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EPI 2670: Injury Epidemiology

EPI 2670: Injury Epidemiology. Transportation Related Injuries. Thomas Songer, PhD University of Pittsburgh. Types of Transportation. Top Ten Public Health Achievement. History of Crashes. Fatality Rate per 100 Million Vehicle Miles. Studying the Epidemiology of Injuries from Crashes.

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EPI 2670: Injury Epidemiology

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  1. EPI 2670: Injury Epidemiology Transportation Related Injuries Thomas Songer, PhD University of Pittsburgh

  2. Types of Transportation

  3. Top Ten Public Health Achievement

  4. History of Crashes Fatality Rate per 100 Million Vehicle Miles

  5. Studying the Epidemiology of Injuries from Crashes

  6. The Accident Triumvirate • Environment • Vehicle • Driver

  7. The Crash Sequence • Pre-crash Period • Crash Period • Post-crash Period

  8. The Haddon Matrix use for planning, resource allocation, strategy identification Human Vehicle Environment Pre-event Event Post-event

  9. How do we know what the impact of crashes are?

  10. Surveillance: Systematic, regular ascertainment of incidence using methods distinguished by their practicality, uniformity, and frequently their rapidity, rather than by complete accuracy. Last, 1990

  11. Definition of Crashes • Police-reported crashes • Fatal crashes • Self-reported crashes • Insurance-reported crashes • Injury-producing crashes • Property-damage producing crashes

  12. Fatality Analysis Reporting System

  13. FARS Police Accident Reports State vehicle registration files State driver licensing files State Highway Department data Death certificates Coroner/Medical examiner reports Hospital medical records Emergency medical service reports

  14. Fatality Analysis Reporting System 39,187 fatal motor vehicle crashes occurred in the United States in 2005, and 43,443 deaths occurred in these crashes.

  15. Fatal Crashes, 1975-2003

  16. Persons Killed, United States, 1975-2003

  17. Fatal Accidents in Pennsylvania Number % Speed % Alcohol Costs Related Related (millions) 1,562 16.1 32.9 $ 4,385 All figures are 1997 State of Pennsylvania Department of Transportation

  18. GESGeneral Estimates System

  19. USA Crash Rates By Severity per 100 million VMT Fatal 1.4 77 Injury Property Damage 156 6,279,000 total crashes 1999 FARS, GES

  20. What are the descriptive factors related to crashes?

  21. Human Age Gender Experience Alcohol Fatigue Failure Design Speed Vehicular Road Cond. Traffic Weather Environmental

  22. Driver Involvement Rates in Crashes by Gender and Crash Severity per 100,000 licensed drivers Males Females 50 40 30 20 10 0 Fatal 1999 GES/FARS

  23. Crash Death Rates per 100,000 population by Age and Gender 1999 FARS

  24. Motor Vehicle Crash Death Rates among Males by Country, 1980 Age group

  25. Percent of Drivers in Crashes with Alcohol Involvement by Age Group Fatal Injury Age (in years) 1999 GES/FARS

  26. Drivers Involved in Fatal Crashes by Previous Driving Record Previous Crashes 14.8% Previous Suspensions 12.4% Previous DWI Convictions 3.4% Previous Speeding Convictions 21.0% Other Moving Violations 17.6% No Previous Convictions 57.3% 1999 FARS

  27. Proportion of Vehicles Involved in Traffic Crashes 1999 GES/FARS

  28. Crash Rates by Type of Vehicle per 100 million vehicle miles traveled Fatal Crashes 1997 FARS

  29. Crash Rates by Type of Vehicle per 100 million vehicle miles traveled Injury Property Damage 1997 GES

  30. USA Crash Rates by Month per 100 million vehicle miles traveled 1999 GES/FARS

  31. Crash Rates by Road Type, 1997, Pennsylvania (per 100 million VMT) PennDOT

  32. Crashes by Hour of Day, PA Number 1997 PennDOT

  33. Alcohol Involved Crashes by Time of Day Number of Crashes 1999 GES,FARS Morning Evening

  34. Alcohol Related Crashes by Time of Day 1999 GES,FARS Property Damage Injury Fatal Injury Morning Evening

  35. Crash Severity by Posted Speed Limit Property Damage Injury Fatal Injury % 1999 GES/FARS

  36. Research Issues

  37. No Standard Definition of Crashes • Police-reported crashes • under-reports non-fatal & less severe events • Self-reported crashes • drivers with impairments may under-report • Injury-producing crashes • does not include less severe events • Property-damage producing crashes • under-reporting to insurance companies

  38. General Underreporting of Accidents Various sources suggest that about half the motor vehicle crashes in the country are not reported to the police, the majority of these unreported crashes involve only minor property damage and little personal injury.

  39. Death Rates per 10,000 Vehicles Registered by Country Ethiopia Bangladesh Swaziland Ecuador Hong Kong

  40. MMUCC Model Minimum Uniform Crash Criteria Important Data Elements • Crash Date & Time • Place • Manner of Crash • Weather Conditions • Road Condition • Vehicle Make • VIN • Total Occupants • Seating Position • Injury Status • Seat Belt Use • Alcohol Involvement • Air bag Deployment

  41. CODES To measure benefits in terms of reducing death, disability, and medical costs, NHTSA determined that statewide data were needed that included all persons involved in police-reported crashes -- those who were injured as well as those who were not injured.

  42. Prevention of Injuries from Motor Vehicle Accidents • Changes in Highway Design • Changes in Vehicle Design • Seat Belts • Air Bags • Speed Limits • Changes in Licensing

  43. Air Bags Work (except for a few) - Up through December 1999, air bags have saved an estimated 4969 lives. - In purely frontal crashes, air bags reduce car driver deaths by 26-32 percent. - Since 1990, 175 deaths have been caused by airbags

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