Road, Safety and Health – Is there a

disconnect ?Dr. N Girish, Additional Professor of Epidemiology, NIMHANS

Dr N Girish,

Additional Professor of Epidemiology,

Centre for Public Health,

NIMHANS, Bangalore – 560 029

Roads

Critical infrastructure in a nation’s development

‘Not just roads but safe roads’

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RTI Deaths

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RTIs

Road deaths in 10 states 2000-2011

Uttar Pradesh

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Road deaths in 10 states 2000-2011

Road Deaths in Indian cities, 2000-2011

Lucknow

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Road Deaths in Indian cities, 2000-2011

Road Injuries - Both sexes -

India

Measurement 1990 2010

Deaths 11 8

Years Life Lost 15 9

DALYs 13 8

All ages

15 – 49 yrs (males)

Measurement 1990 2010

Deaths 5 (2) 2 (1)

Years Life Lost 4 (2) 2 (1)

DALYs 4 (2) 2 (1)

Indicator Name 80 90 95 00 05 09

Motor vehicles (per 1,000 people)

14 18

Passenger cars (per 1,000 people)

9 12

Mobile cellular

subscriptions (per 100 people)

0 0 <0.

01

0.3 7.9 43

Telephone lines (00,000)

21 51 120 324 502 371

NCAER, 2005 (projected

demand)

NCAER, 2005 (/1000 HHs)

Health expenditure per capita(current US$)

0.0

10.0

20.0

30.0

40.0

50.0

60.0

1995 2000 2005 2010

16.520.7

30.0

54.2

Health and Road Traffic Injuries

Health Sector bears the brunt

Provision of care and rehabilitation

For prevention, management and rehabilitation, we need evidenceNumber of deaths

Number of hospitalizations

Number disabled

Socio economic impact

Causes

Who ? / Why ? / Where ? / How ?

Road user categories (%)

Place of Death

Injury Deaths in Rural areas RTI Deaths in Bengaluru

During

transpor

t to

hospital ,

11.00%

At crash

site ,

38.00%

In the

hospital ,

51.00%

City / Municipal roads , 56

Highway , 27

Inner Roads, 15

Rural Roads, 2

Others , 1

Place of Road Deaths (%) in

Bengaluru, 2009

Distribution of Fatal RTIs along with

the speed limits of the areas

Bengaluru Injury Pyramid

Deaths (1)

Serious Injuries (20)

Minor Injuries (50)

5000

1,00,000

2,50,0000

Comparison of the distribution of nonfatal

injuries in urban and rural areas, 2009

Urban Rural

Others,

2.70%

Fall,

17.30%

Road

traffic

injury,

62.70%

Assault,

7.40%

Poisoning

, 4.20%

Animal

bites, 4%

Fall of

object,

1.80%

Poisoning,

12.00%

Burns,

2.20%

Animal

bites,

4.70%

Road traffic

injury,

51.50%

Fall of

object,

2.00%

Others,

3.20% Fall, 5.00%

Assault,

19.40%

Colliding Vehicle with Pedestrians

Fatal RTIs Bangalore (Police) Non-Fatal RTIs Bangalore (Hospital)

bus, 20

lorry, 14

auto, 6

2 wheeler,

24

unknown

vehicle, 2

van, 8

Others, 3

car, 24Car ,

12.90%

2 wheeler

, 46.60%

Autoriksha

w , 10.00%

4 Wheeler ,

7.10% Cycle ,

0.60%Unknown ,

7.20%

Tractor ,

1.10%

Bus , 7.20%

Truck ,

4.20%

Van , 2.40%

Jeep ,

0.70%

Helmet use among two wheeler riders : results of an

observational study (%)

Full face, 55.6

Half face helmet, 11.5

Half head helmet, 32.9

Road crossing behavior : Results of

observational study (%)

Crossing at the right time, 43.1

Crossing during red light, 33.9

Did not cross during green

light, 6.2

Crossing at all locations, 16.8

Public perception study on

drinking and driving -

conclusions Drinking and driving is a huge problem

47% of the surveyed alcohol users drove a vehicle under the influence of alcohol

Nearly one fifth (18.5%) sustained or was involved in a RTI / crash

Majority of the alcohol users (78%) suffered the consequence of drinking and driving (injury or hospitalization)

Alcohol users are twice at risk to be involved in an accident with another alcohol user.

Greater numbers (78% alcohol users and 60% non users) frequently travelled with a person under the influence of alcohol

Two-thirds were uninformed about the hazards and risks associated with drinking and driving

Drinking and driving is hazardous One-third had ignored all traffic rules

Two-third acknowledged that their ability to drive has reduced.

Public perception study on drinking

and driving – conclusions (contd)

Driving under the influence of alcohol poses several risks 38% were on a two wheeler

42% had to travel more than 5 kms

Greater incidence during weekends

Drinking and driving is a neglected offence Only 2% were caught and of which less than 5% paid

penalty

9 out of 10 did not know what the penalty was

95% opined that they would not be caught by the police

Less than 1% knew the permissible Blood alcohol concentration

Alcohol consumption in Fatal and Non

fatal injuries in Bangalore

No,

73.3

Yes, 7

Not

Known

, 19.7

No,

62.2

Yes,

19.7

Not

Known

, 13.3

FatalNon fatal

0

5

10

15

20

25

30

35

1994 2000 2002 2005 2010

Trend of Drink driving cases

booked by the Bangalore City

police

0

20000

40000

60000

80000

2005 2006 2007 2008 2009 2010

Drink Driving

Alcohol presence in road

crashes in Bangalore

Alcohol -

ve, 92

Alcohol

+ve, 8

Persons driving under the

influence of alcohol: Results

from an observational study

(%)

Alcohol presence in Injury

cases ( Men, 16 +

yrs, night time crashes)

Alcohol

+ve, 42.8

Alcohol -

ve, 57.2In 39 police stations, 6202 vehicle

stopped and checked for Alcohol

Workplace Alcohol Prevention Programme

Reduced drinking

Improved work performance

Improved health

Reduced loans

Satisfied family

Road Safety: a public health

approach

Define the problem

Identify risk and

protective factors

Develop and test prevention strategies

Adopt and monitor implementation

Vulnerable Road

Users

Vulnerability

What works for control of RTIs

Enforcement of helmet – drink drive – seat belt – speed control

laws.

Engineering for pedestrian safety in terms of footpaths, crossing places

, speed control mechanisms

Increasing visibility

Education to support enforcement and engineering

Emergency and trauma care strengthening

Strengthening public transportation

Improved vehicle safety

Need for a lead regulatory agency

Capacity building of all concerned agencies and departments

Responsibility, Leadership, Coordination – Who?

The big

disconnect

Than

kyou