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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

Pr Hassen Ghannem

Department of Epidemiology

University Hospital Farhat Hached Sousse,




  • 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.
  • 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 epidemiology1


  • 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

descriptive epidemiology2


  • 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 epidemiology3

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.
  • 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.


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).

The key


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 :


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.


1- World report on road traffic injury prevention.

Geneva (Switzerland), World health organization, 2004.


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.