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U n i t 1
Magnitude and
impact of road
traffic injuries
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Objectives
By the end of this unit, the trainee should be able to:
• describe the global magnitude and trends of road traffic
fatalities;
• discuss the global socioeconomic and health burden of
road traffic injuries;
• describe the magnitude and trends of road traffic injuries
in his or her own country, region or city;
• discuss the socioeconomic and health burden of road
traffic injuries in his or her own country, region or city.
Objectives
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• 1.2 million deaths a year
• 20-50 million are injured
or disabled
• 11th leading cause of
death
• account for 2.1% of all
deaths globally
Copyright Etienne Creux, Pretoria News
Road traffic injuries are a huge public health and
development problem
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Distribution of global injury mortality by cause
Road traffic injuries
account for 23% of all
injury deaths
worldwide
Source: WHO Global Burden of Disease project, 2002, Version 1
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WHO region Low- and middle-
income countries
High-income
countries
African Region
Region of the Americas
South-East Asia Region
European Region
Eastern Mediterranean Region
Western Pacific Region
28.3
16.2
18.6
17.4
26.4
18.5
–
14.8
–
11.0
19.0
12.0
Road traffic injury mortality rate (per 100 000 population) in WHO
regions, 2002
The African Region has the highest mortality rate.
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Road traffic injury mortality rates (per 100 000
population) in WHO regions, 2002
The majority of road traffic deaths occur in low- and middle-income countries.
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2030 Disease or injury
2002Disease or injury
10. Perinatal conditions10. Road traffic injuries
9. Tuberculosis9. Trachea, bronchus, lung
cancers
8. Road traffic injuries8. Tuberculosis
7. Trachea, bronchus, lung cancers7. Diarrhoeal diseases
6. Diabetes mellitus6. Perinatal conditions
5. Chronic obstructive pulmonary disease
4. Chronic obstructive pulmonary disease4. HIV/AIDS
3. HIV/AIDS3. Lower respiratory infections
2. Cerebrovascular disease2. Cerebrovascular disease
1. Ischaemic heart disease1. Ischaemic heart disease
5. Lower respiratory infections
WHO predicts that road traffic injuries will rise to
eighth place by 2030 as a cause of death
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Source: Kopits E, Cropper M., 2003.
The World Bank predicts that road traffic deaths will increase
by 67% worldwide between 2000 and 2020
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0
5
10
15
20
25
30
35
1960
1962
1964
1966
1968
1970
1972
1974
1976
1978
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
Years
Fat
alit
y ra
te p
er 1
00 0
00 p
op
ula
tio
n
UK Australia USA
Downward trends in road traffic fatalities in high-income countries
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Upward trends in road traffic fatalities in low-and middle-income countries
0
2
4
6
8
10
12
14
16
18
1961 1971 1981 1991
Years
Tra
ffic
fata
liti
es p
er 1
00 0
00
popu
lati
onBrazil
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Upward trends in road traffic fatalities in low-and middle-income countries
India
0
1
2
3
4
5
6
7
8
9
1971 1975 1981 1985 1991 1992 1993 1994 1995 1996 1997 1998
Years
Tra
ffic
fata
liti
es p
er 1
00 0
00
popu
lati
on
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Upward trends in road traffic fatalities in low-and middle-income countries
Trinidad and Tobago
0
5
10
15
20
25
1960 1965 1970 1975 1980 1985 1990 1995 2000
Years
Tra
ffic
fat
alit
ies
per
100
000
p
opu
lati
on
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Most of those killed are vulnerable road users
Source: Various WHO collaborators in countries
0% 20% 40% 60% 80% 100%
USA
Thailand
Colombo, Sri Lanka
South Africa
Netherlands
Malaysia
Kenya
Japan
Bandung, Indonesia
Delhi, India
Ghana
Australia
Pedestrians Bicyclists Motorized 2-wheelers Motorized 4-wheelers Other
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• Half of all global road traffic deaths occur among young adults
between 15 and 44 years of age.
• 73% of all global road traffic fatalities are males.
• In Africa, a third of all road traffic deaths occur among those
aged 5-14 years.
• Males takes more risks as drivers or pedestrians.
• In high-income countries young drivers are disproportionately
represented.
• In low- and middle-income countries, most young victims are
vulnerable road users.
Young adults and males are at greatest risk
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Costs (US $ billion)
The costs of road traffic injuries are enormous
Region Estimated annual crash
GNP 1997 (US $ billion)
GNP (%)
Africa
Asia
Latin America and Caribbean
Middle East
Central and Eastern Europe
370
2 454
1 890
495
659
1
1
1
1.5
1.5
3.7
24.5
18.9
7.4
9.9
Subtotal 5 615 64.5
Highly motorized countries 22 665 2 453.3
Total 517.8
Source: Jacobs G, et al. 2000.
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Economic costs of road traffic injuries to households
• Loss of main breadwinner
• Loss of earnings
• Medical bills, funeral costs, legal bills
• Rehabilitation costs
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• Worldwide, about 1.2 million persons are killed in
road traffic crashes every year.
• 20 million to 50 million more are injured or disabled
in these crashes.
• Road traffic injuries account for 2.1% of global
mortality and 23% of all injury deaths worldwide.
• Road traffic injuries are predicted to rise from tenth
place in 2002 to eighth place in 2030 as a cause of
death.
Key points (1)
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• There are downward trends in road traffic deaths in
high-income countries and increases in most low- and
middle-income countries.
• The global economic cost of road traffic injuries is
about US $ 518 billion per year.
Key points (2)
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Task
Look at the table on the next slide which presents data on estimated
road traffic fatalities per 100 000 population in the WHO African
Region for 2002. Carefully study the table and write down key
features related to the distribution of road traffic fatalities per
100 000 by sex and age.
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Estimated mortalitya caused by road traffic injuriesb in WHO African region
Agec in years Males Females
0–4 18.6 11.0
5–14 42.6 25.5
15–29 27.2 10.0
30–44 53.4 15.0
45–59 65.7 22.1
60 and above 81.9 35.8
Total 39.3 17.4
a Mortality is measured by number of road traffic fatalities per 100 000 population.b Road traffic injury = ICD10 V01–V89, V99, Y850 (ICD9 E810–E819, E826–E829, E929).C Age-standardized.
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Expected results
The purpose of this exercise is to assist trainees to identify and
summarize key elements in the distribution of road traffic fatalities
per 100 000 population for the WHO African Region. They are to
describe variations noted in this indicator by different age groups
for males and females.
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Questions to think about
a) What challenges does your country face as a result of
road traffic crashes?
b) In most countries, road traffic injury costs exceed 1% of
gross national product. This figure is generally
considered to be an underestimate of national road
traffic collision costs. What is the estimated cost of road
traffic injuries in your country? How is this estimate
derived? How often is this estimate updated?
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Questions to think about
c) Conduct a review of literature to establish how much
research has been done on costs of road traffic injuries in
your country. Look for published research on this issue in
both local and international journals. This activity is meant
to equip you with library research skills and capacity to
examine existing literature. You can work on your own, or
with two or three colleagues. Try to summarize the results
and indicate gaps in knowledge that need to be filled.
Consider preparing a manuscript based on your review to
submit to a journal.
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Questions to think about
d) Identify a family you know where someone has been
involved in a non-fatal road traffic collision recently. Seek
permission to gather information on the economic costs
of that crash for that family. Prepare a summary of the
economic costs to the family and immediate society.
Think of ways of using this information to enhance
prevention of road traffic injuries in your local setting.