ROAD TRAFFIC ACCIDENTS

( MANAGEMENT & PREVENTION)

MANAGEMENT OF ACCIDENTS

 1.Self help & local help:

 First aid measures : dressing for bleeding

 Safe & prompt transportation to nearby health

facility.
 2.Trauma centers:

 Developed in big cities & national highways.

 9th plan – many hospitals strengthened with
facilities for management & trauma care
services.
 A conceptual model for Delhi prepared, which
emphasizes
 On site resuscitation of trauma victims

 Fully equipped ambulance: first aid &

transportation
 Networking of institutions for manpower,
material & communication.
 During 10th plan period:

 Efforts made to strengthen primary, secondary

& tertiary care centers through
 Training of medical & paramedical personnel
 Provision of facilities for transport of patients
 Strengthening of emergency & casualty
services
 Improving referral linkages.
 To a large extent RTA are preventable.
 The epidemic of RTA in India and other
developing countries is still at an early stage &
 we can learn lessons from the developed
countries and from within our own country.
 Both crash and injury rates have significantly
declined in past 20 yrs in high income
countries due to a combination of strategies
 ensuring safer divers,

 safer roads & transportation systems,

 safer vehicles.

 This was aided by the development of the

Haddon matrix.
 The Haddon matrix
Prevention of RTA Human factors Vehicle factors Environmental
factors
Pre-crash Driver experience, Vehicle Transport systems,
fitness to drive, maintenance & road engineering,
driver behavior features( electronic visibility
stability control)
Crash Use of protective Vehicle design for Fixed objects at
equipment impact protection roadside, safely
(helmets, seat belts, barriers
child restraints)
Post-crash Preexisting Entrapment, fire Location, speed of
conditions, emergency
emergency response, access to
response care, trauma care
rehabilitation
 Following this the WHO & World bank advocate
a system of approach to road safety.
 This address traffic system as a whole &
examines the interactions between
 road users,

 road infrastructure, transport systems &

 vehicles to identify effective solutions.

ROAD USERS

 In high income countries,, legislated

interventions that relate yo improving safety in
drivers such as
1. Blood alcohol limits of drivers

2. Licensing & registration systems

3. Lower speeding limits

4. Mandatory restraint & helmet laws have been

tremendously successful in reducing RTA.
Do not mix drinking and driving
BLOOD ALCOHOL LIMITS OF DRIVERS

 The relative risk of RTA is more with increasing

blood alcohol levels for drivers
 also increases risk of fatal crashes for
pedestrians.
 Legal alcohol limits for experienced drivers –
0.05mmol/l.
 For others – zero level.
 Such restrictions are supported by research,
demonstrating reduced crashes up to 4% to
24% .
LICENSING & REGISTRATION SYSTEMS

 This is very essential to road safety

 Recommendations for effective graduated
licensing systems-
Licensing phase Component

Learner phase •Min age at least 16yrs

•Mandated min learner period 6months
to 2yrs
•adult supervision mandatory
Licensing phase Component
Provisional license phase •Min starting age for un superwised driving
at least 16.5yrs
•Passenger restrictions
•Night driving restrictions
•Mandated min provisional license period
Both learner & provisional license phase •Blood alcohol restrictions
•Speed limitations
•Display of license status plates
•Testing regimes as drivers move from one
phase to another
•Removal of discounts that encourage
early licensure
SPEED CONTROL
 Speed affects both the risk of being involved in
the crash and severity of the injuries caused.
 At higher speeds the driver has less time to
respond to a sudden event.
 Finch et al Study showed that increase in
speed of 1km/h is associated with 3% higher
crashes,
 Kloden et al study showed with each 5km/h
increase in above 60kms doubles crash rates.
Speed Thrills - but Kills
 There are number of ways that speed can be
maintained
 Speed enforcement detection devices (ex fixed
or mobile speed cameras)
 Traffic calming (use of physical structures to
reduce speed)
 Speed limiting devices in the vehicles.
DRIVER EDUCATION AND TRAINING

 There are several types of driver education and

training
 School based road safety education

 Pre & post license driver training courses

taught by professional instructors
 One to one driving instruction with professional
instructors provided during learner phase.
Do not endanger young generation
ROAD SAFETY EDUCATION

 Taught at schools as part of normal curricula.

