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….