Road Safety 1

5/18/2018 Road Safety 1

1/60 WHO, 20071

U n i t 1

Magnitude andimpact of roadtraffic injuries


2/60

WHO, 20072

1.2 million deaths a year

20-50 million are injured

or disabled

11th leading ause o!

death

aount !or 2.1" o! all

deaths globally

Copyright Etienne Creux, Pretoria News

Road trafc injuries are a huge public health and

development problem


3/60

WHO, 20073

Distribution o global injury mortality by cause

#oad tra!!i injuriesaount !or 2$" o! all

injury deaths

%orld%ide

&oure' WHO (lobal )urden o! *isease +rojet, 2002, ersion 1


4/60

WHO, 20074

WHO region o%- and middle-

inome ountries

High-inome

ountries

!rian #egion

#egion o! the merias

&outh-/ast sia #egion

/uro+ean #egion

/astern editerranean #egion

Western ai!i #egion

2.$

13.2

1.3

17.4

23.4

1.5

14.

11.0

16.0

12.0

Road trafc injury mortality rate (per 100 000 population) in WH

regions! "00"

he !rian #egion has the highest mortality rate.


5/60

WHO, 20075

Road trafc injury mortality rates (per 100 000

population) in WH regions! "00"

he majority o! road tra!!i deaths our in lo%- and middle-inome ountries.


6/60

WHO, 20076

20$0

*isease or injury

2002

*isease or injury

10. erinatal onditions10. #oad tra!!i injuries

6. uberulosis6. rahea, bronhus, lung

aners

. #oad tra!!i injuries. uberulosis

7. rahea, bronhus, lung aners7. *iarrhoeal diseases

3. *iabetes mellitus3. erinatal onditions

5. 8hroni obstruti9e+ulmonary disease

4. 8hroni obstruti9e +ulmonary disease4. H:;:*&

$. H:;:*&$. o%er res+iratory in!etions

2. 8erebro9asular disease2. 8erebro9asular disease

1. :shaemi heart disease1. :shaemi heart disease

5. o%er res+iratory in!etions

WH predicts that road trafc injuries #ill rise to

eighth place by "0$0 as a cause o death


7/60

WHO, 20077

&oure'


8/60

WHO, 20078

0

5

10

15

20

25

$0

$5

Years

Fatalit

rate

per1!

!

!!!

population

=< ustralia =&

Do#n#ard trends in road trafc atalitiesin high+income countries


9/60

WHO, 2007"

,ost o those 'illed are vulnerable road users

&oure' arious WHO ollaborators in ountries

0" 20" 40" 30" 0" 100"

=&

hailand

8olombo, &ri an>a

&outh !ria

?etherlands

alaysia


10/60

WHO, 20071!

Hal! o! all global road tra!!i deaths our among young adults

bet%een 15 and 44 years o! age.

7$" o! all global road tra!!i !atalities are males.

:n !ria, a third o! all road tra!!i deaths our among those

aged 5-14 years.

ales ta>es more ris>s as dri9ers or +edestrians.

:n high-inome ountries young dri9ers are dis+ro+ortionately

re+resented.

:n lo%- and middle-inome ountries, most young 9itims are

9ulnerable road users.

-oung adults and males are at greatest ris'


11/60

WHO, 200711

.conomic costs o road trafc injuries to households

oss o! main household inome generator BmaleC

oss o! earnings

edial bills, !uneral osts, legal bills

#ehabilitation osts


12/60

WHO, 200712

World%ide, about 1.2 million +ersons are >illed in

road tra!!i rashes e9ery year.

20 million to 50 million more are injured or disabled

in these rashes.

#oad tra!!i injuries aount !or 2.1" o! global

mortality and 2$" o! all injury deaths %orld%ide.

#oad tra!!i injuries are +redited to rise !rom tenth+lae in 2002 to eighth +lae in 20$0 as a ause o!

death.

/ey points (1)


13/60

WHO, 200713

here are do%n%ard trends in road tra!!i deaths in

high-inome ountries and inreases in most lo%- and

middle-inome ountries.

he global eonomi ost o! road tra!!i injuries isabout =& D 51 billion +er year.

