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“Occupational Road Safety in India” - Interactive Driving Systems

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“Occupational Road Safety in India” - Interactive Driving Systems Powered By Docstoc
					           Presentation By :


dr param preet GHuman
          mBBs, pGdHa, mBa
       senior medical officer
 employee state insurance corporation
                india
“Health of the Nation is more important
    than the wealth of the Nation”
n   Road safety is a major public health concern.
n   Indian road network is second longest in the world covering
    more than 3 million Kilometers.
n   80% of road length consists of village and other roads and
    12% constitutes major districts roads.
n   85% of passenger loads and 70% of freight load is carried by
    road.
n   As per 2004 data there were 72.7 million vehicles on roads and
    vehicle fleets are doubling after every 6 to 7 years.
n   Financial outlay for road transport sector during 10th plan i.e.
    2002-2007 was 9416.90 crores.
Types of vehicles plying on
Indian roads along with their
wrong usage according to their
capacity is a matter of great
concern for road safety. These
vehicles create traffic chaos and
are a cause of road crashes.
Few examples are :--
A mini shop on a cycle
Carriage of goods on Horse carts
Wrong loading of Jeep
Wrong sitting posture of a man in a goods carrier
Traffic Mix…!
Load volume larger than the vehicle
Labourer carrying a special ladder
(Gohri) and his material on cycle
Carrying animal on a motor cycle
Jeep with over capacity of passengers
Road Accidents in India (In Thousands)

Year        Road      Persons Killed   Persons
          Accidents                    Injured
1970       114.1          14.5          70.1

1980       153.2          24.6         109.1

1990       282.6          54.1         244.1

2000       391.4          78.9         399.3

2005       439.2          94.9         465.2
n   India has only 1 % of world vehicle population, but
    accounts for 6 % of the accidents and 10 % fatalities
    due to road traffic injuries.
n   Total economic loss to society on account of road
    accidents is estimated to be Rs. 55000 crores per
    annum.
n   In India 11 % of deaths due to non communicable
    diseases are due to injuries and 78 % of these injury
    deaths are due to road traffic crashes. Hence road
    safety becomes important responsibility of the
    governments.
Factors affecting Road Traffic
 Crashes:--

n   Types of roads and road users.
n   Colliding vehicles.
n   Environment and road related factors like road
    geometry, design, visibility, diversions etc.
n   Vehicle related causing traffic mix.
n   Composition and flow of road traffic.
n   Adherence / enforcement of road safety regulations.
n   Unsafe driving behavior.
n   Traffic congestion caused by increased use of private
    mode of transport and less practice of vehicle pooling.
n   Highway capacity shortages (National Highways
    constitute less than 2 % of the road length of the
    country but carry 40 % of road based traffic).
n   Lack of valid and fake driving licenses
n   Nature of traffic management.
•Over loading of vehicles particularly trucks and tractor
trolleys.




             Improper and overloading
Improper and overloading
Overloaded trolley
Vertical overload
Bottle necks in Road Safety:-

n   Drivers especially of heavy vehicles operate under
    inhospitable conditions which induces high levels of
    stress and possibility of accidents.
n   No organized wayside amenities, maintenance and
    repair facilities.
n   Coverage of extra long distances by drivers leading to
    fatigue and long spells of absence from home leading
    to emotional and sexual deprivation causing increased
    mental stress.
n   Concessions given to drivers by wayside eateries also
    known as “Dhabas” in the form of free food and
    alcohol for their own profit.
n   Lack of parking space alongside highways leading
    to parking on roads.
n   Inexperienced, untrained and underage,
    cyclists and rickshaw pullers on the road with
    no separate path for them.
n   Presence of beggars on busy road junctions
    and traffic lights.
n   Use of mobile phones while driving.
n   Drug addiction.
n   Presence of wine outlets near the roads.
n   Sale of lotteries, helmets etc near roadside.
Presence of slums near the roads.
n
n   Selling of fruits on road side.
n   Sale of Jaggery near the road.
n   Sale of small items like tissue papers, agarbatis,
    Christmas caps, car shades, balloons,
    newspapers, magazines etc on traffic light.
n   Roads used as dumping place for
    construction material.
Dangers to Road safety due to religious reasons :--

