Road traffic accidents in Tunisia:
a man made disaster
Pr Hassen Ghannem
Department of Epidemiology
University Hospital Farhat Hached Sousse,
Tunisia
Disaster
Webster’s Dictionary defines disaster as
a baleful or fatal event leading to ruin.
•Family
•Country
What’s more disastrous for someone than
the death of a relative following a road
traffic accident.
INTRODUCTION
Injuries account for 12% of the global
burden of disease (1, 2)
Traffic accidents are costing countries
between 1% to 2 % of their gross
national product
Traffic accidents are a major
preventable public health problem
About 1,2 millions persons were killed
and 50 millions were injured,
worldwide, in 2002.
DESCRIPTIVE EPIDEMIOLOGY
Figure 2 : Road traffic injury mortality rates in
the different regions of the world (1)
DESCRIPTIVE EPIDEMIOLOGY
Worldwide
Road traffic injuries mortality rates :
* 1,2 millions persons killed every year
* 3242 persons killed every day
* Traffic accidents : 11th cause of death
* Developing countries:
- 2/3 of the world population
- 90% of deaths due to road crashes
DESCRIPTIVE EPIDEMIOLOGY
Worldwide
Road traffic injury mortality rates :
* Increase in the mortality rates of 10% between 1990 and 2002 (1)
* Differences between developped and developing countries
Figure 3 :
Changes in road
crashes mortality
rates according
to countries (1)
DESCRIPTIVE EPIDEMIOLOGY
In Tunisia
During the period 1996-1998 (3):
- 32 197 accidents, with 14,9 deaths per
100 accidents
- an average traffic accidents incidence :
116,3 / 100 000 inhabitants / year
- an average mortality rate :
14,2 deaths / 100 000 inhabitants / year
- 5,9 persons killed per 100 humans implied
- the average age of the persons who were implied
in the accidents : 33,6 years
- About 61,7 % of drivers were aged 20-40 years;
21 times more males than females among drivers
- Pedestrians were the most vulnerable and the most
severely injured.
RISK FACTORS
The risk depends on four elements :
A) Exposure excess (need to travel)
B) Risk of crash, given a particular exposure,
C) Risk of injury, given a crash,
D) Risk of death or severe consequences,
given an injury.
PREVENTION
Taffic accidents are preventable.
The three targets of the road safety actions :
- the road users
- the vehicles
- the roads infrastructure as well as the
traffic management.
PREVENTION
A- A scientific approach to the issue is necessary :
Many conditions are required to guarantee the efficiency of
the prevention strategies which are adopted.
To collect, analyse and carefully interpret reliable data
: The National Traffic Observatory in Tunisia was
established to fulfill theses missions.
To define objectives.
To promote research, which subjects are concerned
with road safety.
To encourage the cooperation between different
organizations intervening in traffic accidents
prevention (NETWORKING).
B-
The key
organizations
intervening in
the prevention
strategies :
Figure 7 : Organizations intervening
in road safety actions(1)
C- Prevention measures :
Prevention strategies are made of interventions
which are aiming to :
diminish the exposure risk.
avoid road crashes, given a particular
exposure.
reduce the severity of injuries caused by
crashes
improve the medical care for victims.
Measures avoiding road crashes, given an
exposure
Speed limitation
Measures against « alcohol and driving »
Measures avoiding the drivers fatigue :
Measures ensuring pedestrian and cyclists safety
Prevention of traffic accidents implying young
drivers
The prohibition of the use of hand-held mobile
telephones while driving
More road visibility
Measures reducing the severity of injuries
caused by crashes :
a – The use of seat-belts
When used, the seat-belt reduce the risk of
fatal or severe accident, between 40% and 65
% (1).
Making the wearing of safety belts compulsory
improves their use rates.
b- Use of helmets
c- Availability of air bags
Actions improving post-crash injury outcome
- pre-hospital mesures :
* Bystanders : call for help, carry out simple acts to
rescue victims, protect victims from
an other accident
* Larger access to emergency services
* Better pre-hospital medical care
- actions in the hospital :
CONCLUSION
Traffic accidents constitute a huge
public health problem: a man made
disaster.
The situation is going to be worse
unless prevention strategies are
adopted.
There is a hope to avoid such losses of
lives, of health and of money by setting
road safety actions.
A scientific approach to the issue is
essential in every country, so that road
safety policies could be founded on
reliable data, and meeting financial
resources of each region.
REFERENCES
1- World report on road traffic injury prevention.
Geneva (Switzerland), World health
organization, 2004.
(http:/www.who.int/violence_injury_prevention )
2- Bovet B. Health transition and emerging
cardiovascular disease in developing countries :
situation and strategies for prevention, Super
course.
3- Henchir N. Epidemiology of traffic accidents in
Tunisia [thesis]. Sousse : Medicine
Faculty of Sousse 2001.
THANK YOU