/ey points (")


14/60

WHO, 2007

U n i t 2

#is$ factorsforroad traffic injuries


15/60

WHO, 200715

$C %e&elop and

e&aluateinter&entions

What %or>sE

2C #is$ factoridentification

What are theausesE

1C 'ur&eillance

What is the+roblemE

4C (mplementation

Ho% is it doneE

ublic health approach


16/60

WHO, 200716

nderstand the our inter+related steps o the public

health approach

What is the +roblemE

- *etermine the magnitude, so+e and harateristis

o! the +roblem.

What are the ausesE

- :denti!y !ators that inrease the ris> o! disease,

injury or disability.

- *etermine !ators that are +otentially modi!iable.


17/60

WHO, 200717

nderstand the our interrelated steps o the public

health approach

What %or>sE

- ssess measures that an be ta>en to +re9ent

the +roblem.

- ilot test and e9aluate inter9entions.

Ho% is it doneE

- :m+lement +ro9en and e!!eti9e inter9entions.

- /9aluate e!!eti9eness o! inter9entions.


18/60

WHO, 200718

ehiles and eFui+ment /n9ironment

Gators

hase Human

re-rash 8rash+re9ention

:n!ormation

ttitudes

:m+airment

olie en!orement

#oad%orthiness

ighting

)ra>ing

Handling

&+eed management

#oad design androad layout

&+eed limits

edestrian!ailities

8rash :njury+re9ention

during therash

=se o! restraints

:m+airment

Ou+ant restraints

Other sa!ety de9ies8rash +roteti9e design

8rash-+roteti9eroadside objets

ost-rash i!esustaining

Girst-aid s>ill

ess to medis

/ase o! aess

Gire ris>

#esue !ailities

8ongestion

Haddon ,atri2


19/60

WHO, 20071"

=nderstand the system as a %hole.

=nderstand interations bet%een di!!erent om+onents.

8onsider not only underlying !ators, but also role o!

di!!erent agenies and ators in +re9ention e!!orts.

3ystems approach

# d d t t t


20/60

WHO, 20072!

*esired out+ut

#oad and

en9ironment

#oad users

ehile

Human

!ators

#oad anden9ironmental

!ators

ehile!ators

obility

&ystem o! tri+s

8rashes and rash !ators

=ndesired

out+uts

#oad and trans+ort system

#oad tra!!i rashes

OtheronseFuenes

o! trans+ort

Wor>

&hool

eisure

&ho++ing

Others

System

approach


21/60

WHO, 200721

Factors influencing e)posure to ris$ eonomi !ators

demogra+hi !ators

land-use +lanning +raties

tra!!i mi

road !untion 9ersus design and layout

,ajor ris' actors are identi4able


22/60

WHO, 200722

#is$ factors influencing cras* in&ol&ement s+eed

alohol or drugs

!atigue

male

9ehile de!ets

youth dri9ing together

9ulnerable road users



23/60

WHO, 200723

#is$ factors influencing cras* se&erit s+eed

seat-belts, hild restraints

helmets

?on-rash +roteti9e roadside objets

insu!!iient 9ehile rash +rotetion

alohol and other drugs



24/60

WHO, 200724

#is$ factors influencing post+cras* outcome of injuries

delay in deteting rash

delay in trans+ort to a health !aility

!ire resulting !rom ollision lea>age o! haAardous materials

alohol and other drugs

resue, etration, e9auation

+oor trauma are and rehabilitation



25/60

WHO, 200725

road tra!!i ollision is the outome o! the interation among a

number o! !ators, some o! %hih may not a++ear to be diretly

related to road tra!!i injuries.

he +ubli health a++roah is hel+!ul in the analysis o! ris>

!ators and guiding deision-ma>ing.

he Haddon matri hel+s to identi!y human, 9ehile and

en9ironmental !ators during +re-, rash- and +ost-rash +hases.

/ey points (1)


26/60

WHO, 200726

he systems a++roah onsiders all !ators ontributing to roadtra!!i injuries as %ell as the role o! di!!erent agenies and ators

in +re9ention e!!orts.

ain ris> !ators an be ategoriAed into !our grou+s'

I !ators in!luening e+osure to ris>

I !ators in!luening rash in9ol9ement

I !ators in!luening rash and injury se9erity

I !ators in!luening +ost-rash injury outomes

/ey points (")


27/60

U n i t 3

,*e importanceof e&idence as

a foundation forpre&ention


28/60

WHO, 200728

*esribe the burden o! road tra!!i injuries. ssess ris> !ators.

