Skills Development for Research on Road Traffic Injuries Samath SL.pdf · 2015. 5. 17. ·...
Transcript of Skills Development for Research on Road Traffic Injuries Samath SL.pdf · 2015. 5. 17. ·...
Skills Development for Research on Road Traffic Injuries
Samath D DharmaratneMBBS, MSc, MD
Secretary, Road Traffic Injuries Research Network,Department of Community Medicine, Faculty of Medicine,
University of Peradeniya, SRI LANKA
5th January 2006Plant Genetic Resource Centre,
Gannoruwa, Kandy,Sri Lanka
Global Burden of InjuryGlobal Burden of Injury
Estimated Estimated 5 million people5 million people died from died from
INJURIESINJURIES in 2000 (WHO 2002)in 2000 (WHO 2002)
Accounting for Accounting for 9% of global deaths9% of global deaths
90%90% of the injury deaths occur in of the injury deaths occur in
lowlow-- and middle income countriesand middle income countries
Burden of injury in Sri LankaBurden of injury in Sri Lanka
Injuries are the Injuries are the leading cause of leading cause of
hospital admissions (2000 per hospital admissions (2000 per
100,000 population) (AHB, SL 2002)100,000 population) (AHB, SL 2002)..
Injuries are the 10Injuries are the 10thth leading cause of leading cause of
hospital deaths (AHB, SL 2002).hospital deaths (AHB, SL 2002).
ROAD TRAFFIC INJURIESROAD TRAFFIC INJURIES
Road traffic injuriesRoad traffic injuries are the are the
leading cause of injury related leading cause of injury related
mortality and morbidity in Sri Lanka mortality and morbidity in Sri Lanka
accounting for 25% to 30% of the accounting for 25% to 30% of the
burden (AS, SL 2004).burden (AS, SL 2004).
Global Burden of Global Burden of RTIsRTIs
More than More than 20 million20 million people are injured people are injured
and killed annually from and killed annually from RTIsRTIs (WHO 2004)(WHO 2004)
Burden falls most heavily on Burden falls most heavily on developing developing
countriescountries (particularly Asia), due to the (particularly Asia), due to the
rapid increaserapid increase in the number of vehiclesin the number of vehicles
By 2020, By 2020, 2.3 million will die2.3 million will die
ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES ––Globally Globally –– CostCost
Economic cost estimated as Economic cost estimated as US$ US$
518 billion518 billion annually (TRL 2000)annually (TRL 2000)
Of this Of this 12.5%12.5% or or US $US $ 65 billion65 billion is is
accounted for by the developing accounted for by the developing
countriescountries
Global Burden of Global Burden of RTIsRTIs
Globally, Globally, RTIsRTIs will increase by will increase by over 60%over 60%
•• 80% increase in low and middle 80% increase in low and middle
income countriesincome countries
•• 30% decrease in high income 30% decrease in high income
countriescountries
ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES ––Situation in Sri LankaSituation in Sri Lanka
In the year 2000, In the year 2000, 54,239 54,239 road traffic road traffic
crashes were reported, killing crashes were reported, killing 2,1502,150
people and injuring people and injuring 19,83519,835 (TP data)(TP data)
Daily Daily –– 6 people are killed6 people are killed
Every hourEvery hour –– 2 are injured2 are injured
Every 10 minutesEvery 10 minutes –– a RTC is reporteda RTC is reported
ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES ––Situation in Sri LankaSituation in Sri Lanka
No information about the No information about the
unreported crashes.unreported crashes.
Documented that 25% of Documented that 25% of
fatal fatal RTCsRTCs are not reported are not reported
((WootonWooton J et al 1996).J et al 1996).
Research neededResearch needed
To identify causesTo identify causesTo interest policy makersTo interest policy makersTo plan and implement preventive To plan and implement preventive programsprograms
Skills Development for ResearchSkills Development for Research
Therefore the RTIRN is conducting Therefore the RTIRN is conducting this workshopthis workshop
ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES ––Situation in Sri LankaSituation in Sri Lanka
Majority killed and injured are Majority killed and injured are young young
peoplepeople, between 15, between 15--44 years.44 years.
People needed for the development People needed for the development
programs of the country.programs of the country.