n   Astrologers, palmists, tarot card readers etc. advise people to do certain
    rituals known as “Upaayays” which cause traffic chaos. eg. throwing
    something in flowing rivers, placing certain things on centre of the road or
    at cross junctions etc.
n   Practice of donating money on certain specific days of the week in the
    name of religion and presence of these donation seekers on busy roads and
    traffic lights eg people on Saturday worship Saturday God known as
    “Shani Devta” and there are special persons known as “Dandaut” who
    dress up specially and hold a utensil in hand containing mustard oil and a
    iron casting of Saturday God.
n   Partial encroachment of roads in the name of religion by building religious
    structures which may be small or big.
n   Creating indigenous road blocks for organizing religious community
    kitchens also known as “Langars” .
n   Organizing religious community kitchens on road and participation by
    overenthusiastic devotees on road.
Fulfilling of myth…A Traffic hazard
Collecting donation in the name of religion
             (Saturday God)
Person donating alms in name of “Saturday God”
Creating road blocks for religious functions
Devotees stopping vehicles for serving food etc.
Devotees stopping vehicles for serving food etc.
Other Threats to Road Safety :-

n   Movement of animals on busy roads -
n   Flouting of rules by road users.
n   No separate pathway for the non motorized transport and
    pedestrians.
n   Poor visibility due to fog.
n   Parking of any type of vehicle at own convenience.
n   Playing mischief on road (specially with women drivers) while
    driving.
n   Seeking attention on road by playing gimmicks like leaving
    the handle while driving, standing while driving etc.
n   Use of pressure horns or horns with loud and funny noises.
n   Listening to loud music etc.
Animals roaming on roads
Animals roaming on roads
Animals roaming on roads
Poor visibility and no separate pathway for pedestrians
Playing mischief on road
Person carrying helmet in hand during riding
Where is the helmet ?
Cause for chaos on Road
Road Traffic Injuries cause:--
n   Death.
n   Disability.
n   Hospitalization.
n   High Social and economic costs which include medical costs,
    cost related to administration, Legal and police expenditure,
    collateral damage in terms of damage to property and motor
    vehicles, loss due to income forgone rising out of absence
    from work or disability.
n   In 2005, there were 4.4 Lakh road accidents leading to death
    of 94,968 persons i.e. there was one road accident every
    minute and one road accident death every 6 minutes.
n   Quality of life of accident survivors becomes poor as they live
    with pain and suffering.
Multisectorial Involvement in Road Traffic Crash


       Road Designers                                Transport Sector

  Civic Agencies
                             Road Traffic                        Health Sector
                               Crash



          Legal Sectors                                 Insurance Sector


                          Automobile Manufacturers




Complete co-ordination in all these sectors is needed for the
rescue, transportation, trauma care and relief, investigation and
 compilation of data to achieve total road safety in the interest
                          of road users.
Flow of information in case of road traffic crash:
  --
                  Road Traffic crash




                          Informer




                 Police Control Room
                        (PCR)

                                          Removes injured to the
                                          hospital after giving first
                 PCR Van or Ambulance
                                          aid and pre-hospital care
                                          where ever possible.

                      Traffic Police




                         Police Station
Sign board for emergency help
Sign board for emergency help
Existing Health care setup:-

n   Sub Centres at village level
n   Primary Health Centres
n   Community Health Centres
n   Civil Hospitals
n   District Civil Hospitals and Trauma Centres
n   Tertiary Care / Referral Hospitals and Medical Colleges with
    Super specialist set up.
n   All through the chain of setup private practitioners are present,
    who also treat road traffic crash victims and form a very
    important link in treating and providing data for road traffic
    crash victims.
n   Data regarding road traffic crashes and the treatment of crash
    victims can be collected from all these health set ups.
Post Road Traffic Crash Care:--

n   Aim is speedy and effective trauma care and management to save life.
n   Assistance by bystanders. People are reluctant for the fear that they may be
    involved in police case. Awareness is now being spread that any body who
    shifts the traffic crash victims to hospital will not be harassed as per law.
n   For any vehicle involved in accident that has caused injury to the person it
    is the duty of the driver to shift the accident victim to the nearest doctor
    and report the accident to the nearest police station with in 24 hours and the
    insurance company.
n   Any vehicle government or private without any jurisdictional formality
    should shift the accident victim to the hospital at the earliest to save life
    even in cases of fatal accidents rather than declaring the victim dead on the
    spot. There might be hope for him.
n   Courteous behavior by police and health staff towards the person who has
    shifted the crash victim to the hospital.
n   Help the crash victim promptly and to the best of your ability. Remember
    some time it could be you or your near and dear one. Think and act
    empathetically and try to save life of the victim.
Treatment of the Road Crash Victim:--

