 , 28.2 , and 15.1% of all accidents , respectively .
the major cause of traffic accidents was drivers behaviors ( 76.1% ) ( 14 ) .
traffic accidents are the main causes of disability - adjusted life years ( dalys ) in iran .
more than 30,000 deaths due to traffic accidents are reported in iran each year , with an associated fatal incidence rate of 44 per 100,000 ) ( 15 ) .
the estimated cost of traffic injuries in iran in 2012 was 180,000 billion iranian rails ( us$ 6,000,000,000 ) , which amounted to 6.64% of iran s gross national income in 2013 ( 16 ) .
however , to date , there has been little discussion about the rate of traffic injuries and the related costs in bandar - abbas .
the objectives of this research were to study the knowledge , attitudes , and practices of taxi drivers towards traffic regulations in bandar - abbas , iran , and to determine the relationships between demographic features and the knowledge , attitudes , and practices of drivers towards traffic regulations .
this cross - sectional study was conducted in 2014 in bandar - abbas county , hormozgan province , iran . according to some cross - sectional studies performed in bandar - abbas on automobile drivers ( 17 , 18 ) ,
there is a need for more research on drivers behaviors in this city to reduce the severity of accidents and the fatality rates .
we used the following formula to determine the sample size : n = z1-/2 p(1-p)/d , where n is the required sample size , z1-/2 is the value for a level of confidence ( 1.96 ) , p is the expected proportion ( 0.5 ) , and d is the precision ( 0.04 ) . based on this formula , a sample size of 306 male taxi drivers was determined .
another 43 drivers worked for exclusive taxi services and said they did not have time to participate in the research .
thus , a total of 241 drivers ( response rate 78.7% ) who operated within the city of bandar - abbas participated in this study , and the data obtained from these drivers were used for the analyses . to study the knowledge , attitudes , and practices of intra - city drivers towards traffic regulations in bandar - abbas ,
the two authors designed questionnaires to assess their knowledge and attitudes and a checklist for assessing the drivers practices were used .
the knowledge questionnaire included 15 questions extracted from parts of iran s driver s license test .
the internal consistency of the knowledge questionnaire was assessed by cronbach s alpha (  = 0.82 ) .
the attitude questionnaire included seven questions that were designed to assess drivers attitudes in relation to various traffic regulations .
it was prepared under the supervision of experienced traffic police officers , and it included various items , such as using seat belts , exceeding the speed limit in low - volume traffic on intercity roads , driving in restricted areas in an emergency situation , keeping a safe distance behind the car in front , crossing the center line of a road in low - volume traffic , coming to a complete stop before entering a main street from a side street , and eating and drinking while driving .
the internal consistency of the attitude questionnaire was assessed by cronbach s alpha (  = 0.75 ) .
this checklist included 35 questions concerning drivers behaviors , such as risky overtaking maneuvers , exceeding the speed limit over speed bumps , turning in prohibited areas , sudden braking , and running a red light .
chicago , il , usa ) was used to analyze the data . the mean and standard deviation ( sd )
were used to report the numerical data , while frequency and percentage were used to report qualitative variables .
the chi - squared test was performed to determine the relationships between the knowledge , attitudes , and practices of taxi drivers towards traffic regulations and demographic features .
this cross - sectional study was conducted in 2014 in bandar - abbas county , hormozgan province , iran . according to some cross - sectional studies performed in bandar - abbas on automobile drivers ( 17 , 18 ) ,
there is a need for more research on drivers behaviors in this city to reduce the severity of accidents and the fatality rates .
we used the following formula to determine the sample size : n = z1-/2 p(1-p)/d , where n is the required sample size , z1-/2 is the value for a level of confidence ( 1.96 ) , p is the expected proportion ( 0.5 ) , and d is the precision ( 0.04 ) . based on this formula , a sample size of 306 male taxi drivers was determined .
another 43 drivers worked for exclusive taxi services and said they did not have time to participate in the research .
thus , a total of 241 drivers ( response rate 78.7% ) who operated within the city of bandar - abbas participated in this study , and the data obtained from these drivers were used for the analyses .
to study the knowledge , attitudes , and practices of intra - city drivers towards traffic regulations in bandar - abbas , the two authors designed questionnaires to assess their knowledge and attitudes and a checklist for assessing the drivers practices were used .
the knowledge questionnaire included 15 questions extracted from parts of iran s driver s license test .
the internal consistency of the knowledge questionnaire was assessed by cronbach s alpha (  = 0.82 ) .
