Analysis of RTI data is crucial for controlling its highly mortality and morbidity, especially in our country Iraq

1. Epidemiological Characteristics
of Road Traffic Injuries in
Baghdad, Iraq, 2010-2011
Dr. Munir T. Salman
IFETP student
Cohort 2
A.S. Sultan
FETP Mentor
F. Al Lami
PhD, Resident Advisor

2. Injury :
A bodily lesion at the organic level, resulting from
acute exposure to energy, in amounts that exceed the
threshold of physiological tolerance.
Accident: is an unexpected occurrence
which happens by chance.
Injury: is a definable, correctable event,
with specific and identifiable risks for
occurrence.

3. Injuries killing
more than
5 million
people worldwide
each year and
causing more
cases of disability.
Neuropsychiatric
disorders
12%
Respiratory
infections
6%
Cardiovascular
diseases
10%
Source: World Health Report, 1999
WHO

4. Neuropsychiatric
disorders
12%
Respiratory
infections
6%
Cardiovascular
diseases
10%

5. Neuropsychiatric
disorders
12%
Respiratory
infections
6%
Cardiovascular
diseases
10%

6. Road traffic injuries RTI
Globally;
Constitute a major public health.
killed more than 1.2 million, and injured more
than 50 million.
The vast majority – 90% – of road traffic deaths
were in low-income and middle-income countries,
including Iraq, (Despite it has only 48% vehicles
of world).

7. 1 Lower respiratory infections
2 Diarrhoeal diseases
3 Perinatal conditions
4 Unipolar major depression
5 Ischaemic heart disease
6 Cerebrovascular disease
7 Tuberculosis
8 Measles
9 Road traffic injuries
10 Congenital abnormalities
1 Ischaemic heart disease
2 Unipolar major depression
3 Road traffic injuries
4 Cerebrovascular disease
5 COPD
6 Lower respiratory
infections
7 Tuberculosis
8 War
9 Diarrhoeal diseases
10 HIV
Change in rank order of the 10 leading causes
of the global burden of disease
1990 2020
Source; Mathers C, Loncar D. Updated projections of
global mortality and burden of disease, 2002-2030:
data sources, methods and results.
Geneva, World Health Organization, 2005.

8. 1 Lower respiratory infections
2 Diarrhoeal diseases
3 Perinatal conditions
4 Unipolar major depression
5 Ischaemic heart disease
6 Cerebrovascular disease
7 Tuberculosis
8 Measles
9 Road traffic injuries
10 Congenital abnormalities
1 Ischaemic heart disease
2 Unipolar major depression
3 Road traffic injuries
4 Cerebrovascular disease
5 COPD
6 Lower respiratory
infections
7 Tuberculosis
8 War
9 Diarrhoeal diseases
10 HIV
Source; Mathers C, Loncar D. Updated projections of
global mortality and burden of disease, 2002-2030:
data sources, methods and results.
Geneva, World Health Organization, 2005.
Change in rank order of the 10 leading causes
of the global burden of disease
1990 2020

9. Objectives:
1- determines RTI vulnerable groups and
risk factors.
2- Characterize RTI in term of person, time
and place.
3- Calculate the reclaim cost.

10. A cross sectional study of RTI from three sources
For two years 2010 – 2011:
1 – Iraq Sentinel Injury Surveillance System (ISISS).
2 - Iraq Road Traffic Police(IRTP) Annual Reports.
3 - Iraqi National Insurance Company(INIC)
archives.
Methods

11. Iraq Sentinel Injury Surveillance System (ISISS)
6.6%
16.3% 18% 19.6%
39.3%
0
5
10
15
20
25
30
35
40
45
Explosions Domestic
incidents
RTI Out side
Incidents
Others
Injuries by circumstances, Total cases 128 844
2010 – 2011

12. Iraq Sentinel Injury Surveillance System (ISISS)
6.6%
16.3% 18% 19.6%
39.3%
0
5
10
15
20
25
30
35
40
45
Explosions Domestic
incidents
RTI Out side
Incidents
Others
Injuries by circumstances, Total cases 128 844
2010 – 2011

