intro to Road traffic accidents

1. Dr. Abhishek Tiwari,
Assistant Professor
Department of Community Medicine
MLN Medical College, Prayagraj
Epidemiology,
Prevention & Control of
Road Traffic Accidents

2. Learning Objectives
To understand if Road Traffic Accident is a Public
Health Concern
To understand the Epidemiology of RTA – Agent,
Host, Environment
What all could be done to Prevent infection?
What are the ways available to minimise RTA?
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3. Introduction
A road traffic accident (RTA) is any injury due to
crashes originating from, terminating with or involving
a vehicle partially or fully on a public road.
It is projected that RTA will become third position by
2020 among leading causes of the global disease
burden
They are considerable economic losses to victims,
their families, and to countries as a whole.
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4. Introduction
The Global status report on road safety 2013 says
1.24 million people die per year.
Leading cause of death among young people, aged
15–29 years.
Children, pedestrians, cyclists and older people are
among the most vulnerable of road users constituting
half of those dying on the world’s roads
Majority of the world's fatalities on roads occur in
low-income and middle-income countries, even
though these countries have approximately half of
the world's vehicles.
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5. India
More than 1.3 lakh people died, giving India the
dubious honour of topping the global list of fatalities
from road crashes
Rapid urbanization, motorization, lack of
appropriate road engineering, poor awareness levels,
non-existent injury prevention programmes, and
poor enforcement of traffic laws has exacerbated the
situation.
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6. Road Accidents : A Snapshot
Major but a Neglected Public Health Problem as it
mainly effects males in productive age group
resulting in loss of an earning member of Family
India : 2016
Accidents – 4,80,652
Deaths – 1,50,785
Person Injured – 4,94,624
Every Day 1,317 Accidents /day and 413 Persons
killed/day
Every Hour 55 Accidents /hr & 17 Persons killed /hr
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7. RTA types
Thus RTA includes a collision between vehicles;
between vehicles and pedestrians; between vehicles
and animals; or between vehicles and geographical
or architectural obstacles.‘
Road traffic accidents are a human tragedy. They
involve high human suffering and socioeconomic
costs in terms of premature deaths, injuries, and loss
of productivity,
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8. Measurement of Problems
Mortality
Proportional mortality rate
Number of deaths per million population
Death rate /1000 (or 1 lakh) registered vehicles/yr
Number of accidents or fatalities as a ratio of number
of vehicles per km or passengers per km.
Deaths of vehicles occupants per thousand vehicles /
year.
Morbidity - Based on Abbreviated injury scale
Serious injuries and Slight injuries
Disability- temporary or permanent ,partial/total 11-10-2021
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9. www.decadeofaction.org
www.who.int/roadsafety/decade_of_action
Worsening situation
Rank Disease or Injury
1 Ischaemic heart disease
2 Cerebrovascular disease
3 Lower respiratory infections
4 Chronic obstructive
pulmonary disease
5 Diarrhoeal diseases
6 HIV/AIDS
7 Tuberculosis
8 Trachea, bronchus, lung
cancer
9 Road traffic injuries
10 Prematurity & low-birth
weight
Rank Disease or Injury
1 Ischaemic heart disease
2 Cerebrovascular disease
3 Chronic obstructive
pulmonary disease
4 Lower respiratory infections
5 Road traffic injuries
6 Trachea, bronchus, lung
cancer
7 Diabetes mellitus
8 Hypertensive heart disease
9 Stomach cancer
10 HIV/AIDS
2004 2030
Top 10 leading causes of death

10. Epidemiology
The Triad of RTA
Agent – Vehicle
(Speed,
Maintenance
status, driver etc.)
Host – Individual
at risk (most
common)
Environment –
Condition of Road
etc. 11-10-2021
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11. Risk factors
Many human factor contribute to RTA
Drunken driving, over speeding, refusal to follow
traffic rules, and reckless driving are main reasons
for road accidents.
Drunken driving is one of the major causes
of RTA especially among commercial vehicle drivers
on highways. (70% of road fatalities in Delhi and
Mumbai)
Risk of being involved in a crash increases
significantly above a (BAC) of 0.04 g/dl. 11-10-2021
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12. Risk factors
Over speeding increases the probability of fatal
injuries for car occupants from near zero to almost
100% as the change of speed during the impact
increases from 20 kilometers per hour to 100
kilometers per hour.
Pedestrians have a 90% chance of surviving car
crashes at 30 kilometers per hour or below, but a
less than 50% chance of surviving impacts at
45 kilometers per hour or above.
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13. Risk factors
Reckless driving like use of mobile phones
during driving, non-use of helmets, non-use of seat-
belts are significant contributing factors
Driver fatigue & sleepiness contribute to
crashes
Improper designing of roads and lack of
pedestrian pavement are other contributing factors
Only 28 countries have comprehensive road
safety laws on major key risk factors like drunken
driving, speeding, and failing to use helmets, seat-
belts, and child restraints. 11-10-2021
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14. Prevention Strategies
Helmets for two-wheeler riders:
Enforcing mandatory helmet use is an effective
intervention for reducing injuries and fatalities
among two-wheeler users
Wearing a helmet decreases
the risk and severity of injuries
by about 72% and likelihood
of death by 39% as per WHO
road safety manual on use of
helmets. 11-10-2021
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15. Prevention Strategies
Seat-belts & child restraints: It should be mandatory
to wear seatbelts both for front & rear occupants
Wearing a seat-belt reduces risk of a fatality among
front-seat passengers by 40–50% & of rear-seat
passengers by 25–75%
Children of any age should not be seated in the front
seat and should have child restraints
The latter is also effective in reducing injuries that
can occur during non-crash events, such as a sudden
stop, a swerving evasive manoeuvre or a door opening
during vehicle movement. 11-10-2021
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16. Prevention Strategies
Setting and enforcing speed limits:
Pedestrians have 90% chance of survival if hit by
car at 30km/h or below, but less than 50% chance
of surviving an impact of 45km/h or above
Setting and enforcing alcohol limits: Laws
that establish blood alcohol concentration (BAC) of
0.05g/dl or below are effective
Banning drivers from using hand-held
mobile phones: they are four times more likely to
be involved in a crash
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17. Prevention Strategies
Road Safety: The central & state governments
have been implementing measures to make our
roads safer
All stakeholders have to join hands to make road
safety a social movement
“Road Safety Week” is observed throughout the
country every year in the month of January.
Road Safety and Transport Bill, 2014: The new Bill
makes penalties more stringent, with an obvious
aim to curb traffic violation 11-10-2021
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18. Management Strategies
The term "golden hour" is commonly used to
characterize the urgent need for the care of trauma
patients. This term implies that morbidity and
mortality are affected if care is not instituted within
the first hour after injury.
If proper first aid is given, road accident victims
have a greater chance of survival and a reduction in
the severity of their injuries, even the The Hon’ble
Supreme Court has stressed that victims of RTA
need to be provided medical aid FIRST
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19. Road Safety-shared responsibility
The
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20. Thank you all
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