Osmania University

&
GVK Emergency Management and
Research Institute

Advanced Post Graduate Diploma in

Emergency Care
(EMT - Advanced)
A Retrospective Study To Assess Road Traffic Accidents
In SPSR Nellore district at Andhra Pradesh.
Name: Mr.T.CHIRANJEEVI
Regd No: 2048-15-533-004

GVK Emergency Management and Research

Institute.
Devar Yamzal, Medchal Road, Secunderabad – 500 078.
Telangana, India.

JULY - 2017
 A
RESEARCH PROJECT
ON

A Retrospective Study To Assess Road Traffic Accidents

In Nellore district at Andhra Pradesh.

A Research Submitted To The Osmania University,

Hyderabad, Telangana For Advanced Post Graduate
Diploma In Emergency Care.

JULY - 2017
A Retrospective Study To Assess Road Traffic Accidents
In SPSR Nellore District at Andhra Pradesh.

Approved By The Dissertation Committee On

Research Guide _____________________________________

Dr. G.V. Ramana Rao
MD., D.P.H., PGDGM

Director of EMLC

A Research Submitted To The Osmania University, Hyderabad,

Telangana For Advanced Post Graduate
Diploma In Emergency Care.

JULY - 2017
Certified That This Is Bonafide Work
Mr.T.CHIRANJEEVI.

A Research Submitted To The Osmania University,

Hyderabad, Telangana For Advanced Post Graduate
Diploma In Emergency Care.

College Seal:
Dr. G.V. Ramana Rao
MD., D.P.H., PGDGM
Director of EMLC
GVK E M RI
Secunderabad

JULY - 2017
 DEDICATION

I Dedicate this Dissertation to:

My Parents MR & MRS. Sri T.GURUSWAMY and Smt

T.LAKSHMAMMA for the Continuous Encouragementfor the
continuous helpful and Being Understanding When I would not are
there for them during Moments of Intense Concentration on the
Studies.
 CERTIFICATE

This is to certify that MR.T.CHIRANJEEVI has completed

Research project on “A Retrospective Study To Assess Road
Traffic Accidents In SPSR Nellore District at ANDHRA
PRADESH", as a part of IIIrd Semester, Advanced Post Graduate
Diploma in Emergency Care, affiliated to Osmania University. This
Study work done by him under the Guidance of Dr.SANKET
PATIL, Faculty-APGDEC.

Signature of Guide
Dr.SANKET PATIL,

Faculty of APGDEC.

Date:
Place:
 ACKNOWLEDGEMENT

It is my greatest privilege to recall my persons to whom I am indebted for their

contribution in various ways directly and indirectly with profound sentiments of heart full
gratitude, I offer my sincere thanks to all those who have contributed to the successful
completion of this work.

I praise and thank my almighty God for showering his abundant blessings on me all
throughout the project work.

My special thanks to my study participants who extended their co-operation

throughout my study period.

I honestly express my heart full thanks to my family members and my friends.

I express my sincere thanks to Dr. Ramana Rao G.V MD, DPH. Director of
Emergency Medicine Learning Centre (EMLC) & Research, GVK Emergency Management
and Research Institute, Telangana Correspondent of our college, for given me an opportunity
to study in this esteemed organization.

I am very much thankful to Mrs. Usha saie madam MBBS,DM , wise principle of
APGDEC GVK EMRI 108 Hyderabad,Telangana for is excellent research guidance.

I am very much thankful to Mrs. B. N. Hemavathy, Instructor of APDEC, GVK EMRI 108
Hyderabad, Telangana for her excellent research guidance.

I express my upgraded thanks to our Research Dr.SANKET PATIL, Instructor of APDEC,

GVK EMRI 108 Hyderabad, Telangana. Itis a matter of fact without his esteemed
suggestions; highly scholar touch and piercing insight form the inception till completion of
study.

I am very much thankful toMr.Vimal sir,Dr. Keshav sir, Instructor of APDEC, GVK EMRI
108 Hyderabad, Telangana for his excellent research guidance.

I honestly express my heart full thanks to Mr. AJENDER SINGH,for his support, direction
for their help throughout my study

I wish to thank the management of GVK Emergency Management and Research Institute,
Hyderabad for following me to providing Data to Ranga Reddy District, Telangana.

My special thanks to all non-teaching staffs of GVK EMRI 108 and I am indebted to all my
classmates for their help throughout my study.

Special thanks to my family for their good natured forbearance with the process and for their
pride in this accomplishment.
ABSTRACT

According to the world health organization report, 1.3million people die each year
due to road traffic accidents in Worldwide and 1,05,725 Road traffic accident deaths occur in
the every year in India . STATEMENT OF THE PROBLEM“A Retrospective study ro
Assess Road Traffic Accidents in Chittoor District at Andhra Pradesh State.”OBJECTIVES"
To find out the high frequency area Road traffic accidentsin SPSR Nellore district at Andhra
Pradesh State ".To determine the cause's of Road traffic accidents in SPSR Nellore district.To
study the relationship between Road traffic accidents with their selected demographic
variable".METHODOLOGY" Research methodology one of the vital section of the
research, since the success of any research is mostly depend upon the methodological issue
that are followed in the execution of the research work. The role of methodology consists of
procedures and technique for concluding the study.SAMPLE SIZE"A total no. of 17458
cases of Road traffic accidents which was collected from GVK EMRI 108 in Andhra Pradesh
in particular District SPSR Nellore DATA COLLECTING"The data of Road traffic
accidents cases from 1st January 2016 to 31st December 2016 were obtained from the records
of the GVK EMRI Hyderabad Telangana.CONCLUSION"The research findings were
several however they are other similar different from earlier studies as evidenced by literature
that release to the study evidenced findings are summarized and interpreted in the further
discussion.
 INDEX

