Public health

Incidence of Motorcycle Accidents

Memberś of group :
‫ايات حسن كريم‬
‫دعاء عبد الرضا جبر‬
‫مروة مازن زامل‬
‫صابرين عواد هاشم‬
‫نبأ محمد حسني‬

Supervisor by :
Dr salam sahib Alrubaiey
Dr saad l. Al-Ghabban

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 Abstract
Background: Road traffic accidents are a major global concern
which affects all people regardless of their age, sex, wealth,
among others. Injuries and deaths due to motorcycle are highly
increasing, especially in
developing countries. Wearing helmet has been shown to
significantly reduce deaths and injuries due to
motorcycle accidents.

Key words: Risk factors; injury pattern; motorcycle accidents; road

traffic accidents; Holy karbala

Objective: To shed light on the risk factors and pattern of injuries

in motorcycle accidents in Holy Karbala.

Design: Hospital-based cross-sectional, study.

Setting: Al-Husain teaching hospital in Holy Karbala in Iraq, from
1st of January 2021 to 12th of July 2021.
Patients and Methods: This study involved all injured motorcyclists
involved in road traffic accidents who were admitted to the
emergency department and their mortalities which were referred to
the medico-legal department (N=194). The information collected
included personal identification data, the person’s position on the
motorcycle during the event, in addition, the type and site of injury
and the outcome of the victims were reported

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 Patients and Methods
This prospective clinical study was performed on 194 patients with road traffic accident (RTA)
who had been admitted to, general surgery ward, neurosurgical ward and intensive care unit in Al-
Hussein Teaching Hospital, Karbala - Iraq, from 1st of January 2021 to last of August 2021.
The patients had been classified into three groups according to the mechanism of trauma, these
include: motorcycle accidents (no.= 150), car accidents (no.=34), or others (no.=10), for car and
motorcycle accidents, both pedestriansand drivers or cyclists are included in this study.
For each included patient, a detailed history was taken including name, age, sex, residence,
detailed history about the trauma, complete physical examination and history of smoking or
alcohol or drug addiction.
The fate of each patient was recognized to whether discharged with full recovery or with chronic
disability or died.
Statistical methods done by using statistical package social sciences (SSPS) were used to assess
whether the obtained differences could be accepted as insignificant (if p=0.05), significant (if
p≤ 0.05).
The consent of the patients and official requirements were taken.

Results
Table 1 reveal 194 patient were included in this prospective study with history of road traffic
accident (RTA), as following: 150 patients (77.3%) with motor cycle accident, 34 patients with
car accident (17.5%), and 10 patients (5.2%) with other types of RTA.

Male patients represent 61.3% of RTA, were female patient represent 38.7%, meanwhile 87
(58%) male patient considered in motor cycle accidents and female patients were 63 (42%), as
shown in table 2 and figure 1.

Table 3 and figure 2 reveal the most affected age group in RTA 21-40 years old age (127 patients,
65.5%), at the same time in motor cycle accident were (112 patients, 74.7%).

The most common types of injury in motor cycle accident is fracture and massive bleeding in 43
patients (28.7%), as shown in table 4.

Table 5 consider the site of injury in motor cycle accident which is seen mostly in limbs in 64
patients (42.7%).

The outcomes of the injury in patients with motor cycle accident as follow as death in 10 patient
(6.6%), full recovery in 127 patients (84.7%), and chronic disability in 13 patients (8.7%), as
shown in table 6 and figure 4.

Table 7 and figure 5 reveal distribution of patients with motor cycle accident according to the
presence of history of past- events, 64 patients (42.7%) had positive history of past-events out of
150 total patients.

54 smoker patients (36%) out of 150 patients with motor cycle accidents, and 96 non-smoker
patients (64%), as shown in table 8 and figure 6.

In motor cycle accident, 32 patient (21.3%) had history of alcohol intake, and 118 patient (78.7%)

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had no history of alcohol intake as shown in table 9 and figure 7.

Table (1) Distribution of patients according to the types of road traffic accident
(RTA)

Types Patients No. Percentage

Motorcycles 150 77.3
accidents
Car accidents 34 17.5
Others 10 5.2
Total 194 100.00

Table (2) Distribution of patients with RTA according to the gender

Types Male Patients Female Patients

Motor cycles 87 (58%) 63 (42%)

accidents
Car accidents 25 9
Others 7 3
Total 119 (61.3%) 74 (38.7%)

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Figure (1) Distribution of patients with motor cycle accidents according to the
gender

Table (3) Distribution of the age of patients in relation to type of RTA

Types Patient’s Age Total No.

≤ 20 years 21 - 40 years 41 - 60 years > 60 years
Motor cycles 27 (18.0%) 112 (74.7%) 10 (6.7%) 1 (0.6%) 150
accidents
Car accidents 3 14 15 2 34
Others 5 1 3 1 10

Total 35 (18.0%) 127 (65.5%) 28 (14.4%) 4 (2.1%) 194

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Figure (2) Distribution of patients with RTA according to the age

Table (4) Distribution of patients with motor cycle accident according to the types of
injury

Types of Injury No. Percentage (%)

Bruising 35 23.3
Fracture 41 27.3
Fracture and 43 28.7
massive bleeding
Other 31 20.7
Total 150 100.0

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Figure (3) Distribution of patients with RTA according to the types of injury

Table (5) Distribution of patients with motor cycle accident according to the site of
injury

No. Percentage (%)

Site of Injury
Limbs 64 42.7
Head and neck 46 30.7
Others 40 26.7
Total 150 100.0

