Road traffic accidents -Dr.Sujatha Sathananthan

Road Traffic Accidents
Dr.S.Sujatha MD.,DPH.,
Assistant Professor,
Department of Community Medicine
Chengalpattu Medical College

What is an Accident
1.An unexpected, unplanned occurrence that may involve injury.
2. Unpremeditated event resulting in recognizable damage
(WHO Advisory Group)
3. Occurrence in a sequence of events, which usually produces
unintended injury,death or property damage.
8 September 2019 2Chengalpattu Medical College

Classification of Accidents
1. Road Traffic Accidents
2. Domestic Accidents-
Drowning,Burns,Falls,Poisoning,Injuries from sharp
,Bites and other injuries from animals
3. Industrial Accidents
4. Railway Accidents
5. Aircraft crash
6. Maritime accidents
7. Violence
8 September 2019 Chengalpattu Medical College 3

Measurement of Problems
1. Mortality
 Proportional mortality rate
 Number of deaths per million population
 Death rate per 1000 (or 1 lakh) registered vehicles per
year.
 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 per
year.

Cont….
2.Morbidity
Based on Abbreviated injury scale
1. Serious injuries
2. Slight injuries
3.Disability- temporary or permanent ,partial/total
International Classification of Functioning,Disability and
Health (ICF) by WHO

Road Accidents : A Snapshot
 Road Accidents - a leading cause of Injuries,
Deaths & Disabilities.
 India : 2017
• Accidents – 4,64,910
• Deaths – 1,47,913
• Person Injured – 4,70,975
In Every Day :
1,274 Accidents /day and 405 Persons killed/day
In Every Hour:
53 Accidents /hr and 17 Persons killed /hr
Source:Road traffic Accidents in India 2017
www.morth.nic.in

www.morth.nic.in

Source:Road traffic Accidents in India 2017 - www.morth.nic.in

Ministry of Road transport and highways
www.morth.nic.in

Risk Factors
1.Speed:
Pedestrians has 90% chance of surviving a car crash at
30Km/h or below.
Reducing respiratory problems associated with car
emissions
2.Drink – Driving:Blood Alcohol Concentration(BAC)of
0.05g/dl or below reducing the alcohol related crashes.
Enforcing Sobriety Check points & Random breath testing
can reduce 20%of alcohol related crashes.

Risk Factors Cont…
3. Motor cycle Helmets: Reduce the risk of death by 40% and risk of
severe injury by 70%
Strict Laws should be enforced
4.Seat –Belts and Child Restriants:
Reduces risk of fatality among Front seat passengers by 40-50%
Rear –seat passengers by 25-75%
5. Mobile Phone usage - 4 times the risk of crash increases

6.Factors influencing exposure to risk:
Rapid motorization
Demographic factors
Transport, land use and road network planning
Increased need for travel
Choice of less safe forms of travel
7.Risk factors influencing crash involvement:
Speed
Pedestrians and cyclists
Young drivers and riders
Alcohol
Medicinal and recreational drugs
Driver fatigue
Hand-held mobile telephones
Risk factors – cont..

OtheRisk Factors – cont....Risk
Factors:
8.Risk factors influencing injury severity:
Lack of in-vehicle crash protection
Non-use of crash helmets by two-wheeled vehicle
users
Non-use of seat-belts and child restraints in motor
vehicles
Roadside objects
9.Risk factors influencing post-crash injury
outcome:
Pre-hospital factors
Hospital care factors

Reasons for more Accidents in
Developing countries
 Large numbers of pedestrians and animals share the
common roadway
 Large number of old , poorly maintained vehicles
 Large numbers of buses often overloaded
 Large number of motor cycles, scooters and mopeds
 Low driving standards
 Widespread disregard of traffic rules
 Defective roads, poor street lighting, defective layout of
cross roads and speed breakers
 Unusual behaviour of men and animals

RTA: Epidemiological Triad Triad
Agent: Vehicles
Environment:
Physical
status of
Road
Social context
Host:
Individual at
Risk

