Journal ClubArticle: A study of road traffic

accidents and road safety behavior in Pune : a mixed method approach

Authors : Raghav PR, Prasad NB, Dholakia M

Published in : Indian Journal of Community & Family Medicine, Vol 1, Issue 2, Jul-Dec, 2015

Presented by : Sourav Goswami

Moderator : Dr B S Garg

1

FrameworkIntroduction

Objectives of the article

Learning objective

Methodology followed in the article

Results in the article

Discussions in the article

Critical Analysis of the article

Review from similar articles

Legislations regarding road traffic rules

Conclusion

References 2

IntroductionApproximately 1.24 million1 people die every year

on the world’s roads, and another 20 to 50 million1 sustain non- fatal injuries as a result of road traffic crashes. These injuries and deaths have an immeasurable impact on the families affected, whose lives are often changed by these tragedies, and on the communities in which these people lived and worked.

Road traffic injuries are estimated to be the eighth 1 leading cause of death globally, with an impact similar to that caused by many communicable diseases, such as malaria

3

Introduction contd…It is the leading cause of death of young people aged 15-29 years 1

RTA accounts for 2.1% 2of global mortality

RTA accounts for 55% 2 of all accidental deaths in children

In developing countries, 85% 2 of the deaths are as a result of RTA

India accounts for 10% 2 OF RTA fatalities worldwide

In India, over 80,000 people die in traffic crashes annually , over 1.2 million injured seriously and about 3,00,000 disabled permanently. 3

4

Objective of the studyTo assess the problem of

road traffic accidents, road safety behavior and its qualitative aspects.

5

Learning objectives

Learning the basic of Road Traffic Accidents

6

Methodology

Study Quantitative Cross sect. study

Qualitative Inclusion/ Exclusion

Where? 1.IDI 2.FGD

Methods- 4 methods 3. Playground test 4. Observation

7

Results

1. Quantitative Part

2. Qualitative Part

8

Age distribution of accident victims

9

Mean age of the road traffic accident victims as per their gender

Gender Number Mean age

SD ‘t’ test P value

Males 35 34.69 19.99 0.849 0.399

Females 25 30.24 20.04

10

Profile of the drivers and vehicles or road condition during an accident

Profile of drivers/road condition

Percentage 95% confidence limits

Not used helmets/seat belt

92.6 75.7 – 99.1

Under influence of alcohol

3.7 0.1 – 19.0

Rash driving 14.8 4.2 – 33.7

Did not have a driving license

3.7 0.1 – 19.0

Vehicle defect 3.7 0.1 – 19.0

Road problem 81.5 47.3 – 95.7 11

Results contd…Qualitative Analysis:

A) Findings from In-depth interviews:

They know the traffic rules

According to the participants, wearing helmets were unnecessary.

B) Findings from FGDs:

The students know the traffic ruleswell

They pointed out the necessity of zebra crossing and speed breakers

While crossing the road, they don’t get any help from the policemen

12

Results contd… C) Findings of Playground test:

It confirms their knowledge regarding the traffic norms and how to cross road safely

D) findings of observation by the author at traffic points:

Busy hours were 8 am to 9 am and 8 pm to 9 pm….. During these periods traffic rules are well maintained.

But beyond these periods, traffic norms are violated

Two wheelers & auto rickshaw are mostly involved in breaking traffic rules.

13

Discussion1. Majority of the accident victims were males in

the age group 20 – 40 years

2. In FGD it was found students have adequate knowledge about traffic rules.

3. In their study ------ age group of accident victims were wide---- 3 years to 74 years. So, they concluded that, irrespective of age ,all are prone to RTA.92.6% of the drivers did not use any safety means i.e helmets/seatbelts.

During the IDIs it was found that the drivers felt wearing helmet unnecessary.

14

Discussion contd….In a report of WHO (WHO global report) ,wearing

a standard good quality motorcycle helmet can reduce the risk of death by 40 % and risk of serious injury during RTA by 70 %. 1

In this study, they found that, only 3.7% 2of the drivers were under the influence of alcohol while other similar study conducted by Patil SS et al says 29% drivers were under the influence of alcohol in India , during driving.

15

Critical analysis

Cross sectional study: STROBE guidelines

Qualitative study: Consolidated criteria for reporting qualitative research (COREQ)

16

REVIEW FROM SIMILAR ARTICLES/LITERATURE

17

Review of similar studies on RTA(In India)

Socio-demography of RTA victims3

18

Review of similar studies on RTA contd..

Source: 3

19

Review of similar studies on RTA contdSource:3

20

Review of similar studies on RTA contd

Timings of RTA: The month-wise distribution of ‘road accidents’ has shown maximum number of accidents during May followed by January while least number of road accidents were reported in the month of August . 1

 Maximum number of ‘road accidents’ were reported during 1800 hrs to 2100 hrs. 1

64.28% victims died on the scene or died during transportation or within 24 hours of injury. 3

21

Review of similar studies on RTA contd

The major un-natural cause of death in India is RTA ( 34.3%) followed by sudden death, drowning, poisoning etc. 4

24.9% victims of RTA were occupants of “two wheelers” 1, 4

While road traffic fatality rates are decreasing in some high-income countries, the rapid increase in road traffic crashes in low- and middle- income countries has driven an overall global increase in deaths and injuries. Indeed, current trends suggest that road traffic injuries will become the fifth leading cause of death by 2030 1

22

Review of similar studies on RTA contd

India spends 12.5 billion dollars 6 on average, towards RTA, which excludes the economic burden of accident survivors with a permanent disability.

