NIMHANS

DEPARTMENTS

Department of

Epidemiology

WHO Collaborating Centre for Injury Prevention and Safety Promotion

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Road Traffic Injuries

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 :WHO Collaborating
  Centre:
. About Us
. Mission
. Faculty
. Capacity building
and HRD
. Projects and Programmes
. Injuries in India
. Injuries in South-East Asia
. Road Traffic Injuries
. Traumatic Brain Injuries
. Suicides
. Violence
. Major contributions
. Collaboration
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. Information Dissemination
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Road traffic injuries result in death of more than 100,000 people and hospitalization of 1.5 million people in India resulting in an estimated economic loss of 3% of GDP for the country. The entire South-East Asia region is experiencing this epidemic and impact of unplanned and unsafe growth in recent years. The centre has been providing inputs to various national, regional and international agencies to strengthen road safety in India and other south-east Asian countries apart from undertaking research

Estimating the burden of Road Traffic Injury and prioritizing measures for prevention

The report titled "Road traffic injury prevention in India" brings out to the fore the extent, risk factors, status of trauma care, disabilities and impact, socioeconomic burden and related issues based on secondary sources of data. Outlining the current Indian initiatives and experiences of high income countries (HICs), the project outlines the number of initiatives been developed to reduce and prevent the growing burden of RTIs.

Road safety information systems

Reliable and scientific information is one of the basic requisites to plan, implement and evaluate road safety activities. Information of RTIs is primarily collected by the Police department and information is non-available from the health sector. Under reporting is a serious issue undermining the public burden and impact of RTIs. The Bangalore study showed that nearly 5-10% of deaths and more than 50% of moderate to serious injuries are not included in official reports.

Road Traffic Injury surveillance – developing a feasibility module

In order to strengthen RTI information a project is under progress to develop a surveillance programme with data collection from 25 major hospitals along with linkages to police records. The present endeavor as a prelude to integration with the larger Government of India's integrated disease surveillance project is focusing on developing a validated surveillance tool, process of data gathering, mechanisms of data entry and feed back systems. Examination of police records and strengthening of the same to gather more reliable data is an inbuilt part of the project. The study to be completed in 2007 will outline mechanisms for injury and RTI surveillance in India.

Reducing drinking and driving

Driving while intoxicated is a well established risk factor for road crashes. The role and impact of alcohol in road traffic injuries and traumatic brain injuries has been a major research activity in the centre through several research projects. The findings from various studies have been incorporated into a demonstration project on reducing drinking and driving in collaboration with Bangalore City Police, Bangalore Agenda Task Force and Global Road Safety Programme. The various activities has included conducting baseline hospital and road side surveys, training of police in use of breathalyzers, documenting and analyzing findings and stepping of enforcement programmes. The programme has gained strength with increased enforcement activities from year to year.

Helmet promotion, legislation and enforcement

Nearly 30-40% of road deaths and injuries in India are among riders and pillions of motorized two wheeler vehicles. Nearly half of these deaths and injuries are due to damage experienced by brain and nervous system. Helmets have been proven to reduce deaths, severe injuries, skull fractures, neurological disabilities, extent of hospitalization and consequent socio-economic burden. The department has examined this issue in detail through a number of epidemiological projects over a period of time.

The centre has contributed and facilitated the introduction of helmet legislation in the state of Karnataka (covering 4 million riders) by conducting and publishing research, public education programmes to dispel Myths, advocacy for legislation, supporting state to notify legislation, monitoring progress and by information dissemination to all concerned agencies. The impact of legislation will be measured through a prospective study in 2007.

Strengthening pre-hospital and emergency care

Emergency trauma care can save the lives of those who survive the initial impact of injuries. The availability and affordability along with awareness about trauma care at different levels has been examining by the department through several research projects in both urban and rural areas. Along with this, emergency acute care in the casualty departments of hospitals has been systematically analyzed to study the existing gaps. The findings have been incorporated into several policies and programmes in the strengthening of trauma care in Indian and other south-east Asian countries.

Highway trauma care

Even though highways contribute for only 2% of total road network, they account for 25% of transportation and 40% of road traffic deaths and injuries. A recent study by a multidisciplinary team has examined the status of highway safety on a stretch of highway with regard to current status of engineering, enforcement, education and trauma care facilities. Findings have revealed major inadequacies in highway trauma care and have provided critical inputs for planning highway trauma care in India.

Socio-economic impact of RTIs

RTIs lead to huge social, economic and psychological burden on survivors and house holds due to its unanticipated happening. In a large population based study covering 100,000 populations from 20,000 households of urban and rural Bangalore and similar sample from Bangladesh, the study has documented the impact of RTIs and TBIs after an injury. This collaborative study with DFID and TRL has also helped in improving and developing costing methodologies to assess economic impact in low and middle income countries.

Road safety policies and programmes in India and South-East Asia

Despite the huge enormity of the burden and impact of RTIs, India and many countries of South–East Asian region do not have well defined road safety policies, programmes and coordinated mechanisms for reducing the burden. The department developed the first Bangalore agenda on road safety in 1999. The centre has worked very closely with - expert working group of the planning commission in government of India, National Human Rights Commission, Government of India: Expert committee set up by the Ministry of Transport to develop directorate of road safety: Karnataka road safety council; Bangalore city road safety council, expert committees of WHO and other international agencies, number of civil society groups within and outside India to promote road safety on a more scientific and systematic basis.