10. Good one Epi of Accidents and Injuries.ppt

Dr ibrahim Abdi Hassan

1. EPIDEMIOLOGY OF
ROAD TRAFFIC
ACCIDENTS

2. ROAD TRAFFIC ACCIDENTS
Everyyearthelivesofapproximately1.3millionpeoplearecutshortasa
resultofaroadtrafficcrash.
Between20and50millionmorepeoplesuffernon-fatalinjuries,withmany
incurringadisabilityasaresultoftheirinjury.
Roadtrafficinjuriescauseconsiderableeconomiclossestoindividuals,their
families,andtonationsasawhole.
Theselossesarisefromthecostoftreatmentaswellaslostproductivityfor
thosekilledordisabledbytheirinjuries,andforfamilymemberswhoneed
totaketimeoffworkorschooltocarefortheinjured.
Roadtrafficcrashescostmostcountries3%oftheirgrossdomesticproduct.

3. What is an Accident
Anunexpected,unplannedoccurrencethatmay
involveinjury.
Unpremeditatedeventresultinginrecognizable
damage(WHOAdvisoryGroup)
Occurrenceinasequenceofevents,whichusually
producesunintendedinjury,deathorproperty
damage.

4. Classification of Accidents
1.RoadTrafficAccidents
2.DomesticAccidents-
Drowning,Burns,Falls,Poisoning,Injuriesfromsharp,Bitesandother
injuriesfromanimals
3.IndustrialAccidents
4.RailwayAccidents
5.Aircraftcrash
6.Maritimeaccidents
7.Violence

5. Measurement of Problems
Mortality
Proportionalmortalityrate
Numberofdeathspermillionpopulation
Deathrateper1000registeredvehiclesperyear.
Numberofaccidentsorfatalitiesasaratioofnumberof
vehiclesperkmorpassengersperkm.
Deathsofvehiclesoccupantsperthousandvehiclesper
year.

6. Measurement of Problems
Morbidity
BasedonAbbreviatedinjuryscale
Seriousinjuries
Slightinjuries
Disability-temporaryorpermanent,partial/total
InternationalClassificationofFunctioning,DisabilityandHealth
(ICF)byWHO

7. Epidemiology of road traffic accidents
Approximately1.3millionpeopledieeachyearasaresultof
roadtrafficcrashes.
TheUnitedNationsGeneralAssemblyhassetanambitious
targetofhalvingtheglobalnumberofdeathsandinjuriesfrom
roadtrafficcrashesby2030(A/RES/74/299)
Roadtrafficcrashescostmostcountries3%oftheirgross
domesticproduct.

8. Epidemiology of road traffic accidents
Morethanhalfofallroadtrafficdeathsareamongvulnerable
roadusers:pedestrians,cyclists,andmotorcyclists.
93%oftheworld'sfatalitiesontheroadsoccurinlow-and
middle-incomecountries,eventhoughthesecountrieshave
approximately60%oftheworld'svehicles.
Roadtrafficinjuriesaretheleadingcauseofdeathforchildren
andyoungadultsaged5-29years.

9. Who is at risk?
Socioeconomicstatus
RoadtrafficinjurydeathratesarehighestintheAfricanregion.
Evenwithinhigh-incomecountries,peoplefromlowersocioeconomic
backgroundsaremorelikelytobeinvolvedinroadtrafficcrashes.
Age
Roadtrafficinjuriesaretheleadingcauseofdeathforchildrenand
youngadultsaged5-29years.
Sex
Fromayoungage,malesaremorelikelytobeinvolvedinroadtraffic
crashesthanfemales.
Aboutthreequarters(73%)ofallroadtrafficdeathsoccuramong
youngmalesundertheageof25yearswhoarealmost3timesaslikely
tobekilledinaroadtrafficcrashasyoungfemales.

10. Risk Factors
Speed:
Pedestrianshas90%chanceofsurvivingacarcrashat
30Km/horbelow.
Reducingrespiratoryproblemsassociatedwithcar
emissions
Drink–Driving:
BloodAlcoholConcentration(BAC)of0.05g/dlorbelow
reducingthealcoholrelatedcrashes.
EnforcingSobrietyCheckpoints&Randombreathtesting
canreduce20%ofalcoholrelatedcrashes.

