JINNAH SINDH MEDICAL UNIVERSITY

ROAD TRAFFIC ACCIDENT

Assessment of severity of injuries among motorcycle or bike riders: A cross sectional study in
Karachi

⮚ Introduction:
A road traffic accident refers to an unexpected incident that occurs on a public road
involving vehicles, resulting in trauma, damage to property, injury or loss of life. It
typically involves the collision of two or more vehicles caused by factors such as
negligence, recklessness or mechanical failure.
Death from RTAs account for around 23%of all deaths from injuries and 2.1% of all
globally. (Approximately 3000 deaths/day on roads throughout the world) and 10/1000
become disable for life). (1)
In China 2019, a survey was conducted around in which 17.4% road traffic injuries were
found to be the bike riders. Each year there was 63000 deaths due to road traffic
accidents since 2016. (2) China has recorded about 256,101 injuries in road traffic
accidents across the country. (2) In China, it has been seen the number of traffic
accidents has significantly decreased, and from 2007 to 2015, fewer people have died in
traffic incidents involving motor vehicles. On the other hand, since 2012, there have
been a lot more fatal non-motor vehicle incidents. A total of 256,101 people were
injured in road traffic accidents in China in 2019. (2) The incident of accidents involving
road traffic injuries in China has significantly increased since 2016. (3)
Low and middle income countries have high burden around 91% of the world’s
fatalities. Road safety campaigns in 2007 reduce severe road traffic incidence by 35%
and increase helmet use from 11% to 46% (4) but no further thereafter. Most RTI are
unrecorded and official statistics only reflect a little part of the problem. (4)
In 2017, approximately there were 4.65 lac officially registered traffic accidents, resulting
in 147,913 fatalities and 4.8 lac injuries, or 405 fatalities and 1,290 injuries daily from
1,274 accidents. 53 people were hurt every hour on Indian roadways in 2017, with 16
people dying. (5)
Research shows that in South Asia men are more likely than women to participate in
RTIs. In terms of RTI mortality, men often pass away earlier than women. Young adults
are the most frequent victims when compared to victims who are males of different
ages. (6)
Now road traffic accidents are the third leading cause of death by 2020. (7)
A study was conducted for the assessment of frequency of risk factors associated with
road traffic accidents of motorbikes in Karachi a city of Pakistan.(7)
A total of 127 accident cases from respected hospital were included in the study. Most
(76%) of the accident cases were younger than 33 years indicating age as a risk factor.
Approximately, 49% of the participants were riding the bikes without driving license
having low awareness and road sense making them more prone to having an injury.
Nearly, 43% never used helmet during riding a most important risk factor.
Approximately, 21% were reported that they were chewing tobacco at the time of
accident. Majority (71%) of the accident occur on the working days that means heavy
traffic and abundance of vehicles increase the risk of accidents. Almost 61% of the
accidents occurred in the evening time. In 43% of the cases, speed of the motorbike was
more than 50 kilometer per hour indicating towards personal behavior of rash riding and
over speeding as an important factor. Nearly, 31% of the victims were riding along with
their friends/family members. Majority (72%) of the accidents occur on the main roads.
About, 38% of the victims reported that they were in depressed mood while riding bike.
In a nut shell mental depression or distractions, young age and lack of driving expertise
were the major risk factors for motorbike accidents. (7)
In Pakistan Injuries are fifth leading cause of loss of healthy life, and second leading
cause of disability. Death rate from RTAs is 4 per 100,000 population and 15 per 10,000
vehicles in Pakistan. (7)
Non-fatal injuries of 19 per 10,000 population has been reported from Karachi. (7) Bike
riders and scooter riders are mostly the victims and experience hardships from severe
injuries and ultimately leads towards death. (7)
Another study showed that the factors discussed are the most contributing in accident:
lack of experience, risky behavior such as one-wheeling, drifting, speeding, ignoring
traffic and safety regulation rider physical and psychological fatigue, female pillion
passenger whose clothes stuck in the wheel or chain(8) In Pakistan motorcyclists are
inherently susceptible to more injuries than car occupants due to lack of protection for
instance the motorcyclists fatality rate is 28 times higher than that of car occupants.(8)
The rapid increase in motorcyclist combined inadequate road safety conditions has led
to increase motorcycle crashes for example in the biggest city Karachi of Pakistan are
involved in 45% of total road crashes.(8)
Motorcycle related safety problems such as speeding underage riding red light running,
riding without helmet. Among the motorcyclists specific characteristics the riders age
and lack of experience are the important factor that affects severity. (8)
Above studies and states clearly show that road traffic accident and specially bike
accidents is one of the most terrible non communicable disease across the world and
despite of so many researches and policies this program is still a point of concern so the
purpose of our research is to find the reliable baseline data on all the severe injuries and
the most prominent areas where these motorcyclists are the major victims in Karachi
and their route causes. find out the gaps and factors that are contributing to this
problem. In order to inform concern authorities so that they would be able to take
certain precautionary or preventive measures on those prone areas, this will ultimately
some how reduce the burden of this RTA.

Objective:
 To assess the severity of injuries among motorcycle accidents reporting to
emergency department of a tertiary care hospital in the months of January -
February 2024
  To determine the use of personal protective equipment among motorcyclists
experiencing accidents and reporting to emergency department of tertiary care
hospital
 To identify the influencing factors at the time of injury among motorcycle accidents
reporting to emergency department of tertiary care hospital

Operational Definition:
Accident:
A collision or incident that occurs on a road involving vehicles, pedestrians or cyclists
resulting in damage, injuries or fatalities often caused by factors such as negligence,
speeding or road conditions.
(OR)
Any unusual or unintentional incident happened on a road either due to the collision
of two vehicles or collision of a vehicle with any object and falling of motorcycle
resulting in any damage or injury would be considered as an accident.