S.No TOPIC NAME PAGE NUMBER

1. CHAPTER-1
INTRODUCTION

BACKGROUND OF THE STUDY

NEED FOR THE STUDY

STATEMENT OF THE PROBLEM

OBJECTIVES

OPERATIONAL DEFINITION
LIMITATIONS
2. CHAPTER-2

REVIEW OF THE LITERATURE

STUDIES RELATED TO ROAD TRAFFIC

ACCIDENTS
3. CHAPTER-3

METHODOLOGY

RESEARCH APPROACH
4. CHAPTER-4

DATA ANLYSIS AND INTERPRETATION

DATA ANALYSIS
DATA INTERPRETATION
5. CHAPTER-5

DISCUSSION

SUMMARY
CONCLUSION
6. CHAPTER-6

GLOSSARY
7. CHAPTER-7
REFERENCE
8. CHAPTER-8

DEMOGRAPHIC VARIABLES OF ROAD

TRAFFIC ACCIDENTS QUESTIONS
TABLE OF CONTENT'S:

CHAPTER NO CONTENTS PAGE NO

I INTRODUCTION

Back ground of the study

Need for the study

Statement of the problem

Objectives

Operational definition

Limitations

II REVIEW OF LITERATURE

Statement related to Head

injury

III METHODOLOGY

Research approach

Type of study

Research design

Descriptive study

Research data

Sample size

Target population

Data collection

IV DATA ANALYSIS AND

INTERPRETATION
V DISCUSSION

VI SUMMERY, CONCLUSION &

INTERPRETATION

VII REFERENCE'S

LIST OF TABLES
&
 CHARTS
S NO TABLE NAME PAGE NO

A SCCHEMATIC REPRESENTATI ON

B According to Age group wise data

C According to Gender wise data

D According to Area Wise data

E According to Monthly Wise data

F According to Vehicle wise data

G According to Social Status wise data

H According to Hospital wise data

S NO CHART NAME PAGE NO

A According to Age group wise

B According to Genderwise

C According to Area wise

D According to Monthly wise

E According to Vehicle wise

F According to Social Status wise

G According to Hospital wise

A RETROSPECTIVE STUDY TO ASSES
ROAD TRAFFIC ACCIDENTS
CHAPTER-I

INTRODUCTION
 CHAPTER- 1
INTRODUCTION

BACK GROUND OF THE STUDY:

Road Traffic Accidents is any vehicular accident occurring on the roadway that is
originating on, terminating on, or involving a vehicle partially on the roadway. This collision
of an automobile with a pedestrian or another automobile or with a non- automobile on the
roadway or fall from a moving vehicle causing injuries or death of the involved individuals.
The modern lives becoming increasingly busy, automobiles have become an invariable means
of transport. Road Traffic Accidents are expected to take third place in the rank order of
disease by the year of 2020.

Worldwide the number of people killed in road traffic crashes each year is estimated
to be around 1.2 million, while the number of injured could be as high as 50 million.
Accidents represent a major epidemic of non-communicable disease in the present century. In
developing countries, the morbidity and mortality burden is increasing due to road traffic
injuries. Road Traffic Accidents acts as a major epidemiological as medico-legal problem.
This is due to the tremendous increase in the number of vehicles, high-speed technology
along with other contributing factors like, poor roads. Inexperienced drivers without proper
driving license, ignorance or intentional violation of traffic rules etc.

Road Traffic Accidents are the eighth leading causes of death globally and the leading
cause of death for young people aged 15-20 more than a million people die each year on the
world roads, and the cost of dealing with the consequences of these road traffic crashes runs
to billions of dollars. Current trends suggest that by 2030 road traffic deaths will become the
fifth leading cause of death unless urgent action is taken. In India, an accident happens every
60 seconds and every 3.7 minutes.

Although globally, 88 countries have reduced the number of road fatalities between
2008 and 2011, India roads have over this time become more deadly. According to a recent
world health organization report, India has the highest number of road deaths in the world,
1,05,725 died last year on its road. Worldwide, 1.3 million lives were lost. India loses 20
billion due to road accidents annually which is enough to feed 50% of the nations
malnourished children.

Many road traffic injuries are not obvious on first presentation, understanding the
effects of force and energy transfer patterns will help in the assessment of the mechanism of
the injury (MOI), which in turn can help predict the most likely type of injuries you will see
when you are in the field. Paramedics are needed to learn to have a high index of suspicious
for injuries that otherwise might be undetected for several hours.
MOTOR VEHICLE CRASHES
According to the National Traffic Highways Safety Administration, in 2009, 33,808
people were killed in an estimated 5,505,000 police- reported motor vehicle traffic crashes;
2,217,000 people were injured; and 3,957,000 crashes involved property damage only. That
year, an average of 93 people died each day in motor vehicle crashes. When a motor vehicle
collides with another object, trauma the crash is composed of five phases tied to the effects of
progressive deceleration. The first phase, deceleration of the vehicle, occurs when the vehicle
strikes another object and brought to an abrupt stop. The second phase is deceleration of
occupant, which starts during sudden braking and continues during the impact of the crash.
This results in deceleration,
compression, and shear trauma to the
occupants. The third phase, deceleration
of internal organs, involves the body
supporting structures (skull, sternum,
ribs, spine, and pelvis) and movable
organs (brain, heart, liver, spleen, and
intestine) that continue their forward
momentum until stopped by anatomic
restraints. The fourth phase is the result
of secondary collisions, which occur Figure 1: Motor Vehicle Crash
when a vehicle occupant is hit by objects
moving within the auto such as loose
objects, packages, animals, or other
passengers. The final phase is the result
of additional impacts that the vehicle may receive, such as when it is the hit by a second
vehicle, or is deflected into another vehicle, or other object. This may increase the severity of
the original injuries or cause further injury.

TYPES OF IMPACTS
Important clues to predict injury types can be obtained by paying attention to the
crash and by an examination of the scene. Using your newfound knowledge of the physics of
trauma, you can make good estimate of how injured your patients might be by looking at the
amount of damage around the scene.

There are primarily five types of impact patterns; frontal or head-on impact, lateral or
side impact, rear impact, rotational or quarter-panel impact, and rollovers.