n   Thrust is on saving life by providing prompt and best medical care right from the
    site of accident, during transportation, in hospital and post hospital care period,
    which may be in form of medication, counseling, rehabilitation and compensation.
n   As soon as crash victim is received in emergency prompt treatment is started for
    resuscitation and maintenance of vital parameters and then according to severity
    and type of injury treatment / surgical intervention by specialists is done
    immediately in emergency operation theatres itself and the patient is kept under
    emergency care post operatively until he stabilizes and is then shifted to respective
    ward where he is fully treated and then discharged.
n   Medico legal work is done only after initial treatment.
n   In case of serious patients treatment even surgical intervention is started without
    waiting for any relative to come for consent in the interest of saving life of the
    accident victim. All legal formalities are done at later stage.
n   When ever accident victim is shifted to tertiary care hospitals a referral form
    containing full detail of the injury and physical status of the patient along with
    treatment given is filled but if patient is very serious he is immediately shifted and
    emergency of tertiary care hospital is informed telephonically by referring doctor so
    that every thing is ready there to receive and treat the patient.
n   As per law any body accompanying the road crash victim is not to be unduly
    questioned or harassed to encourage public participation in shifting the road crash
    victims to hospitals to save life.
Health Records on Road Traffic Crashes:--

n   Health records are inadequate in detail as they lack information on:--
n   Pre Hospital care.
n   On the spot deaths.
n   Transportation details from accident site to the hospital.
n   Data about intoxicated and unconscious states.
n   Injury details.
n   Details of road accident.
n   Use of variable forms in various health institutes in accident cases leading
    to problems in data compiling.
n   Lack of specific Nodal Officers for collection and compilation of road
    traffic injury treatment cases.
n   Lack of collection of data on treatment of road crash victims from private
    practitioners.
n   Lack of matching of data of police and health records.
n   Inadequate data makes it difficult to improve Rapid Evaluation Techniques
    for having authentic information on road traffic crashes and the treatment
    of accident victims there after, but the process to improve the data
    collection, compilation and analysis has now begun as road safety has
    become a public health concern.
Factors Affecting Quality Care of Road Crash Victims:-

Lack of awareness in general public about the legal procedures.
n  Crowd of onlookers at the accident site without serving any purpose.
n  Chaos in emergencies of public hospitals due to overcrowding of patients.
n  Political interference.
n  Lack of adequate spiritual and moral training workshops for casualty
   doctors and nurses.
n  In adequate data on road traffic injuries and their treatment records.
n  Incomplete registration of road traffic crashes. Mostly compromise is
   reached between the crash causing vehicle owner and crash victim and
   accident case is not reported.
n  Due to low awareness level lack of trust by relatives of crash victims in
   health care facilities being provided leading to frequent shifting of patient
   and thus affecting his treatment.
n  Inadequate link between all health institutions for trauma care and
   compilation of data.
Employee State Insurance Scheme:--

n   It is participative health and social insurance scheme to
    provide protection to workers in the organized sector and their
    dependants in contingencies such as sickness, maternity or
    death and disablement due to an employment injury or
    occupational disease. This scheme is administered by
    corporate body called Employee State Insurance Corporation
    which has its central headquarters at New Delhi.
n   ESI Health infrastructure has :--
    n   1422 ESI Dispensaries.
    n   2000 Panel Clinics.
    n   307 Diagnostic Centres.
    n   144 ESI Hospitals
    n   42 Hospital Annexes.
    n   28000 Hospital Beds.
    n   For Super Specialty Treatment, there is tie up with advanced medical
        institutions in country both private as well as public.
    n   825 Branch Offices for payment of cash and other ESI related works.
n   Role of ESI in treating road crash victims:--
    n   It provides all types of care to road crash victims even if
        the person is not a insured person (IP) with the ESI in order
        to save life.
    n   In case of insured person meeting with road accident
        complete treatment along with sickness benefit for 91 days
        and extended sickness benefit for 2 years with 50 % and 70
        % of wages respectively is given after authentication by
        designated authorities.
    n   Any expenditure by the IP in his treatment after road crash
        is reimbursed by ESI in case he has been treated elsewhere
        in emergency outside the ESI health network.
    n   Free supply of physical aids and appliances such as
        crutches, wheel chairs, dentures, spectacles etc.
    n   Funeral expenses on death of an IP subject to a maximum
        of Rs 2500/- payable at branch office.
Clinical Overview of Causes of Road
 Traffic Crashes among industrial
 workers:--
Stress due to :--
    n   Employer behavior.
    n   Interpersonal Stress among employees.
    n   Domestic stresses.
    n   Professional Stress.
n   Fatigue caused by :--
    n   Long working hours.
    n   Rigid and odd working hours.
    n   Practice of overtime irrespective of health status of workers.
    n   Haphazard and unhealthy working environment.
    n   Time bound irrational target oriented work approach.
    n   Inadequate flexible leave for recreation or for doing personal work.
    n   Employment at mercy of employer.
n   Lack of counselors to de-stress workers.
n   Lack of sincere efforts to check working environment.
n   Lack of awareness among workers regarding various
    benefits.
n   Drug addiction, improper and unhealthy diet intake
    from factory canteens leading to physical ailments in
    industrial workers.
n   Maximum use of non-motorized transport by
    industrial workers.