Can SL afford to loose them?Can SL afford to loose them?
ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES ––Situation in Sri LankaSituation in Sri Lanka
About 40% to 50% of the injured and About 40% to 50% of the injured and
killed are killed are pedestrianspedestrians (RHF 2004)(RHF 2004)--
?Poor people?Poor people
Principal wage earner Principal wage earner -- ?Increase in ?Increase in
povertypoverty
RTIsRTIs are a are a SOCIAL PROBLEMSOCIAL PROBLEM
affecting Sri Lankan society.affecting Sri Lankan society.
ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES ––Situation in Sri LankaSituation in Sri Lanka
Economic loss range from Economic loss range from RsRs. 5 billion (5. 5 billion (5thth
MBI 2004) to MBI 2004) to RsRs. 10 billion (US$ = . 10 billion (US$ =
100Rs.).100Rs.).
Estimated loss from a (5Estimated loss from a (5thth MBI 2004),MBI 2004),
•• Fatal crash is Fatal crash is RsRs. 2,000,000. 2,000,000
•• Injury crash is Injury crash is RsRs. 35,000. 35,000
•• Damage only crash is Damage only crash is RsRs. 17,000. 17,000
ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES ––Situation in Sri LankaSituation in Sri Lanka
It was estimated that in 1999, 0.5% It was estimated that in 1999, 0.5%
of the GDP was lost from of the GDP was lost from RTCsRTCs in Sri in Sri
Lanka (5Lanka (5thth MBI 2004) MBI 2004)
In rupees it was,In rupees it was,
5,047,158,5585,047,158,558
ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES –– Situation in Sri LankaSituation in Sri LankaSome statistics related to Some statistics related to RTAsRTAs in Sri in Sri Lanka from 1940Lanka from 1940--1998 (CS data)1998 (CS data)
1940 1998 Increase
Road crashes 3979 50 959 12-fold
Deaths 168 2 023 11-fold
Motor vehicles 30 802 1 511 207 48-fold
Population 5 951 000 17 935 000 3-fold
Roads (km) 10 114 22 457 * 1.2 fold
ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES –– Situation in Sri Situation in Sri LankaLanka
Population growth from 1940 - 2000
02468
101214161820
1940
1945
1950
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
Year
Popu
latio
n in
mill
ions
Population increased by 2 fold
ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES –– Situation in Sri Situation in Sri LankaLanka
Increase in the number of registered motor vehicles (1940 - 2000)
0
200000
400000
600000
800000
1000000
1200000
1400000
1600000
1800000
Year
1943
1947
1951
1955
1959
1963
1967
1971
1975
1979
1983
1987
1991
1995
1999
Year
Num
ber o
f veh
icle
s
Registered motor vehicle increased by 54 fold
ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES –– Situation in Sri Situation in Sri LankaLanka
Road traffic accidents per 100,000 population 1940 - 2000
0
50
100
150
200
250
300
350
1942
1945
1948
1951
1954
1957
1960
1963
1966
1969
1972
1975
1978
1981
1984
1987
1990
1993
1996
1999
Year
RTAs per 100,000 population increased by 3 fold
ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES –– Situation in Sri Situation in Sri LankaLanka
Road traffic injuries per 100,000 population
0
20
40
60
80
100
120
140
1942
1945
1948
1951
1954
1957
1960
1963
1966
1969
1972
1975
1978
1981
1984
1987
1990
1993
1996
1999
Year
Road traffic injuries per 100,000 population increased by 114%
ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES –– Situation in Sri Situation in Sri LankaLanka
Road traffic fatalities per 100,000 population
0
2
4
6
8
10
12
14
1940
1950
1960
1970
1980
1990
2000
Year
Fata
litie
s/10
0,00
0pop
ulat
ion
Road traffic fatalities per 100,000 population increased by 3 fold
ROAD TRAFFIC INJURIES IN SRI LANKA ROAD TRAFFIC INJURIES IN SRI LANKA –– The futureThe future
If no action is taken, in the next 20 If no action is taken, in the next 20 year (Safety 2004),year (Safety 2004),
••50,000 will die50,000 will die••400,000 will be injured400,000 will be injured••More thanMore than