/stablish +riorities and alloate resoures !or

+re9ention.

*e9elo+ and e9aluate inter9entions.

ro9ide in!ormation !or +oliy-ma>ers and

deision-ma>ers.

#aise a%areness.

Why collect reliable data on road trafc injuries5


29/60

WHO, 20072"

olie ?umber o! road tra!!i inidents,

!atalities and injuries

y+e o! road users in9ol9ed

ge and se o! asualties

y+e o! 9ehiles in9ol9ed

olie assessment o! auses

oation and sites o! rashes

roseutions

8ause;res+onsibility e.g. alohol,s+eed, 9ehile !ators

What are the main sources and types o data5


30/60

WHO, 20073!

Health!aility

settings

Gatal and non-!atal injuries


#oad user ategories

8ost o! treatment

lohol or drug in9ol9ement

&e9erity and ty+e o! injuries

Outome e.g. disability

:nsurane!irms

Gatal and non-!atal injuries

*amage to 9ehiles

8ost o! laims

8ost to 9itims



31/60

WHO, 200731

(o9ernmentde+artments and

agenies

o+ulation denominators

:nome and e+enditure data

Health indiators

/+osure data

ollution data

/nergy onsum+tion

iteray le9els



32/60

WHO, 200732

&+eial interestgrou+s

?umber o! road tra!!i inidents,!atal and non-!atal injuries

y+e o! road users in9ol9ed


y+e o! 9ehiles in9ol9ed :nteration o! 9itims %ith 9ehiles

8auses

oation and sites o! rashes

&oial and +syhologial im+ats

:nter9entions and e9aluation *amage and losses

egal issues, insurane laims

O+erational data


e.g.

researh institutes,?(Os, trans+ortunions, trans+ort

om+anies, onsulting!irms


33/60

WHO, 200733

:njury sur9eillane systems' set u+ in hos+itals and othera++ro+riate institutions !or ongoing systemati olletion,

analysis, inter+retation and dissemination o! in!ormation.

8ommunity-based sur9eys' data olleted !rom households

and;or ommunities.

ademi studies on seleted to+is' +ro9ide in!ormation

on s+ei!i to+is and may inlude ase-ontrol studies, in-

de+th rash analysis and om+lementary in9estigations.

Ho# are data on road trafc injuries collected5


34/60

WHO, 200734

*ata olleted and stored by a range o! agenies.

/nsure aess, harmoniAation and lin>age bet%een

di!!erent data soures and users to obtain maimum

9alue !rom the in!ormation.

a>le the +roblem o! oordination and sharing o!in!ormation among di!!erent users.

6t is not enough just to collect data7

7lin' and share


35/60

WHO, 200735

nalyse data to ans%er Fuestions on magnitude, +atterns,

ris> !ators, inter9entions and their e!!eti9eness.

&e9eral so!t%are +a>ages to use e.g. /+i :n!o and &&&.

/nsure that you share and disseminate in!ormation %itholleagues, researhers, +oliy-ma>ers and the +ubli.

=se 9arious strategies to disseminate in!ormation' journal

artiles, re+orts, +oliy brie!s, !at sheets, %eb +age and

ne%s+a+ers.

8nalyse! disseminate and use inormation


36/60

WHO, 200736

?umber o! injuries

bsolute !igure indiating the number o! +eo+le

injured in road tra!!i rashes*esri+tion

=se andlimitations

- =se!ul !or +lanning at loal le9els !or

emergeny medial ser9ies

- =se!ul !or alulating osts o! medial

are

- ?ot 9ery use!ul !or ma>ing om+arisons- large +ro+ortion o! slight injuries are

not re+orted

- islassi!iation o! se9erity o! injury

6ndicators to measure the problem


37/60

WHO, 200737

?umber o! deaths

bsolute !igure indiating the number o! +eo+le

%ho die as a result o! a road tra!!i rash*esri+tion

=se andlimitations

- (i9es a +artial estimate o! the magnitude o!

the road tra!!i injury +roblem, in terms o!

