Pr

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Road traffic accidents in Tunisia a man made
disaster
Pr Hassen Ghannem Department of Epidemiology
University Hospital Farhat Hached Sousse,
Tunisia
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• Disaster
• Websters Dictionary defines disaster as
• a baleful or fatal event leading to ruin.
• Family
• Country
• Whats more disastrous for someone than the death
  of a relative following a road traffic accident.

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INTRODUCTION

• Injuries account for 12 of the global burden of
  disease (1, 2)
• Traffic accidents are costing countries between
  1 to 2 of their gross national product
• Traffic accidents are a major preventable public
  health problem
• About 1,2 millions persons were killed and 50
  millions were injured, worldwide, in 2002.

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DESCRIPTIVE EPIDEMIOLOGY

Figure 2 Road traffic injury mortality rates in
the different regions of the world (1)
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DESCRIPTIVE EPIDEMIOLOGY

• Worldwide
• Road traffic injuries mortality rates
• 1,2 millions persons killed every year
• 3242 persons killed every day
• Traffic accidents 11th cause of death
• Developing countries
• - 2/3 of the world population
• - 90 of deaths due to road crashes

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DESCRIPTIVE EPIDEMIOLOGY

• Worldwide
• Road traffic injury mortality rates
• Increase in the mortality rates of 10
  between 1990 and 2002 (1)
• Differences between developped and
  developing countries

Figure 3 Changes in road crashes mortality
rates according to countries (1)
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DESCRIPTIVE EPIDEMIOLOGY

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  In Tunisia
• During the period 1996-1998 (3)
• - 32 197 accidents, with 14,9 deaths
  per 100 accidents
• - an average traffic accidents
  incidence
• 116,3 / 100 000 inhabitants / year
• - an average mortality rate
• 14,2 deaths / 100 000 inhabitants /
  year
• - 5,9 persons killed per 100 humans
  implied
• - the average age of the persons who
  were implied in the accidents 33,6
  years
• - About 61,7 of drivers were aged
  20-40 years
• 21 times more males than females
  among drivers
• - Pedestrians were the most vulnerable
  and the most severely injured.

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RISK FACTORS

• The risk depends on four elements
• A)   Exposure excess (need to travel)
• B)   Risk of crash, given a particular exposure,
• C)   Risk of injury, given a crash,
• D)   Risk of death or severe consequences,
  given an injury.

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PREVENTION

•  
• Taffic accidents are preventable.
• The three targets of the road safety actions
• - the road users
• - the vehicles
• - the roads infrastructure as well as the
  traffic management.
•  

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PREVENTION

• A- A scientific approach to the issue is
  necessary
• Many conditions are required to guarantee
  the efficiency of the prevention strategies which
  are adopted. 
• To collect, analyse and carefully interpret
  reliable data   The National Traffic
  Observatory in Tunisia was established to fulfill
  theses missions.
• To define objectives.
• To promote research, which subjects are
  concerned with road safety.
• To encourage the cooperation between different
  organizations intervening in traffic accidents
  prevention (NETWORKING).

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• B-
• The key
• organizations
• intervening in
• the prevention
• strategies

Figure 7 Organizations intervening in road
safety actions(1)
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• C- Prevention measures
• Prevention strategies are made of interventions
  which are aiming to
• diminish the exposure risk.
• avoid road crashes, given a particular exposure.
• reduce the severity of injuries caused by
  crashes
• improve the medical care for victims.

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• Measures avoiding road crashes, given an
  exposure
• Speed limitation
• Measures against  alcohol and driving 
• Measures avoiding the drivers fatigue 
• Measures ensuring pedestrian and cyclists safety
• Prevention of traffic accidents implying young
  drivers
• The prohibition of the use of hand-held mobile
  telephones while driving
• More road visibility

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• Measures reducing the severity of injuries
  caused by crashes 
• a The use of seat-belts 
• When used, the seat-belt reduce the risk of fatal
  or severe accident, between 40 and 65 (1).
• Making the wearing of safety belts compulsory
  improves their use rates.
• b- Use of helmets 
• c- Availability of air bags

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• Actions improving post-crash injury outcome 
• - pre-hospital mesures
• Bystanders  call for help, carry out simple
  acts to rescue victims, protect victims from an
  other accident
• Larger access to emergency services
• Better pre-hospital medical care
• - actions in the hospital 
•  

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CONCLUSION

• Traffic accidents constitute a huge public
  health problem a man made disaster.
• The situation is going to be worse unless
  prevention strategies are adopted.
• There is a hope to avoid such losses of
  lives, of health and of money by setting road
  safety actions.
• A scientific approach to the issue is
  essential in every country, so that road safety
  policies could be founded on reliable data, and
  meeting financial resources of each region.

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REFERENCES

• 1- World report on road traffic injury
  prevention.
• Geneva (Switzerland), World health
  organization, 2004.
• (http/www.who.int/violence_injury_prevention
  )
• 2- Bovet B. Health transition and emerging
  cardiovascular disease in developing countries 
• situation and strategies for prevention,
  Super course.
• 3- Henchir N. Epidemiology of traffic accidents
  in Tunisia thesis. Sousse  Medicine
• Faculty of Sousse 2001.

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THANK YOU