Traffic Accident Casualties Research Articles

Characteristics of road traffic accident casualties admitted to a tertiary care hospital in Sri Lanka.

The mortality and morbidity of road traffic accidents (RTA) is increasing in the South Asian region, including Sri Lanka. Therefore, the demographic factors, types of vehicles involved, and the severity of injuries sustained in RTA was studied. Age, gender, and details of the incident of all patients admitted to hospital following a RTA, between January 2007 and August 2012, were obtained by interview. Following a medico-legal examination, the type and severity of injuries was categorized as, non-grievous, grievous, endangering life or fatal in the ordinary course of nature. Of the 579 RTA casualties examined, 72% were males, 28% females, and 26% were in the 20-29year age group. There were 44% passengers, 32% drivers, and 20% pedestrians. Of the 440 vehicle occupants, 37% were on motor cycles, 28% in three wheelers, 13% in dual purpose vehicles and 11% in buses. Of the 114 pedestrians, 33% had been struck by motor cycles, 19% by three-wheelers and 17% by dual purpose vehicles. There was at least one soft tissue injury in 84%, whilst 45% had one or more fractures. In 85% of bicycle riders, the injuries were grievous, endangering life or fatal in the ordinary course of nature. A high proportion of young adults sustained grievous injuries due to RTA. Almost two thirds of the casualties resulted from motorcycle or three wheeler accidents. Laws limiting the number of passengers carried, installation of side doors, mandatory use of seat belts in three wheelers, and protective garments for motorcyclists are recommended.

Mobile Accident Notification

Traffic accidents are one of the most important and serious problems, our country encounters. As the percentage of injured and casualties in traffic accidents are huge in numbers, it causes thousands of people injured or dead in a year. In the situation of coming by a traffic accident that we face commonly in daily life, generally people directly use their mobile phones and call the related units. However, as the required, right and adequate information is not given to these related units, the cases may sometimes end with casualties. One of the most important reasons of casualties in car accidents is the wrong, senseless first aids performed to the victims of injuries by surrenders. In this study, the aim is to determine the exact location of the accident with its latitude and longitude that is determined automatically via the application present in the responsive citizen who tries to help the victims of the accident. With this system named as “Mobile Accident Notification” the users are aimed to send accident notification in online or via sending message when there is no internet access with the help of mobile applications that process in Android Operating System. These accident data kept in remote server are monitored on web pages or Android mobile phones. In this thesis, a web-based, open-source accident filtration system was developed and the accidents were provided to be monitored by the authorized people in related units.

Analysis of Road Traffic Accident Costs in Sudan Using the Human Capital Method

In this study, we used the Human Capital (HC) accident analysis method, to determine the road traffic accident costs in Sudan in two successive years (2010 and 2011) with slight modifications to the recommended and known framework in the way it handles currently and future accident cost components. We evaluated and compared the significance and impact of the economic loss caused by road traffic accidents in Sudan using detailed information on road traffic accident casualties, classified by severity level, vehicle type, and other key parameters such as discount rates and medical and insurance information for Sudan in its entirety. The total cost of road traffic accidents in Sudan in 2010 was estimated at US $391 million, which represents 0.57% of the Gross Domestic Product (GDP), while in 2011 the cost was calculated to reach US $413 million, representing 0.62% of GDP. Findings show that the amount of accident costs is estimated to a certain extent at less than 1% of the total GDP of the country in the two estimation years, but we believe that the evaluation process used fulfilled the eligibility criteria of HC studies and that the produced values for Sudan are valid and reliable. Unit costs for each crash severity level were also estimated in the two years such as death, disability, serious injury, slight injury, and vehicle damage. Death or fatality was equal to US $38,932 and 39,508; disability was equal to US $43,113 and US $45,165; serious injury was equal to US $6963 and US $7596; slight injury was equal to US $2570 and US $3198 and vehicle damage only was equal to US $2268 and US $2579 in the assessment years 2010 and 2011, respectively.

Treatment Costs of Traffic Accident Casualties in a Third-level Hospital in Iran; a Preliminary Study.