RsRs. 20 x. 20 x 5,047,158,558 5,047,158,558 will be lost will be lost
ROAD TRAFFIC INJURIES IN SRI LANKA ROAD TRAFFIC INJURIES IN SRI LANKA –– The futureThe future
0
5
1 0
1 5
2 0
2 5
1940
1944
1948
1952
1956
1960
1964
1968
1972
1976
1980
1984
1988
1992
1996
2000
2004
2008
2012
2016
2020
Y e a r
Fata
lity
rate
per
100
,000
pop
ulat
ion
O b s e r v e d r a te P r e d ic te d r a te9 5 % C I - lo w e r l im it 9 5 % C I - U L
Projected rate for road fatalities in Sri Lanka
By 2020, RT Fatalities rate will increase by 25% to reach 14.5 fatalities per 100,000 population (Safety 2004)
ROAD TRAFFIC INJURIES IN SRI LANKA ROAD TRAFFIC INJURIES IN SRI LANKA –– The futureThe future
0.0
50.0100.0
150.0
200.0
1940
1947
1954
1961
1968
1975
1982
1989
1996
2003
2010
2017
Year
Inju
red
per 1
00,0
00
popu
latio
n
Observed Projected Low er 95% Upper 95%
By 2020, RTI rate will increase by 16% to reach 174.7 per 100,000 population (ISC 2004)
Projected rate for injured from RTAs in Sri Lanka
Road Traffic Injury Prevention Requires a “Systems Approach”
ROAD USER
ROADSVEHICLE
ROAD TRAFFIC INJURIES IN SRI ROAD TRAFFIC INJURIES IN SRI LANKALANKA
IS AN IMPORTANT DISEASE WHICH IS AN IMPORTANT DISEASE WHICH
HAS ASSUMED EPIDEMIC HAS ASSUMED EPIDEMIC
PROPORTIONSPROPORTIONS
WHY NO ACTION?WHY NO ACTION?
Even though everyday at least one Even though everyday at least one
RTC is reported in mediaRTC is reported in media
ROAD TRAFFIC INJURIES IN SRI ROAD TRAFFIC INJURIES IN SRI LANKALANKA
Dengue, Malaria and TB kills far less Dengue, Malaria and TB kills far less but they have programs and but they have programs and campaigns for their prevention and campaigns for their prevention and control (AHB 2002)control (AHB 2002)Even one death attracts huge media Even one death attracts huge media attentionattentionWHY?WHY?I do not know, but is scary? I or you I do not know, but is scary? I or you might be the next victim.might be the next victim.
ROAD TRAFFIC INJURIES IN SRI ROAD TRAFFIC INJURIES IN SRI LANKALANKA
EpidemicEpidemic
No action or interest by relevant No action or interest by relevant
peoplepeople
Reason for my interest in this Reason for my interest in this
diseasedisease
Road Traffic Injury Prevention can be Achieved
0
5
10
15
20
25
30
35
1960
1962
1964
1966
1968
1970
1972
1974
1976
1978
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
Years
Fata
lity
rate
per
100
000
pop
ulat
ion
UK Australia USA
Road Traffic Injuries are a Public Health Problem
Public Health
Injury Surveillance
Research
Prevention & Control
Evaluation
Policy
Services
Advocacy
HEALTH PROFESSIONALS AND HEALTH PROFESSIONALS AND RTI RESEARCHRTI RESEARCH
Health professionals taking an interest is very important to generate interest among others, especially politicians
Easy accessibility in collecting data• From hospitals, police etc.
ROAD TRAFFIC INJURIES IN SRI ROAD TRAFFIC INJURIES IN SRI LANKA LANKA –– PREVENTION & CONTROLPREVENTION & CONTROLAppoint a DIRECTOR for INJURY Appoint a DIRECTOR for INJURY PREVENTION in the Ministry of PREVENTION in the Ministry of Health Health Form a CAMPAIGN for INJURY Form a CAMPAIGN for INJURY PREVENTIONPREVENTIONEstablish an INJURY SURVEILLANCE Establish an INJURY SURVEILLANCE SYSTEMSYSTEM
ROAD TRAFFIC INJURIES IN SRI ROAD TRAFFIC INJURIES IN SRI LANKA LANKA –– PREVENTION & CONTROLPREVENTION & CONTROL
FORM AN ACTIVE COMMITTEE WITH POWER,FORM AN ACTIVE COMMITTEE WITH POWER,
Consisting of all related people, such as Consisting of all related people, such as
Doctors, Engineers, Police, Policy makers, Doctors, Engineers, Police, Policy makers,
EMVsEMVs, RDA and UDA representatives, drivers , RDA and UDA representatives, drivers
(CTB, PVT bus, TW, School vans) etc.(CTB, PVT bus, TW, School vans) etc.
