A presentation about the epidemiology of road trauma in India. Also how innovative use of technology like GIS when combined with the trauma epidemiology can help prevent these cases in developing countries like India.

1. EPIDEMIOLOGY OF
ROAD ACCIDENTS IN
INDIA
Dr Vaibhav Bagaria
MB MS, D Orth, FCPS.
Orthopaedic Surgeon
ORIGYN Healthcare
Nagpur India
WWW.DRBAGARIA.COM
E: drbagaria@gmail.com

2. ‘I keep six honest serving man,
they taught me all I know.
Their names are what, why, when, how, where and who’

3. What does epidemiology follow?
 Incidence – new cases at certain time in
certain area (country, etc.)
 Causes, mechanisms, severity
 Prevalence (morbidity)– total no. of cases at
any given time and certain area
 Mortality
 Health outcomes

4. TRAUMA - World
 Leading cause of deaths, hospitalizations
and disabilities in 15 – 44 years.
 In 1990’s- 9th
leading cause of death, by 2020
– 2nd
leading cause after IHD
 Responsible for 9.1% deaths.
 Occupy 10 – 30% hospital beds.

5. TRAUMA INDIA

6. TRAUMA - India
 Rapidly increasing in India- each day 300 Indians
killed, 1 every 12 sec injured seriously.
 1% world vehicles and 10% deaths.
 80 % in rural and district areas in low and middle
income societies.
 Severe socioeconomic losses to the emerging
economy of the country: 550 bill =3% GDP
 Significantly affect the poorer communities of the
societies

7. Incidence of Trauma Cases
‘As a general rule, the most successful man in life
- is the man who has the best information’

9. Auto Accident Statistics from the
year 1994 to 2004:
YEAR
ROAD ACCIDENTS
(IN THOUSANDS)
PERSONS KILLED
(IN THOUSANDS)
PERSONS INJURED
(IN THOUSANDS)
2004 (Provisional) 429.8 92.5 464.6
2003 406.7 86.0 435.1
2002 407.5 84.7 408.7
2001 405.6 80.9 405.2
2000 391.4 78.9 399.3
1999 386.4 82.0 375.0
1998 385.0 79.9 390.7
1997 373.7 77.0 378.4
1996 371.2 74.6 369.5
1995 348.9 70.6 323.2
1994 320.4 64.0 311.5
Sourced From:
Department of Road Transport and Highways.
Ministry of Shipping, Road Transport and Highways.
Government of India.

10. Rising Trends in accident
statistics for the years

11. 2005 and projections for 2015
Year No of
Deaths
No of
Serious
Injuries
No Of Minor
Injuries.
2005 1,10,300 22,06,000 77,21,000
2015 1,54,600 30,92,000 108,22,000

12. Which group is bearing the maximum
Brunt?

15. Causes, Mechanisms and Severity
‘Epidemiology is a means of learning or asking questions…
and getting answers that lead to further questions’

16. Causes, mechanisms, severity
Causes & mechanisms:
 MVAs – leading cause of TBIs
 Falls – second leading cause
 Work-related TBIs
 Firearms
Alcohol – major factor in many TBIs
Severity: mild, moderate, severe

17. Modes of Road accidents

18. Severity of RTA’s

19. Factors Responsible for RTA’s
‘The study of disease is really the study of man and his environment’

20. Causes of Road Accidents

21. WHO identified Risk Factor in
RTA
 Speed
 Alcohol or drugs
 Fatigue
 Male
 Vehicle defects
 Youth driving together
 Vulnerable road users

22. INDIA is a world Apart?-
Incredible INDIA
 BAD Roads
 BAD Traffic Sense.
 No Pre Hospital phase.
 Not many dedicated Trauma Units.
 No formal or compulsory trainings in Trauma
Care & Resuscitation.
 No Money – No Medicare.

