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ORIGINAL ARTICLE
Year : 2017  |  Volume : 44  |  Issue : 3  |  Page : 145-147

Road geometry as a factor for musculoskeletal injuries due to road traffic accidents in Sub-Himalayan State of Himachal Pradesh


1 Department of Community Medicine, Dr. RP Government Medical College, Tanda, Himachal Pradesh, India
2 Department of Orthopaedics, Dr. RP Government Medical College, Tanda, Himachal Pradesh, India

Date of Web Publication14-Feb-2018

Correspondence Address:
Sunil Kumar Raina
Department of Community Medicine, Dr. RP Government Medical College, Tanda, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jss.JSS_22_17

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  Abstract 

Background: Road traffic accidents (RTAs) kill 1.25 million people each year and injure between 20 and 50 million more people with many incurring a disability as a result of their injury. The road environment (design and geometry) can affect driver speed choice, thereby increasing chances of accidents.Materials and Methods: Patients attending tertiary care center for musculoskeletal injuries after an RTA were enrolled in the study. The data were collected using a standard questionnaire. The details on the geometry of the road (type of road; highway or other, metaled or nonmetaled, straight, and curved) were obtaine through inspection wherever possible. Results: Majority of the RTAs occurred on state highways (n = 154/313, 49.7%) followed by national highways (NH) (n = 94/313, 30%). Link roads account for comparatively less number (n = 65/313, 20.7%) of cases. Majority of the accidents occurred on metaled road (n = 268, 85.6%); however, the association of different vehicles involved in RTA with the condition of road was not found to be significant statistically (P > 0.5). Further, the majority of the RTA occurred on straight roads (n = 204, 65.1%). Conclusion: Road geometry is an important factor in RTAs as drivers generally tend to choose their speed based on their perception of the appropriate speed for the road geometry.

Keywords: Musculoskeletal injuries, road geometry, road traffic accidents


How to cite this article:
Raina SK, Awasthi B, Kumar L, Kalia S, Thakur L. Road geometry as a factor for musculoskeletal injuries due to road traffic accidents in Sub-Himalayan State of Himachal Pradesh. J Sci Soc 2017;44:145-7

How to cite this URL:
Raina SK, Awasthi B, Kumar L, Kalia S, Thakur L. Road geometry as a factor for musculoskeletal injuries due to road traffic accidents in Sub-Himalayan State of Himachal Pradesh. J Sci Soc [serial online] 2017 [cited 2018 Sep 19];44:145-7. Available from: http://www.jscisociety.com/text.asp?2017/44/3/145/225500


  Introduction Top


Road traffic accidents (RTAs) are defined as “accident which took place on the road between two or more objects, in which one is moving vehicle and other is human being.”[1] RTAs kill 1.25 million people each year and between 20 and 50 million more people suffer nonfatal injuries, with many incurring a disability as a result of their injury.

A look at the data on RTAs in India shows that the fatality rates per million population have increased in most regions in India except in the northeastern hill states and the cities of Delhi and Chandigarh (union territories).[2] The study further reveals that the increase was 40%–50% in Madhya Pradesh, Manipur, Tamil Nadu, Meghalaya, Uttar Pradesh, and the increase was 60%–100% in Himachal Pradesh, West Bengal, undivided Andhra Pradesh, Rajasthan, and Karnataka. The reasons for these differences are not known. However, these data do indicate that there are states with high rates and those with low rates in all regions of the country, and Himachal Pradesh is one with high rates. Although Himachal Pradesh contributed less in terms of total number of RTAs, the RTA is of huge concern in terms of accident rate per thousand vehicles registered.

The road environment (design and geometry) can affect driver speed choice. It does so by influencing both the driver's perception of their current speed and the speed that they think is appropriate for the road.[3] These influences and their effects on the speed which a driver chooses to drive on can, therefore, affect crash rates.

