Transcript Document
Dr.Rajkumar Patil Asstt. Prof., Community Medicine AVMCH, Pondicherry Accident Unpremeditated events resulting in recognizable damage Feeling of misfortune,unavoidable nature Injury A bodily lesion due to acute exposure to energy beyond the physiological tolerance. In some cases injury is due to insufficiency of a vital element Feeling of preventable nature Leading contributor in global diseases 1990 1.Lower Rasp. Infec. 2.Diarrhoea 3.Prenatal condition 4.Unipolar major depression 5.IHD 6.Stroke 7.TB /HIV 8.Measles 9.Road traffic Injury 10.Congenital 2020 1.IHD 2.Major Depression 3.Road Traffic Injury 4.Stroke 5.COPD 6.Lower Resp. Inf. 7.TB 8.Perinatal condition 9.Diarrhea Diseases 10.HIV Types of Injuries and Global burden Unintentional (3.5 million deaths, 6.2% of total deaths) Intentional (1.6 million deaths, 2.8% of total deaths) RTA(2.1%) Self inflicted(1.5%) Falls(0.7%) Interpersonal violence(homicide)(1%) Drowning(0.7%) War(0.3%) Poisoning(0.6%) Fires(0.5%) Others(1.6%) Injuries in SEA More than 25% deaths due to injuries occur in SEAR Prioritization of injury problem in India RTA>Work related>Burns>Violence>Poisoning>Drowning Injury related mortality rate in India 97 deaths/100,000 population Epidemiology of Injuries Injury as a disease Pathologic Host condition Agent Vector /vehicle Interaction Malaria Human Plasmodium Mosquito vivax Bite Skull fracture Human Mechanical Motorcycle Energy Crash Host factors Age:15-44 yrs(50% mortality) Sex: More in males Education: Low educational status Diseases: Defective vision,sudden illness,fatigue Psychological factors: Inexperience,aggresiveness,defective judgement, Alcoholism,drugs,stress Road Traffic Accidents(RTA) 90% of all RTA deaths occurs in low,middle income countries Causes of RTA 1.Pedestrians and animals sharing common road 2.Fast and slow moving vehicles 3.Old,poorly maintained vehicles 4.Low driving standards 5.Overloaded vehicles 6.Disobey of traffic rules 7.Defective roads,speed breakers,poor street lighting 8.Unusual behaviour of men and animals Prevention and control of RTA/RTI 1.Education regarding safety “If accident is a disease,education is its vaccine” 2.Promotion of safety measures Seat belts Safety helmets Children on back seats Parking at a suitable place Low beam headlights Avoidance of mobile phones Door locks Proper vehicle design Avoidance of alcohol and drugs 3.Elimination of causative factors o Marking of danger points o Improvement of road conditions o Imposition of speed limit 4.Enforcement of laws o Medical fitness of driver o Alcohol conc. In blood (80 mg/100 ml limit in India) o Driving test o Seat belt wearing o Speed limit o Helmets o Vehicle inspection o Periodic examination of drivers 5.Emergency care services o Planning,organization and management of trauma treatment and emergency care services o Emergency care at the point of accident Domestic Accidents 1.Drowning • Most common cause of accidental deaths in Bangladesh and Maldives • 98000 lives lost (SEAR,2002) Prevention and control of drowning Availability of life jackets and flotation devices around pools & boats Supervision of children by adults Fencing of lakes and ponds Creation of safety standards for public and private swimming pools Ensuring availability of weather reports to fishermen and to those working on rivers and seas 2.Fire/Burn 184,000 deaths (SEAR,2002) SEAR accounts for >50% of all fire related mortality Risk factors Cooking on open fire Explosion of pressure stoves Instability of small stoves Use of open fires in winter Use of inflammable materials in house Use of fire crackers Prevention and control of burns Stable stoves/lamps Replacement of pressure stoves with wick and gas stoves Installation of fire and smoke alrama Promotion of cold water for first aid and burns 3.Poisoning 95,000 death(SEAR,2002) Agents: pesticides,kerosene,prescription drugs, household chemicals Prevention and control of poisoning Restricting availability of hazardous pesticides Promotion of alternative non-chemical methods of pest control Safe packaging of pesticides,insecticides and other chemicals Dying kerosene blue and treating it with bittering agents Selling therapeutic drugs in child resistant containers Educating medical practitioners,health workers and community on effective antidotes to poisons common in community 4.Falls Responsible for largest number of hospital visits for non-fatal injuries Prevention and control of falls 1.Safer playground(Use of mud & sand surfaces instead of paved ones) 2.Safer furniture & house designs 3.Use of grills on windows 4.Safer design of stairs,balconies and rooftops with railings and bars 5.Safer working techniques for construction workers 5.Injuries from sharp objects 6.Animal bites Industrial accidents 200,000 deaths per year in SEAR Risk factors Physical(Heat) Chemical(Pesticides) Biological(Animal bites) 4 “M”s Mechanical Injuries(Thressure) Manual labour Man machine interaction Mental condition Prevention and control of industrial accidents Ensuring the cost effective protection measures Enforcing safety regulations and standards Creating awareness among workers Intentional Injuries 1.6 million deaths(Globally-2002) 390,000 deaths in SEAR 66% suicides in 15-34 years age group Intentional injuries require: • Motivated person who injures • Suitable target • Suitable environment Risk factors • Violence as a means to solve the problem • Lethal weapons availability • Alcohol and drug consumption • Political uninterest • Gender unequality • Depression Prevention and control of violence Avoidance of risk factors Prevention of Accidents and Injuries 1.Inter-sectoral coordination 2.Reporting of all accidents 3.Safety education 4.Promotion of safety measures 5.Alcohol and other drugs 6.Primary care 7.Enforcement of laws 8.Rehabilitation services 9.Accident research extent types environment human behaviour evaluation of control measures