    These workers who are either physically weak or
    fatigued or under mental stress often become a cause
    or a victim of road crash as even while driving /
    walking on the road their mind is occupied.
Road Safety ---- A Responsibility:---

n   Department of Road Transport and Highways with its head
    office at New Delhi is responsible for :--
    n   Formulation / Implementation of policies for road transport
        development.
    n   Maintenance of National Highways.
    n   Transport Research.
    n   Updating of norms for road safety.
    n   Ensure safe mobility of the road transport system in the country.
    n   Administration of Motor Vehicle Act 1988, which lays downs
        principles and procedures and makes authorities responsible for issue
        of driving licenses, issue of permits, grant of fitness certificates for
        vehicles on roads, prescription of emission and safety related norms for
        motor vehicles, norms for type approval in production of new motor
        vehicles, issues relating to compensation in case of motor vehicle
        accidents and compilation of data.
n   Checking of vehicles plying on the road.
n   National Highway Accident Relief Service
    Scheme (NHARSS):--
    n   Under this scheme crash victim is shifted to
        nearest hospital, medical assistance is provided,
        damaged vehicle is removed from site, cranes and
        ambulances are given to NGOs and state
        authorities.
Fire Engine and Ambulance parked on the road
Recovery Van parked on the road
Ambulance parked on the road
n   Proposal to setup National Road Safety and
    Traffic Management Board to provide a co-
    ordinated approach in the area of road
    accidents.
n   Proposal to build and re-strengthen existing
    public private partnerships to enhance road
    safety.
n   Adherence to National Road Transport Policy.
Road Safety – A Challenge:--
n   Thrust of road safety is 4 E’s i.e. education,
    enforcement, engineering and environment.
n   80 % of road accidents are due to driver negligence
    and fault, so there is a need to monitor driver training
    school regarding their infrastructure, equipment,
    quality control, qualified driver training instructors,
    strict code for issue of driving licenses, regular and
    random health checkups of drivers along with
    counseling sessions, checking for any drug and
    alcohol addiction, overloading, over speeding and
    refresher training for existing drivers.
n    Need for parking spaces and truck terminals out side
    the cities to reduce traffic crashes.
n   Need to avoid using mobiles while driving.
n   Need to use helmets and seat belts while driving.
n   Need to inculcate road safety culture.
n   Need to count traveling time for reaching the
    destination.
n   Need to design roads in a way that even if a person is
    wrong the system does not permit him to do that
    wrong.
n   Need to strictly enforce yellow colour code for school
    buses and to regulate their speed.
n   Need to stop the ringing up a e person while he is
    driving.
n   Need for stress free driving, avoid driving while
    under stress.
Road Safety Awareness Measures:--

n   Organization of road safety weeks, seminars and
    exhibitions. This year road safety week was observed
    throughout the country from 1st to 7th January 2009
    and theme was “Carefully Drive Reach Alive”.
n   Display of banners and distribution of pamphlets on
    road safety.
n   Telecasting and broadcasting of TV spots / Radio
    Jingles.
n   Organizing Essay Competitions, Declamation
    Contests on Road Safety.
n   Printing of calendars, stickers, posters containing
    road safety measures.
n   Display of road safety slides in cinema halls.
n   Organizing street plays on road safety.
n   Organizing workshop cum training programs on road
    safety management, road transport regulation and
    planning.
n   Display of road signs and Do’s and Don’ts regarding
    road safety at important locations / traffic junctions to
    inculcate road discipline.
n   Special training for school and college students for
    sensitization to traffic rules.
n   Involvement of NGOs, print, audio and audio visual
    media in all the above activities.
n   Organizing rallies to create awareness on road safety
    measures.
        Remember ….




 “Your Life is Precious and so is the
Life of Others. Drive Safely and Live
        and Let Others Live”
Happy and Safe Driving




     Thank You

				
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