1. ACCIDENTS
AND
INJURIES
Dr. Muhammedirfan H. Momin
Assistant Professor
Community Medicine Department
Government Medical College, Surat.

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3. DEFINITIONS
• ACCIDENT
• Unexpected, unplanned occurrence of an event
which may involve injury.
• In 1956 WHO advisory group defined accidents as
– Unpremeditated event resulting in recognizable
damage.
• Occurrence in a sequence of events which usually
produce unintended injury, death or property
damage.

5. DEFINITIONS
INJURY
A bodily lesion due to acute exposure to energy
beyond the physiological tolerance.

7. • Accidents are the part of prize we are
paying for technological advances.
• Like other diseases accidents are also
having –
• Natural history of disease and
• Agent, Host and Environmental factors

8. Epidemiology of Injuries
Injury as a disease
Pathologic Host Agent Vector Inter-
condition /vehicle action
Malaria Human Plasmodium Mosquito Bite
vivax
Skull Human Mechanical Motorcycle Crash
fracture Energy

9. Leading contributor in global diseases
1990 2020
1.Lower Rasp. Infec. 1.IHD
2.Diarrhoea 2.Major Depression
3.Prenatal condition 3.Road Traffic Injury
4.Unipolar major depression 4.Stroke
5.IHD 5.COPD
6.Stroke 6.Lower Resp. Inf.
7.TB /HIV 7.TB
8.Measles 8.Perinatal condition
9.Road traffic Injury 9.Diarrhea Diseases
10.Congenital 10.HIV

10. How to Measure the Problem of Accident
Mortality:
• Proportionate Mortality Rate
– Number of deaths due to accidents out of 100
total deaths
• Number of deaths per million population
– Killed in Road Traffic Accident (RTA) is defined as
any person who was killed outright or who died
within 30 days as a result of accident.
• Death Rate per 1000 registered vehicles per year
• Number of accidents or fatalities as a ratio of
number of vehicles per km OR passenger per km.

12. • Morbidity:
– Measured in terms of
• Slight injury and
• Serious injury
• Disability:
– Disability is one of the important outcome
of accidents
• Temporary or Permanent disability
• Partial or Total disability

13. Problem statement
World:
• Accidents are endemic all over the world
• Accidents are major cause of deaths in the
age-group of 10-24 yrs
In developed countries -
• 57% of male death and
• 43% of female death in 10-24 yrs are due to
accidents.
• RTA and drowning are the main causes of
death in that age-group.

14. In SEAR:
• Out of total 5.1 million accident deaths in the world 1/4th in
SEAR.
• So thousands of children saved from Nutritional and
infectious disease are killed by accidents.
India:
• Increasing trends in India due to
– Mechanization in agriculture and industries
– Increase in vehicular traffic
• Plus factors like
– Overcrowding
– Lack of awareness and
– Poor implementation of safety precautions

15. Types of accidents
• Road Traffic Accidents (RTA)
• Domestic accidents
– Drowning
– Burns
– Falls
• Industrial Accidents
• Railway accidents
• Violence

16. Causes of accidents
• Accidents are complex phenomena with
multiple causation
• Etiological factors are classified to
– Human
– Environmental
– Psychosocial factors

17. Human factor Environmental factor
• Age
• Relating to road
• Sex
• Relating to
• Education vehicle
• Psychological • Bad weather
factor • Mix traffic
• Lack of body
Increase
protection
vulnerability
and risk
Precipitating factor situation
ACCIDENT

18. Human factor
• Age:15-44 yrs(50% mortality)
• Sex: More in males
• Education: Low educational status
• Medical condition
• Sudden illness
• Heart attack
• Impaired vision
• Fatigue
• Lack of protection
– Helmet

19. Psychosocial
• Lack of experience
• Risk taking behavior
• Impulsiveness
• Defective judgment
• Delay in decision
• Aggressiveness
• Poor perception
• Family dysfunction

20. Environmental
• Related to Roads:
– Defective and narrow
roads
– Defective lay out of
cross-roads,
– speed breakers
– Poor lighting

21. Environmental
• Related to Vehicles:
– High speed
– Poorly maintained vehicles
– Large number of 2-3 wheelers
– Overloaded bus
– Low driving standards
• Bad Weather

22. Environmental
• Inadequate laws
• Mixed Traffic
– Pedestrian
– Animals and vehicles

23. Precipitating factors
• Increased emotional tension
• Use of Alcohol during driving

24. Precipitating factors
• Stolen vehicle
• Group traveling

25. Road Traffic Accident
• “Road Safety is No Accident” – was the slogan given
by WHO for World Health Day – 2004.
• 85% of all road accident deaths occur in developing
countries and nearly half in the Asia-Pacific region.
• India has one of the largest highway and road
networks second only to road network of U.S.

