Mapping Motor Vehicle Crashes in Hawaii:

GIS applications for injury prevention

Dan Galanis

EMS & Injury Prevention System Branch

Hawaii Department of Health

Overview of presentation

Overview of injuries

Importance of GIS for prevention of motor vehicle crashes and drownings

GIS applications in prevention of injuries from motor vehicle crashes

North Hawaii Outcomes Project • Mapping of fatal crashes on Big Island

Hawaii Emergency Medical Services Information System (HEMSIS)

• Mapping of all motor vehicle crashes on Oahu

Drownings in the state

…are the 4th leading cause of death in Hawaii (>700 per year) …the leading cause of death for ages 1 to 40;

more than all other diseases combined

…cause ~14% of all hospitalizations in Hawaii

…cause ~88,000 emergency department visits a year

…account for 33% of EMS emergency calls …~35,000 calls per year

…ARE PREVENTABLE

Injuries…

Causes of fatal injuries in Hawaii, 2006-2010

injury-other

undetermined intent

machinery

natural/environmental

fire/burn

mvc*-bicyclist

other-transport

assault

mvc*-pedestrian

mvc*-motorcyclist

suffocation

drowning

mvc*-occupant

poisoning

falls

suicide

33 (4%)

66 (9%)

2 (0%)

2 (0%)

4 (1%)

4 (1%)

6 (1%)

25 (4%)

29 (4%)

31 (4%)

32 (4%)

64 (9%)

73 (10%)

90 (12%)

108 (15%)

155

(21%)

0 50 100 150

annual number (% of total)

seniors: 84 (12%)

Leading Causes of Injury Mortality and Morbidity

among Hawaii residents, 2006-2010

Fatal injuries

Hospitalizations

EMS calls

1 Suicide 155 21% Falls 2,674 49% Falls 10,112 35%

2 Falls 108 15% Car occupant 471 9% Car occupant 5,332 18%

3 Poisoning 90 12% Suicide

attempt

378 7% Assault 3,440 12%

4 Car occupant 73 10% Assault 302 6% Poisoning 2,073 7%

5 Drowning 64 9% Motorcyclist

277 5% Struck by

object

1,201 4%

Mapping of fatal crashes on the Big Island

North Hawaii Outcomes Project

Started efforts at motor vehicle crash reduction in 2001, given high fatality rates in Hawaii County

• 1st step was to identify locations of fatal crashes

• Later published poster-sized maps, distributed to:

All middle and high schools, police stations, health facilites, etc. Highlighting prevalence of drunk driving

• Also shared with media to increase awareness

• Web site: www.nhop.org

Fatality maps in Big Island media

Fatality maps in NHOP publications and strategic plans

Mapping of EMS-attended crashes on Oahu

HEMSIS data (EMS reports)

Advantages: Real time, detail on mode (car occupant vs. motocyclist vs. pedestrian, etc.), protective factors (seat belts, helments), substance use, and street address/site of crash

Problem is data entry/errors vs. geocoding:

• "H1 WEST EAST OF LUNALILO OFF"

• "swanzy beach park"

• "91-1000 GEIGER RD."

• "Frntg Waianae McDonalds 85-726 farrington hwy"

• "879 Honalua St Hobo, HI 96826"

Solution was to obtain 911 dispatch data from City & County

• CAD interface captures 911 caller's latitude and longitude

• Re-merge with larger EMS database

EMS-attended injuries from motor vehicle crashes on Oahu, 2007-2010

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

# #

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

##

##

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

#

##

#

##

#

#

#

#

#

##

#

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

## #

##

#

#

#

#

#

#

#

#

#

#

#

##

##

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

##

#

#

#

# #

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# ##

#

#

#

#

#

##

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

###

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

##

###

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

## #

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

###

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

# #

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

##

#

#

##

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

##

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

##

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

# #

#

#

#

#

#

##

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

##

#

#

#

#

#

#

#

###

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

###

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# ##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#### #

