The burden of road crashes on the health system in Asia Pacific

Transcription

1 The burden of road crashes on the health system in Asia Pacific Professor Peter F.M. Choong Sir Hugh Devine Professor of Surgery, University of Melbourne Department of Surgery Director of Orthopaedics, St. Vincent s Hospital Melbourne President, Australian Orthopaedic Association

2 Lower infant mortality, healthy aging, better healthcare

3 Life expectancy - Australia Males Females Sources: ABS 2008; ABS 2013a

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5 Leading cause of death years Energy of impact = 1/2 mv 2 Road deaths Australia : 2008 statistical summary. Department of Infrastructure, Transport, Regional Development and Local Government May 2009 Rapid motorization and road traffic accidents in China. Shengchuan Zhao, Dalian University of Technology, Dalian, China

6 The vulnerable road users

7 Mode of transport for serious injury Australia Injured Person Count Percent % Rate per Car occupant Motorcyclist Pedal Cyclist Pedestrian Total AIHW: Henley G and Harrison JE Serious injury due to land transport, Australia Injury research and statistics series no. 67. Cat. no. INJCAT 143. Canberra: AIHW.

8 Key Indicators for Land Transport Injuries Australia Indicator Persons admitted to hospital % of all admissions due to injury 9.8% Mean length of stay in hospital 4.4 (days) Total patient days (incl same day) Crude rate / AIHW: Henley G and Harrison JE Serious injury due to land transport, Australia Injury research and statistics series no. 67. Cat. no. INJCAT 143. Canberra: AIHW.

9 Location of Injuries Car Occupant Motorcyclist Pedal cyclist Pedestrian 23.7% 10.8% 23.3% 30.7% 19.3% 7.8% 4.7% 4.3% 13.5% 35% 44.5% 15.2% 13.7% 7.4% 6.9% 8.8% 11.4% 35.3% 17.2% 36.2%

10 Head Injuries Death, Vegetative state, Cognitive deficit, Motor deficit, Epilepsy

11 Lower limb injuries Loss of mobility Soft tissue defects Nerve/Vessel injury Non-union Deformity Contractures Shortening Amputation

12 Upper limb injuries Loss of independence Nerve injuries Loss of function Poor healing Stiffness and contractures

13 Cost of Road Traffic Accidents 1-3% GDP 5-20% Health Expenditure Australia $27 Billion ($140 Billion) USA $518 Billion ($2.6 Trillion)

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16 Challenges

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20 Societal Cost - Life years lost through disability Road Traffic Injuries 20-50x > than fatalities Asia - 1 Fatality, 20 Hospital admissions, 50 ER visits, 100 minor injuries Road Traffic Accidents (x thousands) Diabetes Heart disease HIV/TB/Malaria Cancer 4483 Force of Nature/War 2289 Global Burden of Disease Study, Lancet 2012; 380:

21 Impact of RTA in Asia road fatalities each year 3.5 million deaths last 5 years 18 million permanently disabled last 5 years 60% of global deaths and injuries By x > HIV/AIDS, 4x > TB New Zealand 4.4 Million Latvia 2.29 Million Mauritius 1.29 Million Luxemberg 502 Thousand Iceland 317 Thousand

22 Road Death rate per 100,000 population - Asia Region Rank Rate World Rank Region Rank Rate World Rank 1 Thailand South Korea Malaysia Uzbekistan Mongolia Myanmar Vietnam Sri Lanka Afghanistan Nepal Kyrgyzstan Georgia Indonesia Philippines Laos Turkmenistan Russia Timor-Leste Kazakhstan North Korea China Azerbaijan India Singapore Bhutan Tajikistan Cambodia Japan Bangladesh Maldives Pakistan Australia Brunei UK Armenia USA

23 Health and Wealth: Poverty impact 22 million: number of families that have experienced a family member being killed or permanently disabled by road accidents in the last 5 years. R. Silcock Guidelines for Estimating the Cost of Road Crashes in Developing Countries. London: Department for International Development; WHO out of 10: number of victims' families that suffer decreased income due to road accidents. Source: R. Silcock Guidelines for Estimating the Cost of Road Crashes in Developing Countries. London: Department for International Development; WHO Two-thirds: proportion of victims' families who end up taking loans to cover income loss. Road Safety in the Western Pacific Region: Call for Action. Geneva. WHO. $15 billion: estimated cost of road accidents in ASEAN countries ADB Transport $96 billion: amount lost annually to road accidents in ADB member countries. Road Safety in the Western Pacific Region: Call for Action. Geneva. WHO.

24 Road Traffic Fatalities in Australia Seat belts Bureau of Infrastructure,Transport and Regional Economics (BITRE), 2014, Road Safety Modelling a Global Phenomenon, Report 141, Canberra ACT.

25 Trinca GW, Dooley BJ. The effects of seat belt legislation on road traffic injuries. Aust N Z J Surg Apr;47(2): Dooley BJ. Medical significance of occupant restraint on road-crash victims and the role of the medical profession. Can J Surg Nov;30(6): Trinca GW, Dooley BJ. The pattern of motor cycle injuries sustained by motor cyclists in Victoria in 1974 and Aust N Z J Surg Apr;49(2):203-7.

26 Seat Belt Wearing vs Fatality Bureau of Infrastructure,Transport and Regional Economics (BITRE), 2014, Road Safety Modelling a Global Phenomenon, Report 141, Canberra ACT.

27 Road Traffic Fatalities in Australia Drink Driving Bureau of Infrastructure,Transport and Regional Economics (BITRE), 2014, Road Safety Modelling a Global Phenomenon, Report 141, Canberra ACT.

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29 Random breath testing

30 Road Traffic Fatalities in Australia Speed camera Bureau of Infrastructure,Transport and Regional Economics (BITRE), 2014, Road Safety Modelling a Global Phenomenon, Report 141, Canberra ACT.

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32 Impact speed in dry conditions 50 km/h 55 km/h 60 km/h 65 km/h 70 km/h 75 km/h 80 km/h Metres Reaction Braking Stops in time Stops in time Touches Hits at 32 km/h Hits at 46 km/h Hits at 57 km/h Hits at 66 km/h

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34 Road Traffic Fatalities vs Road Traffic Injuries Bureau of Infrastructure,Transport and Regional Economics (BITRE), 2014, Road Safety Modelling a Global Phenomenon, Report 141, Canberra ACT.

35 Actual vs Predicted Australian Road Deaths Bureau of Infrastructure,Transport and Regional Economics (BITRE), 2014, Road Safety Modelling a Global Phenomenon, Report 141, Canberra ACT.

36 Actual vs Predicted Australian Road Injuries Bureau of Infrastructure,Transport and Regional Economics (BITRE), 2014, Road Safety Modelling a Global Phenomenon, Report 141, Canberra ACT.

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38 What lessons have we to share? Education Road culture Specific groups Legislation Car seat belts Motor cycle and pedal cycle head protection Alcohol restriction Speed limits Road rules Car safety features