death

- =se!ul !or +lanning at the loal le9el !or

emergeny medial ser9ies

- ?ot 9ery use!ul !or ma>ing om+arisons



38/60

WHO, 200738

Gatalities +er 10 000 9ehiles

#elati9e !igure sho%ing ratio o! !atalities to

number o! motor 9ehiles*esri+tion

=se andlimitations

-&ho%s +robability o! 9ehile in9ol9ement in

!atal rashes

- limited measure !or assessing sa!ety in a

soiety beause it omits non-motoriAed

trans+ort and other indiators o! e+osure

- =sually delines %ith motoriAation



39/60

WHO, 20073"

Gatalities +er 100 000 +o+ulation

#elati9e !igure sho%ing ratio o! !atalities to

+o+ulation*esri+tion

=se andlimitations

- &ho%s the im+at o! road tra!!i rashes on

human +o+ulation as a +ubli health +roblem

- =se!ul !or om+aring road tra!!i injuries as a

health +roblem in di!!erent ommunities- =se!ul !or estimating se9erity o! rashes



40/60

WHO, 20074!

Gatalities +er 9ehile->ilometre tra9elled

?umber o! deaths +er billon >ilometres tra9elled*esri+tion

=se andlimitations

- =se!ul !or some international om+arisons,

dereases %ith motoriAation

- *oes not ta>e into aount non-motoriAed

tra9el



41/60

WHO, 200741

easures healthy li!e years lost to disability and

mortality. One disability-adjusted li!e year lost is

eFual to one year o! healthy li!e lost, either due

to +remature death or disability

*isability-adjusted li!e years B*JsC

*esri+tion

=se andlimitations

- *Js ombine both mortality and disability

- *Js do not inlude all the health

onseFuenes assoiated %ith injury suh as

mental health onseFuenes



42/60

WHO, 200742

*e!initions and standardiAation o! data.

=nder-re+orting.

=na9ailability o! ertain s+ei!i data.

&ienti!i soundness.

a> o! in!ormation, data olletion or e9aluation

o! inter9entions.

roblems and concerns

9ontinue to conduct research and invest in


43/60

WHO, 200743

basis !or generating data and e9idene.

basis !or in!ormed deision-ma>ing.

*e9elo+ national researh a+aity.

?ational and ommunity researh 9ital to identi!y loal

+roblems.

:nde+endene o! researh essential to ensure Fuality

and minimiAe +olitial +ressure.

9ontinue to conduct research and invest in

research capacity


44/60

WHO, 200744

/9idene is needed !or deision-ma>ing and +lanning.

#eliable data and e9idene are essential.

olie de+artments and hos+itals are major soures o! road

tra!!i injury data.

/nsure aess, harmoniAation and lin>ages bet%een di!!erent

data soures and users.

&e9eral +roblems and onerns %ith road tra!!i injury data.

need !or ontinuous researh and researh a+aity

de9elo+ment.

/ey points


45/60

U n i t 4

(mplementing

specificinter&entions to

pre&ent road traffic

injuries

.nergy transer is basic to road trafc injury


46/60

WHO, 200746

rans!er o!energy

Humanbody

/n9ironment

:njuries

.nergy transer is basic to road trafc injurycontrol

.nergy transer is basic to road trafc injury


47/60

WHO, 200747

:njuries are due to trans!er o! energy bet%een thehuman body and the en9ironment.

*amage and se9erity are +ro+ortional to amount o!

energy a9ailable and ehanged during a rash.

#edue and;or manage eess energy that may

ontribute to the ourrene o! a rash and se9erity o!

injuries.

.nergy transer is basic to road trafc injurycontrol


48/60

WHO, 200748

Haddon:s ten strategies or R%6 prevention

1) Prevent the initialaggregation of the particular

energy form:

K disouraging the use

o! 9ehiles

K enouraging

alternati9e tra9el modes

2) Reduce the amount ofenergy aggregated:

K setting s+eed limits

K ma>ing less +o%er!ul

engines


49/60

WHO, 20074"


3) Prevent the inappropriaterelease of energy:

K road users shouldnLt be

able to ma>e mista>es

easily

K better bra>es, sa!er

intersetions,

roundabouts

4) Alter the rate or spatialdistribution of release of the

energy from its source:

K ma>e rounded and!latter sur!aes

K a++ro+riate

rash%orthiness o!

9ehiles


50/60

WHO, 20075!