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

#

# #

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

## #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

###

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

##

#

#

#

#

# #

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

# ##

#

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

##

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

###

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

# #

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

# #

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

# ##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

###

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

##

##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

##

##

# ##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

##

##

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

# # #

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

#

##

#

#

## #

# #

#

#

#

##

#

#

#

#

#

#

#

#

###

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

# #

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

##

#

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

# #

#

#

#

#

#

#

#

##

#

#

#

#

#

#

# ##

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

###

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

## #

#

#

#

#

#

#

#

#

# ##

#

#

#

#

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

#

#

#

# #

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

##

#

#

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

# #

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

##

#

#

#

##

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

##

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

# #

#

#

#

#

#

#

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

# ##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

##

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

##

##

#

#

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

##

#

#

#

#

# #

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

###

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

##

#

#

# #

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

## #

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

# ##

#

#

# #

#

#

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

## #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

##

#

# ##

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

###

#

##

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

## #

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

###

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

###

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

# ##

# #

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

# #

#

#

#

##

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

# ##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

##

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

##

##

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

##

##

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

##

#

#

#

#

#

##

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

##

#

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

###

#

#

##

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

###

#

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

# #

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

###

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

# #

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

## #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

##

#

#

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

#

##

#

#

#

#

#

#

#

# ##

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

## #

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

# ##

#

#

#

#

#

###

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

##

#

#

#

##

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

##

#

#

#

##

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

## #

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# ##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

####

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

###

##

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

###

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

# ##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

Waianae (593)

North Shore (435)

Pearl City (703)

Makakilo/Kapolei (605)

Airport (449)

Koolauloa (208)

Wahiawa (418)

Aiea (542)

Waipahu (755)

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# ##

##

#

#

#

# #

# #

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

##

#

#

##

#

#

#

#

#

#

#

#

#

#

## #

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

#

# #

#

#

##

#

##

#

#

##

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

# #

#

# #

#

#

#

#

#

##

#

##

#

#

#

#

#

#

#

##

#

#

#

#

##

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

## #

#

#

#

#

#

#

#

##

#

#

#

# #

##

#

#

#

#

#

#

#

# #

#

##

#

##

#

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

## #

#

#

#

#

##

#

#

#

#

##

#

# #

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

###

#

# # #

#

#

#

#

#

#

#

##

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

##

#

#

#

## #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

###

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

###

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# ##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

##

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

##

#

#

#

#

# #

#

#

#

##

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

##

#

#

#

#

#

#

#

#

# # #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

# ##

#

#

#

#

##

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

# #

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

###

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

# #

#

#

#

#

# #

# #

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

##

#

#

#

#

#

#

# #

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

# #

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

##

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

###

##

#

#

#

#

#

#

#

#

#

# #

#

#

#

###

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

##

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

##

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

###

#

#

#

#

#

#

#

#

#

#

#

#

#

# #

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

##

##

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

##

#

#

#

#

#

#

#

#

#

#

##

#

#

#

##

#

#

#

##

#

#

#

#

#

#

#

#

#

#

#

#

#

#

#

## #

#

# #

#

#

#

#

Kalihi-Palama (857)

Downtown (509)

Ala Moana (560)

Number of crashes per district

low (0 - 150 crashes)

medium (151 - 400)

high (410 - 1100)

Motor vehicle crashes, by type

car crash#

moped#

motorcycle#

School-based pedestrian safety initiative (School Traffic Safety Committee of the

City and County of Honolulu, Department of Transportation Services)

• Using HEMSIS data to

map ped/bicyclist

injuries

• Locate prime areas for

"ped heads" and

flashing red lights

– 100-300 safety

devices

• Implementation

~September, 2011

EMS-attended pedestrian injuries, 2006-2010:

1. Crash location, per 911 lat/long

EMS-attended pedestrian injuries, 2006-2010:

2. Overlay of school locations

EMS-attended pedestrian injuries, 2006-2010:

3. Draw ¼ mile radius around schools

EMS-attended pedestrian injuries, 2006-2010:

