EPIDEMIOLOGY OF ROAD ACCIDENTS IN

INDIA

Dr Vaibhav BagariaMB MS, D Orth, FCPS.

Orthopaedic SurgeonORIGYN Healthcare

Nagpur IndiaWWW.DRBAGARIA.COME: drbagaria@gmail.com

‘I keep six honest serving man,

they taught me all I know.

Their names are what, why, when, how, where and who’

What does epidemiology follow?

Incidence – new cases at certain time in certain area (country, etc.)

Causes, mechanisms, severity Prevalence (morbidity)– total no. of cases at

any given time and certain area Mortality Health outcomes

TRAUMA - World

Leading cause of deaths, hospitalizations and disabilities in 15 – 44 years.

In 1990’s- 9th leading cause of death, by 2020 – 2nd leading cause after IHD

Responsible for 9.1% deaths. Occupy 10 – 30% hospital beds.

TRAUMA INDIA

TRAUMA - India

Rapidly increasing in India- each day 300 Indians killed, 1 every 12 sec injured seriously.

1% world vehicles and 10% deaths. 80 % in rural and district areas in low and middle

income societies. Severe socioeconomic losses to the emerging

economy of the country: 550 bill =3% GDP Significantly affect the poorer communities of the

societies

Incidence of Trauma Cases

‘As a general rule, the most successful man in life - is the man who has the best information’

Auto Accident Statistics from the year 1994 to 2004:

YEAR ROAD ACCIDENTS(IN THOUSANDS)

PERSONS KILLED(IN THOUSANDS)

PERSONS INJURED(IN THOUSANDS)

2004 (Provisional) 429.8 92.5 464.6

2003 406.7 86.0 435.1

2002 407.5 84.7 408.7

2001 405.6 80.9 405.2

2000 391.4 78.9 399.3

1999 386.4 82.0 375.0

1998 385.0 79.9 390.7

1997 373.7 77.0 378.4

1996 371.2 74.6 369.5

1995 348.9 70.6 323.2

1994 320.4 64.0 311.5

Sourced From:Department of Road Transport and Highways.Ministry of Shipping, Road Transport and Highways.Government of India.

Rising Trends in accident statistics for the years

2005 and projections for 2015

Year No of Deaths

No of Serious Injuries

No Of Minor Injuries.

2005 1,10,300 22,06,000 77,21,000

2015 1,54,600 30,92,000 108,22,000

Which group is bearing the maximum Brunt?

Causes, Mechanisms and Severity

‘Epidemiology is a means of learning or asking questions… and getting answers that lead to further questions’

Causes, mechanisms, severity

Causes & mechanisms: MVAs – leading cause of TBIs Falls – second leading cause Work-related TBIs Firearms

Alcohol – major factor in many TBIs

Severity: mild, moderate, severe

Modes of Road accidents

Severity of RTA’s

Factors Responsible for RTA’s

‘The study of disease is really the study of man and his environment’

Causes of Road Accidents

WHO identified Risk Factor in RTA

Speed Alcohol or drugs Fatigue Male Vehicle defects Youth driving together Vulnerable road users

INDIA is a world Apart?-Incredible INDIA

BAD Roads BAD Traffic Sense. No Pre Hospital phase. Not many dedicated Trauma Units. No formal or compulsory trainings in Trauma

Care & Resuscitation. No Money – No Medicare.

What has not changed?

‘Those who fail to learn from history are bound to repeat its mistakes’

5 A’s

Awareness regarding the issue. Attitude of Government. Apathy towards the issue. Absence of any concerted effort. Available resources, finance and Data.

Disease –related Mortality and Plan Allocation

IndiaStat.comhttp://www.indiastat.com/India/ShowData.asp?secid=16&ptid=0&level=1m), Ministry of Shipping Road Transport and Highways (2006) & Tenth Plan Document(http://planningcommission.nic.in/plans/planrel/fiveyr/10th/volume2/v2_app.pdf)

Disease No of Deaths Scheme Fund (Cr Re)

T B 37,639 National TB Control

680

Malaria 638 NVBDC 1370

AIDS 1094 NACP 1270

Accidents 92, 618 No major Scheme

187

Can You identify these men?

What may be changing for good?

Where is the hope?

BETTER TECHNOLOGIES PUBLIC PRIVATE PARTNERSHIP FOCUS ON EDUCATION AND TRAINING. DEDICATED TRAUMA UNITS CONFERENCES LIKE THESE. GOOD COMMUNICATION SYSTEM.

Better tech: WHAT IS GIS?

GIS is a computer based digital information system which analyzes the events with respect to the earths geography.

Acronym for:Geographic InformationSystem

MATERIALS AND METHODS

Creation of a trauma registry

All non fatal vehicular accidents recorded

Mode of injury, Type of vehicle involved (bicycle, two wheeler or four wheeler), Location and Nature of Trauma was recorded over a period of six months.

MATERIALS AND METHODS

45 variables collected and plotted against the location map using the GIS software.

SOFTWARE

JT Maps, an indeginously (Indian) developed software.

Other available software: Arc view, Map info, ARC/Info, AutoCAD Map, etc.

RESULTS

166 trauma cases recorded over six months.

Plotted against the data analytical software map.

Clustering of cases with similar attributes were analysed.

Results

Clustering of six lower end radius fractures at a particular location.

All victims were male in age group 20 – 35 years.

All accidents involved motorised two wheelers.

Other injuries were evenly distributed over the entire data location map

Analysis

Personal inspections revealed A “Speed breaker” where most of

the accidents occurred.

“Absent street light” around the bend.

All accidents occurred during “Evening and night time”.

IMPLEMENTATION

Study data used to impress upon local authority the need of adequate illumination at the identified location.

Resulted no accidents being reported over the next three months

Public Private Partnership

Govt Involved with private sector to set up basic trauma set ups on National Highways.

Many private trusts and NGOs are taking up the cause.

Some efforts are also to increase the awareness among people to follow traffic rules.

TRAINING AVAILABLE Advanced Trauma Life Support (ATLS)

National Trauma Management Course (NTMC)

Definitive Surgical Trauma Course (DSTC)

Essential Surgical Skills (ESS)

Primary Trauma Care (PTC)

Trauma Nursing Core Course (TNCC)

Trauma Team Training (TTT)

Conferences like these!

Good communication systems!

Million Dollar Question?

Why us Clinicians?...

We are not epidemologists !

Because…..

Because…

Eyes donot see what mind doesnot know…

How we trauma surgeons and clinicians can contribute….?

Suggesting locations for setting up the trauma care centers.

Contribute towards town planning in the perspective of trauma prevention.

Using data to assess the impact of certain interventions.

Monitor the epidemiological trends in trauma over a period of time and suugest appropriate govt. policies.

TAKE HOME MESSAGE

GET INVOLVED –

As health care professionals as well as Human being

‘Health is not mainly an issue of doctors, paramedics and hospitals. It is an issue of social justice’

www.drbagaria.com