Table (6) Distribution of patients with motor cycle accident according to the
outcome of injury
Outcome of Injury No. Percentage (%)

Death 10 6.6
Full recovery 127 84.7
Chronic disability 13 8.7
Total 150 100.0
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Figure (4) Distribution of patients with motor cycle accident according to the
outcome of injury

Table (7) Distribution of patients with motor cycle accident according to the
presence of past- events

Past events No. Percentage (%)

Yes 64 42.7
No 86 57.3

Total 150 100.0

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Figure (5) Distribution of patients with motor cycle accident according to the
presence of past- events

Table (8) Distribution of patients with motor cycle accident according to the
smoking state

Smoking state No. Percentage (%)

Smoker 54 36.0
Non-smoker 96 64.0

Total 150 100.0

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Figure (6) Distribution of patients with motor cycle accident according to the
smoking state

Table (9) Distribution of patients with motor cycle accident according to alcoholic
state

Alcohol state No. Percentage (%)

Yes 32 21.3
No 118 78.7

Total 150 100.0

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Figure (7) Distribution of patients with motor cycle accident according to alcoholic
state

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 Discussion
The hospitalization rate of motorcyclist’s injuries concluded in this study,
which is 4 folds that reported in a series of three papers describing the
epidemiology of motorcycle crashes resulting in death and hospitalization
in New Zealand, point out
The higher incidence of motorcycle
accidents among males concluded in our study in consistent with the
findings of other previous studies in other countries (3, 9, 13,16).
The high morbidity rate among younger
age groups is in accordance with that
concluded by Lin and, Kraus (2009) in
their review of 220 articles on of risk
factors and patterns of motorcycle injuries papers published in developing
countries from January1980 to August 2008 and that of Begg et al (1994)
(4,22). The average age of the injured
motorcyclists in our study is lower than
that concluded by similar studies in
Nigeria, Germany, Tehran and Singapore (36.4, 28.8, 28.11 and 26.4
years respectively)(3,10,13,16); which could be attributed to the fact that,
in our country, adolescence and even children are not prohibited from
driving motorcycles and, even, more than two motorcyclists (riding
one motorcycle, mostly young adults and children) are allowed. The
majority of the injured motorcyclists (77.6%) were 15-39 years of age,
which is the important productive age group; this adds a tremendous
burden on the family and the society. The high morbidity rate among
younger age groups is in accordance with
that concluded by Lin and, Kraus in their review of 220 articles on of risk
factors and patterns of motorcycle injuries papers published from
January1980 to August
2008 and that of Begg et al (1994)(4,22). The declining trend of the
incidence rate with advancing age within the drivers encountered in our
study is similar to that
concluded by Mullin et al (2000) in New
Zealand and Lin et al (2003) in Taiwan
but it is different from that concluded by Tomida et al 2005 in Japan who
concluded that there was no significant correlation between risk of injury

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and age (15,23,24); this
can be attributed to the fact that in our
culture carelessness and risk taking
behaviour during driving, not only
motorcycles but even cars, is more the
younger the driver is. The highest rate of injured drivers who are
teenagers
concluded in this study is similar to that of previous studies in New
Zealand and
Mazandaran Province in Iran (23, 25). They
are in accordance with the two
explanations for the over presentation of young traffic participants in
accidents the so called “beginner risk” and “youth risk”
which explained the relation of age and
accidents (8, 16). Rutter and Quine (1998) in UK found that age played a
much greater role than inexperience in explaining why young age groups
are over-represented in casualty statistics(27). The prevalence of pillion
passengers among injured motorcyclist concluded in our study (32.9%) is
considerably higher
than that concluded by similar previous
studies by Begg et al (1994) in New
Zealand and Zargar et al (1999-2000) in Tehran (12% and 5.6%
respectively)(13,22); this could be explained by the fact that even more
than one pillion passenger were often seen riding with the driver the
highest percent were below 15 years of age .The considerable percent of
females as
pillion passengers concluded could be
attributed on the basis of the increasing needs of easy accessible transport
only.
Having a low level of education has been identified to be a risk factor in
accidents; the low level of education encountered among most of the
drivers concluded in this study is in accordance with similar but higher
than that seen in a study by Iribhogbe and Odai (2006) in Benin City

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Conclusions: Teenagers motorcycle drivers are the most commonly
affected category in
motorcycle accidents. Lower limb injuries represent the commonest site
and fractures represent the commonest form of injury among
motorcyclists involved in road traffic accidents. A considerable
proportion of cases need inpatient medical care. Head injuries were
the predominant cause of deaths

Key words: Risk factors; injury pattern; motorcycle accidents; road traffic
accidents; Holy karbala
Conclusion

This study highlighted that helmet wearing was very low. Having license,
driving strips, exposure to
accident, driving experience and accident risk perception were
determinants of helmet wearing. These
determinants imply that helmet wearing was directly or indirectly relies
on motorcycle drivers’ knowledge
and perceptions about accidents and helmet wearing. Therefore, we
advise all stakeholders to conduct
public education like awareness creation campaigns and via media,
promote motorcycle rider training
programs, routine sensitization on safe riding and give attention to road
safety measures to improve
helmet wearing among motorcyclists. Concerned bodies were also
recommended to prepare and
distribute advocacy messages about the risks of head injury and other
consequences of motorcycle
accidents. The study highlights the importance of setting and enforcing
stringent legislative measures /
mandatory universal helmet legislation. In addition, periodic police
checks also help to improve helmet
wearing. We also advise the relevant key authorities like trafic police to

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allow only riders with a
motorcycle license to ride in order to encourage others to apply for a
license. We also recommend
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