Workplace accidents (WAs) are occupational risks inherent to human activity. Based on estimates by the International Labor Organization (ILO), a fatal workplace accident and a death from a work-related illness occur every 15 seconds worldwide, representing more than 2.3 million deaths per year [1] - [4] .

Due to their high frequency, high morbidity and mortality, workplace accidents are a true “workplace pandemic”. The cost of lost workdays was equivalent to nearly 4% of global gross domestic product (GDP) [5] .

In France, in 2008, there were 703,976 WAs, of which 44,037 resulted in the payment of a permanent partial disability (PPD) pension [6] . These workplace accidents include both accidents themselves and their variants, particularly commuting accidents. A commuting accident is an accident that occurs to a worker while traveling from home to work and vice versa, regardless of the cause, provided that this journey has not been modified or interrupted for personal reasons [2] .

The French National Health Insurance Fund for Salaried Workers (CNAMTS) recognized 87,855 commuting accidents in 2008 [6] . These are generally road traffic accidents (RTAs), as many workers travel to work by land [7] .

In 2021, Belgium recorded 20,660 commuting accidents, a ratio of approximately 8 per 1000 workers, more than half of which were road traffic accidents [8] .

RTAs related to commuting to and from work are one of the leading causes of death in the workplace [9] . The victims of these commuting accidents are generally pedestrians, users of two-wheeled motorized vehicles, and users of public transport vehicles [10] .

The age of commuting accident victims varies from one country to another. Indeed, in Italy, a study of employees who were victims of commuting accidents reported that they were predominantly men aged 51 to 60. Among these workers, 32.1% were motorcyclists and 28.6% were car drivers who were victims of fatal accidents [9] .

In Brazil, however, the victims were younger. From 2009 to 2016, a study reported that commuting accident victims were men aged 20 to 29 and suffered leg or ankle fractures [11] .

In addition to road accidents, which account for the majority of commuting accidents, there are other mechanisms that can cause these accidents. These are accidents caused by falling on the same level or from stairs, assaults, illnesses, impacts against an object generally causing injuries such as contusions, wounds, fractures and sometimes death [10] .

The sectors of activity identified as those whose employees constituted the majority of victims were human health and social work, commercial activities, and call centers [12] .

In Africa, statistics are still poorly known, and these risks are certainly understated. Furthermore, most occupational health and safety systems in Africa do not yet integrate the social economy sector, a sector particularly prone to accidents. However, in Burkina Faso, a study of workplace accident files from 2012 to 2016 indicated that commuting accidents accounted for 62% of claims [13] .

In Côte d’Ivoire, numerous studies have focused on workplace accidents [14] - [16] . However, they have mainly focused on occupational accidents themselves, without including commuting accidents, which, according to written works, are just as frequent and serious [6] [9] [11] [13] . According to the National Social Security Fund (CNPS), the number of occupational accidents was estimated at 79,692 between 2000 and 2012, and the number of commuting accidents at 10,299 [17] . In 2022, the fund’s data estimated the number of workplace accidents at 8000, with an annual average of 5400. Thus, based on the above figures, the number of workplace accidents can be estimated at 142,000 and the number of commuting accidents at 20,500 between 2000 and 2022.

What are the causes, severity, and impacts of commuting accidents reported to the Social Security Fund (IPS-CNPS) during the study period?

The aim of this study was to contribute to improve knowledge of commuting accidents and their prevention. The overall objective was to study commuting accidents reported to the IPS-CNPS from 2000 to 2022. The specific goals were to:

1) Determine the prevalence of commuting accidents reported to the IPS-CNPS from 2000 to 2022.

2) Describe the characteristics of commuting accidents reported to the IPS-CNPS from 2000 to 2022.

3) Analyze the medical and legal consequences of commuting accidents reported to the IPS-CNPS from 2000 to 2022.

Information biases related to the retrospective nature of the study and concerning data on after-effects, fatal commuting accidents, data on professional outcomes, and individual compensation costs should be noted. However, the scientific information provided is usable.

We processed 362 commuting accident files. The victims were workers whose predominant age range was 30 - 49, with an average age of 39.5 years, ranging from 20 to 66. The majority of victims were male (68.5%), with a gender ratio of 2.1. For Malte et al. [18] , in a study conducted in Brazil, the age groups of 18 to 29 and 30 to 39 were found to have a male predominance, reasonably because in both situations, the most active and productive populations come from this age group.