26. Road safety advertising

27. How accidents in developing countries differ from
developed countries:
• Two wheelers are more involved
• Pedestrians are more involved

28. How accidents in developing countries differ from
developed countries:
• Large number of old and poorly maintained vehicles
• Overloaded buses

29. How accidents in developing countries differ from
developed countries:
• Disregard towards traffic rules

30. How accidents in developing countries differ from
developed countries:
• Poor road standards

31. How accidents in developing countries differ from
developed countries:
• Unusual behavior of human and animals

32. • Unusual behavior of car

34. Domestic accidents
• Accidents which takes place in home or in its
immediate surrounding, which are not connected
with traffic vehicles or sports.
• Common domestic accidents are-
– Drowning
– Burns by flame,
– hot liquid,
– electricity,
– crackers, chemicals
– Falls
– Injury by sharp objects
– Animal bites.

35. Drowning
• After immersion in water victim loses
consciousness with in 2 min. and
• Irreversible brain damage occurs at 4 – 6 minutes.

37. Prevention and control of drowning
Availability of life jackets and flotation devices
around pools & boats
Supervision of children by adults
Fencing of lakes and ponds
Creation of safety standards for public and
private swimming pools
Ensuring availability of weather reports to fishermen and
to those working on rivers and seas

38. Burns
• Factors associated with burns
– Explosion of pressure stove.
– Cooking on open fire
– Use of open fire during winter
– Use of inflammable material
– Method of suicide

39. Prevention and control of burns
 Stable stoves/lamps
 Replacement of pressure stoves with wick
and gas stoves
 Installation of fire and smoke alarm
 Promotion of cold water for first aid and
burns

40. Poisoning
• Most common agents are –
– Kerosene
– Pesticides
– Household chemicals
– Drugs
• Kerosene poisoning common among children.

41. Fall
• Large number of hospital visits among
children and young adults for non-fatal
injuries.
• Fall from
– Roof, balcony, stair-case, window are common.
• Among construction workers are common

42. Fall

43. • Prevention and control of falls
• 1.Safer playground (Use of mud & sand
surfaces instead of paved ones)
• 2.Safer furniture & house designs
• 3.Use of grills on windows
• 4.Safer design of stairs, balconies and
rooftops with railings and bars
• 5.Safer working techniques for construction
workers

44. Industrial accidents
• Approximately 580 million workers in SEAR.
• 60-80% are in small scale units

45.  Prevention and control of industrial
accidents
 Ensuring the cost effective protection
measures
 Enforcing safety regulations and standards
 Creating awareness among workers

46. Railway accidents
• In India railway accidents are in increasing
trend due to
– Increasing number of trains
– More number of passengers

48. Violence
• Risk factors for violent behavior:
– Exposure to violence and societal acceptability of
violence as a mode to solve the problem
– Availability of lethal weapon at home
– Consumption of alcohol

49. • Suicide are increasing in SEAR region
– 36/1,00,000 in India
– 22/1,00,000 in Thailand
– 11/1,00,000 in Bangladesh
– 8/1,00,000 in Srilanka
• Common methods of suicide:
– Hanging
– Drowning
• 70% of cases of suicide in 15-35 yrs age
• M:F ratio is 1:13 to 1:3

50. Prevention of Accidents
• Multi-sectorial approach approach for
prevention.
Data collection:
• Reporting system for accidents
• Special surveys for accidents
– Risk factors
– Circumstances
– Chain of event
• No effective system of prevention without
data collection.

53. Safety education:
• “Accident is a Disease – Education is its Vaccine”
– Should start from school days
– Drivers trained for vehicle maintenance and safe
driving.
– Education about traffic rules
– Training in First Aid.
Promotion of Safety measures:
– Helmets
– Seatbelts
– Leather clothing and boots

54. Promotion of
Safety measures:
 Children on back seats
 Parking at a suitable place
 Low beam headlights
 Avoidance of mobile
 Door locks
 Proper vehicle design
 Avoidance of alcohol
and drugs

55. Alcohol and other Drugs:
• Alcohol - 30-50 % of RTA
• Alcohol and drugs like
• Barbiturates,
• Amphetamine must be avoided
Primary care
• Planning, Organization and Management of Trauma
treatment and Emergency care
• Emergency care should begin at the site, continue
during the transport and conclude in the hospital.
• Trauma care hospitals in all major cities

58. Elimination of Causative Factors:
– Improper roads
– Speed limits
– Marking danger points
– Fire guards
– Use of safety equipments
– Safe storage of drugs, poison and weapon.
Enforcement of Law
o Medical fitness of driver
o Alcohol conc. In blood (80 mg/100 ml limit in India)
o Driving test
o Seat belt wearing
o Speed limit

60. Enforcement of Law
o Helmets
o Vehicle inspection
o Periodic examination of drivers
Rehabilitation
– Medical
– Social
– Occupational
Accident Research

61. THANK YOU
Wish you a safe journey of Life….