skills development for research on road traffic injuries samath sl.pdf · 2015. 5. 17. ·...

Skills Development for Research on Road Traffic Injuries

Samath D DharmaratneMBBS, MSc, MD

Secretary, Road Traffic Injuries Research Network,Department of Community Medicine, Faculty of Medicine,

University of Peradeniya, SRI LANKA

5th January 2006Plant Genetic Resource Centre,

Gannoruwa, Kandy,Sri Lanka

Global Burden of InjuryGlobal Burden of Injury

Estimated Estimated 5 million people5 million people died from died from

INJURIESINJURIES in 2000 (WHO 2002)in 2000 (WHO 2002)

Accounting for Accounting for 9% of global deaths9% of global deaths

90%90% of the injury deaths occur in of the injury deaths occur in

lowlow-- and middle income countriesand middle income countries

Burden of injury in Sri LankaBurden of injury in Sri Lanka

Injuries are the Injuries are the leading cause of leading cause of

hospital admissions (2000 per hospital admissions (2000 per

100,000 population) (AHB, SL 2002)100,000 population) (AHB, SL 2002)..

Injuries are the 10Injuries are the 10thth leading cause of leading cause of

hospital deaths (AHB, SL 2002).hospital deaths (AHB, SL 2002).

ROAD TRAFFIC INJURIESROAD TRAFFIC INJURIES

Road traffic injuriesRoad traffic injuries are the are the

leading cause of injury related leading cause of injury related

mortality and morbidity in Sri Lanka mortality and morbidity in Sri Lanka

accounting for 25% to 30% of the accounting for 25% to 30% of the

burden (AS, SL 2004).burden (AS, SL 2004).

Global Burden of Global Burden of RTIsRTIs

More than More than 20 million20 million people are injured people are injured

and killed annually from and killed annually from RTIsRTIs (WHO 2004)(WHO 2004)

Burden falls most heavily on Burden falls most heavily on developing developing

countriescountries (particularly Asia), due to the (particularly Asia), due to the

rapid increaserapid increase in the number of vehiclesin the number of vehicles

By 2020, By 2020, 2.3 million will die2.3 million will die

ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES ––Globally Globally –– CostCost

Economic cost estimated as Economic cost estimated as US$ US$

518 billion518 billion annually (TRL 2000)annually (TRL 2000)

Of this Of this 12.5%12.5% or or US $US $ 65 billion65 billion is is

accounted for by the developing accounted for by the developing

countriescountries

Global Burden of Global Burden of RTIsRTIs

Globally, Globally, RTIsRTIs will increase by will increase by over 60%over 60%

•• 80% increase in low and middle 80% increase in low and middle

income countriesincome countries

•• 30% decrease in high income 30% decrease in high income

countriescountries

ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES ––Situation in Sri LankaSituation in Sri Lanka

In the year 2000, In the year 2000, 54,239 54,239 road traffic road traffic

crashes were reported, killing crashes were reported, killing 2,1502,150

people and injuring people and injuring 19,83519,835 (TP data)(TP data)

Daily Daily –– 6 people are killed6 people are killed

Every hourEvery hour –– 2 are injured2 are injured

Every 10 minutesEvery 10 minutes –– a RTC is reporteda RTC is reported


No information about the No information about the

unreported crashes.unreported crashes.

Documented that 25% of Documented that 25% of

fatal fatal RTCsRTCs are not reported are not reported

((WootonWooton J et al 1996).J et al 1996).

Research neededResearch needed

To identify causesTo identify causesTo interest policy makersTo interest policy makersTo plan and implement preventive To plan and implement preventive programsprograms

Skills Development for ResearchSkills Development for Research

Therefore the RTIRN is conducting Therefore the RTIRN is conducting this workshopthis workshop


Majority killed and injured are Majority killed and injured are young young

peoplepeople, between 15, between 15--44 years.44 years.

People needed for the development People needed for the development

programs of the country.programs of the country.

Can SL afford to loose them?Can SL afford to loose them?