The costs of traffic accidents in low- and middle-income countries are estimated to add up to $65 billion annually, which is a little higher than the amount they receive as a final aid for development. The present retrospective study aims to evaluate the treatment costs of the hospitalized injured individuals in traffic accidents. The present study was carried out in Imam Hossein Hospital, Tehran, Iran. The study population consisted of all the individuals injured in traffic accidents, admitted to the hospital wards. Data were collected by a trained emergency physician. Demographic data, injury mechanism, the type of vehicle, the admission ward of the patient, and treatment costs were collected. 200 patient files were evaluated (males: 89%). The results showed that 54% of the patients were in the 18-40-year age group and collisions between cars and motorcycles were the most frequent accidents (47%). The mean hospitalization cost for each patient was estimated to be $1622.1. Statistical analyses showed that treatment costs in the neurosurgery ward was significantly higher than orthopedic and general surgery (df: 3; F=9.5, P=0.008). The results of the present study showed that the mean cost of each traffic accident victim in Tehran is approximately $1622.1 and these patients sustain significantly higher costs in neurosurgery ward.

Characteristics and Prediction of Traffic Accident Casualties In Sudan Using Statistical Modeling and Artificial Neural Networks

Road traffic accident (RTA) casualties in Sudan are among the major causes of death in the age group of 21 to 60.with 61% fatalities. The fatality rate of 35 per 10,000 vehicles is among the highest in the world despite the low car ownership of 1 vehicle to 100 persons. This paper presents accident characteristics and considers road safety management. Crucial issues discussed in the paper include prediction and safety measures. The paper applies Artificial Neural Network (ANN) and regression techniques to comparatively predict traffic accident casualties. Both approaches modeled accident casualties using historical data on population, number of registered cars and other related factors from 1991 to 2009. Comparison of predictions with recorded data was very favorable. Predictions during 2010 - 2014 were determined using projected values for the same predictor variables. ANN forecasts provided the best fit for the data with a maximum difference of 1.84% between predictions and observed data. The study demonstrated that ANNs provide a powerful tool for analysis and prediction of accident casualties. The major causes of accidents were attributed to driver behaviour, vehicle fleet and conditions, road network defects, speed-limit violation, negligence of seat-belt usage and lack of traffic-law enforcement.

Assessing the Trends in Road Traffic Accident Casualties on Nigerian Roads

The paper assesses the trend of road traffic accident casualties on Nigerian roads. In spite of efforts by law enforcement agencies to curb the carnage on Nigerian roads, traffic safety still remains a crucial issue in the country. The study used data on number of casualties from road traffic accidents in Nigeria for the period 1975 - 2009. These were obtained from records of the Nigerian Police, Federal Road Safety Commission and Na tional Bureau of Statistics. The data were analysed using the Statistical Package for the Social Sciences ( SPSS) and Regression models were developed for predicting death and injuries on Nigerian roads. The study showed that the establishment of the Federal Road Safety Commission in the country has had positive impact on the ra te of casualties from road traffic accidents in the country. In order to reduce deaths and injuries from r oad traffic accidents in Nigeria, the study recommends that law enforcement, education and research funding shou ld be the focus of government in the country.

교통안전을 고려한 도심형 중앙분리대 설치기준 마련에 관한 연구

The Government is implementing the safety measures for pedestrian in living zone to decrease the traffic accident casualties in half. It is urgently to study the guideline because it contains to make the guideline of a median strip in City to prevent the violation of central line and jaywalking on the main contents. So, this study analyzed the pedestrian accidents and the violation of central line, and studied the type of a median strip, the installation guideline through studying the minimum crossing. Consequently, this study found out that a median strip which revised the attention inducement stick to decrease jaywalking could not have the strong prevention function of a crash barrier, so if it happens separation after the collision between vehicles, it induced the secondary accidents, and could take negative effects on traffic safety. In consideration of driving safety, this study analyzed that if it installs a median stirp, it has to ensure one meter, and such a thing could prevent the separation of lane or damage of facilities. However, if it is hard to ensure the space because of narrow road width, it could install a median strip in case of installing the road surface mark 0.5m. And the installation of the attention inducement stick or a median strip on the central line could be possible to induce the violation of central line, thus it is desirable not to install only anythings but also raised pavement markers.

