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U n i t 2 Risk factors for road traffic injuries. Objectives. By the end of this unit, the trainee should be able to: discuss the basic elements of the public health approach to road safety and the Haddon matrix;

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U n i t 2 risk factors for road traffic injuries l.jpg

U n i t 2

Risk factors

for

road traffic injuries


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Objectives

  • By the end of this unit, the trainee should be able to:

  • discuss the basic elements of the public health approach to road safety and the Haddon matrix;

  • apply the principles of a systems approach to the analysis of risk factors for road traffic injuries;

  • discuss the key risk factors for road traffic injuries;

  • relate these risk factors to the trainee's own country, region or city.


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Public health approach

2) Risk factor identification

What are the causes?

1) Surveillance

What is the problem?

3) Develop and evaluate interventions

What works?

4) Implementation

How is it done?


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Understand the four inter-related steps of the public health approach

What is the problem?

- Determine the magnitude, scope and characteristics of the problem.

What are the causes?

- Identify factors that increase the risk of disease,

injury or disability.

- Determine factors that are potentially modifiable.


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Understand the four interrelated steps of the public health approach

What works?

- Assess measures that can be taken to prevent the problem.

- Pilot test and evaluate interventions.

How is it done?

- Implement proven and effective interventions.

- Evaluate effectiveness of interventions.


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Haddon Matrix approach

Factors

Vehicles and equipment

Phase

Human

Environment

Roadworthiness

Lighting

Braking

Handling

Speed management

Crash prevention

Information

Attitudes

Impairment

Police enforcement

Pre-crash

Road design and road layout

Speed limits

Pedestrian facilities

Injury prevention during the crash

Crash

Use of restraints

Impairment

Occupant restraints

Other safety devices

Crash protective design

Crash-protective roadside objects

Ease of access

Fire risk

First-aid skill

Access to medics

Rescue facilities

Congestion

Life sustaining

Post-crash


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Systems approach approach

  • Understand the system as a whole.

  • Understand interactions between different components.

  • Consider not only underlying factors, but also role of different agencies and actors in prevention efforts.


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Work approach

Human factors

Vehicle factors

School

Leisure

Road and environmental factors

Shopping

Others

Road and transport system

System approach

Road users

Road and environment

Vehicle

Desired output

Undesired outputs

Mobility

Other consequences of transport

Road traffic crashes

System of trips

Crashes and crash factors


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Major risk factors are identifiable approach

Factors influencing exposure to risk

  • economic factors

  • demographic factors

  • land-use planning practices

  • traffic mix

  • road function versus design and layout


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Major risk factors are identifiable approach

  • Risk factors influencing crash involvement

    • speed

    • alcohol or drugs

    • fatigue

    • male

    • vehicle defects

    • youth driving together

    • vulnerable road users


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Major risk factors are identifiable approach

Risk factors influencing crash severity

  • speed

  • seat-belts, child restraints

  • helmets

  • Non-crash protective roadside objects

  • insufficient vehicle crash protection

  • alcohol and other drugs


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Major risk factors are identifiable approach

Risk factors influencing post-crash outcome of injuries

  • delay in detecting crash

  • delay in transport to a health facility

  • fire resulting from collision

  • leakage of hazardous materials

  • alcohol and other drugs

  • rescue, extraction, evacuation

  • poor trauma care and rehabilitation


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Key points (1) approach

  • A road traffic collision is the outcome of the interaction among a number of factors, some of which may not appear to be directly related to road traffic injuries.

  • The public health approach is helpful in the analysis of risk factors and guiding decision-making.

  • The Haddon matrix helps to identify human, vehicle and environmental factors during pre-, crash- and post-crash phases.


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Key points (2) approach

  • The systems approach considers all factors contributing to road traffic injuries as well as the role of different agencies and actors in prevention efforts.

  • Main risk factors can be categorized into four groups:

  • ○ factors influencing exposure to risk

  • ○ factors influencing crash involvement

  • ○ factors influencing crash and injury severity

  • ○ factors influencing post-crash injury outcomes


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Learning activity approach

  • Task

  • Read carefully this description of a road traffic collision scene.

    • A speeding motorist who is late for a meeting approaches a road junction and goes through a traffic light that has just turned red. He hits a motorcyclist, for whom the lights had just turned green. The motorcyclist, who is not wearing a helmet, suffers severe head injuries. The motorist suffers facial injuries. The police find out that the motorist had not put on his seat-belt.

  • Using the Haddon matrix, identify the pre-crash and crash risk factors related to the driver and the motorcyclist.


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Expected results approach

This exercise is meant to assist trainees in identifying the chain of events involved in road traffic injury causation. The exercise seeks to identify a few risk factors in this scene and classify them under the three phases of the Haddon matrix (pre-crash, crash, and post-crash) and by group (human, vehicle and equipment, and environment). In addition to identifying the risk factors, this exercise should lead trainees to look at the interaction among different elements of the broader system of road, road user, vehicle and environment, in the case presented.


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Questions to think about approach

  • Why is the public health approach a useful framework in dealing with road safety issues?

  • What are the most important risk factors for road traffic injuries in your local setting?


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