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ACCIDENTS
Dr Beeson Thomas
20/03/2020
VI &VII Semester
Specific LearningObjectives
• At the end of session, the learner shall be able
to describe:
Types of ACCIDENTS
Risk factors of ACCIDENTS
Prevention of ACCIDENTS
Haddon matrix
CONTENTS
Types ,Risk factors and Prevention of ROAD
TRAFFIC ACCIDENTS
• 2 Domestic Accidents:
– Drowning
– Burns
– Falls
• Industrial Accidents
• Railway accidents
DEFINITIONS
• ACCIDENT
• Unexpected, unplanned occurrence of an event which
may involve injury.
• In 1956 WHO advisory group defined accidents as
– Unpremeditated event resulting in recognizable damage.
• Occurrence in a sequence of events which usually
produce unintended injury, death or property damage.
DEFINITIONS
INJURY
•A bodily lesion due to acute exposure to energy beyond the physiological tolerance.•Accidents are the part of prize we are paying for technological advances.
•Like other diseases accidents are also having –
• Natural history of disease and
• Agent, Host and Environmental factors
Epidemiology of
Injuries
Injury as a disease
Host AgentPathologic condition
Malaria Human
Vector
/vehicle
Mosquito
Inter-action
Bite
Skull fracture
Human
Plasmodium
vivax
Mechanical Energy
Motorcycle Crash
Leading contributor in global
diseases
• 1990
• 1.Lower Rasp. Infec.
• 2.Diarrhoea
• 3.Prenatal condition
• 4.Unipolar major depression
• 5.IHD
• 6.Stroke 7.TB /HIV
8. Measles
9. Road traffic Injury
10. Congenital
2020
1. IHD
2. Major Depression
3. Road Traffic Injury
4. .Stroke
5. COPD
6. Lower Resp. Inf.
7. TB
• 8.Perinatal condition
• 9.Diarrhea Diseases
• 10.HIV
How to Measure the Problem of Accident
Mortality:•Proportionate Mortality Rate
–Number of deaths due to accidents out of 100 total deaths
•Number of deaths per million population–Killed in Road Traffic Accident (RTA) is defined as
any person who was killed outright or who died within 30 days as a result of accident.
•Death Rate per 1000 registered vehicles per year•Number of accidents or fatalities as a ratio of number of vehicles per km OR passenger per km.
• Morbidity:
–Measured in terms of
• Slight injury and
• Serious injury
• Disability:
–Disability is one of the important outcome of accidents
• Temporary or Permanent disability
• Partial or Total disability
Problem statementWorld:•Accidents are endemic all over the world•Accidents are major cause of deaths in the age-group of 10-24 yrsIn developed countries -•57% of male death and•43% of female death in 10-24 yrs are due to accidents.•RTA and drowning are the main causes of death in that age-group.
In SEAR:
•Out of total 5.1 million accident deaths in the world 1/4th
in SEAR.
•So thousands of children saved from Nutritional and infectious disease are killed by accidents.
India:
•
• Increasing trends in India due to
– Mechanization in agriculture and industries
–Increase in vehicular traffic
Plus factors like
– Overcrowding
– Lack of awareness and
– Poor implementation of safety precautions
Types of accidents
• Road Traffic Accidents (RTA)
• Domestic accidents
– Drowning
– Burns
– Falls
• Industrial Accidents
• Railway accidents
• Violence
RiskFactors1. Speed:
likelihood of a crash occurring and to the severity of the
consequences of the crash.
2. Drink–driving:
risk of a crash and the likelihood that death or serious injury.
3. Motorcycle helmets:
reduces the risk of death by 40% and of severe injury by 70%.
4. Seat‐belts and child restraints:
reduces the risk of a fatality among front‐seat passengers by 40–
50% and of rear‐seat passengers by 25–75%.
5. Distracted driving:
Drivers using a mobile phone are 4 times more likely to be
involved in a crash.
Causes of accidents
• Accidents are complex phenomena with multiple causation
• Etiological factors are classified to
– Human
– Environmental
– Psychosocial factors
• Age
• Sex
• Education
• Psychological
factor
• Lack of body
protection
• Relating to road
• Relating to
vehicle
• Bad weather
• Mix traffic
Increase
vulnerability and
risk situation
Precipitating factor
ACCIDENT
Human factor Environmental factor
Human factor• Age:15-44 yrs(50% mortality)
• Sex: More in males
• Education: Low educational status
• Medical condition
• Sudden illness
• Heart attack
• Impaired vision
• Fatigue
• Lack of protection
– Helmet
– Safety belts
Psychosocial• Lack of experience
• Risk taking behavior
• Impulsiveness
• Defective judgment
• Delay in decision
• Aggressiveness
• Poor perception
• Family dysfunction
Environmental•
Related to Roads:
– Defective and narrow roads
– Defective lay out of cross-roads,
– speed breakers
– Poor lighting
Environmental• Related to Vehicles:
– High speed
– Poorly maintained vehicles
– Large number of 2-3 wheelers
– Overloaded bus
– Low driving standards
•
Bad Weather
inadequate laws
Mixed Traffic–Pedestrian–Animals and vehicles
Precipitating factors
• Increased emotional tension
• Use of Alcohol during driving
• Stolen vehicle
• Group traveling
Road Traffic Accident
• “Road Safety is No Accident” – was the slogan given by WHO for World Health Day – 2004.
• 85% of all road accident deaths occur in developing countries and nearly half in the Asia-Pacific region.
