Road traffic accidents: It's not just happen, it's caused

What is a road traffic accident (RTA)?

Any injury due to crashes originating from, terminating with, or involving a vehicle partially or fully on a public road.

What is the problem statement?

According to WHO, around 1.35 million people die each year as a result of road traffic crashes in the world. 

• More than half of all road traffic deaths are among pedestrians, cyclists, and motorcyclists. 
• 93% of the world's fatalities on the roads occur in low- and middle-income countries, even though these countries have approximately 60% of the world's vehicles. 
• Road traffic injuries are the leading cause of death for children and young adults aged 5-29 years. 
• Around 1.54 lake people die annually in India (NCRB-2019) in road traffic accidents.

What are the causes of RTA?

• Rapid urbanization
• Motorization
• Lack of appropriate road engineering
• Poor awareness levels
• Nonexistent injury prevention programs, and 
• Poor enforcement of traffic laws has exacerbated the situation.

Who are at risk?

• People with low socioeconomic status: Around 90% of road traffic deaths occur in low- and middle-income countries highest in the African region. Even within high-income countries, people from lower socioeconomic backgrounds are more likely to be involved in road traffic crashes.
• Younger age:  Children and young adults aged 5-29 years are more vulnerable
• Male sex: Males are more likely to be involved in road traffic crashes than females. 
• People with certain medical conditions: Sudden illness, heart attack, impaired vision, fatigue, etc.
• People with certain psychosocial factors: Lack of experience, risk-taking, impulsiveness, detective judgment, delay in decisions, aggressiveness, poor perception, family dysfunction, Heightened emotional tension, etc.
• People without body protection: Helmets, safety belts, and child restraints. 
• People who drive under the influence of alcohol and other psychoactive substances

What are the risk factors?

Environmental:

• Defective narrow roads
• The defective layout of cross-roads and speed breakers
• Poor lightening
• Lack of familiarity
• Bad weather
• Mixed traffic (slow & fast-moving, pedestrians and animals)
• Traveling in groups
• Inadequate enforcement of existing laws
• Inadequate post-crash care centers

Relating to vehicles:

• Excessive speed-Directly related both to the likelihood of a crash occurring and to the severity of the consequences of the crash.
• Old & poorly maintained vehicles- Safe vehicles play a critical role in averting crashes and reducing the likelihood of serious injury.
• The large number of 2 or 3 wheelers
• Overloaded vehicles
• Low driving standards
• Distracted driving: Drivers using mobile phones are approximately 4 times more likely to be involved in a crash.
• Use of stolen vehicles

What should be done to reduce RTA?

Accidents don't just happen; they are caused and it can be prevented. Governments need to take action in a holistic manner which requires involvement from multiple sectors such as transport, police, health, education, and actions that address the safety of roads, vehicles, and road users. 

• Data collection: All accidents should be reported and investigated properly to know the risk factors, circumstances & chain of events leading to accidents.
• Road safety education: It should begin from the school children & all drivers should be trained in safe driving & proper maintenance of vehicles. 
• Promotion of safety measures: Seat belts, safety helmets, door locks, proper vehicle design, use of laminated high-penetration resistance windscreen glass, etc.
• Avoidance of alcohol & other drugs: As it impairs the driving ability & increases the risk of RTA. Strict laws should be enforced.
• Designing safer infrastructure: Incorporating road safety features into land-use and transport planning for all types of vehicles with taking pedestrians into consideration.
• Improving post-crash care for victims: Planning, organization & management of trauma treatment and emergency care services at every hospital or PHC.
• Setting and enforcing laws: To eliminate related to key risks & causative factors like improvement of roads, the imposition of speed limits, marking of dander points, safety measures, drunken driving, etc.
• Rehabilitation centers: Medical, social & occupational rehabilitation to prevent, reduce, or compensate disability & thereby handicap.
• Accident research/ accidentology: For new & better methods to prevent accidents.

References:

1. https://www.nhp.gov.in/road-traffic-accidents_pg
2. https://www.who.int/news-room/fact-sheets/detail/road-traffic-injuries
3. https://ncrb.gov.in/sites/default/files/Chapter-1A-Traffic-Accidents_2019.pdf
4. Park, K., 2019. Park's Textbook Of Preventive And Social Medicine. 25th ed. Jabalpur: M/s Banarsidas Bhanot Publishers, p.1000.
5. https://www.who.int/health-topics/road-safety#tab=tab_3
6. https://www.who.int/docs/default-source/infographics-pdf/road-safety/10-strategies-for-keeping-kids-safe-on-the-road-en.pdf?sfvrsn=968cba78_2 photo credit
7. https://www.who.int/violence_injury_prevention/road_safety_status/2018/1.35-million.jpg?ua=1 photo credit
8. https://www.who.int/violence_injury_prevention/road_safety_status/2018/1st-cause.jpg?ua=1 photo credit
9. https://www.who.int/violence_injury_prevention/road_safety_status/2018/8th-leading-cause.jpg?ua=1 photo credit
10. https://www.who.int/violence_injury_prevention/road_safety_status/2018/54-percent-deaths.jpg?ua=1 photo credit
11. https://www.who.int/violence_injury_prevention/road_safety_status/2018/Low-income-countries.jpg?ua=1 photo credit