FRONTAL OR HEAD ON IMPACTS:

 In frontal or head on impacts, the front end of the car distorts as it dissipates kinetic
energy (KE) and decelerates its forward
motion. Abrupt deceleration injuries are
produced by a sudden stop of a body’s
forward motion. Whether from a fall, shaking
a baby, or a high-speed vehicle crash,
decelerating forces can induce shearing,
avulsing, or rupturing of organs and their
restraining fascia, vasculature, nerves, and
other soft tissues. These injuries are often
invisible during examination, so every
paramedic needs to understand how such Figure 2: Frontal or Head On Impacts
injuries are sustained. When there is damage to
the steering column, there is critical injury to the driver until proven otherwise. In order to
visualize the steering column, you may need to move to move the inflated airbag.

LATERAL OR SIDE IMPACTS:

Lateral impact, “T”-bone, and side
impacts impart energy to the near-side
occupants almost directly to the pelvis and
chest. Unrestrained occupants will remain
almost motionless, literally having the car
pushed out from under them. Seat belts do
little to protect these passengers because they
are designed to limit forward hinging injuries,
As one vehicle makes contact with the side of
the other vehicle, the occupant nearest the Figure 3: Lateral or Side Impacts
impact is hit by the door of the car as the
passenger compartment beings to deform and collapse. In a lateral crash, if the greater
trochanter of the femur is impacted and transmits forces to the pelvis, sometimes it may be
driven through the acetabulum into the pelvis. If the force reaches the Ilium, the pelvis may
fracture.
REAR IMPACTS:
Rear impacts or rear-end impacts have the
most survivors, if the driver and passengers are
properly restrained. If the vehicle coming from
the rear is traveling at excessive speed,
however, most bets on survivability are off.
Most often in this kind of crash, a stationary
vehicle is struck from behind and the impact
energy is transmitted as a sudden forward

accelerating force. Figure 4: Rear Impacts

ROTATIONAL IMPACTS:
A Rotational or quarter panel impact occurs when a lateral crash is off center. In this
case, rotation occurs as part of the car continues to move and part of the car comes to a stop.
The vehicles forward motion stops at the point of impact. The point of greatest speed loss of
the vehicle is the site where the greatest damage to the occupant will occur. The point of
greatest deceleration becomes the location of the most severely injured patients. Occupants
tend to receive a combination of frontal and lateral injuries. Three-point seat belts are
effective in effective in preventing injury in angled crashes of up to 45 degree angle.

ROLLOVERS IMPACTS:
Rollover are not common, but lead to
greater rates of server injury and death. Some of
these are secondary events that occur after a
collision with a run-off-road crash or a collision
Figure 5: Rollover Impacts
with another vehicle.

EMS MANAGEMANT:

Bleeding control:
 Apply direct pressure over the wound.
 Elevation of the injury part above the level of the heart if no fracture is
suspected.
 Pressure to be given at bleeding area while maintaining direct pressure.
 Tourniquet is last resort.

Wound care and bandaging:

 Clean the debris at over injury with sterile water.

 Apply the appropriate pressure dressing and bandage.
Splinting and immobilization:
 Reduces pain.
 Controls the bleeding.
 Prevents further injury.

Emergency care:
 Maintaining Airway, and ventilation.
 Apply supplementary oxygen.
 Give the fluids maintaining 90-100mm/hg systolic blood pressure.

NEED FOR THE STUDY:

According to the World Health Organization (WHO), Road Traffic Accidents caused an 1.24
million deaths Worldwide in the year of 2020. That is one person is killed every 25 seconds.
Have five adequate laws all five risk factors:

A) Speed B) Drunken-driving C) Helmets D) Seat belts E) Child restraints

Half of the World's road traffic deaths occur among motor cyclists 23%, pedestrians 22%,
and cyclists 5%.

Nearly 3,400 people die on the world’s roads every day. Tens of millions of people injured,
or disabled every year.

The Global status report on road safety 2013 presents information on road safety from
182 countries, accounting for almost 99% of the World’s population. The report indicates that
Worldwide the total number of road traffic deaths remains unacceptably high at 1.24 million
every year. Only 28 countries, covering 7% of the World’s population, have comprehensive
road safety laws on five key risk factors; Drinking and driving, speed, and failing to use
motorcycle Helmets, Seat belts, and child restraints.

This report serves as a baseline for the decade of action for road safety 2011-2020, declared
by the UN general Assembly.

According to the Global status report on road safety 2013 estimates that more than 2,31,000
people are killed in road traffic crashes in India every year. Adults aged between 15&44
years account for 59% of Global road traffic deaths. 77% road deaths are among men.

According to the Deccan chronicle about 1,734 persons died in road accidents involving auto
rickshaws and the Andhra Pradesh has the highest number of such deaths in the country. The
road traffic crashes caused an 44,165 peoples deaths in Andhra Pradesh.

India has a road network of over 46,89,842 km. The second largest road network in the
World. At 0.66 km of road per square kilometer of land, the quantitative density of India road
network is similar to that of China (0.16) or Brazil (0.20).

However, qualitatively India roads are a mix of modern highways and narrow, unpaved
roads, and are being improved. As of 2011, 54 percent about 2.53 million kilometers of India
roads were paved.

About 41 peoples killed every day in Andhra Pradesh due to road traffic accidents. Andhra
Pradesh ranked 3rd in road traffic accidents in India.

The Victims in road traffic accidents sustain varieties of injury, external as well as internal.
External injuries may be abrasions, lacerations, contusions etc. The studies of injuries help in
implementation of measures to present fatalities due to road traffic accidents.

Therefore, here is an attempt to analyze the pattern of road traffic accidents by retrospective
study.

STATEMENT OF THE PROBLEM

A RETROSPECTIVE STUDY ON ROAD TRAFFIC ACCEDENTS IN SPSR NELLORE
DISTRICT AT ANDHRA PRADESH STATE

OPERATIONAL DEFINITION
Accident: An unfortunate incident that happens unexpectedly and unintentionally, typically
resulting in damage or injury.
Any Accident or injury can occur due to road traffic accidents, results can acute physiological
and structural change (injury) that occurs in a patient body.