The current study was planned with the aim to study the influence of road geometry (surface of the road, whether it is straight or curved, flat, or sloping, etc.) on RTAs in the Sub-Himalayan state of Himachal Pradesh.


  Materials and Methods Top


The study was conducted as a hospital-based descriptive study at a tertiary care hospital in a rural area of Himachal Pradesh, a northwestern state in India using nonprobability sampling. Himachal Pradesh extends between 32°22'–33°12'N, and 75°45'–79°04'E covering an area of 56,090 km 2. Topography of the state is dominantly mountainous with the altitude ranging between 350 and 6975 m. The state has a total population of 6,856,509 and 90.2% people live in rural setup.[4]

Methodology

All consecutive patients with musculoskeletal injuries due to nonfatal road traffic injuries of all age groups, presenting to the center from June 1, 2014, to May 31, 2015, were included in the study, except those denying consent to be included in this study. Written informed consent was obtained from all the patients and attendants included in this study. In case of minors, consent was taken from the parents/local guardians. The study was approved by the institution ethics committee.

The standard questionnaire was completed as per data collection form which included details on the geometry of the road (type of road; highway or other, metaled or nonmetaled, straight, and curved) at the site of the accident. The questionnaire used for the purpose of this study is a part of questionnaires being used as part of registry established by the Department of Orthopedics to register the cases of musculoskeletal injuries due to RTAs.[5] Metaled road was defined as a road made of stone chippings mixed with tar to form the road surfacing material tarmac. A site inspection of the road, wherever possible, was done to assess the accuracy of the road details.

History regarding the mode of trauma was taken from the patient and his attendants.

After clinical examination, relevant radiological assessment was done to arrive at diagnosis, and accordingly, the patient was managed with conservative/operative intervention after relevant blood investigation.

Statistical analysis

Data collected was entered in MS Excel 2007. The statistical analysis was done using Statistical Package for Social Sciences version 17.0 (IBM, Armonk, New York, USA). statistical analysis software. The results were expressed as percentages. The statistical significance was assessed using Chi-square test and P < 0.05 was taken as statistically significant.


  Results Top


[Table 1] shows that majority of the RTAs occurred on state highways (n = 154/313, 49.7%) followed by national highways (NH) (n = 94/313, 30%). Link roads account for comparatively less number (n = 65/313, 20.7%) of cases. The study also reveals that the major contributor to RTAs is the two-wheeler users although the proportion of the two-wheeler involvement in RTA on link road was higher (n = 49/65, 75.3%) whereas light as, well as heavy motor vehicle was involved in RTA state and NH more commonly.
Table 1: Proportion of road traffic accidents in relation to types of road

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Association of vehicular involvement in the RTA on different type of road was found to be statistically significant (P < 0.05). [Table 2] shows that majority of the accidents occurred on metaled road (n = 268, 85.6%); however, the association of different vehicles involved in RTA with condition of road was found not significant statistically (P > 0.5). [Table 3] demonstrates the relationship of the different vehicles involved in RTA with the curvature of the road. Majority of the RTA occurred on straight roads (n = 204, 65.1%). However, the association was not found b significant statistically (P > 0.05).
Table 2: Proportion of road accidents in relation to condition of road

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Table 3: Proportion of road accidents in relation to curvature of road

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  Discussion Top


The Government of India launched a major program to expand and improve highways in India in the year 2000. Currently, 70,000 km of NH are maintained by the National Highway Authority (NHAI), and through the National Highway Development Programme, NHAI is upgrading nearly 49,000 km of NH.[2]

The major reason behind highway up gradation apart from improving intercity and interstate connectivity has been to improve highway safety. Even though the NH comprise of only 15% of the total length of roads in India, these account for 33% of the fatalities. The state of Himachal Pradesh has 9 NH with total length of 1,208 km and 19 state highways with total length of 1,625 km thereby contributing to around 8% (less than the national average) of total road length of 34647 km.[6] The current study shows that most of the RTAs occurred on state highways followed by NH; together accounting for 80% of total accidents. The relatively high rate of accidents on highways could be because they carry a significant proportion of passenger and freight traffic.[2]