About 40% to 50% of the injured and About 40% to 50% of the injured and

killed are killed are pedestrianspedestrians (RHF 2004)(RHF 2004)--

?Poor people?Poor people

Principal wage earner Principal wage earner -- ?Increase in ?Increase in

povertypoverty

RTIsRTIs are a are a SOCIAL PROBLEMSOCIAL PROBLEM

affecting Sri Lankan society.affecting Sri Lankan society.


Economic loss range from Economic loss range from RsRs. 5 billion (5. 5 billion (5thth

MBI 2004) to MBI 2004) to RsRs. 10 billion (US$ = . 10 billion (US$ =

100Rs.).100Rs.).

Estimated loss from a (5Estimated loss from a (5thth MBI 2004),MBI 2004),

•• Fatal crash is Fatal crash is RsRs. 2,000,000. 2,000,000

•• Injury crash is Injury crash is RsRs. 35,000. 35,000

•• Damage only crash is Damage only crash is RsRs. 17,000. 17,000


It was estimated that in 1999, 0.5% It was estimated that in 1999, 0.5%

of the GDP was lost from of the GDP was lost from RTCsRTCs in Sri in Sri

Lanka (5Lanka (5thth MBI 2004) MBI 2004)

In rupees it was,In rupees it was,

5,047,158,5585,047,158,558

ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES –– Situation in Sri LankaSituation in Sri LankaSome statistics related to Some statistics related to RTAsRTAs in Sri in Sri Lanka from 1940Lanka from 1940--1998 (CS data)1998 (CS data)

1940 1998 Increase

Road crashes 3979 50 959 12-fold

Deaths 168 2 023 11-fold

Motor vehicles 30 802 1 511 207 48-fold

Population 5 951 000 17 935 000 3-fold

Roads (km) 10 114 22 457 * 1.2 fold

ROAD TRAFFIC INJURIES ROAD TRAFFIC INJURIES –– Situation in Sri Situation in Sri LankaLanka

Population growth from 1940 - 2000

02468

101214161820

1940

1945

1950

1955

1960

1965

1970

1975

1980

1985

1990

1995

2000

Year

Popu

latio

n in

mill

ions

Population increased by 2 fold


Increase in the number of registered motor vehicles (1940 - 2000)

0

200000

400000

600000

800000

1000000

1200000

1400000

1600000

1800000

Year

1943

1947

1951

1955

1959

1963

1967

1971

1975

1979

1983

1987

1991

1995

1999

Year

Num

ber o

f veh

icle

s

Registered motor vehicle increased by 54 fold


Road traffic accidents per 100,000 population 1940 - 2000

0

50

100

150

200

250

300

350

1942

1945

1948

1951

1954

1957

1960

1963

1966

1969

1972

1975

1978

1981

1984

1987

1990

1993

1996

1999

Year

RTAs per 100,000 population increased by 3 fold


Road traffic injuries per 100,000 population

0

20

40

60

80

100

120

140

1942

1945

1948

1951

1954

1957

1960

1963

1966

1969

1972

1975

1978

1981

1984

1987

1990

1993

1996

1999

Year

Road traffic injuries per 100,000 population increased by 114%


Road traffic fatalities per 100,000 population

0

2

4

6

8

10

12

14

1940

1950

1960

1970

1980

1990

2000

Year

Fata

litie

s/10

0,00

0pop

ulat

ion

Road traffic fatalities per 100,000 population increased by 3 fold

ROAD TRAFFIC INJURIES IN SRI LANKA ROAD TRAFFIC INJURIES IN SRI LANKA –– The futureThe future

If no action is taken, in the next 20 If no action is taken, in the next 20 year (Safety 2004),year (Safety 2004),

••50,000 will die50,000 will die••400,000 will be injured400,000 will be injured••More thanMore than