OBJECTIVES
 To find out the high frequency area in Road Traffic Accidents at SPSR Nellore
district, Andhra Pradesh.
 To find out the incidents in Road Traffic Accidents at SPSR Nellore, Andhra Pradesh.
 To study the relationship between Road Traffic Accidents with their selected
demographic variables.
 To find out the time of incidents on Road Traffic Accidents in SPSR Nellore district
at Andhra Pradesh.

LIMITATIONS
 The study is limited to SPSR Nellore district only.
 The study is limited to only in Road Traffic Accidents at SPSR Nellore district.
 The collecting data GVK EMRI 108 Office Hyderabad from 1st January 2016 to
31stDecember 2016 only.
 CHAPTER-II

REVIEW OF LITERATURE
 CHAPTER-2

REVIEW OF THE LITERTURE

A Review of literature is the process of collecting, selecting and reading books, journals,
reports, abstracts and other reference material.It is also important step in development any
research project. It helps the researcher to analyze what is known about the topic and to
describe methods of inquiry used in early work including the success.

International Journal of Biomedical And Advance Research Retrospective Study of

Pattern of External Injuries in Road Traffic Accidents stats that Retrospective study of road
traffic accident cases during the period January 1st 2010 to 31st December 2012 conducted in
Sri Siddhartha Medical College, tertiary care center, Tumkur, Karnataka, India. Patients with
alleged history of road traffic accidents brought to the casualty of Sri Siddhartha Medical
College were included in the study. Road traffic accidents are increasing in an alarming rate
throughout the World and causing increased morbidity and mortality among people. Patients
in road traffic accidents sustain varieties of injuries such as abrasions, contusions, lacerations
and fractures, which may be fatal or nonfatal. The present study conducted to know the
pattern of injuries sustained in patients of road traffic accidents, patient’s age and sex.
Implementation of safety measures to prevent the incidence of road traffic accidents is very
much essential.

A study conducted showed that alcohol was a major problem in single vehicle fatal accidents.
In 72 fatal accidents which claimed 87 lives, he showed that half of drivers had serious
drinking problems of chronic nature.

Tiwari RR. et al (2005) study on vehicular related fatalities among teenagers was
carried out from case files of the office of medical examiner, Metro Dade Country Miami,
Florida, United States, between the years 1978-82. during the 5 year period a total of 1919
vehicular related fatalities were examined, of which 247 (12.9%) occurred in individuals
between the ages of 13 and 19 years. Males 191 (77.3%) were more commonly involved that
females 56 (22.7%) in vehicular accidents. Out of total 247 cases, when as in 118 (47.8%) of
cases alcohol was not detected. Common drugs of abuse were found in at least 16.6% of
cases. In majority of cases, victims were either passengers or drivers. Pedestrians as victims
were loss. Only one documented case of an individual dying with a seat belt in use in noted in
five years. Careless driving 63(25.5%) was the major key factor responsible for the fatality.

Meghna R et al (1996) study conducted in municipality of Londrina, a medium- sized

city of southern Brazil to know the characteristics of road traffic accidents that occurred
during the first semester on 1996. 3643 were victims of RTAs during the year 1996. Car or
small truck collisions were the most common type of accidents. The rate of motor cycle
related injuries (per 1,000 registered vehicles) was seven times higher than that resulting from
cars or small trucks. Fatality rates were higher for motor cyclists who colloid with were
injured by Lorries and buses (22.2%), in comparison with a mean fatality

D,Meundi et al (1999) study on the pedestrian casualties and fatalities in the road
traffic crashes was conducted by Division of Economics, University of Natal, Durban, South
Africa, a South African municipality, was undertaken using official road traffic accident data.
The pedestrians were in the age group of 25 to44 years and accounted for 39.3% of the
causalities and 48.2% of the fatalities. The most vulnerable pedestrians were those between
30 to 34 years old and they accounted for 11.7% of the causalities and 14.6% of the fatalities
and those between the age group of 40 to 44 years accounted for 7.5% of causalities and
10.2% of the fatalities. Out of these cars were involved in 52% of the vehicle pedestrian
crashes whereas mini buses and buses which were involved in 1% of the vehicle pedestrian
crashes. There was no statistically significant difference in the monthly distribution of road
traffic crashes.

D,Meundi et al (2000) study conducted to describe road traffic related mortality data
in Iran in Iranian Institute Of Health Sciences Research, Tehran, Iran, revealed the following
data, a total of 15, 482 individuals died from road traffic accidents, most of them were male
(79%), mostly aged 40 years or less (65%) and most of them were pedestrians or car
occupants (62%). Head injury was most common cause of road traffic related mortality
(66%) in males and females of all ages. 57% 0f deaths occurred before admitting in the
hospital. In total injuries, head injury was the most common cause of mortality and most of
the deaths occurred before admitting to the hospital.

Rathinam C et al (2001) Study was conducted by Department Of Emergency

Medicine, Singapore General Hospital, Singapore, to identify the factors that are contributing
for road traffic accidents mortality and pattern of injuries over a period of 1 year. A total of
226 deaths occurred, of which 82.3% victims were males. The median age was 31 years.
Blood alcohol was detected in 42 (18.7%) victims. In the general head injury was the most
common among road traffic victims accounting for (86.7%), followed by thoracic (67.7%)
and abdominal (31.4%) injuries. Severe lower extremity trauma was most common among
pedestrians and pedal cyclists (20.6% and 11.0%) respectively.

Pavan BC et al (2001) study conducted analysis from both National and police data
(2001) and data from the Rhone Medical Road Accident Trauma Register (1996-2001) to
know differences between males and females in traffic accident risk in France in 2001. In
France 7,720 people were killed in RTAs in 2001, 75% of which were men, where as the
number of injured people were 153,945 of which 65% were men. Male and female incidence
rate was 3.1 for mortality and 1.7 for morbidity. Two wheel motorized vehicle accidents are
very specific to males. The fatality rate and severs injuries rate among survivors are higher;
Males are more severely injured for all body regions and have more often severe after effects.