13. 20%
80%
Total
CO
ER
cases 23 192
4 638
18 554
ISISS: RTI registered cases
8 governorates
CO: coroner, dead cases.
ER: emergency cases.
*
*
*
*
year 2010 - 2011

14. 20%
80%
Total
CO
ER
cases 23 192
4 638
18 554
CO: coroner, dead cases.
ER: emergency cases.
*
*
*
*
Baghdad share was 5900 case
ISISS: RTI registered cases
8 governorates year 2010 - 2011

15. CO ER
Baghdad 5900 RTI cases By Reporting Site
year 2010 - 2011
74%26%

16. Governorate No. Of deaths Population MR
1- Baghdad 749 7647482 9.7
2- Al-Basra 61 2032495 3
3- Anbar 166 1660123 10
4- Erbil 276 1707260 16
5- Karballa 125 1000546 12.4
6- Misan 114 889440 12.8
7- Mousel 198 3090611 6.4
8- Sulaimaniya 278 2088018 13.3
2010
RTI Mortality rate in Baghdad and other sentinel
governorates for the year 2010 -2011
No. of deaths/105

17. Governorate No. Of deaths Population MR
1- Baghdad 749 7647482 9.7
2- Al-Basra 61 2032495 3
3- Anbar 166 1660123 10
4- Erbil 276 1707260 16
5- Karballa 125 1000546 12.4
6- Misan 114 889440 12.8
7- Mousel 198 3090611 6.4
8- Sulaimaniya 278 2088018 13.3
No. of deaths/1052010
RTI Mortality rate in Baghdad and other sentinel
governorates for the year 2010 -2011

18. 2010
Governorate No. Of deaths Population MR
1- Baghdad 749 7647482 9.7
2- Al-Basra 61 2032495 3
3- Anbar 166 1660123 10
4- Erbil 276 1707260 16
5- Karballa 125 1000546 12.4
6- Misan 114 889440 12.8
7- Mousel 198 3090611 6.4
8- Sulaimaniya 278 2088018 13.3
No. of deaths/105
RTI Mortality rate in Baghdad and other sentinel
governorates for the year 2010 -2011

19. 2010
Governorate No. Of deaths Population MR
1- Baghdad 749 7647482 9.7
2- Al-Basra 61 2032495 3
3- Anbar 166 1660123 10
4- Erbil 276 1707260 16
5- Karballa 125 1000546 12.4
6- Misan 114 889440 12.8
7- Mousel 198 3090611 6.4
8- Sulaimaniya 278 2088018 13.3
No. of deaths/105
The average of MR = 10.45/105
RTI Mortality rate in Baghdad and other sentinel
governorates for the year 2010 -2011

20. Governorate No. Of deaths Population MR
1- Baghdad 789 7046029 11
2- Al-Basra 98 2526957 4
3- Anbar 187 1553320 12
4- Erbil NA 1609937 NA
5- Karballa 178 1062934 17
6- Misan 168 968801 17
7- Mousel 231 3258180 7
8- Sulaimaniya 306 1875893 16
2011 No. of deaths/105
RTI Mortality rate in Baghdad and other sentinel
governorates for the year 2010 -2011

21. 2011
Governorate No. Of deaths Population MR
1- Baghdad 789 7046029 11
2- Al-Basra 98 2526957 4
3- Anbar 187 1553320 12
4- Erbil NA 1609937 NA
5- Karballa 178 1062934 17
6- Misan 168 968801 17
7- Mousel 231 3258180 7
8- Sulaimaniya 306 1875893 16
No. of deaths/105
RTI Mortality rate in Baghdad and other sentinel
governorates for the year 2010 -2011

22. 2011
Governorate No. Of deaths Population MR
1- Baghdad 789 7046029 11
2- Al-Basra 98 2526957 4
3- Anbar 187 1553320 12
4- Erbil NA 1609937 NA
5- Karballa 178 1062934 17
6- Misan 168 968801 17
7- Mousel 231 3258180 7
8- Sulaimaniya 306 1875893 16
No. of deaths/105
RTI Mortality rate in Baghdad and other sentinel
governorates for the year 2010 -2011

