Epidemiology of Road Traffic Accidents in India

100 Pages·2011·0.79 MB·English

Road Traffic Accidents (RTAs) are an important public health problem requiring
urgent attention in the context of developing countries such as India, which
has the highest proportion of deaths due to RTAs in South East Asia. Statistics
indicate that the incidence of accidental deaths in India has increased by
32.5% in the last 10 years (1998 - 2008).
This report has been prepared as part of an initiative by Sir Ratan Tata Trust to
identify areas of research and design intervention strategies to reduce deaths
and disabilities due to RTAs.
Epidemiology of
The report presents a comprehensive review of information available in India
on incidence, distribution and patterns of RTAs; interventions - nationally and
internationally - to address the increasing incidence and to identify gaps in
Road Traffic Accidents in India:
research and information on RTAs.
a Review of Literature
2 011
Sir Ratan Tata Trust
Bombay House,
24, Homi Mody Street,
Fort, Mumbai 400 001.
Sir Ratan Tata Trust
www.srtt.org
Road Traffic Accidents (RTAs) are an important public health problem requiring
urgent attention in the context of developing countries such as India, which
has the highest proportion of deaths due to RTAs in South East Asia. Statistics
indicate that the incidence of accidental deaths in India has increased by
32.5% in the last 10 years (1998 - 2008).
This report has been prepared as part of an initiative by Sir Ratan Tata Trust to
identify areas of research and design intervention strategies to reduce deaths
and disabilities due to RTAs.
Epidemiology of
The report presents a comprehensive review of information available in India
on incidence, distribution and patterns of RTAs; interventions - nationally and
internationally - to address the increasing incidence and to identify gaps in
Road Traffic Accidents in India:
research and information on RTAs.
a Review of Literature
2 011
Sir Ratan Tata Trust
Bombay House,
24, Homi Mody Street,
Fort, Mumbai 400 001.
Sir Ratan Tata Trust
www.srtt.org
Keywords:
1. Road Traffic Accidents, 2. Road traffic accident prevention, 3. Road
traffic injuries, 4. Accidental deaths, 5. Road traffic accident victims,
6. Road crashes, 7. Helmets, 8. Seat Belts, 9. Risk behaviour, 10. Drink driving,
11. Road traffic fatalities, 12. Fatal accidents, 13. Road safety, 14. Speed
reduction, 15. Pedestrian safety, 16. Driver safety, 17. Motorised vehicles,
18. Accidental trauma care.
Title:
Epidemiology of Road Traffic Accidents in India: a Review of Literature
Running Title:
Road Traffic Accidents in India: a Review
Disclaimer:
All reasonable precautions have been taken by the author to verify the information
contained in this publication. However warranty of any kind, either expressed or implied.
The responsibility for the interpretation and use of the material lies with the Trust be
liable for damages arising from its use.
Epidemiology of Road Traffic
Accidents in India:
a Review of Literature
Aarti Kelkar-Khambete
2011
Sir Ratan Tata Trust
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Preface
Recent years have been witnessing an increasing amount of traffic on the roads, leading to
increased risks for road traffic accidents to occur. Evidence from developed and especially
developing countries indicates that road traffic accidents are on the rise and are the fifth
important cause of deaths globally, leading to a significant proportion of injuries, deaths and
disabilities in the population. Road traffic accidents have been identified as an important
public health problem requiring urgent attention in the context of developing countries such
as India, which has the highest proportion of deaths due to road traffic accidents in South
East Asia. Recent statistics indicates that the incidence of accidental deaths has increased
by 32.5% in the last ten years i.e. from 1998 to 2008, in India. The following report presents
a comprehensive review of the information available in India on the incidence, distribution
and patterns of Road Traffic Accidents, the interventional attempts made nationally and
internationally to cope with this increasing incidence of RTAs and attempts to identify the
gaps in research and information on RTAs. The purpose of this report is to explore the areas
where attempts can be made to design research as well as intervention strategies that can
help to significantly reduce the deaths and disabilities due to RTAs.
The report begins by providing a brief introduction followed by a section on the methodology
used to conduct the review and then goes on to present the findings of the review in the
results section. The first part of the results section sheds light on the burden of RTAs in
India. The second part looks at the distribution and patterns of RTAs in the Indian context,
while the third part describes the range of interventions tried in the context of developed
as well as developing countries to deal with the problem of RTAs. The report concludes by
a brief discussion on the findings of the review and by suggesting the way forward.