Prehospital Trauma System Reduces Mortality in Severe Trauma: A Controlled Study of Road Traffic Casualties in Iraq

In low-resource communities with long prehospital transport times, most trauma deaths occur outside the hospital. Previous studies from Iraq demonstrate that a two-tier network of rural paramedics with village-based first helpers reduces mortality in land mine and war-injured from 40% to 10%. However, these studies of prehospital trauma care in low-income countries have been conducted with historical controls, thus the results may be unreliable due to differences in study contexts. The aim of this study was to use a controlled study design to examine the effect of a two-tier prehospital rural trauma system on road traffic accident trauma mortality. A single referral surgical hospital was the endpoint in a single-blinded, non-randomized cohort study. The catchment areas consisted of some districts with no formal Emergency Medical Services (EMS) system, and other districts where 95 health center paramedics had been trained and equipped to provide advanced life support, and 5,000 laypersons had been trained to give on-site first aid. The hospital staff registered trauma mortality and on-admission physiological severity blindly. Assuming that prehospital care would have no significant impact on mortality in moderate injuries, only road traffic accident (RTA) casualties with an Injury Severity Score (ISS)≥9 were selected for study. During a three-month study period, 205 patients were selected for study (128 in the treatment group and 77 in the control group). The mean prehospital transit time was approximately two hours. The two groups were comparable with regards to demographic characteristics, distribution of wounds and injuries, and mean anatomical severity. The mortality rate was eight percent in the treatment group, compared to 44% in the control group (95% CI, 25%-48%). Adjusted for severity differences between the treatment and control groups, prehospital care was a significant contributor to survival. Where prehospital transport time is long, a two-tier prehospital system of trained paramedics and layperson first responders reduces trauma mortality in severe RTA injuries. The findings may be valid for civilian Emergency Medical Services interventions in other low-resource countries.

Predictive factors of chronic post-traumatic stress disorder 6 months after a road traffic accident

Background This study sets out to identify risk factors for post-traumatic stress disorder (PTSD) after a road traffic accident with a view to improving prevention. Methods The study used a prospective cohort of road traffic accident casualties. All subjects over 15 years of age were recruited in the course of an interview conducted while they were receiving care in a hospital of the Rhône area administrative département. Six months after their accident, they answered a self-administered postal questionnaire that included the Post-traumatic Check-List Scale (PCLS) in order to evaluate PTSD. Multivariate logistic regression analysis was conducted to compare those subjects with a PCLS score of 44 or over with those with a lower score, in order to identify factors that might be associated with PTSD. Results 592 subjects (out of 1168) returned the 6-month questionnaire and 541 completed the PCLS test. One hundred subjects had a PCLS score ≥44, suggesting PTSD, and 441 subjects did not. The factors associated with PTSD were initial injury severity, post-traumatic amnesia, the feeling of not being responsible for their accident and persistent pain 6 months after it. A lower odds-ratio was associated with users of two-wheel than four-wheel motor vehicles (OR = 0.4; 0.2–0.9). Conclusion Besides predictive factors for PTSD (injury severity, post-traumatic amnesia and the feeling of not being responsible for their accident), our study suggested a reduced risk of PTSD among two-wheel motor vehicle users.

Alcohol and anaesthesia

Two-thirds of adults in England drink alcohol on a weekly basis, and 30% drink more than the recommended daily level. Among children, 46% of 15 yr olds and 3% of 11 yr olds admit to drinking periodically. Alcohol misuse is estimated to cost the NHS £3 billion per year. Alcohol-related disease was the primary or secondary diagnosis for over 180 000 NHS hospital admissions in 2004/2005. This includes a doubling in the number of admissions for alcoholic liver disease over the past 10 yr. Casualties in road traffic accidents involving a driver over the legal limit for alcohol numbered 17 000 in 2004, representing 6% of the total and including 590 fatalities. Twelve per cent of A&E attendances are for alcohol-related problems, and 22% of attendees have recently consumed alcohol. Risk of injury is greatest with episodic, heavy drinking, a pattern that is increasing in Britain. The high prevalence of alcohol-related disease means that the anaesthetist will frequently encounter such patients and must consider both the acute and chronic effects of alcohol consumption.

2105 現実感のあるドライビングシミュレータの開発と応用(OS6-1 シミュレータ・ソフトウエアの開発,OS6 ヒューマンファクタ,オーガナイズド・セッション)

Active safety systems are being developed with the aim of helping to reduce the number of traffic accident casualties to zero, but the creation of more effective systems requires analysis of driving behavior and verification of the effectiveness of accident prevention technologies. For this reason, a driving simulator (DS) has been developed that reproduces realistic scenarios of Japanese city streets where accidents are prevalent. The DS consists of a mock vehicle, a turntable inside a dome, a 6-degree-of-freedom (DOF) hexapod system, shakers (vehicle vertical vibration actuators), and a translational motion system capable of moving 35 meters longitudinally and 20 meters laterally. The system is also capable of projecting images of actual city streets and highways onto a 360° spherical screen. As a result, it can reproduce a driving environment that is virtually the same as the real traffic.