5) eparate susceptiblestructures from the energy

being released by means of

space or time:

K se+arated lanes

K daytime ur!e%s !or

tru>s in ities

!) "nterpose a material barrierto separate the released

energy from susceptible

structures:

K road di9iders on

high%ays


51/60

WHO, 200751


#) $odify contact surfaces orbasic structures that can be

impacted:

K so!ter ar and bus

!ronts

K brea>a%ay +oles on

high%ays

K use o! helmets by t%o-

%heeler riders

%) trengthen human beings&ho are susceptible by the

energy transfer:

K treatment o!

osteo+orosis in older

road users


52/60

WHO, 200752


') (uicly detect and evaluatedamage* and prevent its

continuation or e+tension:

K e!!iient systems !or

etration o! 9itims

!rom 9ehiles

K emergeny are

K management o! rash

sites

1,) -arry out all necessarymeasures bet&een the

emergency period

immediately follo&ing

damage and ultimate

stabili.ation of the process:

K intermediate and long-

term re+airK rehabilitation


53/60

WHO, 200753

#eduing e+osure to ris> through trans+ort and land-use +oliies

I reduing the 9olume o! motor 9ehile tra!!i

I +ro9iding e!!iient net%or>s

I enouraging +eo+le to s%ith to lo%er-ris> modes o! trans+ort, e.g.

mass transit systems in 8uritiba, &ao aulo, )ogota and )eijing

I +laing restritions on motor 9ehile users

I +romoting sa!ety-entred +lanning, design and o+eration

What interventions can be implemented5


54/60

WHO, 200754

&ha+ing the road net%or> !or road tra!!i injury +re9ention

I lassi!ying roads and setting s+eed limits by their !untion, e.g. the

*uth sustainable sa!ety +oliy %ith di!!erent s+eeds !or three road

ategories' !lo% roads, distributor roads and residential aess

roads

I im+ro9ing sa!ety o! single-lane arriage%ays

I im+lementing tra!!i-alming measures, e.g. s+eed bum+s in (hanaredued rashes by $5" at a high-ris> rash site



55/60

WHO, 200755

:m+ro9ing 9isibility o! road users

I use o! daytime running lights

I use o! re!leti9e and +roteti9e lothing

I illuminating ross%al>s



56/60

WHO, 200756

romoting rash-+roteti9e 9ehile designI stronger +assenger om+artment

I head-rests to +re9ent %hi+lash injury

I olla+sible steering olumn

I laminated %indsreens

I +added instrument +anels

I door lo>s

I rash-resistant roo!sI side +rotetion bars on doors

I !ront end design


h i i b i l d5


57/60

WHO, 200757

&etting and seuring om+liane %ith road sa!ety rules

I setting and en!oring s+eed limits

I enating and en!oring la%s on alohol im+airment Be.g. alohol la% in

hailandC

I enating and en!oring la%s on the use o! seat-belts Be.g. in 8osta #iaC

and hild restraints

I enating and en!oring la%s on the use o! helmets Be.g. alaysian

helmet la% and +rogrammeC


% l i h l d l h l


58/60

WHO, 200758

%ools or action on helmets and alcohol

htt+';;%%%.%ho.int;9ioleneMinjuryM+re9ention;+ubliations;

%h l d ti
http://www.who.int/violence_injury_prevention/publications/http://www.who.int/violence_injury_prevention/publications/


59/60

WHO, 20075"

/duation is a >ey om+onent o! road sa!ety

it im+ro9es >no%ledge

it +ro9ides basi s>ills

it brings about a ulture o! onern

but +rogrammes +ro9iding high%ay sa!ety eduation need to

be lin>ed and used in ombination %ith other a++roahes

there must be a balaned a++roah to the role o! eduation

and +ubliity

%he role o education

/ i t


60/60

:njuries are aused by a trans!er o! energy bet%een the human

body and the en9ironment.

here is no standard +a>age o! inter9entions suitable !or all

ontets and ountries.

&e9eral good +raties an be !ollo%ed'

- reduing e+osure to ris> through trans+ort and land-use

+oliiesN

- sha+ing the road net%or> !or road tra!!i injury +re9entionN

- im+ro9ing 9isibility o! road usersN

- +romoting rash-+roteti9e 9ehile designN

- setting and seuring om+liane %ith >ey rulesN

- deli9ering +ost-rash are.

/ey points

Documents

Road Safety 1