ACCIDENTS

SEH001
OLAITAN OYEDUN
D E PA R T M E N T O F C O M M U N I T Y H E A LT H

OAUTHC, ILE-IFE
Outline
▪ What is an Injury
▪ Types of Injury
▪ Road Traffic Accidents/Injuries
▪ Public Health Approach to Injury Prevention
▪ The Haddon Matrix
▪ RTA – Risk Factors
▪ Pre-Crash Prevention
▪ Crash Severity Reduction
▪ Post Crash Measures
▪ Summary
 What is Injury ?
Physical change that results when a human body is suddenly
or briefly subjected to intolerable levels of energy
◦ Can be a bodily lesion from acute exposure to energy in
amounts that exceed the threshold of physiological tolerance
◦ Bruise, Wounds, Burns, Fracture, Joint dislocation, sprain
◦ Can be an impairment of function from lack of one or more vital
elements
◦ Water- drowning
◦ Air- strangulation
◦ Warmth- freezing
Types of Injury
Unintentional (accidental)
◦Road traffic
◦Domestic
◦ Drowning, burns, poisoning (drugs, insecticides, rat
poisoning, falls, bites, injuries from sharp or pointed
instruments.
◦Industrial
◦Railway
◦Airway
Types of Injury (2)
Intentional (deliberate)
◦ Interpersonal violence
◦ Assault, homicide, intimate partner violence, sexual violence
◦ Self directed violence (self –harm)
◦ Deliberate overdose of drugs and alcohol (poisoning), self mutilation, suicide
◦ Legal intervention
◦ Action by police or other law enforcement personnel
◦ War, civil insurrection and disturbances
◦ Demonstrations, riots
Undetermined intent
◦ Difficult to judge between intentional or accidental
Road Traffic Accidents/Injuries
Road Traffic Accidents are among the leading causes of unintentional injuries globally
Globally about 1.2million people died of RTI every year. 85% of these occur in
developing countries
Another 20-50million were injured most of whom were in the economic productive age
group (14-44years)
According to the WHO, low- and middle-income countries account for over 90% of road
traffic deaths but have only about 50% of registered vehicles.
The number of temporary and permanent disabilities resulting from traffic injuries is
many times greater than the number of deaths.
RTI were reported to be the 10th leading cause of death and the 8th leading cause of
disability adjusted life year lost
Leading causes of Injury Deaths Globally
Poisoning 5%