RsRs. 20 x. 20 x 5,047,158,558 5,047,158,558 will be lost will be lost


0

5

1 0

1 5

2 0

2 5

1940

1944

1948

1952

1956

1960

1964

1968

1972

1976

1980

1984

1988

1992

1996

2000

2004

2008

2012

2016

2020

Y e a r

Fata

lity

rate

per

100

,000

pop

ulat

ion

O b s e r v e d r a te P r e d ic te d r a te9 5 % C I - lo w e r l im it 9 5 % C I - U L

Projected rate for road fatalities in Sri Lanka

By 2020, RT Fatalities rate will increase by 25% to reach 14.5 fatalities per 100,000 population (Safety 2004)


0.0

50.0100.0

150.0

200.0

1940

1947

1954

1961

1968

1975

1982

1989

1996

2003

2010

2017

Year

Inju

red

per 1

00,0

00

popu

latio

n

Observed Projected Low er 95% Upper 95%

By 2020, RTI rate will increase by 16% to reach 174.7 per 100,000 population (ISC 2004)

Projected rate for injured from RTAs in Sri Lanka

Road Traffic Injury Prevention Requires a “Systems Approach”

ROAD USER

ROADSVEHICLE

ROAD TRAFFIC INJURIES IN SRI ROAD TRAFFIC INJURIES IN SRI LANKALANKA

IS AN IMPORTANT DISEASE WHICH IS AN IMPORTANT DISEASE WHICH

HAS ASSUMED EPIDEMIC HAS ASSUMED EPIDEMIC

PROPORTIONSPROPORTIONS

WHY NO ACTION?WHY NO ACTION?

Even though everyday at least one Even though everyday at least one

RTC is reported in mediaRTC is reported in media


Dengue, Malaria and TB kills far less Dengue, Malaria and TB kills far less but they have programs and but they have programs and campaigns for their prevention and campaigns for their prevention and control (AHB 2002)control (AHB 2002)Even one death attracts huge media Even one death attracts huge media attentionattentionWHY?WHY?I do not know, but is scary? I or you I do not know, but is scary? I or you might be the next victim.might be the next victim.


EpidemicEpidemic

No action or interest by relevant No action or interest by relevant

peoplepeople

Reason for my interest in this Reason for my interest in this

diseasedisease

Road Traffic Injury Prevention can be Achieved

0

5

10

15

20

25

30

35

1960

1962

1964

1966

1968

1970

1972

1974

1976

1978

1980

1982

1984

1986

1988

1990

1992

1994

1996

1998

2000

2002

Years

Fata

lity

rate

per

100

000

pop

ulat

ion

UK Australia USA

Road Traffic Injuries are a Public Health Problem

Public Health

Injury Surveillance

Research

Prevention & Control

Evaluation

Policy

Services

Advocacy

HEALTH PROFESSIONALS AND HEALTH PROFESSIONALS AND RTI RESEARCHRTI RESEARCH

Health professionals taking an interest is very important to generate interest among others, especially politicians

Easy accessibility in collecting data• From hospitals, police etc.

ROAD TRAFFIC INJURIES IN SRI ROAD TRAFFIC INJURIES IN SRI LANKA LANKA –– PREVENTION & CONTROLPREVENTION & CONTROLAppoint a DIRECTOR for INJURY Appoint a DIRECTOR for INJURY PREVENTION in the Ministry of PREVENTION in the Ministry of Health Health Form a CAMPAIGN for INJURY Form a CAMPAIGN for INJURY PREVENTIONPREVENTIONEstablish an INJURY SURVEILLANCE Establish an INJURY SURVEILLANCE SYSTEMSYSTEM

ROAD TRAFFIC INJURIES IN SRI ROAD TRAFFIC INJURIES IN SRI LANKA LANKA –– PREVENTION & CONTROLPREVENTION & CONTROL

FORM AN ACTIVE COMMITTEE WITH POWER,FORM AN ACTIVE COMMITTEE WITH POWER,

Consisting of all related people, such as Consisting of all related people, such as

Doctors, Engineers, Police, Policy makers, Doctors, Engineers, Police, Policy makers,

EMVsEMVs, RDA and UDA representatives, drivers , RDA and UDA representatives, drivers

(CTB, PVT bus, TW, School vans) etc.(CTB, PVT bus, TW, School vans) etc.