Workers who were victims of commuting accidents were distributed across various sectors and fields of activity, particularly in transport and telecommunications (49.7% of victims) and in industry (24.9%). These results are comparable to those of Lacerda et al. in Salvador-BA, where most victims worked in commerce, construction, real estate, hospitality, food, and transport [19] . Employees represented 82% of workers who were victims of commuting accidents. This category of workers represents the most vulnerable and the most exposed to the risk of aggression during the commute to and from work. Indeed, due to low incomes and the high cost of traditional transportation, these workers are forced to use unsuitable means of transportation such as motorcycle taxis or walking, with a potentially high risk of commuting accidents in our environment.

Analysis of accident data reveals that 33.1% of victims were pedestrians and 29.3% used motorcycles or bicycles to get to work. These commuting accidents occurred at varying times, but had peak periods. Thus, we observe that 38.1% of these risks occurred during peak hours, which are between midnight and 7 a.m., and 30.4% occurred between 6 p.m. and 11 p.m. Road traffic accidents accounted for 55.2% of the victims, and assaults (with knives and blunt objects) accounted for 27.6%. His results are proportional to those of Da Silva et al. in France who found 26% of vehicles and 47% of pedestrians involved in the occurrence of reported commuting accidents [20] . We can therefore affirm that these results could be explained by the fact that workers leave early in the morning from their homes to the workplace and are sometimes exposed to physical attacks or are hit by vehicles. Whatever the causative agent, the accident caused various injuries to the body. The most frequent were wounds (47%) and fractures (22.1%); multiple locations were predominant on different parts of the human body (40.6%) contrary to the results of Gounongbé et al. in Benin dominated by fractures (22.9%) followed by wounds (21.1%), a difference probably linked to a larger population of motorcycle taxis providing the bulk of public transport in this country and the incivility of drivers [21] [22] . In the series of Rahmani et al. in 2013 [23] and Lompo et al. In 2019 in Ouagadougou, fractures also topped the list with higher proportions of 25.21% and 48.88% respectively [13] . The reasons mentioned above could also explain this discrepancy between the results. Wounds could be of varying severity, superficial or deep. However, the most common in these commuting accidents were cuts, contusions, and abrasions. Fractures most often affected the lower limbs (legs, ankles, feet) and upper limbs (arms, wrists, hands). These preferential locations concern the limbs, the most exposed body segments. The severity of the fractures varied considerably depending on the nature and type of injuries, ranging from simple wrist fractures to complex fractures of the long bones. They resulted in temporary work interruptions in 95.9% of cases. The related non-working days ranged from 10 to 29 days, with an average of 28 days. They totaled 10,280 lost workdays.

The progression of injuries was toward recovery for 66.3% of victims; it was unknown for 33.7% of employees. The evolution of injuries resulted in recovery for 66.3% of victims, while it was unknown or not specified in the file for 33.7% of employees, likely due to administrative issues or loss to follow-up. This situation could lead to an underestimation of the true burden of long-term disabilities or fatal outcomes. No commuting accidents or fatal outcomes were documented. Unlike the 2013 study by Kouassi et al. on workplace accidents, which revealed that the outcomes of injuries were recovery (93%), consolidation (5%), and death (2%) [14] , these outcomes may be the result of good medical care. However, we do not know the potential progression to death or sequelae, as well as the related proportions of victims whose outcomes could not be documented.

We observed a relatively high prevalence of commuting accidents. The victims, mostly men, were assaulted or victimized by vehicles, generally on the way to and from work, at extreme hours. They suffered multiple injuries requiring a relatively long period of incapacity. The progression was often towards recovery and in some cases the evolution was unknown. This observation encourages the conduct of other epidemiological studies, particularly prospective ones, in order to seek data on the after-effects, the individual cost of compensation and the professional future. It would be relevant to include commuting accidents of agricultural workers who use motorcycles on village tracks of uncertain quality. The assessment of severity should also combine the economic cost, in particular the cost of absenteeism and the opportunity cost. The prevention of these commuting accidents should involve collaboration with the Ministry of Transport. This collaboration should focus on improving public transportation for early and late shifts, and strengthening road safety infrastructure in high-risk areas.