Road-related injuries

Transcription

1 Road-related injuries An Advocacy Role for Paediatricians AJ Nicholson CESP Dec 2006

2 Paediatricians and Prevention Immunisation spectacular success Antenatal screening renal, cardiac, others Postnatal screening - Guthrie, DDH, Hearing Early detection Diabetes tight glycaemic control Early intervention for developmental delay

3 Paediatric hard nuts Social inequity Obesity Asthma Micropremmies Allergies Injuries

4 What is our role? Transfer of critically ill victims ICU management Rehabilitation Family support Consider prevention

5 In Europe, more children die of injuries than all other childhood diseases combined.

6 The IMPACT of child injury beyond deaths

7 Applied science approach to safety FAULT DOCTRINE APPLY SCIENCE acts of God Hazards / design Blame/sue someone Reduce hazards Change behaviour Education/training

8 Injuries the disease model Explore epidemiology Identify risk factors Establish countermeasures Assess effectiveness of countermeasures

9 Injury Epidemic Every day around the world, 3,000 people die from road-related related injury Low/middle income countries account for 85% of deaths 90% of disability adjusted life years lost due to road traffic injury Road-related deaths are projected to drop by 30% by 2020 in high-income income countries but will rise in low/middle-income income countries

10

11

12 Road injuries profile Males > females (3:1) age group Childhood deaths increased in low/middle- income countries EU 40,000 deaths and 150,000 disabled for life due to road injuries

13

14 Protecting Pedestrians

15 Pedestrian injuries Typically, accidents in year olds are back overs and year olds are dart outs. High traffic volume, lower income and younger age are all associated with pedestrian injuries*. *

16

17 Child Pedestrian Injuries by Hour of Day and Day of Week, Monday Tuesday Wednesday Thursday Friday Saturday Sunday

18

19 Overview re Pedestrian Injuries Childhood pedestrian injuries occur largely in urban areas during the evening time. Boys are more commonly involved than girls. Children in the most deprived wards have a fivefold increase in pedestrian injury.

20 Protecting Cyclists

21 Bicycle Injuries Helmets lead to reductions in head and brain injuries of 63% - 88% Motorcycle helmets can reduce head injuries in motorcyclists by 72% Mandatory helmet wearing legislation has lead to a 25% reduction in head injuries in cyclists

22 Cyclist Fatalities by Age n = Fatalities yrs 4-6yrs 7-9 yrs yrs 13-15yrs

23 Helmet Wearing Helmet Use Fatal Serious Minor Total Yes No Total

24 Young drivers Reduce exposure to high risk scenarios for young, inexperienced drivers (eg( reduction of engine size from 250 -> > 125 cc for learner motorcycle drivers) Graduated driver licensing systems for young drivers Zero tolerance of alcohol in learner drivers (permitted BAC to 0.01 g/dl)

25 Safer road design Motorways with median barriers are the safest of all roads Safer rural roads with periodic lanes for overtaking Traffic calming measures in residential access roads (< 30 km/hour) Separate pedestrian and bicycle routes

26 Motorways are safest roads

27 Designing smart vehicles Smart, audible seat belt reminders Use of a digital road map onto which speed limits have been coded -> > intelligent speed adaptation Alcohol ignition interlock system detect alcohol on the breath of drivers -> > vehicle will not start Electronic stability programme to maintain vehicle stability in adverse weather

28 Protecting Car Passengers

29 Protecting car passengers Age -appropriate car restraints are effective Vehicle design so that compartment maintains its integrity in a crash Carseat fitting stations EU standards re carseats

30 Carseats at different ages

31 Do not forget 6 12 year olds Booster cushion Frequently non- compliant

32 Car seat usage over study period p< % car seat usage

33 Carseat study In initial cohort, car seat use was associated with higher social class(p<0.01) and breast feeding (p<0.05) Subsequent cohorts; car seat usage in all social classes Persistent non-compliant group asylum seekers/unemployed/leaving in a taxi

34 Road User Categories n = 6,045 28% 10% 62% vehicle pedestrian cyclist

35 Vehicle Fatalities by Age n = Driver Front Rear yrs

36 Seatbelt Wearing by Age n = 3, yrs 4-6 yrs 7-9 yrs yrs yrs seatbelt no seatbelt

37 Compliance with road safety rules Enforcement levels need to be high and maintained Apprehension with swift administration of penalties Speed cameras -> > automated fines Enforce BAC limits -> > random (1 in 10 drivers/yr) Public education without enforcement has negligible effect

38 Enforcement is the key!

39 The Paediatrician role Promotion of injury surveillance Discovery of risk factors that might increase or decrease risk of crash injuries Study effective interventions Advocacy role Cross-sectoral sectoral collaboration

40 Skills required for the task Patience Collaboration with others Communication skills Media skills Persistence

41 Key organizations for policy development Government Citizens Paediatricians Media RTA Prevention Policy Police Special Interest Groups Industry

42 The Role of the Paediatrician when meditating over a disease,i never think of finding a remedy for it but,instead a means of preventing it Louis Pasteur 1884

43 Useful websites for further information health-day/2004/en/ For statistics and reports from the World Health Organization of road traffic injuries and injury prevention For the UN, Economic Committee for Europe, activities in the field of road safety For the European politico-legislative legislative context on road safety. This website contains facts and figures.