ROAD TRAFFIC INJURIES CAN BE ROAD TRAFFIC INJURIES CAN BE PREVENTED PREVENTED –– in Sri Lankain Sri Lanka

But, copying strategies directly from But, copying strategies directly from

developed countries might not work.developed countries might not work.

WHY?WHY?

Because the scenario is different.Because the scenario is different.

Need to find local risk factors and solutions Need to find local risk factors and solutions

ROAD TRAFFIC INJURIES CAN BE ROAD TRAFFIC INJURIES CAN BE PREVENTED PREVENTED –– in Sri Lankain Sri Lanka

For which local research is neededFor which local research is needed

For research money is neededFor research money is needed

To get money, people with money To get money, people with money

have to recognize that have to recognize that RTIsRTIs and and

deaths are a significant problemdeaths are a significant problem

VISION AND MISSION OF RTIRNVISION AND MISSION OF RTIRN

To reduce RTI’s in Low & Middle Income Countries

Road Traffic Injuries Research Road Traffic Injuries Research Network (RTIRN)Network (RTIRN)

RTIRN SECRETARIAT IN SRI RTIRN SECRETARIAT IN SRI LANKALANKA

Opportunity for Sri Lanka as well as

regional countries to highlight the

importance of RTIs

VISION AND MISSION OF RTIRN VISION AND MISSION OF RTIRN SECRETRIATSECRETRIAT

To generate knowledge on To generate knowledge on RTIsRTIs

•• At Launch of the SERETARIAT At Launch of the SERETARIAT –– 44thth January 2006January 2006

•• Workshop on Workshop on ““Skills development in RTI researchSkills development in RTI research”” –– 55thth

January 2006January 2006

•• NewsletterNewsletter

•• Increasing membershipIncreasing membership

•• Web siteWeb site

VISION AND MISSION OF RTIRN VISION AND MISSION OF RTIRN SECRETRIATSECRETRIAT

Thereby Thereby generate interest in RTI’samong relevant people to investigate them – researchResearch needs fundsMore people becoming interested will generate more funds which will make more people interested etc.Capacity building

RTIRN SECRETRIATRTIRN SECRETRIAT

Most of the regional countries have Most of the regional countries have people interested in people interested in RTIsRTIsSri Lanka very fewSri Lanka very fewHaving the Secretariat in Sri Lanka Having the Secretariat in Sri Lanka will be a great opportunity for me as will be a great opportunity for me as well as the people of Sri Lanka to well as the people of Sri Lanka to address this forgotten National address this forgotten National TragedyTragedyThank you Thank you

Public Health Emergency and Public Health Emergency and Disaster Management Training Disaster Management Training

CourseCourse

13th December 200513th December 2005

Road Traffic Injuries –Group work

Group oneGroup oneTopic: Develop a Road Traffic Injury/ Topic: Develop a Road Traffic Injury/

Accident Surveillance SystemAccident Surveillance System

What is it?What is it?Why it is needed?Why it is needed?Plan a RTI SS Plan a RTI SS –– identify resources identify resources needed, construct one needed, construct one –– local or local or nationalnationalCost ?effectivenessCost ?effectivenessMonitoring and evaluationMonitoring and evaluation

Group twoGroup twoTopic: Develop a RTI/RTA prevention Topic: Develop a RTI/RTA prevention

program/campaignprogram/campaign

JustificationJustificationObjectivesObjectivesIdentify resourcesIdentify resourcesCost? Cost? –– effectivenesseffectivenessLocationLocationMonitoring and evaluationMonitoring and evaluation

Group threeGroup threeTopic: How to quantify the under Topic: How to quantify the under reported reported RTAs/RTIsRTAs/RTIs in Sri Lankain Sri Lanka

skills development for research on road traffic injuries samath sl.pdf · 2015. 5. 17. ·...

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