Epidemiology, prevention & control of rta

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? 11-10-2021 2

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 . 11-10-2021 3

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 . 11-10-2021 4

5. India M ore 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 . 11-10-2021 5

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 11-10-2021 6

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 , 11-10-2021 7

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 8

9. 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 10

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 11

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 . 11-10-2021 12

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 13

14. Prevention Strategies Helmets for two-wheeler riders : E nforcing 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 14

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 15

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 11-10-2021 16

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 17

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 11-10-2021 18

19. Road Safety-shared responsibility The 11-10-2021 19

20. Thank you all 11-10-2021 20