Burns 5%

Falls 6%

War 10%

Drowning 10%

Homicide 11%

Suicide 15%

Other Unintentional causes 18%

Motor Vehicle Crash 20%

0% 5% 10% 15% 20% 25%

cause of death
Road Traffic Accidents in Nigeria
In Nigeria, injuries and deaths resulting from RTA are on the rise, and account for
the highest proportion of deaths on the Africa continent.
Road accidents are Nigeria's third-leading cause of overall deaths, the leading
cause of trauma-related deaths and the most common cause of disability
Nigeria has 1042 deaths a year for every 100,000 vehicles, one of the highest
rates of road fatalities in the world;
Motorcycle accidents constituted about 31.5% of all reported RTAs nationwide
The commonest types of injuries sustained were abrasions and cuts(67.6%)
Factors Contributing to continuing RTIs
Rapid population growth
Increasing motorization
Little access to emergency care
Lack of safety features in car
Crowded roads
Poor road maintenance
Lack of police enforcement
Accidents and Earphone Use
A major cause of “distraction danger” among pedestrians, particularly
young people, globally
Distraction danger is the risks that people are exposed to everyday by
being distracted from their surroundings while listening to music on the
move.
• One out of 10 crashes recorded is as a result of distraction.
• Survey shows that using music players is one of the most practiced behaviors that is
potentially distracting.
• Eight people are killed every day as a result of accidents caused by distractions.
Examples include
o stepping out into a road
o bumping into somebody
o not hearing a vehicle approaching.
Accidents and Earphone Use (2)
More than one in four young people between 18 and 34 have put
themselves in harm’s way when wearing headphones
Situations where to avoid wearing ear/headphones:
◦ While Driving
◦ While Cycling
◦ While running/Jogging/walking on the road
◦ While commuting in public transport
“the use of Hands-Free Devices does not in any way reduce the dangers of
distracted driving, which on its own is a traffic offense. Thus, the dangers of
distracted driving are still very much present even when the driver's eyes are
on the road and hands are on the wheel”
Public Health approach to Injury Prevention
Determine the magnitude, scope and characteristics of the
problem
Identify factors that increase the risk of injury or disability and
to determine which factors are potentially modifiable
Assess what measures can be taken to prevent the problem, by
using the information acquired to design, pilot test and evaluate
interventions
Implement the most promising intervention on a broad scale
The Haddon Matrix
Used as theoretical framework for preventing and controlling RTAs
It Combines the Levels of Prevention with the Epidemiological Triad
in a 3X4 matrix to identify points for intervention
Levels of prevention are in 3 rows (Primary Prevention – “Pre-crash”,
Secondary Prevention – “Crash”, Tertiary Prevention – “Post-crash”)
Epidemiological triad is in 4 columns (Agent – Vehicle Factors, Host –
Factors, Environmental Factors – Physical and Social Environment)
 Risk factors to RTA
Human
◦ Human error
◦ Sex – 96% of riders in an accident were males
◦ Age- over 50% of mortality due to RTIs occur in young adults aged
14-44
◦ Lack of skill and experience- in 20% of crashes ineffective braking was
a factor
◦ Inappropriate or excessive speed- excessive speed for the prevailing
condition was found in 23% of crashes in a study in Australia
◦ Dangerous overtaking: Responsible for 48% of all accidents in Nigeria
◦ Lack of body protection, helmets, safety belts etc
◦ Heightened emotional tension
Risk factors to RTA
Human (2)
◦ Alcohol and drug use
◦ Licensing
◦ Fatigue
◦ Distraction: handheld telephones usage has increased, eating, drinking,
changing radio stations and smoking cause distraction.
◦ Other factors include visibility of drivers, rate at which information is
processed by the brain, risk taking, medical conditions etc
Risk factors to RTA
Vehicular Factors
◦ Vehicle maintenance- brake failure, wobble tyre, incorrect tyre
pressure, etc
◦ Vehicle overload:
Environmental factors
◦ Bad roads- slippery roads, potholes, defective narrow roads,
defective lay out of crossroads, and speed breakers, poor lighting,
lack of familiarity with the roads,
◦ Bad weather
◦ Others include presence of stray animals, flying objects, pebbles
and negligence of pedestrians
Interventions to Reduce the incidence of RTIs
Group into 3 phases: Pre crash, Crash and Post crash,
Pre-Crash
◦ Measures which reduce exposure to risk
◦ Measures which prevent road crashes from occurring

Crash
◦ Measures aimed at reducing the severity of injury

Post -Crash
◦ Measures to reduce the consequences of injury through improved post collision care
Pre crash prevention
Reducing exposure to risk
◦ Well regulated Mass transit systems eg bus and train
Prevent crashes from Occurring
◦ Enactment of laws to prevent drinking
◦ Road safety education
◦ Ensuring Vehicular roadworthiness
◦ Improvements in Road designs
◦ Regulations relating to speed and engine performance
◦ Increasing legal age at driving
◦ Introduction of graduated licensing systems
Crash severity Reduction
Wearing of correct protective equipment
Enactment and Enforcement of helmet law, seat belt etc
Airbags in cars
Use of protective clothing
Post Crash measures
Provision of appropriate first aid , pre-hospital and hospital care for
victims
Functional Ambulance system
Rehabilitation services
Accident research
Summary
◦Injuries can be accidental or intentional
◦Road Traffic Accidents are the most common form of
Unintentional (accidental) Injuries
◦Public Health control principles are effective in
preventing and controlling RTAs
◦The Haddon Matrix is useful for identifying risk factors
and how to prevent them
Acknowledgement
Injuries and Poisons as Public Health Problems – PowerPoint Presentation by AA Fatiregun
Ansari H, Mohammadpoorasl A. Using Earphone and its Complications: An Increasing Pattern in
Adolescents and Young Adults, Health Scope. 2016 ; 5(1):e32130. doi:
10.5812/jhealthscope.20153.