Road Casualties and Enforcement: Distributional Assumptions of Serially Correlated Count Data

Objective. Road safety data are often in the form of counts and usually temporally correlated. The objective of this research is to investigate the distributional assumptions of road safety data in the presence of temporal correlation. Methods. Using the generalized linear model framework, four distributional assumptions are considered: normal, Poisson, quasi-Poisson and negative binomial, and appropriate models are estimated. Monthly casualty and police enforcement data from Greece for a period of six years (January 1998–December 2003) have been used. The developed models include sinusoidal latent terms to capture the temporal serial correlation of observations. Several statistical goodness-of-fit diagnostic tests have been performed for the results of the estimated models, and the predictive capabilities of the models are investigated. Results. The residuals of the quasi-Poisson and negative binomial models do not show any serial correlation. The signs of the estimated coefficients for all models are consistent and intuitive. In particular, a negative coefficient value for the number of breath alcohol controls indicates that the number of persons killed and seriously injured decreases as the intensity of breath alcohol controls increases. The Poisson model fails to capture the overdispersion in the data, thus underestimating the standard errors of the estimated coefficients. Conclusion. The results suggest that the quasi-Poisson and negative binomial outperform the normal and Poisson models in this application. The findings of this research demonstrate a clear link between the intensification of police enforcement and the reduction of traffic accident casualties. In particular, an increase in the number of breath alcohol controls in Greece after 1998 contributed to a reduction in the number of persons killed and seriously injured from traffic accidents.

Management of the Mass Casualties of Traffic Accidents in the City

Management of the Mass Casualties of Traffic Accidents in the City

Analysis of agreement between coding of underlying cause of death by traffic accidents

An evaluation of information researched as to basic underlying cause of death by traffic accidents and a comparison with codings attributed on the basis of death certificates. The official coding of underlying cause of death on Death Certificates was compared with coding based on primary data obtained from five hospitals and accident reports. Kappa statistics with 95% CI were used to assess the agreement between the two coding systems. The research covered 1,719 patients. 57 of whom died. Of these 57 deaths, the official coding for 50 was obtained. Data showed an underreporting of deaths by traffic accidents, since 32% of the 50 deaths were coded as non-specific accidents (E928.9) There were also 38% of deaths coded as non-specific traffic accidents (E 819.9). Using primary data, non-specific traffic accidents dropped to 4%, accidents to pedestrians (E814.7) being responsible for 48% of deaths. The Kappa coefficient (0.124), with 95% confidence interval (-.1533-0.4022) was calculated to assess the inter-rater reliability between the two codings, which was considered poor. It is concluded that coroners, who perform autopsies on casualties of traffic accidents, should dedicabe greater effort to filling out Death Certificates correctly.

An investigation into the effects of British Summer Time on road traffic accident casualties in Cheshire.

To assess the effect of British Summer Time (BST) on road traffic accident casualties and to analyse whether the introduction of year round BST would result in reductions in casualty numbers. A comparative study of road traffic accident data from before and after the onset of BST. The county of Cheshire. Data from a total of 4185 casualties from the period 1983 to 1993. The effect of BST on both vehicle, cycle, and pedestrian casualties and casualties among schoolchildren. The onset of BST in spring was associated with reductions in casualty numbers of 6% in the morning and 11% in the evening. The anticipated rise in casualties with the darker mornings was not seen and as reductions were maximal in the pedestrian (36%), cyclist (11%), and schoolchild (24%) subgroups they were presumed to be due to an altered reliance on vehicular transport. The change back to Greenwich Mean Time (GMT) in autumn produced an anticipated reduction (6%) in casualties in the lighter mornings. The darker evenings, as predicted, were associated with significant increases in casualties (4%), mainly vehicle (5%) and pedestrian (8%) casualties. There was an overall net reduction in casualty numbers when the analysed periods of BST were compared to those during GMT. The use of BST in Cheshire over the period studied was associated with reductions in casualty figures. The application of these results nationally may be expected to produce more and less pronounced changes the further north or south, respectively, the area studied. The introduction of year-long BST would result in beneficial effects on road traffic accident casualties.

