Road traffic accidents in Tunisia:

a man made disaster

Pr Hassen Ghannem
Department of Epidemiology
University Hospital Farhat Hached
Sousse,
Tunisia
 Disaster
Websters Dictionary defines disaster
as
a baleful or fatal event leading to ruin.
Family
Country

Whats 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 interveni

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