the attitude questionnaire included seven questions that were designed to assess drivers attitudes in relation to various traffic regulations .
it was prepared under the supervision of experienced traffic police officers , and it included various items , such as using seat belts , exceeding the speed limit in low - volume traffic on intercity roads , driving in restricted areas in an emergency situation , keeping a safe distance behind the car in front , crossing the center line of a road in low - volume traffic , coming to a complete stop before entering a main street from a side street , and eating and drinking while driving .
the internal consistency of the attitude questionnaire was assessed by cronbach s alpha (  = 0.75 ) .
this checklist included 35 questions concerning drivers behaviors , such as risky overtaking maneuvers , exceeding the speed limit over speed bumps , turning in prohibited areas , sudden braking , and running a red light .
chicago , il , usa ) was used to analyze the data . the mean and standard deviation ( sd )
were used to report the numerical data , while frequency and percentage were used to report qualitative variables .
the chi - squared test was performed to determine the relationships between the knowledge , attitudes , and practices of taxi drivers towards traffic regulations and demographic features .
tables 1 and 2 illustrate the questions about attitudes and practices and the percentage and frequency of drivers responses to attitude and practice items towards traffic regulations , respectively .
the highest number of participants ( 55 drivers ) was in the 3135 age group .
two hundred thirty - eight of them ( 98.8% ) were married . among all of the drivers , 113 obtained their driver s license between 1992 and 2002 . among the 241 drivers , 97 ( 40.2% )
had completed the middle school educational level , 32.4% of them had work experience of 610 years . as shown in tables 1 and 2 , 120 drivers ( 49.8% )
totally agreed with the statement ,  eating and drinking while driving is dangerous .  and 124 of them ( 51.5% ) believed that it is necessary to keep a safe distance from a car in front .
one hundred and seven taxi drivers did not wear a seat belt while driving and 190 of them ( 78.8% ) exchanged taxi fares while driving .
there were no significant relationships between age , educational levels , and the year the drivers obtained their driver s licenses and drivers knowledge ( p > 0.05 ) .
the chi - squared test showed a significant difference between knowledge and the work experience of drivers ( p = 0.014 ) .
approximately 30.2% of the drivers ( among 169 drivers ) who had 610 years of work experience had adequate knowledge about traffic regulations .
the results , as shown in table 5 , indicated that there were no significant relationships between demographic features and the attitudes of drivers towards traffic regulations ( p > 0.05 ) .
approximately 43.5% of the drivers in the 3140 year age group had positive attitudes towards traffic regulations ( among 216 drivers expressed positive attitudes ) , while 46.8% of the drivers in this group who had diplomas and higher levels of education had positive attitudes . among the drivers who obtained their driver s licenses between 1992 and 2002 ,
the data in table 6 indicate that there were no significant differences between the drivers practices and their demographic features ( p > 0.05 ) .
ninety two drivers ( 44.4% ) in the 3140 age group had safe practices towards traffic regulations ( among 207 drivers with safe practice ) .
in the group that had 6 to 10 years of work experience , 71 drivers ( 34.3% ) had safe practices towards traffic regulations .
the objectives of the current study were to study the knowledge , attitudes , and practices of taxi drivers towards traffic regulations in bandar - abbas , iran , and to determine the relationships between demographic features and knowledge , attitudes , and practices of drivers towards traffic regulations .
ninety - seven drivers ( 40.6% ) disagreed that the use of a seat belt caused discomfort .
the importance of the wearing a seat belt has been mentioned in many previous studies ( 6 , 7 ) .
the findings of many studies have shown that wearing a seat belt may decrease the risk and severity of injuries .
although most of the drivers in their study ( 88% ) were aware of the effectiveness and benefits of wearing a seat belt in decreasing the severity of injuries in traffic crashes , only 63% of them actually wore a seat belt while driving ( 19 ) .
approximately 15.8% of the drivers admitting to running red lights , and 44.4% of them performed risky overtaking maneuvers , both of which increase the risks of traffic accidents ( 20 ) .
most of the drivers believed that engaging in distracting activities , such as eating and drinking is dangerous while driving ( 49.8% totally agree and 34.9% agree ) .
the results of other studies have indicated that distracting activities may decrease the driver s performance ( 21 ) . among the 241 drivers in the current study , 103 of the drivers ( 42.7% ) used a mobile phone while driving . among 287 victorian drivers ( australian state of victoria ) ,
60% of them used mobile phone while driving , and one - third of them used their phone in the hand - held mode ( 22 ) .