4. Publish school-specific maps

Applications of HEMSIS maps

DTS School Traffic Safety Committee

Complete Streets Coalition • Used for Neighborhood Board presentations in support

of Complete Streets Ordinance

10 Neighborhood Boards, 7 City Council members

Safe Routes to School, managed by Hawaii State DOT • Used for review of RFP's

• Supported SRTS 2012 application from UH

Mapping of drownings in Hawaii, 1996-2010

%U

%U

%U

%U

%U

%U

%U

%U

%U

#S

#S

#

#

#

#

#

#

#S

#S

#S

#S#S

#S

##

#

# #S#

#

#

#

#S

#S#S

#S

##

#

#S

#S

##

#

##

#

#

#

#S

#S

#

#

#

#S

#S #S

#S

#S

#S

#S

#

#

#

#

#S

#S#S

#S#

#

##

#S#S

#

#

#S#S

#S

#S

#S

#S

#

#

#

#

#S #S#S

KauaiKauai

Lifeguard towers%U

Ocean drownings, by season

April - September#

October - March#SNorth Shore (Polihale-Lighthouse): 35

-23 (63%) from Oct-March

East Shore (Larsens - Lihue): 23 -14 (61%) from April-Sept.

South Shore (Kekaha-Poipu): 23 -15 (65%) from April-Sept.

Seasonality

%U

%U

%U

%U%U%U%U

%U

%U

%U

#

#

#S#

#S

#S

#

#S

#S

#S

#S

#S

#

#

#S

#S

#S

#

#S

#S

#S

#

##

#S#

#S

#S

#S

#S

#S

#S

#

#S

#S

#

#S

#

#S

#S

#

#

#

#

#S

#

##S

#S

#

#S

#

#S

#S

#

#

#S#S

#

#S

##

#

#

#S

#

#

#

#

#

#S

#S

#S

#S

#

#S

#S

#

#S

#

#S

#

#S

#S#S

#

#S

#S

#

#S

#

#

#S#

#S

#S

#S

#S

Lifeguard towers%U

HawaiiOcean drownings, by victim residence

non-resident#

Hawaii resident#S

west coast

(Mauna Kea-Milolii): -32 of 50 (64%) victims non-residents

south and windward coasts: -33 of 40 (83%) victims non-residents

Residence

Summary and next steps

GIS an important component of injury prevention

• Best applications in motor vehicle safety and ocean safety

Next steps • Expand HEMSIS geocoding capability to Neighbor Islands

• Produce crash atlases

Acknowledgements

• Dr. Sharon Vitousek & staff, NHOP

• Chief Wayne Kruse & staff, City & County of Honolulu EMS

• Dr. Linda Rosen and staff, Hawaii State EMS, DOH

• Kari Benes, Injury Prevention Program, DOH

EMS-attended injuries from motor vehicle crashes

on Neighbor Islands, by district, 2007-2010

South

Kohala (413)

North

Kona (1014)

South

Hilo (943)

Puna (742)

Kau (230)

Kawaihau (216)

Lihue (280)

Lahaina (397)

Wailuku (1044)

Makawao (515)

Number of crashes per district

low (0 - 150 crashes)

medium (151 - 400)

high (410 - 1100)

Causes of fatal injuries among Hawaii residents, 2006-2010

Rank

infants

(543)

1-9 y

(128)

10-19 y

(245)

20-29 y

(613)

30-39 y

(944)

40-64 y

(9,777)

65+ y

(34,639)

all ages

(46,889)

1

perinatal

conditions

298

unintent.

injuries

38

unintent.

injuries

96

unintent.

injuries

248

unintent.

injuries

216

cancer

3,154

heart

diseases

8,865

heart

diseases

11,145

2

congenital

anomalies

74

cancer

15

suicide

51

suicide

123

cancer

151

heart

diseases

2,091

cancer

7,440

cancer

10,835

3

unintent.

injuries

24

congenital

anomalies

8

cancer

26

cancer

48

heart

diseases

128

unintent.

injuries

712

CVD

2,624

CVD

3,157

4

respiratory

disease

9

homicide

7

congenital

anomalies

14

heart

diseases

45

suicide

125

CVD

488

CLRD*

1,264

unintent.

injuries

2,102

5

septicemia

7

heart

disease

6

homicide

8

injuries of

und. intent

33

CVD

34

diabetes

346

influenza/

pneumonia

1,122

CLRD*

1,461