N.Deepika et al (2001) population study conducted by Department of Health and

society, Division of social Medicine and public Health Science, Faculty Of Health Sciences,
Linkoping, Sweden to acquire knowledge about prevalence of first aid training and incidence
of being a bystander and of the first aid provided at traffic crashes and impact of first aid
training on the risks people take in road traffic. A questionnaire was administered to 2800
randomly selected persons aged 18-74 years. The response rate was 67.55. During the
previous five years, 39% of the population had received first aid training with higher rate
among younger individuals and those with higher education. After training, 30% of the
respondents had used their skills and 41% took fewer risks in traffic, particularly those who
were older or had a lower level education. 14% of those with training had been bystanders at
a traffic crash and 20% 0f the crashes, a bystander had administered first aid, and one third of
those provided such assistance had use of their training.

Chalmers DJ et al (2001) study done on 331 victims of road traffic accident at KMC
Manipal Karnataka, revealed that the maximum number of victims 23(26%) were in the age
group of 21-30 years, followed by 17(20%) in 41-50 years age group. Male to female relation
was 7:1, among the 87 victims, 26(29.9%) were pedestrians and 61% were occupants in
various types of vehicles, of which 33 (37.93%) were two wheelers, 10(11.4%) were three
wheeler occupants 18(20.68%) were four wheelers occupants. Two wheelers are more prone
for accidents as compared with three and four wheeler vehicles. Most of chest injuries
included contusion and laceration.

Norten R et al (2001) study conducted revealed; nearly 80% of those killed in Delhi
and Mumbai are vulnerable road users. Collision of heavy vehicles like buses and trucks with
these road users results in greater number of severe injuries and deaths. In urban and sub
urban areas, buses and trucks are involved in higher proportion of fatal crashes with VRUs.
Among fatalities during peak hours, 62% of responsible vehicles for crashes were buses are
trucks, while those killed were primarily pedestrians, bicyclists or motor cyclists. Even on
national highways, pedestrians constitute 30% of fatalities and 65% of all deaths occur
among VRUs.

Langley JD et al (2005) study conducted shows that pedestrians (40%) and motorized
two wheeler riders and pillion (32%) were the major category of killed people. Data from
Chennai reveal that pedestrians, two-wheelers and cyclists constituted 28%, 5% and 29% of
total deaths (sathyasekaran, 1991). Hospital studies in Bangalore during 1993, 1998, and
2005 have shown that pedestrians, motorized two-wheeler occupants and bicyclists are
injured and killed to the extent of 25-35%, 30-40% and 7-10% with minor variation across
studies (Gururaj, 1993; 2000; 2005). Studies from Delhi, Pondicherry, Chennai, Hyderabad,
Patiala point to similar observations. Data from population-based surveys also indicate a
similar picture. In a recent study of 709 RTA injured persons from a population base of
96,619, it was observed that pedestrians, two wheeler occupants and bicyclists constituted
26%, 43% and 8%, respectively.

Ellsasser G. (2006) in his study in “Epidemiological Analysis of injuries among

children under 15 years of age in Germany” stated that since 1990, total injury mortality
among children under 15 years has declined by more than two-thirds in Germany (from 10.2
to 3.0 per 100,000 during the period 1990-2004).

Bener A. (2005) in his study on “neglected epidemic: road traffic accidents in a

developing country, State of Qatar” in the year of 2000. Identified a total of 52,160 RTA,
1130 injuries and 85 fatalities. The major cause of traffic accidents in Qatar was careless
driving (71%). Relatively there was a more rapid increase in the number of registered
vehicles (155%), but accidents were only 61% in 2000 compared to the year 1983. The
majority of victims (53%) were in the age group 10-40 “the most productive class in
Society.” Forty-three percent of the total drivers who died due to RTA were in the age group
between 10-19.

Mayou R. (2003)conducted study on “Consequences of road traffic accidents for

different types of road user.” There were 1148 respondents from 1441 consecutive attenders
over a 1-year period. Pedestrians and motorcyclists suffer the most severe injuries and report
more continuing medical problems and greater resource use, especially in the first 3 months.

Richter M, et al. (2001)in his study on “Current situation of traffic accidents in children and
adolescents” stated that there were 12,309 traffic accidents occurred in the area of Hanover,
Germany between 1985 and 1998. 7.5% (n=2,317) of the involved persons and 10.5%
(n=1,734) of the injured road users were children and adolescents. 30.3% of the injured
children were car occupants, 32.1% bicyclists, 33.3% pedestrians. 30.3% of the children were
unrestrained car occupants, 42.1% used safety belts designed for adults, and 36% used special
devices.

Redondo Calderon J, et al. (2000)observed that in his study on “Trends in traffic accident
mortality in Spain, 1962-1994.” An increasing trend during the whole for the national traffic
accident mortality rate, especially from 1982 to 1989 in the younger age groups, followed by
a decrease since 1990.

Kemp A. (1997)in his study on “Childhood accidents: epidemiology, trends and

prevention on Department of Child Health,” University of Wales College of Medicine,
Cardiff, UK, identified accidents are the most common cause of death in children over one
year of age. In 1992, 559 children died in United Kingdom as a result of an accident, 240
from traffic accidents and 100 from burns and scalds. Every year 50 children drown.
Accidents cause significant disability to children. Many Children, up to one in four of the
population in urban areas, attend accident and emergency departments, and 5-10% of these
are admitted to hospital.

Ganveer GB, et al (1999) conducted a cross sectional on “Injury pattern among non-fatal
road traffic accident cases: Nagpur, a city in central India.” There were 423 non-fatal cases of
road traffic accidents reporting for treatment to Indira Gandhi Medical College, Nagpur Out
of total 423 subjectts, 363 (85.8%) were male while only 60 (14.2%) were female subjects.
Majority of the victims (75%) were in the age group of 18-37 years.

Rathinam .C et al. (2007)conducted a study on “Self-reported motorcycle riding behavior

among school children in India” this study was done in Yamunanagar, India where boys as
young as 8 years ride motorcycles. It attempts to find out the behavioral and non-behavioral
factors leading to motorcycle use and the predisposition to accidents among male school
children aged between 10 and 16 years aggressive behavior and previous encounter with the
Police are the two strong predictors of accidents (p<0.001). Children as riders are exposed to
higher risks of accident and longer life with disability. It also explains how these children
behaviorally take up adult roles and seek adult risk taking attitudes.