ROAD TRAFFIC INJURIES CAN BE ROAD TRAFFIC INJURIES CAN BE PREVENTED PREVENTED –– in Sri Lankain Sri Lanka
But, copying strategies directly from But, copying strategies directly from
developed countries might not work.developed countries might not work.
WHY?WHY?
Because the scenario is different.Because the scenario is different.
Need to find local risk factors and solutions Need to find local risk factors and solutions
ROAD TRAFFIC INJURIES CAN BE ROAD TRAFFIC INJURIES CAN BE PREVENTED PREVENTED –– in Sri Lankain Sri Lanka
For which local research is neededFor which local research is needed
For research money is neededFor research money is needed
To get money, people with money To get money, people with money
have to recognize that have to recognize that RTIsRTIs and and
deaths are a significant problemdeaths are a significant problem
VISION AND MISSION OF RTIRNVISION AND MISSION OF RTIRN
To reduce RTI’s in Low & Middle Income Countries
Road Traffic Injuries Research Road Traffic Injuries Research Network (RTIRN)Network (RTIRN)
RTIRN SECRETARIAT IN SRI RTIRN SECRETARIAT IN SRI LANKALANKA
Opportunity for Sri Lanka as well as
regional countries to highlight the
importance of RTIs
VISION AND MISSION OF RTIRN VISION AND MISSION OF RTIRN SECRETRIATSECRETRIAT
To generate knowledge on To generate knowledge on RTIsRTIs
•• At Launch of the SERETARIAT At Launch of the SERETARIAT –– 44thth January 2006January 2006
•• Workshop on Workshop on ““Skills development in RTI researchSkills development in RTI research”” –– 55thth
January 2006January 2006
•• NewsletterNewsletter
•• Increasing membershipIncreasing membership
•• Web siteWeb site
VISION AND MISSION OF RTIRN VISION AND MISSION OF RTIRN SECRETRIATSECRETRIAT
Thereby Thereby generate interest in RTI’samong relevant people to investigate them – researchResearch needs fundsMore people becoming interested will generate more funds which will make more people interested etc.Capacity building
RTIRN SECRETRIATRTIRN SECRETRIAT
Most of the regional countries have Most of the regional countries have people interested in people interested in RTIsRTIsSri Lanka very fewSri Lanka very fewHaving the Secretariat in Sri Lanka Having the Secretariat in Sri Lanka will be a great opportunity for me as will be a great opportunity for me as well as the people of Sri Lanka to well as the people of Sri Lanka to address this forgotten National address this forgotten National TragedyTragedyThank you Thank you
Public Health Emergency and Public Health Emergency and Disaster Management Training Disaster Management Training
CourseCourse
13th December 200513th December 2005
Road Traffic Injuries –Group work
Group oneGroup oneTopic: Develop a Road Traffic Injury/ Topic: Develop a Road Traffic Injury/
Accident Surveillance SystemAccident Surveillance System
What is it?What is it?Why it is needed?Why it is needed?Plan a RTI SS Plan a RTI SS –– identify resources identify resources needed, construct one needed, construct one –– local or local or nationalnationalCost ?effectivenessCost ?effectivenessMonitoring and evaluationMonitoring and evaluation
Group twoGroup twoTopic: Develop a RTI/RTA prevention Topic: Develop a RTI/RTA prevention
program/campaignprogram/campaign
JustificationJustificationObjectivesObjectivesIdentify resourcesIdentify resourcesCost? Cost? –– effectivenesseffectivenessLocationLocationMonitoring and evaluationMonitoring and evaluation
Group threeGroup threeTopic: How to quantify the under Topic: How to quantify the under reported reported RTAs/RTIsRTAs/RTIs in Sri Lankain Sri Lanka