• India has one of the largest highway and road networks second only to road network of U.S.
Road safety advertising
How accidents in developing countries differ from developed countries:
• Two wheelers are more involved• Pedestrians are more involved
How accidents in developing countries differ from developed countries:
• Large number of old and poorly maintained vehicles• Overloaded buses
How accidents in developing countries differ from developed countries:
• Disregard towards traffic rules
How accidents in developing countries differ from developed countries:
• Poor road standards
How accidents in developing countries differ from developed countries:
• Unusual behavior of human and animals
• Unusual behavior of car
Domestic accidents• Accidents which takes place in home or in its immediate surrounding, which are
not connected with traffic vehicles or sports.
• Common domestic accidents are-
– Drowning
– Burns by flame,
– hot liquid,
– electricity,
– crackers, chemicals
– Falls
– Injury by sharp objects
– Animal bites.
Drowning
• After immersion in water victim loses consciousness with in 2 min. and
• Irreversible brain damage occurs at 4 – 6 minutes.
Prevention and control of drowning
Availability of life jackets and flotation devices around pools & boats
Supervision of children by adults
Fencing of lakes and ponds
Creation of safety standards for public and private swimming pools
Ensuring availability of weather reports to fishermen and to those working on rivers and seas
Burns
• Factors associated with burns
– Explosion of pressure stove.
– Cooking on open fire
– Use of open fire during winter
– Use of inflammable material
– Method of suicide
Prevention and control of burns
Stable stoves/lamps
Replacement of pressure stoves with wick
and gas stoves
Installation of fire and smoke alarm
Promotion of cold water for first aid and
burns
Poisoning
• Most common agents are –
– Kerosene
– Pesticides
– Household chemicals
– Drugs
• Kerosene poisoning common among children.
Fall
• Large number of hospital visits among
children and young adults for non-fatal
injuries.
• Fall from
– Roof, balcony, stair-case, window are common.
• Among construction workers are common
Prevention and control of falls
•1.Safer playground (Use of mud & sand surfaces instead of
paved ones)
•2.Safer furniture & house designs
•3.Use of grills on windows
•4.Safer design of stairs, balconies and rooftops with railings
and bars
•5.Safer working techniques for construction workers
Industrial accidents
• Approximately 580 million workers in SEAR.
• 60-80% are in small scale units
Prevention and control of industrial accidents
Ensuring the cost effective protection measures
Enforcing safety regulations and standards
Creating awareness among workers
Railway accidents
• In India railway accidents are in increasing trend due to
– Increasing number of trains
– More number of passengers
Violence• Risk factors for violent behavior:
– Exposure to violence and societal acceptability of
violence as a mode to solve the problem
– Availability of lethal weapon at home
– Consumption of alcohol
• Suicide are increasing in SEAR region
– 36/1,00,000 in India
– 22/1,00,000 in Thailand
– 11/1,00,000 in Bangladesh
– 8/1,00,000 in Srilanka
• Common methods of suicide:
– Hanging
– Drowning
• 70% of cases of suicide in 15-35 yrs age
• M:F ratio is 1:13 to 1:3
Prevention of Accidents
• Multi-sectorial approach approach for prevention.
Data collection:
• Reporting system for accidents
• Special surveys for accidents– Risk factors
– Circumstances
– Chain of event
• No effective system of prevention without data collection.
Safety education:
•“Accident is a Disease – Education is its Vaccine”
– Should start from school days
– Drivers trained for vehicle maintenance and safe
driving.
– Education about traffic rules
– Training in First Aid.
Promotion of Safety measures:
– Helmets
– Seatbelts
Leather clothing and boots
Promotion of Safety measures:
Children on back seats
Parking at a suitable place
Low beam headlights
Avoidance of mobile
Door locks
Proper vehicle design
Avoidance of alcohol and drugs
Alcohol and other Drugs:
•Alcohol - 30-50 % of RTA
•Alcohol and drugs like
•Barbiturates,
•Amphetamine must be avoided
Primary care
•Planning, Organization and Management of Trauma treatment
and Emergency care
•Emergency care should begin at the site, continue during the
transport and conclude in the hospital.
•Trauma care hospitals in all major cities
Elimination of Causative Factors:
–Improper roads
–Speed limits
–Marking danger points
–Fire guards
–Use of safety equipments
–Safe storage of drugs, poison and weapon.
Enforcement of Law
oMedical fitness of driver
oAlcohol conc. In blood (80 mg/100 ml limit in India)
oDriving test
oSeat belt wearing
oSpeed limit
Enforcement of Law
Helmets
Vehicle inspection
Periodic examination of drivers
Rehabilitation
– Medical
– Social
– Occupational
Accident Research
HaddonMatrix
Phase Human Vector
(Vehicl
e)
Risk
Environment
Socioecnomi
c
Environment
Pre‐Inju
ry
Alcohol
intoxicati
o n
Instabilit
y in
vehicle
Poorvisibility
of road
hazards
Lack of knowledge
regarding injuryrisks
Injury Not
wearing
seatbelt
Noairbag Tree too
clsoe tothe
road
Lack ofenforcement of
safety belt legislation
Post‐Inju
ry
Elderly,
pre‐existing
medical
conditio
n
Rapidity
of energy
reductio
n
Slow
Emergenc
y medical
response
Lack of funding for
emergencymedical
services and
rehabilitation services
THANK OU
Wish you a safe journey of Life….