Background Highways account for a major share of travel and transport in India and many other LMICS. Road deaths and injuries are also significantly high on these highways due to different transport characteristics as compared to other roads. Despite this, the burden and pattern of highways crashes are not clearly known to develop sustainable interventions.
Methods The burden, pattern, characteristics and outcomes of highway road crashes was delineated using combined data from police and hospital sources. Using mixed method approaches, comprehensive resource mapping, facilities inventory, discussion with stake holders, environmental scanning and identifying characteristics of high risk crash locations was completed.
Results Road Traffic Injuries (RTIs) contributed for 39% of fatal and 34% of non-fatal injuries in the district. In 2014, 280 fatal road crashes were registered resulting in death of 336 persons. In the same period, 596 non fatal crashes were registered with police resulting in injuries among 1213 persons with a ratio of 1:4 between deaths and injuries. Information from just 2 major hospitals revealed that 8518 RTIs were registered in this period, indicating huge underreporting in police records. The 2 national highways and 5 state highways contributed for 37% and 25% of total road deaths, respectively, with 32% of nonfatal crashes occurring on both highways. Males, 16–45 years, two wheeler riders and pedestrians were involved in high number of crashes. Collision patterns indicated a greater involvement of heavy vehicles like buses and trucks along with motor cars on highways. Nearly 43% died at the crash site and remaining deaths occurred on the way to hospital or in the hospital. Use of helmets- seat belts was extremely low and drink driving was recorded among 18.5% of hospitalised RTIs. Excessive speeding was a major cause of crashes as informed in focussed group discussions. Several high risk crash locations were identified and possible human, vehicle and road related factors delineated. Injuries to head and face along with extremity injuries were most frequent and both prehospital and inhospital care had several limitations and deficiencies.
Conclusions Safety of all road users and especially vulnerable road users should be given greater importance on highways with implementation of well proven countermeasures along the five pillars of road safety in India and other LMICs.
- Highway road crashes
- Risk factors
- Trauma care
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