23. The average of MR = 12/105
2011
Governorate No. Of deaths Population MR
1- Baghdad 789 7046029 11
2- Al-Basra 98 2526957 4
3- Anbar 187 1553320 12
4- Erbil NA 1609937 NA
5- Karballa 178 1062934 17
6- Misan 168 968801 17
7- Mousel 231 3258180 7
8- Sulaimaniya 306 1875893 16
No. of deaths/105
RTI Mortality rate in Baghdad and other sentinel
governorates for the year 2010 -2011

24. The average of RTI MR for the 8 sentinel governorate
for the tow years 2010 – 2011
= 11.45/105
The average of RTI MR for the Baghdad governorate
for the two years 2010 – 2011
= 10.3/105

25. Female Male
Baghdad 5900 RTI case Gender distribution
year 2010 - 2011
19% 81%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Female Male
ER
COCO
ER

26. Female Male
Baghdad 5900 RTI case Gender distribution
year 2010 - 2011
19% 81%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Female Male
ER
COCO
ER

27. 1
139 178
86 135 145 110 126 83 65
1
262
422 423
1337
984
512
315
218 162
0
200
400
600
800
1000
1200
1400
1600
0-0 01-04 05-09 10-14 15-24 25-34 35-44 45-54 55-64 65-100
female male
Baghdad RTI cases distributed by Age groups and
gender, year 2010 - 2011

28. 1
139 178
86 135 145 110 126 83 65
1
262
422 423
1337
984
512
315
218 162
0
200
400
600
800
1000
1200
1400
1600
0-0 01-04 05-09 10-14 15-24 25-34 35-44 45-54 55-64 65-100
female male
45.6%
15 - 34
Baghdad RTI cases distributed by Age groups and
gender, year 2010 - 2011

29. 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
01-04 05-09 10-14 15-24 25-34 35-44 45-54 55-64 65-100
ER
CO
Baghdad RTI cases by death or injury percent
and age group, year 2010-2011

30. 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
01-04 05-09 10-14 15-24 25-34 35-44 45-54 55-64 65-100
ER
CO
Baghdad RTI cases by death or injury percent
and age group, year 2010-2011

31. 0
50
100
150
200
250
300
350
400
450
500
c 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
Baghdad RTI cases by daily hours, Year 2010 - 2011

32. 0
50
100
150
200
250
300
350
400
450
500
c 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
10 am 2 pm
Baghdad RTI cases by daily hours, Year 2010 - 2011

33. DAY CO ER TOTAL
Sunday 201 698 899
Monday 200 709 909
Tuesday 195 646 841
Wednesday 218 669 887
Thursday 223 573 796
Friday 219 541 760
Saturday 214 518 732
Total 1470 4354 5824
Baghdad RTI cases (CO and ER) by DAYS of the week

34. DAY CO ER TOTAL
Sunday 201 698 899
Monday 200 709 909
Tuesday 195 646 841
Wednesday 218 669 887
Thursday 223 573 796
Friday 219 541 760
Saturday 214 518 732
Total 1470 4354 5824
p-value=0.003
Baghdad RTI cases (CO and ER) by DAYS of the week

35. CO%
22.4
22.0
23.2
24.6
28.0
28.8
29.2
DAY CO ER TOTAL
Sunday 201 698 899
Monday 200 709 909
Tuesday 195 646 841
Wednesday 218 669 887
Thursday 223 573 796
Friday 219 541 760
Saturday 214 518 732
Total 1470 4354 5824
p-value=0.003
Baghdad RTI cases (CO and ER) by DAYS of the week

36. p-value=0.003
Baghdad RTI cases (CO and ER) by DAYS of the week
CO%
22.4
22.0
23.2
24.6
28.0
28.8
29.2
DAY CO ER TOTAL
Sunday 201 698 899
Monday 200 709 909
Tuesday 195 646 841
Wednesday 218 669 887
Thursday 223 573 796
Friday 219 541 760
Saturday 214 518 732
Total 1470 4354 5824

