WHO’s World report on Road Traffic Injury Prevention defines a Road Traffic Injury as fatal or non-fatal injuries incurred as a result  of Road Traffic crash.  A Road Traffic crash is defined as a collision or incident that may or may not lead to injury, occurring on a public road and involving at least one moving vehicle.

           Throughout the world, roads are bustling with cars, buses, trucks, motorcycles and other types of two and three wheelers.  India has one of the largest highway and road network second only to road network of U.S.  The total road length exceeds 3 million.  By 2050 – 267 million vehicles will be on Indian roads.  Of the worldwide average of 7,00,000 RTA, 10% is in India.  The latest annual statistics indicate over 80,000 are killed on Indian roads.  3 lakh people sustain injuries every year.  If current trends continue number of people killed and injured on roads will rise > 60% between 2000 and 2020.

            Like any other disease, accidents too are caused by interaction between host and environment.  Human factors include age, (accidents most common between 10-24 years), sex, education, medical conditions (heart attack, impaired vision), fatigue, influence of alcohol and other drugs, lack of bodily protection ( like helmets, seat belts) and psychosocial factors like lack of experience, impulsiveness, aggressiveness, defective judgment and delay in decisions.

            A comprehensive study found human error was sole cause in 57% of accidents.  People driving are bombarded with information.  Mostly visual – road, other vehicles, pedestrians, passing scenery and signs;  auditory – listening to radio, talking on cell phone, carrying on conversation with co-passenger.  Internal – thinking what to make for dinner and so on. 

            Drunken driving is another important risk factor.  Under the influence of alcohol, the driver  & car have the potential for becoming most lethal weapons.  An Indian estimate shows 25% of RTA to be alcohol related.  Alcohol causes poor judgment, slowed reaction time, loss of concentration and impaired vision.

            Environmental factors include condition of roads, defective vehicles, proportion of different types of road users, bad weather and inadequate enforcement of existing laws.

            RTA injuries  can be classified into three – fatal, serious and slight.  Fatal injuries are those where death occurs in < 30 days as a result of crash, not natural causes or suicide.  Serious injury – eg. fractures, internal injury, severe cuts, crushing, concussions requiring hospital treatment, detention in hospital as inpatient and also injuries to casualties who die 30 or more days after crash from injuries sustained in that crash.  Slight injury includes bruises, slight cuts and sprains.

            There are solutions to road safety problems.  They include making road safety rules compulsory in school curricula;  addressing safety and concern of pedestrians and cyclists in road planning & designing;  replacing level crossings with over bridges; provide retro reflective road  signs and thermoplastic road markings.  A Pereuvian Bus Driver quotes, “You can have the most modern bus but if the road is from stone age, it won’t be safe”.  Roads must be designed according to function (as highway / suburban roads);  traffic calming measures such as speed brakes must be used where necessary.  Wearing of helmets must be made compulsory and strict penalties must be handed out for non-use.  Seat belt and child restraint usage must be made compulsory.

            At present permissible level of alcohol in blood during driving is set at 50 mg / 100ml.  Drinking and driving is to be discouraged.  In some countries, hotels, restaurants have a method wherein they encourage diners to appoint one person the designated driver and provide him with free meal.  The others who are not going to drive are allowed to eat and drink as they please.  Random breath analyzer tests must be mandatory on highways.

            The first recorded pedestrian accident was in Britain in 1896.  Mr.Bridget Driscoll, who was killed by car traveling at 4 m/h.  Nearly a century later, WHO estimates show 1.2 million people dying worldwide in RTA.  Recognizing the magnitude of the problem.  April 7, 2004 World Health Day focused on ‘Road Safety’.  A new area of research termed Accidentology, which looks at interaction between vehicles, road users and road infrastructure to identify solutions is now emerging.

Seminar was conducted on January 25^th for CRRI.

Seminar presented by Dr.Pirabu.