Road Safety is No Accident World Health Day 2004

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Road Safety is No AccidentWorld Health Day 2004

• New Delhi, 7 April 2004

Dr Madan Upadhyay, Dr Gyanendra
Sharma Disability and Injury Prevention
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Why Are We Concerned about Road Traffic Injuries?

• Reality Bytes !
• 1.2 million deaths in 2002
• In 2020, it is expected to kill 2.4 million,
  more than those dying due either to malaria, TB
  or , HIV/AIDS

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RTI Robs Breadwinner of a Family
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Road traffic injuries- A Drain on Resources!
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Road Traffic Injury Pyramid South East Asia
Proportion
Estimates for South-East Asia
Death (1) Admission (20) Emergency Care
(50) injured (gt 100)
354 000 7 million 18 million gt35 million
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Source World Health Report 2002

• For every injury death, 50 injured attend
  emergency care
• 18 million people are estimated to visit
  emergency room

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Myths Abound !

• Problem of rich countries only
• Problem of rich vehicle owners only
• Accidents are accidents, they cannot be prevented

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Myth Dispelled Low- and middle-income
countries have 90 of global burden of RTIs
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South-East Asia The Worst-Affected Region in the
World
Kopits E Croper M, Traffic Fatalities and
Economic Growth , World Bank,
EAP- East Asia and Pacific, ECA- East Europe
Central Asia, LAC, Latin America Caribbean,
MNA- Middle East N. Africa, SA- South Asia,
SSA- Sub-Saharan Africa
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Myths Abound !

• Problem of rich countries only
• Problem of rich vehicle owners only
• Accidents are accidents, they cannot be prevented

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Regional Picture- impact on the voiceless

• In the South-East Asia Region, over 354,000
  deaths occurred from road traffic injuries (or
  1,000 deaths per day, 40 deaths per hour, Two
  deaths every Three minutes)
• Who are the ones killed?
• pedestrians, bicycle and motorcycle riders,
  vehicle occupants mostly HMV drivers.
• Most are NOT the vehicle owners
• By 2020,there will be 864,000 deaths per year,
  2400 deaths per day 100 per hour, 5 deaths every
  3 minutes).

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Delhi, Bandung or Colombo Pedestrian have the
highest risk!
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Myths Abound !

• Problem of rich countries only
• Problem of rich vehicle owners only
• Accidents are accidents, they cannot be prevented

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Yes We Can Prevent RTI
HOW ??
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RTI rapidly increasingly in India
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A constant effort has paid back in HICs
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Risk Factors are known !

• Risk factors related to
• Human behavior
• Excess speeding
• Driving under influence of alcohol
• Not using safety devices (e.g. helmets, seat
  belts, child restraints)
• Road factors
• Poor road design
• Lack of pedestrian footpaths
• Inadequate traffic calming and signals
• Inadequate visibility
• Vehicle designs/condition
• Faulty designs and poor safety features
• Poor roadworthiness of vehicle
• Trauma care system
• Poor trauma care systems

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Traffic injuries are Preventable

• Seat belts gt10 000 lives saved/year (US)
• Speed for 1 km/hr less, 2-3 less fatal
  collisions
• Reflectorisation 50 reduction night-time
  pedestrian collisions
• White helmets 45 reduction in
  conspicuity-related bike injuries
• Alcohol Designated driver, law enforcement 36-
  42 reduction in Australia
• Road design traffic calming measures,
  over-bridges, etc 19 42 reduction in UK

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Road safety is a shared Societal Responsibility
Road Safety is a Public Health Issue
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Road traffic injuries are a public health and
development issue
Public Health
Prevention Control
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What Can Health Professionals Do?

• Convey the message that
• Road Traffic Injuries do not occur by chance,
  therefore are NOT Accidents
• Risk factors are known and RTIs can be prevented
• Road Safety ALSO does not happen by accident, it
  requires a deliberate effort
• Promote the policy changes
• Set up surveillance, promote and undertake
  research
• Strengthen health systems response to the victims
  

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Solutions can be adapted in low- and
middle-income countries

• Speed thrills but also kills. Seat-belts and
  child restraints keeps families together
• Alcohol One drink for the road, last drink for
  the life
• Visibility Spare yourself and others- be
  visible on the roads
• HElmets Spare your head for a next ride
• Roads Zero Tolerance

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Reduce Speed- Save Lives

• Probability of crash (Speed)2
• Probability of serious crash (Speed) 3
• Probability of fatal crash (Speed)4

• Speed from 30 km/hr to 50 km/hr 8 times
  increase in risk of a pedestrian death
• 31 times increase in risk if a vehicle speeds
  from 60 km/hr to 80 km/hr

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Speeding the Sure Way to Heaven!
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Alcohol and driving- a fatal combination

• BAC 80 mg/dl Two times the risk of crash
• BAC 100mg/dl Three times of the risk of crash
• Two wheelers Risk high if more than Zero
• A third of injured motorized two wheeler riders
  in New Delhi were under influence of alcohol
• In Thailand, 80 of people perceived a low chance
  of punishment for drinking and driving while 90
  knew that law existed

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There is no Safe Limit for Drinking and Driving
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Reducing injuries in motorcyclists

• 70-90 of injuries in Thailand are among
  motorized two-wheeler riders
• Use of crash helmets reduces 20-45 of head
  injuries among motorcycle riders
• Use of daytime running lights reduces crash rate
  by 10 29
• Children wearing adult helmets has almost no
  protection

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Strengthening care prevents mortality and
disability

• Optimizing pre-hospital and emergency trauma care
  response
• Training personnel
• Providing proper equipment and enhancing their
  their utilization
• Rehabilitation services to the survivors of trauma

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World Report on Road Traffic Injury Prevention

• WHO World Bank collaboration
• 18 months in the making
• Over 100 experts from 40 countries
• Health, transport, education, police, social
  science etc
• Governmental and nongovernmental
• 2 documents
• Full report for practitioners, researchers, etc
• 40 page summary for policy-makers

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World Report on Road Traffic Injury Prevention

• 5 chapters
• Fundamentals
• Epidemiology
• Risk factors
• Interventions
• Recommendations

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Recommendations

• Identify a lead agency in government to guide the
  national road traffic safety effort.
• Assess the problem, policies and institutional
  settings.
• Prepare a national road safety strategy and plan
  of action.

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Recommendations

• Allocate financial and human resources to address
  the problem.
• Implement specific actions to prevention road
  traffic crashes, minimize injuries and their
  consequences and evaluate the impact of these
  actions.
• Support the development of national capacity and
  international cooperation.

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Follow up events Global and Regional
Regional Consultation New Delhi, 5 7 May 2004
UN General Assembly New York, April 2004
Regional Committee, Male, Sep 2004
World Health Assembly Geneva, May 2004
Good Practices on Road Safety, Oct 2004
7th World Conference on Injury Prevention and
Safety Promotion Vienna, June 2004
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