Age
Sex
Education
Medical Conditions
- Sudden illness
- Heart attack
- Impaired vision
Psychosocial factors
- lack of experience
- risk-taking
- impulsiveness
- defective judgements
- aggressiveness
- poor perception
- family dysfunction
Lack of body protection
- helmets
- safety belts
Relating to road
 defective, narrow roads
 defective lay out of cross roads and
speed breakers
 poor lighting
 lack of familiarity
Relating to vehicle
 over speeding
 bad maintenance
 large numbers
 overloading
 low driving standards
Bad weather
Mixed traffic
H
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V
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S8 September 2019 20Chengalpattu Medical College

Increased vulnerability
and/or risk factors
Precipitating
factors
Emotional tension
Alcohol and drugs
Precipitating
factors
Special traffic
conditions
Social pressure
Stolen vehicles
ACCIDENT

Prevention of RTA Human factors Vehicle factors Environmental
factors
Pre-crash Driver experience,
fitness to drive,
driver behavior
Vehicle maintenance
& features(
electronic stability
control)
Transport systems,
road engineering,
visibility
Crash Use of protective
equipment (helmets,
seat belts, child
restraints)
Vehicle design for
impact protection
Fixed objects at
roadside, safely
barriers
Post-crash Preexisting
conditions,
emergency response
care, rehabilitation
Entrapment, fire Location, speed of
emergency response,
access to trauma
care
The Haddon matrix

Prevention
 Data collection
 Safety education
 Promotion of safety measures
 Alcohol and other drugs
 Primary care
 Elimination of causative factors
 Law enforcement
 Rehabilitation
 Accident research

1.Data collection
 Basic reporting of all cases
 Supplementation by national surveys
 Eliciting the data about conditions and
environmental factors leading to accidents
 Making Police investigation
of an accident mandatory
 Vahan NR e services - www.vahan.nic.in

2.Safety education
‘If Accident is a disease, Education is its vaccine’
 Initiated at the school level
 Educate regarding risk factors, traffic rules, safety
precautions and first aid.

3.Promotion of safety measures
 Seat belts
 Safety helmets
 Safety measures for children
 Others like door locks, proper vehicle design ,air bags
and so on

4.Alcohol and other drugs
 Abstinence from alcohol and depressant drugs before
and during driving
 Barbiturates , amphetemines and Cannabis –impairs
driving ability
 Education
 Law enforcement

5.Primary care
 Planning, organization and management of
trauma and emergency care services improved
 At accident site --Transportation-Hospital
 Skill of the Health Care Provider
 Accident Services Organization and one fully
equipped specialised trauma care hospital in all
major cities

6.Elimination of Causative factors
 Improve roads
 Impose speed limits
 Mixed Traffic
 Bad weather
 Mark danger zones
 Improve the Vehicle Conditions
 Drunk and drive
 Lack of body protection

7.Enforcement of laws
 Driving tests
 Medical fitness to drive
 Speed limits
 Compulsory wearing of seat belts
 Compulsory wearing of helmets
 Checking for blood alcohol concentration
 Road side breath analyzer,
 Regular and periodic inspection of vehicles,
 Periodic examination of drivers above the age of 55 yrs .

8.Rehabilitation services
 Medical rehabilitation
 Social rehabilitation
 Occupational rehabilitation

9.Accident research
New field called Accidentology
1.Gathering information about Type, extent &
characteristics of accident
2.Corelating accidents with personal and environmental
factors
3.Devising measures to
alter human behaviour
make environment safe
accident control measures

Government Initiatives
 Multi-pronged road safety programmes and initiatives
 Mass awareness/ education programmes,
 Engineering measures (both road and vehicle),
 Enforcement of safety laws
 Emergency care to road accident victims.

Recent Measures taken by
MoRTH
Road Engineering measures:
 black spots will be identified NH and State roads and its
Rectification .
 Road Safety Audits
 All road development projects have provision for essential
road safety furniture: like road signs, markings, delineators
etc.
 Crash barriers installed in hilly areas.

Recent Measures taken by MoRTH
(contd.)
Vehicular safety standards and IT enabled safety measure
 Trucks prohibited from carrying protruding roads;
 Anti-locking Brake System (ABS) made mandatory on
Heavy Vehicles.
 Cars to have provision for fitment of at-least one child
seat.
 AHO (Automatic Headlight On) made mandatory for
Two Wheelers.
 Bus and truck code for safe cabins for drivers and
others.