37. 115 110 116 106
159
123 135 116 116
144 132
166
320
399
340
392
335
285
239
419
457 458
362 356
1 2 3 4 5 6 7 8 9 10 11 12
CO
ER
Baghdad RTI cases (ER vs. CO) by monthly distribution,
Year 2010 - 2011
Months
20102011

38. 3 32
349
868
2082
2568
0
500
1000
1500
2000
2500
3000
Unknown Others Bicycle Motorcycle Car Pedestrain
Baghdad RTI cases by accident’s circumstance 2010 - 2011
43.5%

39. Baghdad RTI cases By Circumstance and CO Vs. ER 2010 -
2011
0 500 1000 1500 2000 2500 3000
Others
Bicycle
Motorcycle
Car
Pedestrain
CO ER

40. Ambulance
3%
Other
Vehicle
96%
Others
1%
Unknown
0%
Baghdad RTI cases Mode of arrival to health facilities 2010 - 2011

41. Ambulance
3%
Other
Vehicle
96%
Others
1%
Unknown
0%
Baghdad RTI cases Mode of arrival to health facilities 2010 - 2011

42. 6 6 7 9 38 62 190
5584
0
1000
2000
3000
4000
5000
6000
Unknown Farm and
countryside
Others Market Public
gathering
Workplace Home Street/high
way/road
Baghdad RTI cases by place of occurrence 2010 - 2011

43. 6 6 7 9 38 62 190
5584
0
1000
2000
3000
4000
5000
6000
Unknown Farm and
countryside
Others Market Public
gathering
Workplace Home Street/high
way/road
Include 20 coroner cases
(deaths)
16 male
4 female
Baghdad RTI cases by place of occurrence 2010 - 2011

44. 0
100
200
300
400
500
600
700
800
900
other upturned Collision Run over
2010
2011
Baghdad RTI Types of crashes 2010 - 2011

45. 0
100
200
300
400
500
600
700
800
900
other upturned Collision Run over
2010
2011
Baghdad RTI Types of crashes 2010 - 2011

46. 0
200
400
600
800
1000
1200
other passengers road pedestrian car drivers
2010
2011
Baghdad RTI by offender Year 2010 - 2011

47. 0
200
400
600
800
1000
1200
other passengers road pedestrian car drivers
2010
2011
71.3%
Baghdad RTI by offender Year 2010 - 2011

48. 0 200 400 600 800 1000
2010
2011
Baghdad RTI by type of vehicle 2010 - 2011
Saloon
Station
Tractor
Bus
Pickup
Trailer
Motorcycles
Others
Vans
Agricultural
equipments

49. 0 200 400 600 800 1000
2010
2011
More than tow fold increase in
bus Crashes this might explain
the raise in deaths Due to RTI ;
749 deaths 2010
789 deaths 2011
Saloon
Station
Tractor
Bus
Pickup
Trailer
Motorcycles
Others
Vans
Agricultural
equipments
Baghdad RTI by type of vehicle 2010 - 2011

50. Case
No. of
finished
file
Reclaim cost
(Iraqi dinar)
Deaths 66 326 585 000
Disabilities 45 143 100 000
Total 111 469, 685, 000
~ 375 000 000 US $
Source ; INIC (Iraq National Insurance
Company data )
We obtain data and reclaim cost of 111 file out of 188 case ( 77 file
not finished )
Baghdad RTI Reclaim Expenditure : 2010- 2011

51. The average of death reclaim
~ 5 000 000 ID ~ 4000 US $
The average of disability reclaim
~ 3 500 000 ID ~ 2900 US $
 The INIC reclaim less than 6%
of the 5600 RTI incidents occurred
in Baghdad.

52. Conclusions
Although the RTI mortality rate was increasing in
Baghdad, it is far below the WHO estimate.
Surveillance database lacks information on risk
factors.
Insurance compensation shows a big deficit.
Multisectoral collaboration is recommended.
More in depth study at national level are indicated.

53. Thank you