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Road traffic accidents in Tunisia: a man made disaster Pr Hassen Ghannem Department of Epidemiology University Hospital Farhat Hached Sousse, Tunisia Disaster Webster’s Dictionary defines disaster as a baleful or fatal event leading to ruin. Family Country

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Road traffic accidents in Tunisia: a man made disaster

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Road traffic accidents in Tunisia:

a man made disaster

Pr Hassen Ghannem

Department of Epidemiology

University Hospital Farhat Hached Sousse,

Tunisia


  • Disaster

  • Webster’s Dictionary defines disaster as

  • a baleful or fatal event leading to ruin.

    • Family

    • Country

  • What’s more disastrous for someone than the death of a relative following a road traffic accident.


  • INTRODUCTION

    • Injuries account for 12% of the global burden of disease (1, 2)

    • Traffic accidents are costing countries between 1% to 2 % of their gross national product

    • Traffic accidents are a major preventable public health problem

    • About 1,2 millions persons were killed and 50 millions were injured, worldwide, in 2002.


    DESCRIPTIVE EPIDEMIOLOGY

    Figure 2 : Road traffic injury mortality rates in the different regions of the world (1)


    DESCRIPTIVE EPIDEMIOLOGY

    Worldwide

    • Road traffic injuries mortality rates :

      *1,2 millions persons killed every year

      * 3242 persons killed every day

      * Traffic accidents : 11th cause of death

      * Developing countries:

      - 2/3 of the world population

      - 90% of deaths due to road crashes


    DESCRIPTIVEEPIDEMIOLOGY

    Worldwide

    • Road traffic injury mortality rates :

      * Increase in the mortality rates of 10% between 1990 and 2002 (1)

      * Differences between developped and developing countries

    Figure 3 : Changes in road crashes mortality rates according to countries (1)


    DESCRIPTIVE EPIDEMIOLOGY

    In Tunisia

    During the period 1996-1998 (3):

    - 32 197 accidents, with 14,9 deaths per 100 accidents

    - an average traffic accidents incidence :

    116,3 / 100 000 inhabitants / year

    - an average mortality rate :

    14,2 deaths / 100 000 inhabitants / year

    - 5,9 persons killed per 100 humans implied

    - the average age of the persons who were implied in the accidents : 33,6 years

    - About 61,7 % of drivers were aged 20-40 years;

    21 times more males than females among drivers

    - Pedestrians were the most vulnerable and the most severely injured.


    RISK FACTORS

    The risk depends on four elements :

    • A)   Exposure excess (need to travel)

    • B)   Risk of crash, given a particular exposure,

    • C)   Risk of injury, given a crash,

    • D)   Risk of death or severe consequences, given an injury.


    PREVENTION

    • Taffic accidents are preventable.

    • The three targets of the road safety actions :

      - the road users

      - the vehicles

      - the roads infrastructure as well as the traffic management.


    PREVENTION

    A- A scientific approach to the issue is necessary :

    Many conditions are required to guarantee the efficiency of the prevention strategies which are adopted.

    • To collect, analyse and carefully interpret reliable data  : The National Traffic Observatory in Tunisia was established to fulfill theses missions.

    • To define objectives.

    • To promoteresearch, which subjects are concerned with road safety.

    • To encourage the cooperation between different organizations intervening in traffic accidents prevention (NETWORKING).


    B-

    The key

    organizations

    intervening in

    the prevention

    strategies :

    Figure 7 : Organizations intervening

    in road safety actions(1)


    C- Prevention measures :

    Prevention strategies are made of interventions which are aiming to :

    • diminish the exposure risk.

    • avoid road crashes, given a particular exposure.

    • reduce the severity of injuries caused by crashes

    • improve the medical care for victims.


    Measures avoiding road crashes, given an exposure

    • Speed limitation

    • Measures against « alcohol and driving »

    • Measures avoiding the drivers fatigue :

    • Measures ensuring pedestrian and cyclists safety

    • Prevention of traffic accidents implying young drivers

    • The prohibition of the use of hand-held mobile telephones while driving

    • More road visibility


    Measures reducing the severity of injuries caused by crashes :

    a – The use of seat-belts 

    • When used, the seat-belt reduce the risk of fatal or severe accident, between 40% and 65 % (1).

    • Making the wearing of safety belts compulsory improves their use rates.

      b- Use of helmets 

      c- Availability of air bags


    Actions improving post-crash injury outcome

    - pre-hospital mesures :

    * Bystanders : call for help, carry out simple acts to rescue victims, protect victims from an other accident

    * Larger access to emergency services

    * Better pre-hospital medical care

    - actions in the hospital :


    CONCLUSION

    Traffic accidents constitute a huge public health problem: a man made disaster.

    The situation is going to be worse unless prevention strategies are adopted.

    There is a hope to avoid such losses of lives, of health and of money by setting road safety actions.

    A scientific approach to the issue is essential in every country, so that road safety policies could be founded on reliable data, and meeting financial resources of each region.


    REFERENCES

    1- World report on road traffic injury prevention.

    Geneva (Switzerland), World health organization, 2004.

    (http:/www.who.int/violence_injury_prevention)

    2- Bovet B. Health transition and emerging cardiovascular disease in developing countries :

    situation and strategies for prevention, Super course.

    3- Henchir N. Epidemiology of traffic accidents in Tunisia [thesis]. Sousse : Medicine

    Faculty of Sousse 2001.


    THANK YOU


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