(contd.)
Education and Awareness
 Ministry sanctioned 24 model Institutes of Driving &Training
Research (IDTR) for drivers.
 Road Safety Week February 4th to 10th observed this year
for mass awareness.
 Theme for this Year 2019- “Sadak Suraksha – Jeevan
Raksha”- Road safety - Life Safety
 To support traffic and transport rules.

(contd.)
Post-crash response and trauma care
 “Good Samaritans” guidelines accepted by Supreme
Court – States/U.Ts requested to implement.
 NHAI provide ambulances at a distance of 50-60 kms
on completed stretches of NH.
 MV Amemdment Bill 2019 provide stricter penalities for
traffic offences for strengthening enforcement and
ensuring compliance:

The Motor Vehicles (Amendment)
Bill 2019
 Driving under the influence of alcohol or drugs has
been increased from ₹2,000 to ₹10,000
 Rash driving/dangerous driving-₹5,000.
 Speeding/Racing - ₹5000
 People found driving without a seat belt can be fined
₹1,000
 Driving without a helmet is a fine of ₹1,000 along with
a 3-month suspension of the offender’s driving licence.
 Cashless Treatment for Road Accident Victims within
the first hour (Golden Hour) of its occurrence

Bill 2019
 Overloading of 2 wheeler – ₹.2,000 and Disqualification
of licence for 3 months
 Overloading of vehicle - ₹20,000 and ₹2000 / extra
tonne
 Overloading of passenger - ₹1000/extra passenger
 Not providing way for Emergency vehicle- ₹10,000
 Driving with out insurance - ₹2000
 Vehicle with out permit - ₹10,000

Bill 2019
 Travelling with out a ticket in Govt Bus - ₹ 500
 Violation of General road Rules - ₹500
 Dis obedience of orders of authorities - ₹2000
 Unauthorised use of vehicles without licence - ₹5000
 Talking with mobile phone while driving –₹.5000
 Aadhar card made compulsary-for getting Driving license
and vehicle registration

Bill 2019
 Driving without a licence-₹.5000
 Driving with out Qualification - ₹10000
 Over speeding – ₹. 2000 (for Medium Passenger Vehicle)
and ₹ .1000 (for Light Motor vehicle)
 Specially abled people- vehicle alteration mandatory
 Oversized vehicles - ₹5000

Bill 2019
 Increased Compensation for The Family of the person
died by -Hit and Run - ₹2 lakh ; for Grevious injury –
₹50,000
 Inclusion of Good Samaritan Guidelines
 National Transportation Policy
 Recall of Vehicles
 Compulsory Insurance- ₹10 lakh for deaths and ₹5 lakh
for grevious injuries

Bill 2019
Road safety Board: -
1.Standards of motor vehicles
2.Registration and licensing of vehicles
3. Standards for road safety
4.promotion of new vehicle technology

Bill 2019
Recognition of Offences Committed by Juveniles:
 Gaurdian/owner deemed as guilty with ₹.25000 with 3
years imprisonment ;
 Registration of Motor Vehicle to be cancelled.

Cont..
 Automated Fitness Training for Vehicles-computer-
monitored tests for PUC (pollution under control)
certification, speedometer calibration, brake adjustment,
suspension testing and wheel alignment.
 National Registry for Licenses and Registrations
 Electronic surveillance on national and state highways
and urban roads.
 6 months time limit for application of compensation to
the claims
 Time limit for renewal of driving licence -1 month

mParivahan - Mobile App

Training for 108 workers

Training on Advance Life Support

108 Control Room

TAEI – Tamilnadu Accident &
Emergency Care Initiative
•

TAEI -Triage

4 E’s for Injury Prevention
 Education
 Envronmental modification
 Enforcement of Laws
 Engineering

Seat Belt Importance

I Pledge for Road Safety

References
1.www.morth.nic.in
2. Road traffic Accidents in India 2017 ,www.morth.nic.in
3.K.Park ,Park’s textbook of Preventive and Social Medicine,
25th edition.Banarsidos Bhanot Publishers, (2019),436-
440

Road traffic accidents -Dr.Sujatha Sathananthan

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