It is estimated that 3% gross domestic product 6 is lost due to RTA in India.

23

Review of similar studies on RTA contdRISK FACTORS OF RTA6

HUMAN

• Younger age( 15- 29y)

• Male gender

• Drunken driving

• Fatigue

• Non observance of traffic rules

• Inadequate use of helmet/seat belt

• Medical condition

• Defective judgment

• Distraction while driving

• Family dysfunction etc.

ENVIRONMENTAL

ROADS VEHICLE

Defective & narrow Excessive speed

Defective layout & crossroads

Poorly maintained vehicle

Poor lighting Large no of vehicles

Lack of familarity Low driving standard

Overloaded bus

24

State/UT wise RTA in India (2014)5

25

Legislations regarding road traffic rules

in India 7

Offences and penalties: total 114

26

Sl no offences related to Total no of laws

01 Documents 07

02 Driving 48

03 Towing of vehicles 03

04 Motor vehicle 16

05 Commercial vehicle 18

06 Pollution 07

07 Parking 15

Legislations regarding road traffic rules

in India 7 contd…

OFFENCES MAX PENALTY SECTION

1. Driving without helmet

Rs 100/ 129r/w 177 MVA

2. Seat belt not fastened

Rs 100/- 138(3) CMVR 177 MVA

3. Dangerous driving

Rs 1000/- and or imprisonment ( 6 months)

112-183 MVA

4.Improper use of headlight/ tail light

Rs 100/- CMVR 105(2)(ii) 177 MVA

5. Failing to give signal

Rs 100/- 121 RRR177 MVA

27

Legislations regarding road traffic rules

in India 7 contd…

Offences Max Penalty Section

6. Overtaking from wrong side

Rs 100/- RRR 6/1/177 MVA

7. Using vehicles in unsafe condition

Court Challan 192 MVA

8. Overloading of goods Rs 2000/- plus Rs 1000/- for every additional ton

MMVR 93(v)(i) 177 MVA

9. Stopping without bus stop

Court challan 66/192 MVA

10. Drunken driving 8 blood alcohol content (BAC) LEGAL LIMIT IS 0.03% or 30 micro-ml alcohol in 100 ml of blood---- fine---Rs 2000/- to Rs 10,000/-

Punishment: Imprisonment from 6 months to 4 years

28

ConclusionFactors that need to be addressed:

Road safety infrastructure development .

Appropriate vehicle design for Indian roads, setting vehicle standard, regular inspection of vehicles

Minimizing exposure by segregation of vulnerable road users such as pedestrian and cyclists

Removal of encroachment on foot-paths

Educating public about safety

contd……… 29

Conclusion contd….Strict enforcement of legislation

Improving pre-hospital emergency care for the victim and better rehabilitation services.

CC cameras in the roads.

Vehicles should stop at specific stoppages only e.g: Bus stop/parking places etc

Strengthening of accident research and injury surveillance system for accurate database on RTA.

30

References 1.World Health Organization. Global Status Report on Road

Safety 2013 : Supporting a decade of action. Luxembourg. [Internet][Updated 2014;cited 2015 Nov 15]. Available from: http://www.who.int/violence_injury_prevention/road_safety_status/2013/en/

2. Raghav PR, Prasad NB, Dholakia M. A study of road traffic accidents and road safety behaviour in Pune: a mixed- method approach. Indian Journal of Community & Family Medicine 2015 Jul- Dec; Vol 1, Issue 2:p.75-77.

3. Farooqui JM, Chavan KD, Bangal RS, Syed MM, Thacker PJ, Alam S, Sahu S,Farooqui AA, Kalakoti P. Pattern of injury in fatal road traffic accidents in a rural area of western Maharashtra, India. Australas Med J. 2013 Sep 30;6(9):476-82.

4. National Crime Records Bureau. Ministry of Home Affairs. GOI. Accidental Deaths & Suicides in India 2013.[Internet] [Updated 2014 cited 2015 Nov 15] Available from: http://ncrb.gov.in

Contd…31

References contd… 5. National Crime Records Bureau. Ministry of Home Affairs. GOI.

Maps 2014.[Internet] [Updated 2014 cited 2015 Nov 15] Available from: http://ncrb.nic.in/MAPS-2014/adsi-2014%20maps/all%20map%20adsi-2014.pdf

6. Annadurai K, Mani G, Danasekaran R. Recurring tragedy of road traffic accidents in India: Challenges and opportunities. Indian J Crit Care Med. 2015 Jul;19(7):434-5.

7. Indian traffic rules and signs [Internet][cited 2015 Nov 13] Available from: http://www.trafficsigns.co.in

8. Wikipedia. Alcohol laws in India.[Internet][cited 2015 Nov 12] Available from: https://en.wikipedia.org/wiki/Alcohol_laws_of_India

32

TTHANK YOU !!!

33