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II Road Traffic Accidents in India: a Review
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Table of conTatbelen otf scontents
Preface
Abbreviations used in the report iv
Abstract v
Acknowledgements vi
1. Introduction 1
2. Methods 3
2.1 Available evidence from India
2.2 Locales – geographical area represented by the studies
2.3 Scope of epidemiological studies
3. Results 7
3.1 Burden of RTAs in India
3.2 Pattern of RTAs
3.3 Road traffic accidents prevention
4. Discussion 59
5. The way forward 65
5.1 Short term steps/strategies/interventions
5.2 Long term strategies/steps/interventions
6. Appendix 70
7. References 75
Road Traffic Accidents in India: a Review III
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Abbreviations used in the report
RTAs Road Traffic accidents
RTIs Road traffic incidents
GOI Government of India
MORTH Ministry of Road Transport and Highways
NCRB National Crime Records Bureau
LMICs Low and Middle Income Countries
ALS Advanced Life Support
IRTE Institute of Road Traffic Education
SIAM Society of Indian Automobile Manufacturers
ICAP International Centre for Alcohol Policy
SASPI Society for Alcohol Related Social Policy Initiative
WHO World Health Organisation
NIMHANS National Institute of Mental Health and Neurosciences
GRSP Global Road Safety Partnership
BATF Bangalore Agenda Task Force
SUV Sports utility vehicles
TST Three wheeled scooter taxis
PHC Primary Health Centre
CHC Community Health Centre
RCTs Randomised Controlled Trials
ITS Interrupted Time Series
MTVs Motorised two wheeler vehicles
BAC Blood and Alcohol Concentration
IV Road Traffic Accidents in India: a Review
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Abstract
Recent years have been witnessing an increasing amount of traffic on the roads leading
to increased risks for road traffic accidents (RTAs) to occur. Evidence from developed and
especially developing countries indicates that road traffic accidents (RTAs) are on the rise
and are found to be the fifth important cause of deaths globally leading to a significant
proportion of injuries, deaths and disabilities in the population. Road traffic accidents (RTAs)
have been identified as an important public health problem requiring urgent attention in the
context of developing countries such as India, which has the highest proportion of deaths
due to road traffic accidents in South East Asia. The situation is even more problematic in
the context of India because of lack of proper infrastructural facilities, poor road designs,
poor implementation of traffic rules and regulations and a high load of a range of vehicles
on the roads. Studies indicate that young adults in their early thirties continue to be the
victims of RTAs. Fatalities and morbidities from RTAs mostly affect the economically
productive age group. Studies show that pedestrians, users of non-motorised vehicles and
users of motorised two wheeled vehicles, who are often from poor or lower middle class
households are the victims of fatal RTAs.
Inspite of the high burden of RTAs in the country, there is a lack of systematic information
on the true extent of the problem and the multiple dimensions of the problem as the
existing studies are isolated, sporadic efforts that vary in study designs and thus cannot
be generalisable at the broader level. This lack of adequate and appropriate information
on the patterns, distribution, and outcomes of RTAs across the country because of lack
of systematic data generation mechanisms at the national and state levels through various
sources such as hospitals, traffic police registration systems etc, leads to limitations in
designing appropriate intervention strategies to deal with the problem in the country.
In addition to this, lack of research efforts to understand the multiple dimensions of the
problem in terms of social and economic consequences of deaths, injuries and long term
disabilities and their implications for the different sections of the population, the economic
burden experienced by the poor have led to inadequate information on the consequences
of the problem faced by the most vulnerable members of the population, in India.
The review reveals that the way forward can include efforts that have a multipronged approach
and include systematic data generation to understand the true extent of the problem along
with awareness and educational programmes directed at both the vehicle users as well as
road users. These can be coupled with strict law enforcement mechanisms to control and
regulate traffic on the road, improvement in trauma management systems to reduce the
intensity of injuries suffered by the victims, encouraging use of safety aids such as helmets
among the public and improving infrastructure to make roads safer. Other efforts can also
include encouraging more research on improvement in the existing technologies such as
helmets by adapting them to local circumstances to encourage their use among people
and to promote better vehicular designs that are more stable and crash resistant. Efforts
can also include attempts at creation of a common platform at the national level that can
include research inputs from different specialities that can lead to a better understanding of
the problem and can encourage attention to this problem at the policy level.
Road Traffic Accidents in India: a Review V
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