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17th Chapter Directors’ Conference
April 15-18, 2005 New Orleans, LA
Michele Naddeo, MD
Nikolaos Paidakakos
Who are we? Italian National Association Brain and Spinal Cord Injury Prevention Supported by the SiNch (Italian Neurosurgical
Society) and the SNO (Italian Neurological Science Society)
Non-for-profit Volounteering (neurosurgeons and other medical doctors,
med students, allied health professionals, psycologists, epidemiologists, teachers, civilians)
Donations and sponshorships
Short autobiography
1996 Bip Bip Project – regional
Oct 2003 Dr. M. Naddeo assumes responsibility
7 Jan 2004 Associaton’s birth - national
It is the prevailing cause of
DEATH
and
DISABILITY
In the young adult/adult population
EPIDEMYHead Trauma is a downright
Prevention Levels LEVEL I actions put to use in order to prevent the accident
LEVEL II actions put to use to minimize the consequences of the accident during its unwinding
LEVEL III actions put to use to minimize the consequences of the accident after the latter has occured (short/middle term)
LEVEL IV actions put to use in order to minimize negative outcome (long term)
44%
5%21%
11%
6%
12% 1%
CARS
MOTORBIKES
DOMESTIC
WORK
SPORTS
OTHER CAUSES
UNKNOWN
Head Injury – When/Where
Mortality and Morbidity Causes
70
20
5
2
2
1
OTHER
SPORTS
AGGRESSIONS
ACCIDENTS ATWORK
FALLS
TRAFFICACCIDENTS
Traffic Accidents in numbers
European Union (EU data) 50.000+ deaths / yr 150.000 impaired for life
Worldwide (UN data) 1.26 million people dead / yr 2.2% of global mortality 9° cause of death and disability, could become 3°
by 2020
Social Cost: $518 billion/yr in the world (1-3% of GIP)
Traffic Accidents in numbers Italy, year 2004
225.411 accidents
6.015 deaths 16 died every day 1 died every 78
mins
318.961 wounded
50% deaths < 40 yrs
25% deaths < 25 yrs
1° cause of death < 40 yrs
Prevailing cause of death at the age of 18
The most part of street accidents and wounded within city limits.
Traff ic Accidents in numbers Brain and Spinal Cord Injuries, Italy
300 cases / 100.000 / yr (males > females)
1.578.000 ER admissions / yr (2.768 / 100.000 inhabitants)
150.000 hospitalized / yr (4,5% head fractures, 24,1% intracranial)
25 deaths / 100.000 / yr
25.000 / yr heavily impaired
FIRST CAUSE OF DEATH BETWEEN 15 – 35 YRS
0
10
20
30
40
50
60
70
DRI V PASS PEDES
DEADWOUNDED
Traff ic Accidents in numbers Brain and Spinal Cord Injuries, Italy
0
5
10
15
20
25
30
%
0 1011 2021 3031 4041 5051 6061 70> 70
AGE
Traff ic Accidents in numbers Brain and Spinal Cord Injuries, Italy
Traff ic Accidents in numbers Brain and Spinal Cord Injuries, Italy Causes Part I
Erroneous driving behavior mortality rate 2,2%
Altered psycho-physical state of driver (alcohol, narcotics, drugs, ecc.) mortality rate 6,6%
Traffic Accidents in numbers Brain and Spinal Cord Injuries, Italy Causes Part II
Not keeping safety distance from vehicles ahead
Distracted driving High speed Not granting priority to vehicles coming from
the right Not respecting precedence signaling
Traffic Accidents in numbers Brain and Spinal Cord Injuries, Italy
JUNE – JULY, higher risk months FRIDAY, higher accident number 18.00 HOURS, accident peak Mortality index during NIGHT: 5% Rest of the day: 3% FRIDAY and SATURDAY NIGHTS: 45%
of the whole week
Night Incidence
0
10
20
30
40
50
60
FRI / SAT NI GHTS REMAI NI NGNI GHTS
1980-2003Traff ic Accidents in numbers Brain and Spinal Cord Injuries, Italy
48% overall decrease of mortality Improvement of the emergency response system Progress in anesthesiology Safer vehicles and roads Increase in use of helmets, belts, child restraints, ecc. Establishment of a “legal” blood alcohol level &
controls Stricter speeding controls Driving license point system
Minimal to none decrease in ages 15 – 29 (likely due to lack of danger consciousness)
Traffic Accidents in numbers Italy, Social Costs
€ 34 million / yr (2,7% of Italian GIP)
calculated in terms of: Productive capacity loss Human costs Health costs Tangible property damages
What do we do? Part I
Primary level prevention (actions in order to prevent the accident)
Secondary level prevention (actions put to use to minimize the consequences of the accident during its unwinding)
Accident related data collection from ERs and Depts of Neurosurgery nationwide
Population behavior analysis
Design, evaluation and promotion of prevention schemes
What do we do? Part II
Prevention Education nursery schools elementary schools
Prevention Teaching junior high schools high schools university sports centers (CUS) driving schools professional drivers
What do we do? Part III
Collaboration with implicated State Departments, Agencies and Offices
Collaboration with law enforcement agencies (especially traffic police)
Follow up on all activities
Epidemiological studies and research, database building
How… Level I Prevention
Road maintenance Intelligent road designing/redesigning Periodic vehicle inspection Training towards a defensive and “UNSURE”
driving Expanded speeding controls Expanded blood alcohol levels controls Traffic education from as early as
nursery/elementary school
How… Level II Prevention
Safety equipment (driving, work, sports) Helmets Safety belts Child restraints Head rests Air bags, ecc.
Correct handling and maintenance of the above
Car Accidents
29
71
BELT NO BELT
Motorbike Accidents
58
42
HELMET
NO HELMET
Being young…
Also means… Seeking risk…
…and strong emotions…
On the other hand, loving thri l l means…
recklessness
safety?
or
How… Ongoing Projects Part I
Prevention lessons: education and teaching (schools and elsewhere)
Theatrical interactive performances
Video clip projection in clubs/pubs/bars
Research on the “clubbing effect” (in collaboration with the Dept. of Neuropsycology,
Faculty of Psycology, Turin Univ.)
How… Ongoing Projects Part II
Monitoring of newly licenced drivers
Contacts/interaction with authorities
Press pubblications and releases
Internet (institutional site & prevention promoting portal) www.bip-bip.org www.brividamente.it (brividamente = in a thrilling way)
Campaigns, events, stands, gadgets
National Headquarters
at Turin
Vision for the future Nationwide expansion – reach every single child in the
country
TV program for children 4 – 8 yrs old
Cartoon/comics series
Solid epidemiological database – national neurotrauma registry
Post traumatic mortality and morbidity rates reduced
Affi l iation with ThinkFirst “The Making Of” Lisboa, Portugal – Sept 2003 EANS Congress
Dr. Naddeo meets with Dr. Deleo San Francisco, CA – Oct 2004 CNS Meeting Dr.
Naddeo meets with Mrs. Zirkle and Dr. Lobosky and invites them to the oncoming Bip Bip Conference at Turin
Turin, Italy – Dic 2004 Bip Bip Conference Mrs Zirkle and Dr. Lobosky present ThinkFirst for the first time in Italy
During conference “afterhours” the affiliation goal is being elaborated
Affi l iation with ThinkFirst “The Making Of”
Internet – the parallel world Via e-mail, affiliation details are taken care of, paperwork done, all confirmed
New Orleans, LA – Apr 2005, ThinkFirst Conference We proudly announce integration
Bip Bip – ThinkFirst
Italy