Chinni .F et al. (2006) revealed in their article “Roads home – accident injuries of infants
and adolescent in Cazio region,” described that injured children visit to all emergency
departments. The rate of home accidents among 1-5 years (55.2/1000) while highest rate for
RTA was in 14-18 years children (53.8/1000). The youngest children are at high risk of home
accidents while teen

Stallard et al. (2006) conducted a study to determine the effectiveness of an early

psychological intervention with children involved in road traffic accidents”. Follow-up
assessment completed eight months post accident both experimental and control group with
132 (70/82 of the experimental group) and 62/76 in the control group. The results were
children in both groups demonstrated considerable improvements at follow-up. The early
intervention did not result in any additional significant gains.

Nwadinigwe CU, et al. (2006) in his study on “Fractures in children” at National

Orthopedic Hospital, Enugu, Nigeria stated that causes of the accidents was diverse. Road
traffic accidents were most common an a great number of these resulted from unguarded
children hit by motor vehicles while crossing the road 33 (36.7%). Forty – one (41.8%)
patients fell from various heights of these number thirty (30.6%) fell while playing. Most
fractures were close 70 (71.4%) while 25 (25.5%) were open fractures and 3 (3.1%)
pathological fractures. The most common site of injury was the femoral shaft 33.7% this
study concluded that fractures in children were common and is frequently associated with
morbidities due to interference by traditional bonesetters.
 Waters .A et al. (2005) 28 conducted a study on “Road to Safety” in Irish children over the
past five years. The “Road to Safety” Government strategy was put in place with the aim of
reducing deaths and serious injuries from road traffic accidents by at least 20% over the five
year period beginning 1998 and ending 2002. Age-standardized mortality rates for road
accidents in children (0 – 14 years old) in Ireland are 3.61 per 100,000 as compared to 2.31
per 100,000 in Sweden and thus much needs to be done to reduce this unacceptably high road
toll in Ireland.

Henson .R et al. (1999) 29 in there study on “Injury control strategies: extending the quality
and quantity of data relating to road traffic accidents in children.” At University of Salford
described how an extended database of information can provide the opportunity to go beyond
the traditionally distinct health, engineering and education initiatives in order to identify the
effectiveness of more overarching policies for injury control. Such information can be used to
raise awareness and to encourage community participation in designing a road traffic accident
prevention strategy.

Nair N, Gupta A, Joshi S, Bansal S.5 conducted a study on self reported motorcycle riding
behavior among school children in India . Children as riders are exposed to higher risk of
accident and longer life with disability it also explains how this children behaviorally take-up
adult role and seek adult risk taking attitude. The implication of child motorcycle riders upon
children themselves and on the society are discussed for a greater discourse on road safety
motorcycle riding policy and to highlight the behavioral and non-behavioral factors that are
associated with specific traffic accident.

Dandona. G.A. Raj, T.S., Dandona. L6 conducted a study on pattern of Road Traffic
Injuries in a vulnerable population in which found how Road traffic injuries are caused
(pedestrian and motorized two wheeled vehicle), their type and out come in pedestrian and
Motorized Two wheeled Vehicle users can assist in identifying interventions to improve
Road Safety for the vulnerable population in India, and can also be useful for monitoring the
effectiveness of such interventions.

Dandona. R, Kumar. G.A., Dandona. L2 conducted a study on risky behavior of motorized

two wheeled vehicle rider in India . It suggested the need to enact and enforce policy
intervention for improving the driver’s license system, mandatory use of helmet, effective
traffic law enforcement and ensuring good vehicle condition to reduce the risk factors that
potentially contribute the mortality.

Shailendra Z,Pttanaik AD,Saldnha7conducted a study on understanding some factors

associated with road traffic accidents in that they found the majority of accidents victims
were in 16-25 year age group. Accidents occurrence peeked between 5pm and 8.59pm
information about seat belt used, helmet used and alcohol consumption were not available in
most instances. They concluded that there is need to focus road safety education for young
adults better documentation of helmet use and alcohol consumption will go a long way in
facilitating prevention programs and evaluation efforts.

Turner. C, McClure R conducted a study on quantifying the role of risk taking

behavior in causation of serious road crash related injury. The finding of this study supported
the suggestion that certain host factors increase the risk of crash related serious injury. There
would appear to be a reasonable argument for persisting with injury prevention programmes,
which concentrate on host as well as environment risk factor reduction.

Reader AT, Marshall SW, conducted a study on psychological and social predictor of
motorcycle used by young adults males in New Zealand . It found consistent with earlier
cross sectional research that linked casual and unlicensed driving with less protective
motorcycling opinions and behaviors. Some implications for injury prevention and public
policies regarding motorcycling are discussed. In particular, stricter enforcement of present
licensing regulation and stronger penalties for their violation could help to reduce the number
of less responsible riders.

10
Coggan CA, Disley. B, Patterson P, conducted a study on risk taking behavior in a sample
of New Zealand adolescent. This study showed that adolescent are willing to provide
information on risk taking and that they are engaging in high level of health harming
behavior. Such information is important for designing health promotion programme to
address adolescent risk taking.

According to “world statistics 2015” the total number of road accident in 2015 was
501423 . The resulting number of death was 146133 peoples .
 CHAPTER-III
METHODOLOGY
CHAPTER-3
METHODOLOGY
Research methodology one of the vital sections of research, since the success of any research
is mostly depend upon the methodological issues that are followed in the execution of the
research. The role of methodology consists of procedures and techniques for concluding the
study.

Research approach:

This chapter deals with the methodological approach adopted for the study. It includes
description of research approach, research design, setting of the study, population, sample
criteria for sample selection, sampling technique, development of tool, scoring procedure,
pilot study, data collection procedure and plan for data analysis.

Research design:

A Research design is a systematic plan to study of scientific problem. The design of a

study defines and the study type (Descriptive, co relational, semi experimental, experimental,
review, meta analytic) and sub type (Eg: Descriptional longitudinal case study) research
question, hypothesis, independent, and dependent variables, experimental design and if
applicable data collection methods and a statistical analysis plan.