Material and Method:

Study design:
Cross sectional study during the months from January to February 2024
Study setting:
This study will be carried out among motorcyclist accidents victims who report to
emergency department of a tertiary care hospital at Jinnah post graduate medical
center.
Study Duration:
Three months after approval of IRB board
Sampling technique:
Sampling of convenience, consecutive motorcycle accidents reported to ER
departments at JPMC.

Sample size:
Injuryseverity # reported Place/ year of RR or Sample size
scale for study prevalence
motorbike
PPE helmet use 323 2021 Karachi With head Total:86
Pakistan injury samples were
N=112, 34.7% used which will
Helmet users: split in each
n-23, 20.5% group as
Non-helmet (helmet users-
users: n= 89, 43samples,
79.5% non-helmet
Without head users-
injury 43samples)
excluded
 Influence
factors

Mobile 49 (53.8%) (2017-2018) 98.9%

Karachi Pakistan

2015 Karachi
Cigarette 127 Pakistan 3.8times 1.6,9.0
( most of
accident cases)
64% younger
than 30 years

Department of 40%
Alcohol 192 forensic medicine 274
Male = 189 and toxicology
Female= 11 Nawabshah
(2014-2017)

Sample selection:
Inclusion:
Any motorcycle accident victim reporting to the Jinnah hospital (emergency and wards)
during January - February 2024
Exclusion:
 Anyone who refuses to respond to survey questions
 Outside patients from Karachi will be excluded

Data collection method:

Study team member will schedule visits to Emergency departments of JPMC during day time
and evenings, and might information will be obtained in early morning and records from
night staff
Data collection tool:
(Questionnaire)
Based on objectives
Data entry and analysis:
Data entry program will be made in SPSS and analysis will be performed in SPSS.

References:
 1) https://www.who.int/china/activities/protecting-chinese-e-bike-users-from-road-
injuries-and-deaths#:~:text=According%20to%20police%20data%20from,to
%20police%20data%20from%20China

2) https://www.statista.com/statistics/276260/number-of-fatalities-in-traffic-accidents-in-
china/\

3) https://peerj.com/articles/7423/
4) Slesak G, Inthalath S, Wilde-Smith A, Barennes H. Road traffic injuries in northern
Laos:
Trends and risk factors of an underreported public health problem.
Trop.Med.Int.Health. 2015, 20(11).
5) Pal R, Ghosh A, Kumar R, Galwankar S, Paul SK, Pal S, et al. Public health crisis of
road traffic accidents in India: Risk factor assessment and recommendations on
prevention on the behalf of the Academy of Family Physicians of India. J Family Med
Prim Care. 2019, 8(3)
6) Vinish V, Chakrabarty J, Vijayan S, Nayak BS, Shashidhara YN, Kulkarni M, et al.
Prevalence of road traffic injuries in South East and South Asian region. J Neurosci
Rural Pract. 2023, 14(6) 2).
7) Ali A, Mehraj J, Mehmood S, Mirza Z, Tahir M. Frequency of risk factors associated
with road traffic accidents of motor bikes in a big city of developing country. JDUHS.
2010, 4(2):1.
8) Pervez A, Lee J, Huang H. Identifying factors contributing to the motorcycle crash
severity in Pakistan. J. Adv. Transp. 2021.

Personal characteristics
Age
Sex
Education
Experience / years of motorcycling
During a day hours of bike riding
How many times have you experienced bike accident?
License
Contact number:
Accident:
Place
Time
Time to reach hospital
Vehicle collision
Pedestrian collision
Weather; sunny if day; dark if night; evening...Dust; fog
Roundabout, road,
Pillion riders (number, age groups,)
Condition of vehicle; (good bad…breaks…)
Injury:
Severity
Scale
Admitted / not admitted
Site of injury: face, head, upper limb, lower limb, back, spine,
chest
First aid on the road

Personal protective equipment

Helmet
Dress pant

Influencing factors:
Cigarette smoking; habit; time of accident; drugs;
Mobile use

# Characteristics Response Skip

 Section I Personal characteristics
1 Age in years -----------
2 Sex
3 Accident
1.Collision with pedestrian 2
2.Another motor bike
3.vehicle larger truck
4.cars
4 Education
1)Primary
2) Matric
3)Inter
4)Graduated
5 Experience of motorbike
1) How long have you been riding a
motorbike?
6 Time of accident? Need to be exact
1) Day
2) Night
7 Do you have a license?
1) Yes
2) No
8 How many times have you
experienced bike accident in past?
1) Once
2) Twice
3) Thrice
4) Multiple times
Location of the accident?
1. District East
2. District South
3. District North
4. District west
What were the condition of the road
at the place of accident?
1) pothole
2) dry
3) wet
4) mud
Other/specify
How accident happened?
1) Vehicle collision
 2) Pedestrian collision
How was the weather at the time of
the accident?
1) Sunny
2) Dark
3) Evening
4) Fog
5) Dust
6) Rain
7) Storm
8) Windy
Number of persons with you at the
time of accident?
What was the condition of your
vehicle?
1) Brakes working?
2) Horn?
3) Indicators?
4) Quality of vehicle?
Time to reach hospital?
1) Immediately
2) Within one hour
Admitted or not admitted?
First aid provided on road or not?
Site of injury?
1) Face
2) Head
3) Upper limb
4) Lower limb
5) Chest
6) Spine
7) Neck
Personal protective equipment?
1) Helmet
2) Dress pant
3) Gloves
4) Jacket
Influencing factors?
1) Mobile use
2) Cigarette smoking
3) Alcohol use
4) Drug use
5) Dupatta or scarf