24. What has not changed?
‘Those who fail to learn from history are
bound to repeat its mistakes’

25. 5 A’s
 Awareness regarding the issue.
 Attitude of Government.
 Apathy towards the issue.
 Absence of any concerted effort.
 Available resources, finance and Data.

26. Disease –related Mortality and Plan
Allocation
IndiaStat.comhttp://www.indiastat.com/India/ShowData.asp?secid=16&ptid=0&level=1
m), Ministry of Shipping Road Transport and Highways (2006) & Tenth Plan Document(
http://planningcommission.nic.in/plans/planrel/fiveyr/10th/volume2/v2_app.pdf)
Disease No of Deaths Scheme Fund (Cr Re)
T B 37,639 National TB
Control
680
Malaria 638 NVBDC 1370
AIDS 1094 NACP 1270
Accidents 92, 618 No major
Scheme
187

27. Can You identify these men?

29. What may be changing for good?

30. Where is the hope?
 BETTER TECHNOLOGIES
 PUBLIC PRIVATE PARTNERSHIP
 FOCUS ON EDUCATION AND TRAINING.
 DEDICATED TRAUMA UNITS
 CONFERENCES LIKE THESE.
 GOOD COMMUNICATION SYSTEM.

31. Better tech: WHAT IS GIS?
GIS is a computer based digital information
system which analyzes the events with respect
to the earths geography.
Acronym for:
Geographic
Information
System

32. MATERIALS AND METHODS
 Creation of a trauma registry
 All non fatal vehicular accidents recorded
 Mode of injury, Type of vehicle involved (bicycle,
two wheeler or four wheeler), Location and Nature of
Trauma was recorded over a period of six months.

33. MATERIALS AND METHODS
 45 variables collected and plotted against
the location map using the GIS software.

34. SOFTWARE
 JT Maps, an indeginously (Indian) developed
software.
 Other available software: Arc view, Map info,
ARC/Info, AutoCAD Map, etc.

35. RESULTS
 166 trauma cases recorded over six
months.
 Plotted against the data analytical software
map.
 Clustering of cases with similar attributes
were analysed.

36. Results
 Clustering of six lower end radius fractures at
a particular location.
 All victims were male in age group 20 – 35
years.
 All accidents involved motorised two
wheelers.
 Other injuries were evenly distributed over
the entire data location map

38. Analysis
Personal inspections revealed
 A “Speed breaker” where most of the
accidents occurred.
 “Absent street light” around the
bend.
 All accidents occurred during “Evening
and night time”.

39. IMPLEMENTATION
 Study data used to impress upon local
authority the need of adequate illumination at
the identified location.
 Resulted no accidents being reported over
the next three months

41. Public Private Partnership
 Govt Involved with private sector to set up
basic trauma set ups on National Highways.
 Many private trusts and NGOs are taking up
the cause.
 Some efforts are also to increase the
awareness among people to follow traffic
rules.

42. TRAINING AVAILABLE
 Advanced Trauma Life Support (ATLS)
 National Trauma Management Course (NTMC)
 Definitive Surgical Trauma Course (DSTC)
 Essential Surgical Skills (ESS)
 Primary Trauma Care (PTC)
 Trauma Nursing Core Course (TNCC)
 Trauma Team Training (TTT)

43. Conferences like these!

44. Good communication
systems!

45. Million Dollar Question?

46. Why us Clinicians?...
We are not epidemologists !
Because…..

47. Because…
Eyes donot see what mind
doesnot know…

48. How we trauma surgeons and
clinicians can contribute….?
 Suggesting locations for setting up the
trauma care centers.
 Contribute towards town planning in the
perspective of trauma prevention.
 Using data to assess the impact of certain
interventions.
 Monitor the epidemiological trends in trauma
over a period of time and suugest
appropriate govt. policies.

49. TAKE HOME MESSAGE
GET INVOLVED –
As health care
professionals as well as
Human being
‘Health is not mainly an issue of doctors, paramedics and hospitals.
It is an issue of social justice’

50. www.drbagaria.com