There are many ways to classify research design, but sometimes the distinction is
artificial and other times different designs are combined, nevertheless the list below number
of useful distinctions, between possible research designs.

Research data:

There are a total number of 17458 cases of Road traffic accidents with inSPSR
Nellore district, Andhra Pradesh state, data taken from GVK EMRI, Hyderabad.

Sample size:

A Total number of 17458 of Road traffic accidents which was collected from GVK
EMRI, Hyderabad, in particularly SPSR Nellore district.

Target population:

A Total number of populations in SPSR Nellore district. 2,966,082.

Data collection:

The data Road traffic accidents cases from January 1st 2016 to December 31st 2016
were obtained from the records of the GVK EMRI, Hyderabad.

The cases data documentation of Road traffic accidents cases recorded during the
period of January 1st 2016 to December 31st 2016 were obtained from GVK EMRI,
Hyderabad, to collect information.

According demographic variables on –Age, Sex, Area wise (urban/rural/tribal),

Month, Vehicle type, Social status and patients was shifting by 108 ambulances.

A total number of Road traffic accidents incidence during the period of January 1st
2016 to December 31st 2016.
TABLE NO-1

SCHEMATIC REPRESENTATION OF METHODOLOGY

Research Approach

Quantitative Approach

Type of the study

Retrospective study

Target population

SPSR NelloreDistrict Andhra

Pradesh

Data collection procedure

GVK EMRI Hyderabad

Data analysis & interpretation

Descriptive statistics
 CHAPTER-IV
DATAANALYSIS
&
INTERPRETATION
CHAPTER- 4

DATAANALYSIS & INTERPRETATION

Analysis of data is a process of inspecting, cleaning, transforming, and modeling data

with the goal of discovering useful information, suggesting conclusions, and supporting
decision-making. Data analysis has multiple facets and approaches, encompassing diverse
techniques under a variety of names, in different business, science, and social science
domains.

Data mining is a particular data analysis technique that focuses on modeling and
knowledge discovery for predictive rather than purely descriptive purposes. The process by
which sense and meaning are made of the data gathered in qualitative research, and by which
the emergent knowledge is applied to clients' problems. This data often takes the form of
records of group discussions and interviews, but is not limited to this.

I observed that the case of Road traffic accidents is more common with males than
females. The factor of affecting of Road traffic accidents are not following traffic rules not
wearing helmet, receiving mobile phone while driving, without blinding seatbelt ,overloaded.
A total of 17458 cases of Road traffic accidents were recorded during the period of 1st
January 2016 to 31st December 2016 from SPSR Nellore district and data collected from
GVK EMRI Hyderabad, Telangana.

I was reported earlier that the majority of the Road traffic accidents occur among the
Rural population respectively(chart -3) they are mostly not fallow the traffic rules during
accident period.
TABLE NO -2

According To Age Wise Data

S.No AGE TOTAL NUMBER OF % of age
CASES
a) 0-10 years 694 3.9%
b) 11-20 years 1797 10.2%
c) 21-30 years 5189 29.7%
d) 31-40 years 4150 23.7%
e) 41-50 years 2871 16.4%
f) 51-60 years 1762 10.5%
g) 61-100 years 985 5.6%
GRAND TOTAL 17458 100%

According to Age wise data cases are more victims affected between 21-30 age group (5189)
CHART NO: 1

6000

5000

4000

3000

2000

1000

0
0-10 years 11-20 years 21-30 years 31-40 years 41-50 years 51-60 years > 60 years

According to Age wise data cases are more victims affected between 21-30 age group (5189)
TABLE NO – 3

According to Gender wise data

S.No GENDER TOTAL NUMBER OF CASES % of GENDER

a) MALE 13766 78.8%
b) FEMALE 3692 21.2%

GRAND TOTAL 17458 100%

According to Gender wise data cases are more affected from Males (13766) than Females (3692)
CHART NO: 2

According to the Gender wise data:

Male
Female

According to Gender wise data cases are more affected from Males (13766) than Females (3692)
TABLE NO -4

According to Area wise data

S.No AREA TOTAL NUMBER OF CASES %OF AREAWISE

a) URBAN 11454 65%
b) RURAL 6004 35%
GRAND TOTAL 17458 100%

According to Area wise data cases are more affected from Rural area (11454) than Urban (6004)
CHART NO: 3

According into the Area wise data

Rural

Urban

According to Area wise data cases are more affected from Rural area (11454) than Urban (6004)
TABLE NO – 5

According to Monthly wise data

S.No MONTH AND YEAR TOTAL NUMBER OF CASES % OF MONTH & YEAR

a) JANUARY – 2016 2103 12.5%

b) FEBRUARY – 2016 1978 11.3%
c) MARCH – 2016 2136 12.2%
d) APRIL – 2016 2218 12.7%
e) MAY – 2016 2194 12.5%
f) JUNE – 2016 1884 10.7%
g) JULY – 2016 866 4.9%
h) AUGUST – 2016 909 5.2%
i) SEPTEMBER – 2016 864 4.9%
j) OCTOBER – 2016 827 4.7%
k) NOVEMBER – 2016 740 4.2%
l) DECEMBER – 2016 739 4.2%
GRAND TOTAL 17458 100%

According to Monthly wise data cases are more victims affected April month(2218) – (12.7%)
than other months.
CHART NO: 4

According to the Monthly wise data

2500

2218 2194
2136
2103 Jan
1978
2000 1884 Feb
Mar
Apr
1500 May
June
July
1000 909 Aug
866 864 827
740 739 Sep
Oct
500 Nov
Dec

According to Monthly wise data cases are more victims affected APRIL month (2218) – (12.7%) than other months
TABLE NO – 6

According to Vehicle wise data

S.NO TYPE OF VEHICLE TOTAL NUMBER % OF CASES
OF CASES
a) Two Wheeler 15389 88.0%
b) Three Wheeler 963 5.5%
c) MCI 159 0.9%
d) MV 548 3.1%
e) Pedestrian 68 0.3%
f) Vehicle rollover 86 0.4%
g) Train Accidents 177 1.5%
i) Others 68 0.3%
Total 17458 100%