The real number of road traffic accident casualties in the Netherlands: A year-long survey

Between August 1986 and July 1987 more than 24,000 households, containing nearly 67,000 persons, were surveyed by telephone about traffic injuries during the past three months. Expressed on an annual basis, approximately 430,000 people, or about 1 in 34 of the Dutch population, had suffered some sort of injury in a road accident. The road traffic morbidity was, therefore, 2,942 per 100,000 inhabitants. Of these, about 135,000 had to be treated in hospital (20,000 as inpatients). More than 100,000 did not need treatment. Cyclists formed by far the largest category of road user, but mopedists had the highest injury rate per kilometer travelled. 210,000 of these casualties fell within the definition for recording by the police. The police recorded only 49,748 traffic casualties, or about 25%, during the same period. The police data were not representative; the completeness declined according to severity of the injuries: inpatients, about 70%; outpatients 26%; extramural about 11%. Cyclists (11%), children (9%), and single vehicle accidents (5%) were very much underrepresented. The largest category of road user is cyclists, not car occupants as indicated by the police data. A number of recommendations are made for supplementing the police data and the existing hospital inpatient data. These include extending the Home Accident Recording System of outpatients and the General Practitioner Panel to include road accident victims. Together a representative sample of 95% of all those receiving medical treatment would thus be obtained.

Effects of subsidising bus travel on the occurrence of road traffic casualties.

Between 1975 and 1 April 1986, public transport by bus in the metropolitan county of South Yorkshire, England, was increasingly subsidised. Trends in road traffic accident casualties between 1974 and 1983 in all the six provincial English metropolitan counties have been compared in order to examine the possible effect of this unique subsidy on the incidence of road traffic accident casualties. During that period the total number of casualties in South Yorkshire did not change significantly compared to the other metropolitan counties. However, the proportion of all casualties in South Yorkshire who were bus occupants did increase relative to other metropolitan counties, indicating either an increase in the amount of bus travel or a decrease in travel by other modes. There was a large increase in bus patronage in South Yorkshire relative to the other metropolitan counties, and the conclusion is that it is the transport policy in South Yorkshire which resulted in an actual increase in distances travelled by bus. Since bus is the safest form of road travel, it is concluded that the public transport subsidy in South Yorkshire has benefited the health of the local population by providing the social amenity of additional travel at the least additional health cost.

Effects of random breath testing on hospital admissions of traffic-accident casualties in the Hunter Health Region.

During the period of six years from 1977 to 1982, the number of admissions of victims of traffic accidents to public hospitals in the Hunter Health Region of New South Wales fell from 2099 to 1734, a decline of 21%. About three-quarters of these patients were male; one-quarter were in the 15-20 year age group. Since the introduction of random breath testing (RBT) in 1982, there has been a further decline in admissions of traffic accident victims to hospitals of nearly 20%, attributable to the introduction of RBT. The initial decline of 30% appears to have stabilized at 20% after 12 months. The decline in admissions occurred in the urban hospitals (31%), and not in the rural hospitals; it was greater among male (31%) than among female (8%) accident victims. In the Hunter region, it is estimated that RBT has resulted in a saving of more than 3000 hospital bed-days in its first year.

The probability of death score: An improvement of the injury severity score

Two large sets of data containing information on the injuries and survival status of traffic accident casualties were used to develop a summary injury score from the Abbreviated Injury Scale (AIS). The summary injury score, dubbed the Probability of Death Score (PODS), was based on a logistic regression model of the two highest AIS codes taken from a 19-category coding scheme. A third large set of trauma data was used to compare the statistical performance of the PODS to that of the Injury Severity Score (ISS). Several measures of predictive accuracy and goodness of fit demonstrated the relative advantage of the PODS over the ISS in characterizing the association between injury and death.

Hyperpigmentation in the long bones of the lower limbs as a basis for vehicle identification and traffic accident reconstruction

Following the earlier studies on the identification of injuries in unbroken cranial bones, the described method was adapted for the examination of the long bones in fatal casualties of traffic accidents. Two types of bumper injuries might occur: the bumper was found to cause fracturing of limbs [1], and femoral muscle contusions and microtraumas within compact and spongiose parts in the femoral with subsequent maculate hyperpigmentation [2]. The authors show that the correlation of above mentioned traces of the trauma, facilitates the reconstruction of the accident and also the identification of the vehicle.