 School based education programs- improve the
pedestrian skills of children &
 to modify the abilities of parents to assess
accurately the skills of their children in crossing
streets.
Riding with out helmet
 SEAT BELT & MOTORCYCLE HELMET
LEGISLATION
 vital aspect of road safety.
 In general seat belt wearing rates are high as
90-99% for front seat occupants in high income
countries,
 where as in low- and middle income countries
the rates are much lower.
 Wearing motor cycle helmet rates- 90% in
countries enforced with helmet legislation
 20% - without the law.
Used proper approved seat belts
Cellular on wheels will be a costly deal
 Some challenges to improve seat belt and
helmet wearing rates in low & middle income
countries
1. cars are fitted with proper front and rear seat
belts.
2. Availability of high quality but affordable
helmets.
DRIVER DISTRACTION

 This can be caused by

 Use of mobile phones (hand held as well as
hands free phones)
 Passengers

 Music

 Other technology such as satellite navigation

systems.
FATIGUE MANAGEMENT

 RTA that are attributed to fatigue or sleepiness

vary, but range from a few percent to more than
one third of all crashes.
 It is a particular issue in road freight industry, a
work environment for which there are many
challenges, including
1. Vast distance
2. Tight delivery schedules
3.Low, unregulated freight rates
4.Penalties for late delivery
5.Extended driving schedules
6.Need to meet deadlines
 This all may affect driving behavior, cause
fatigue, stress, and the use of stimulants in
order to stay awake.
 Interventions used to manage fatigue are
 Social marketing ,

 community education

 Use of legislation mandating the maximum

number of permitted driving hours for
commercial drivers,
ROAD AND TRANSPORT SYSTEMS
 Building road safety into road engineering,
urban design, and transport planning is vital for
reduction in RTA.
 Building high quality, appropriately signposted
roads - a major priority for governments around
the world.
 Implementation of improved engineering
solutions as, safe road side barriers, such as
guardrails, crash cushions, reduces RTA
 Examining traffic mix, developing transport
systems so that fast moving traffic are
separated from slow moving traffic and
vulnerable road users.
 Transport planning includes

 managing exposure to risk, as reduction in

distance traveled is associated with reduction
in crashes.
 Encouraging people to use low risk forms of
transport, priority to higher occupancy vehicles
such as buses, placing limitations on motor
vehicle use.
 Having good road design, appropriate speed
limits for the road type and road engineered for
safety contributes to low crash & injury rates.
Keep safe distance between vehicles ahead of you
VEHICLES

 Improvements in vehicle design over the past

few decades have been credited with saving
thousands of lives.
 Ex- use of electronic stability control results in
reduction in crashes
 seat belts & airbags prevent serious injuries.
 Improvements in the vehicle design to reduce
impact on crash injuries
 Space under the hood giving sufficient
clearance between the hood and the engine
components below to minimize head impacts,
 Laminated windscreens

 Smoother, recessed and softer bumpers

 External airbags
 Improve visibility such as lights and bright
materials, increases visibility of pedestrians &
cyclists
 High mounted brake lights reduces rear end
crashes between 15 to 50%.
THE FUTURE

 Training and continued support, both financial

& intellectual, are vital for developing in country
workforce,
 including policy makers,

 jurisdictional authorities,

 police and

 researchers.
 A global, multi-sectoral, and multidisciplinary
approach as advocated by WHO is urgently
needed to ensure that the epidemic of road
traffic injuries world wide is slowed.
Signals to
other drivers
Overtaking
REFERENCES

 Sunderlal textbook of community medicine ed-

2nd.
 International encyclopedia of public health, vol
5, author- Heggen Hougen.