also , the results of some studies indicated that talking on a cell phone may increase the risks of traffic accidents ( 23 ) .
the results obtained from the assessment of relationships between demographic features and drivers knowledge indicated that drivers in the 3140 age group had adequate knowledge of traffic regulations .
the chi - squared test showed a significant difference between drivers knowledge and the work experience of taxi drivers . a greater knowledge of traffic regulations was reported in drivers in the group that had 610 years of work experience .
eighty - two drivers ( 48.5% ) with the educational levels of diploma and higher had greater knowledge of traffic regulations than the other drivers .
the study of drivers knowledge , attitudes and practices in tehran illustrated a significant relationship between education levels and drivers knowledge ( p= 0.02 ) .
no significant differences were found between other demographic features and drivers knowledge . in other words ,
although no significant differences were found between drivers knowledge and their educational levels in the current study , a greater knowledge towards traffic regulations was reported in 48.5% of drivers with higher educational levels .
the chi - squared test did not show any significant differences between the attitudes of drivers towards traffic regulations and demographic features .
the findings of yunesian and moradi indicated that there were significant differences between the attitudes of drivers and two demographic variables of drivers , i.e. , age ( p= 0.02 ) and marital status ( p= 0.002 ) .
the most positive attitudes towards traffic regulations in this study ( 43.5% ) were reported in taxi drivers in the 3140 age group ( among 216 drivers expressed positive attitudes ) .
the safer practices ( 44.4% ) were reported in drivers in the 3140 year age group ( among 207 drivers with safe practice ) , drivers with the educational levels of diploma and higher ( 45.9% ) , and drivers in the group that had 610 years of work experience .
these findings were consistent with other research in which it was found that drivers with higher educational levels may have safer practices than those with lower educational levels ( 11 ) .
many of the taxi drivers in bandar - abbas had inadequate knowledge , less positive attitudes , and risky practices towards traffic regulations .
the increase in knowledge , attitudes , and practices of taxi drivers towards traffic regulations may decrease the rate of traffic injuries and deaths .
implementation of effective intervention programs may increase the taxi drivers knowledge , attitudes , and practices towards traffic regulations .
a limitation of this study was that the relationships between the knowledge , attitudes , and practices of taxi drivers towards traffic regulations and traffic crashes were not examined .
many taxi drivers in bandar - abbas had inadequate knowledge , less positive attitudes , and risky practices towards traffic regulations .
implementation of effective intervention programs may increase the taxi drivers knowledge , attitudes , and practices towards traffic regulations .
 introductiontraffic injuries are among the leading causes of death and disability in many countries . 
 the knowledge , attitudes , and practice of drivers towards traffic regulations are key factors in decreasing traffic injuries and deaths . 
 the objectives of this research were to study the knowledge , attitudes , and practice of taxi drivers towards traffic regulations in bandar - abbas , iran , and to determine the relationships between demographic features and knowledge , attitudes , and practice of taxi drivers towards traffic regulations.methodsthis cross - sectional study was done in 2014 in bandar - abbas , iran ( hormozgan province ) . 
 to study the knowledge , attitudes , and practice of 241 intra - city taxi drivers towards traffic regulations , researchers developed questionnaires and a checklist . 
 the chi - squared test was performed to determine the relationships between knowledge , attitude , and practice of drivers towards traffic regulations and demographic features.resultsamong the 241 drivers , 50 of them ( 20.7% ) thought that the seat belt could cause discomfort while driving , and 107 ( 44.4% ) did not wear a seat belt while driving . 
 the study determined that there was a significant difference between the knowledge and work experience of the drivers ( p = 0.014 ) . 
 the 94 drivers ( 43.5% ) in the 3140 year age group had positive attitudes towards traffic regulations ( among 216 drivers expressed positive attitudes ) and 92 ( 44.4% ) of the drivers in this age group had safe practices towards traffic regulations ( among 207 drivers with safe practice).conclusionmany of the taxi drivers in bandar - abbas had inadequate knowledge , less positive attitudes , and risky practices towards traffic regulations . 
 implementation of effective intervention programs may increase the taxi drivers knowledge , attitudes , and practices towards traffic regulations . 
1. Introduction
2. Material and Methods
2.1. Research design and setting
2.2. Sampling
2.3. Measurement tool
2.4. Statistical analyses
3. Results
4. Discussion
5. Conclusions