Since details of vehicle Kilometer traveled on various categories of highways are not available, it may not be possible to make a comparison based on exposure rates. The study also reveals that the major contributor to RTAs is the two-wheeler users. This finding is in conformity with the findings at the national level. According to data available, the majority (68%) of those getting killed on highways in India comprise vulnerable road users.[2] Data obtained from three highway segments from 2009 to 2013 shows a similar pattern with pedestrian and motorized two-wheelers being the main contributor to accidents on highways.[2]

Most of the accidents occurred on metaled, straight roads. This may be because rough road surfaces lead to greater noise and vibration inside the vehicle. Drivers tend to slow down to minimize the discomfort caused by a rough surface.[3] The results from our study are different from a study conducted in Shimla [7] where maximum crashes were observed at the curved level of road primarily because of the difference in road patterns between our study area and Shimla study, wherein the roads generally follow a curved pattern only. However, the study results were similar to results obtained by Ghosh et al. in their study [8] conducted in Delhi in which maximum crashes were found on the straight level road wherein speed of the vehicle may again be an important contributor. Drivers generally tend to choose their speed based on their perception of the appropriate speed for the road environment and their motivation to comply with legal and/or safe speeds. Data regarding alcohol intake, condition of vehicles, health status of the driver, licensed driver, speed of vehicles, weather conditions such as fog, rain, etc. could not be collected which could be a possible source of confounding.

Road categorization on the bases of its geometry may be an effective way of preventing RTA. In addition, defining speed limits on all roads may be the way forward.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Mishra B, Sinha Mishra ND, Sukhla S, Sinha A. Epidemiological study of road traffic accident cases from Western Nepal. Indian J Community Med 2010;35:115-21.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Mohan D, Tiwari G, Bhalla K. Road Safety in India Status Report. Transportation Research and Injury Prevention Programme. Available from: http://www.tripp.iitd.ernet.in/roadsafetyinIndiastatusreport.pdf. [Last accessed on 2017 Apr 14].  Back to cited text no. 2
    
3.
Edquist J, Rudin-Brown CM, Lenné MG. Road Design Factors and Their Interactions with Speed and Speed Limits. Available from: http://www.onlinepubs.trb.org/onlinepubs/conferences/2011/RSS/2/Lenné, M.pdf. [Last accessed on 2017 Apr 14].  Back to cited text no. 3
    
4.
Raina SK, Raina S, Chander V, Grover A, Singh S, Bhardwaj A, et al. Is dementia differentially distributed? A study on the prevalence of dementia in Migrant, Urban, Rural, and tribal elderly population of Himalayan Region in Northern India. N Am J Med Sci 2014;6:172-7.  Back to cited text no. 4
    
5.
Awasthi B, Raina SK, Verma L, Kalia S. Cost of initial management of musculoskeletal injuries due to road traffic crashes: A register-based study from North-West India. J Sci Soc 2017;44:31-5.  Back to cited text no. 5
  [Full text]  
6.
Brief Facts of Himachal Pradesh 2012-2013. Economics and Statistics Department Himachal Pradesh. Available from: http://www.admis.hp.nic.in/himachal/economics. [Last accessed on 2017 Apr 14].  Back to cited text no. 6
    
7.
Mahajan N, Aggarwal M, Raina S, Verma LR, Mazta SR, Gupta BP, et al. Pattern of non-fatal injuries in road traffic crashes in a hilly area: A study from Shimla, North India. Int J Crit Illn Inj Sci 2013;3:190-4.  Back to cited text no. 7
  [Full text]  
8.
Ghosh PK. Epidemiological study of the victims of vehicular accidents in Delhi. J Indian Med Assoc 1992;90:309-12.  Back to cited text no. 8
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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Introduction
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