11. Risk Factors
MotorcycleHelmets:
Reducetheriskofdeathby40%andriskof
severeinjuryby70%
StrictLawsshouldbeenforced
Seat–BeltsandChildRestriants:
ReducesriskoffatalityamongFrontseat
passengersby40-50%
Rear–seatpassengersby25-75%
MobilePhoneusage–
4timestheriskofcrashincreases

12. Risk Factors
Factorsinfluencingexposuretorisk:
Rapidmotorization
Demographicfactors
Transport,
landuseandroadnetworkplanning
Increasedneedfortravel
Choiceoflesssafeformsoftravel
Riskfactorsinfluencingcrashinvolvement:
SpeedPedestriansandcyclists
Youngdriversandriders
AlcoholMedicinalandrecreationaldrugs
Driverfatigue
Hand-heldmobiletelephones

13. Risk Factors
Riskfactorsinfluencinginjuryseverity:–
Lackofin-vehiclecrashprotection
Non-useofcrashhelmetsbytwo-wheeledvehicleusers
Non-useofseat-beltsandchildrestraintsinmotorvehicles
Roadsideobjects
Riskfactorsinfluencingpost-crashinjuryoutcome:
Pre-hospitalfactors
Hospitalcarefactors

14. Reasons for more Accidents in Developing
countries
Largenumbersofpedestriansandanimalssharethecommon
roadway
Largenumberofold,poorlymaintainedvehicles
Largenumbersofbusesoftenoverloaded
Largenumberofmotorcycles,scootersandmopeds
Lowdrivingstandards
Widespreaddisregardoftrafficrules
Defectiveroads,poorstreetlighting,defectivelayoutofcross
roadsandspeedbreakers
Unusualbehaviourofmenandanimals

16. Asthma
-Safety belt
Factors increasing traffic accidents

19. Datacollection
Safetyeducation
Promotionofsafetymeasures
Alcoholandotherdrugs
Primarycare
Eliminationofcausativefactors
Lawenforcement
Rehabilitation
Accidentresearch
Prevention

20. Prevention
Datacollection
Basicreportingofallcases
Supplementationbynationalsurveys
Elicitingthedataaboutconditionsandenvironmentalfactors
leadingtoaccidents
MakingPoliceinvestigationofanaccidentmandatory

21. Prevention
Safetyeducation
IfAccidentisadisease,Educationisitsvaccine’
Initiatedattheschoollevel
Educateregardingriskfactors,trafficrules,safetyprecautions
andfirstaid.

22. Prevention
Promotionofsafetymeasures
Seatbelts
Safetyhelmets
Safetymeasuresforchildren
Otherslikedoorlocks,propervehicledesign,airbagsandso
on

23. Prevention
Alcoholandotherdrugs
Abstinencefromalcoholanddepressantdrugsbeforeand
duringdriving
Barbiturates,ampheteminesandCannabis–impairsdriving
ability
Education
Lawenforcement

24. Prevention
Primarycare
Planning,organizationandmanagementoftrauma
andemergencycareservicesimproved
Ataccidentsite–Transportation-Hospital
SkilloftheHealthCareProvider
AccidentServicesOrganizationandonefully
equippedspecialisedtraumacarehospitalinall
majorcities

25. Prevention
EliminationofCausativefactors
Improveroads
Imposespeedlimits
MixedTraffic
Badweather
Markdangerzones
ImprovetheVehicleConditions
Drunkanddrive
Lackofbodyprotection

26. Prevention
Enforcementoflaws
Drivingtests
Medicalfitnesstodrive
Speedlimits
Compulsorywearingofseatbelts
Compulsorywearingofhelmets
Checkingforbloodalcoholconcentration
Roadsidebreathanalyzer,
Regularandperiodicinspectionofvehicles,
Periodicexaminationofdriversabovetheageof55yrs.

27. Prevention
Rehabilitationservices
Medicalrehabilitation
Socialrehabilitation
Occupationalrehabilitation
Accidentresearch
NewfieldcalledAccidentology
GatheringinformationaboutType,extent&characteristicsof
accident
Corelatingaccidentswithpersonalandenvironmentalfactors
Devisingmeasuresto
alterhumanbehaviour
makeenvironmentsafe
accidentcontrolmeasures

28. Government Initiatives
Multi-prongedroadsafetyprogrammesand
initiatives
Massawareness/educationprogrammes,
Engineeringmeasures(bothroadandvehicle),
Enforcementofsafetylaws
Emergencycaretoroadaccidentvictims.