According to Vehicle wise data cases or more affected Two wheeler accidents (15389) – (88.0%)
than other vehicles.
CHART NO:5

According into the Vehicle wise data

CASES

2wheeler
3wheeler
MCI
MV
PEDESTRIAN
V-ROLLOVER
TRAIN ACCIDENTS
OTHERS

According to Vehicle wise data cases are more affected two wheeler accidents (15389) – (88.0%) than other vehicles.
TABLE NO – 7

According to the Social Status wise data:

S. no Social Status No. of Cases % of cases

3341 19.3%
1 OC

8294 47.5%
2 BC

4181 23.9%
3 SC

860 4.9%
4 ST

782 4.4%
5 Others

17458 100%
Grand Total
9000

8000

7000

6000

5000
No. of Cases
4000 % of cases

3000

2000

1000

0
OC BC SC ST OTHERS
TABLE No -8

According to Hospital wise data:

S.No Type of hospital No. of Cases % of Cases

16458 94.2%
1 Govt. Hospitals
850 5.0%
2 Private Hospitals
150 0.8%
3 Others
17458 100%
Grand Total

According to Hospital Wise data Cases are more admitted at the Govt Hospitals
(16458) – (94.2%) than other Hospitals.
CHART NO – 7

According to Hospital wise data

No. of Cases

Govt Hospitals
Private Hospitals
Others

According to Hospital Wise data Cases are more admitted at the Govt Hospitals
(16458) – (94.2%) than other Hospitals.
CHAPTER-V
DISCUSSION
 CHAPTER-V
DISCUSSION

In this present study, males are especially involved but it is a serious economic loss of
the community for their education and training has been wasted. The incidence of head injury
also varies with such environmental factors as time of day , day of the week, weather
condition , type of road design and surface , lighting and visibility.

The severity of accidents and the mortality resulting them from may be affected for
better or worse by the structural design of the vehicle's involved. Head injury dose not
usually have a single cause each individual accident is likely to have several causative factor.
The effect of various factors must be isolated in order to asses their importance in causation
and hence in prevention.

The result of present study relevant that cases 17458 out of 13766 numbers of total
victims were male(78.8%) and 17458 out of 3692 numbers of total victims were females
(21.2 %) . It means men are very prone than women. The most effective & common reasons
behind greater Road traffic accidents in Males have driving before Alcohol drinking and over
limit speed, not wear seat belts and not wear helmets so they are prone to met with accidents.

In this study, a high accidents cases note in 21 to 30 age (no:5189 29.7 %) in this
between because of people s their family problems, work burden and their personal habits
drunk alcohol during driving these are all causes more prone to met accidents. Then 31 to 40
age groups as per my data second leading place (23.7%, no4150) they are more prone to
attracted new things (bike driving , alcohol, smoking, driving fast) that is the behind reason
for this age group more prone to get accidents.

In this study Majority of Road traffic accident cases as per data found in Rural area
(65.6% no: 11454). Two wheeler accidents accounted for (no: 15389, 88.1%) of the cases
reported. Very few cases are recorded other vehicles accidents (no: 2069, 11.9%) including
all vehicle accidents other than two wheeler accidents.
CHAPTER-VI
SUMMERY, CONCLUSION
&
RECOMMENDATION
 CHAPTER-VI

SUMMERY, CONCLUSION & RECOMMENDATION'S

SUMMARY:
By conducting whole research I found that the road traffic accidents cases more
vulnerable accident's than other and also there is high mortality ratio for those who are
suffering by these accident's. If they are survivor most of them have permanent disability's
can occur. Also found that the management for such accident's are very costly and not
affordable for every one in the society.

CONCLUSION:
After completing my whole research activity I got concluded that Head injury cases
mostly seen in male gender especially in the who are taken alcohol before driving and
especially in Rural victims does not followed traffic rules and not wear helmets. Rural area
people's compare than Urban area peoples mostly delay to reach related consult hospital so
mortality rate also decrease.

RECOMMENDATION'S:
 C-Spine immobilization for prevent secondary injury's.
 Stoping drink Alcohol.
 Follow the traffic rules and wearing helmets.
 Don't receiving mobile phone while driving and when travelling binding seat belt.
 Indications for transporting patients with a head injury from the scene of injury
directly to the nearest neurosurgen centre, bypassing the nearest emergency
department.
 Indications for and timing of CT head scans in the emergency department, with
particular reference to anticoagulant therapy and levels of circulating brain injury
biomarkers.
CHAPTER-VII
REFERENCES
 CHAPTER-VII
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APPENDIXES

DEMOGRAPHIC VARIABLES OF ROAD TRAFFIC ACCIDENTS

QUESTION-1: Age group wise Road traffic accidents data

a)
0 - 10 years
b)
11 - 20 years
c)
21 - 30 years
d)
31 - 40 years
e)
41 - 50 years
f)
51 - 60 years
g)
> 60 years

QUESTION – 2: Gender wise Road traffic accidents data ratio

a)
Male
b)
Female

QUESTION -3: Area wise Road traffic accidents data ratio

a)
Urban
b)
Rural
c)
Tribal
QUESTION – 4: According to GVK EMRI monthly wise cases
a)
January – 2016
b)
February – 2016
c)
March – 2016
d)
April – 2016
e)
May – 2016
f)
June – 2016
g)
July -2016
h)
August – 2016
i)
September – 2016
j)
October – 2016
k)
November – 2016
l)
December - 2016

QUESTION – 5: According to Vehicle wise Cases

a) 2WHEELER

b) 3WHEELER

c) MCI

d) MV

e) PEDESTRIAN

f) V- ROLLOVER

g) TRAIN ACCIDENTS

h) OTHERS

QUESTION – 6: According to Social Status wise Cases

a) OC

b) BC

c) SC

d) ST

e) OTHERS
QUESTION – 7: According to Hospital wise Cases

a) GOVT HOSPITALS

b) PRIVATE HOSPITALS

c) OTHERS