A Study on Awareness and Behaviour of Adolescents towards Road Traffic Accidents.

Transcription

1 International Journal of Current Medical And Applied Sciences, vol.4. Issue:1, September: PP: A Study on Awareness and Behaviour of Adolescents towards Road Traffic Accidents. S.B. Salve*, R.K. Dase**, V.S. Jadhav**, S.M. Mahajan*** & S.A.Adchitre***. *Professor, **Assistant Professor & *** Associate Professor, Department of Community Medicine, Mahatma Gandhi Missions Medical College Aurangabad, Maharashtra, INDIA. Corresponding ID: rdase25@gmail.com Research Article Subject: Community Medicine Abstract: Fatal road traffic accidents in adolescents constitute a significant public health problem. So to assess the knowledge and practices amongst adolescents, present study was carried out in five coaching classes in Aurangabad city in urban field practice area of MGM Medical College Aurangabad, Maharashtra, India during the period January 2013 to March A total 599 boys and 452 girls of tenth, eleventh and tweleveth standard were included in this study.data was collected in pre designed questionnaire. Health Education was given with the help of slide show to promote Adolescents for safe driving. Awareness for vehicle condition, traffic signal and signs was good amongst boys and girls, boys were more aware than girls. Awareness towards road condition was average amongst boys and girls as well. The percentage of road traffic accidents was high, i.e., 219 (68.44%) amongst boys due to risk taking behaviour like driving with triple seats, performing stunts, over-limit speeding, etc. Conclusion-knowledge for road signals, signs and vehicle condition was good. Key Words: Road Traffic Accident, Adolescent s Awareness, Driving Practices. Introduction: Accident means Unexpected, unplanned occurrence which may result in an injury. According to WHO definition of accident is an unpremeditated event resulting in recognizable damage. Occurrence in a sequence of events which usually produces unintended death or property damage. Motor vehicle accident was defined as the unintended collision of one motor vehicle with another, a stationary object, or persons, resulting in injuries, death and/ or loss of property. Accidents tragically are not often due to ignorance, but are due to carelessness and over confidence. William Haddon [1] has pointed out that road accidents were associated with numerous problems each of which needed to be addressed separately. More than 1.2 million people are died in road traffic accidents and about 50 million injured in road traffic accidents worldwide every year. On an average 3242 persons die each day around world in road crashes. In the developed countries, 57% of male deaths and 43% of female deaths are in age group 10-24yrs due to Road Traffic Accidents.Emergence of Road Traffic Injuries (RTIs) a leading cause of Deaths & Disabilities in India. The magnitude of Road traffic accidents and fatalities in India is alarming in 2009, 4.22 lakh Road traffic accidents and 1.27 lakh Road traffic fatalities were reported. These numbers translate into one road accidents every minute and one road accident death every four minutes [2]. The world health organization (WHO) estimated that 1.17 million deaths occur each year worldwide due to Road traffic accidents. This increased rate has been attributed by population explosion and increased motorisation. This increased motorisation may be characterised briefly as the Automotive revolution that is the motorizing of urban population especially in the developing countries.statistics indicate that over 90 percent of traffic accident situation in Nigeria can be attributed to driver s errors [3, 4]. The motorization of India especially during the past two decades has resulted in greater number of deaths and injuries due to absence of Road safety policies, programmes, and environmental norms. Road traffic accidents have been increasing significantly due to rapid motorization, urbanization and migration of people along with the lack of a safety environment. Nearly 60% of those killed injured are in the age group of 2014 Logic Publications, IJCMAAS,E-ISSN: ,P-ISSN: page I 33

2 16 to 45 years with a male to female ration of 4:1 [5]. Accidents impose significant costs 3% GDP for India ( ) 1% GNP for low income countries 1.5 % GNP for middle income countries 2% GNP for high income countries. Traffic crashes also impact on the economy of developing countries at an estimated cost 1:2 % of a countries GNP per annum, as a result of morbidity, mortality and property related cost [6]. Road accidents occur due to different reasons like: Defects in vehicle, Error of driver, Environment around the road, Defects in roads etc. Human error is estimated to account for between 64 to 95 % of all causes of Traffic Crashes in developing countries [3]. The accidents are increased in and around Aurangabad city, Maharashtra State India, due to various reasons: 1) Rapid Urbanization, 2) Industrialization, 3) Increase in educational institutes and expansion of residential area towards out-skirts of the city, migration of population for jobs from nearby places but no residential area nearby to accumulate more and more migrants which compel them to reside on out-skirt area. So distance from residential area to work place, schools and colleges has increased to and fro and moreover busy parent which leads to increased vehicle use by adolescents. The reasons for higher rate of Road traffic accidents amongst young drivers are minimal information about Road safety and limited practice, immaturity and inexperience particularly in the necessary driving skills and capabilities [7]. So this present study was carried out with an Aim -to assess the awareness and practices followed by adolescents while driving a vehicle and Observations & Results: Table 1: Adolescents Gender & Age-group: to motivate them to follow traffic rules to prevent Road traffic accidents. Objectives:- To assess awareness about road traffic rules amongst adolescents To study their behavieral pattern while driving the vehicle. To know the causes of accidents To compare male and female adolescents awareness and behavieral pattern. Material Methods: This present cross sectional study was carried out amongst adolescents attending academic coaching classes in Aurangabad city during the period January 2013 to March A predesigned and pretested questioner was used for collection of information from the adolescents. Questions like presence of road divider, street lights, signals and signs boards, condition of roads, stray animals on road were included to assess their awareness towards road conditions, questions were also included to know their awareness towards vehicles conditions and driving practices. Based on these questions grading score was given to ascertain the level of traffic safety awareness amongst adolescences. For answering five to six questions correctly Grade -I that is good SCORE, for 3-4 correct answers Grade-II that is average score and for less than three correct answers Grade-3 that is poor score was given. Health education was given with the help of power point presentation and by question answer session for motivation of adolescents to prevent road traffic accidents. Age Group (In years) Boys Girls Total Percentage N % N % < % % % % % % % % Total % % % Out of 1051 adolescents, 81.45% were in age-group years, percent were in age group years & only 5.51 percent below 15 years. Out of 1051, 599 (56.99%) were boys & 452 (43.01%) were girls Logic Publications, IJCMAAS,E-ISSN: ,P-ISSN: Page 34

3 Logic IJCMAAS, E-ISSN: ,P-ISSN: Table 2: Use of Vehicle by adolescents for travelling from home to coaching classes: Vehicles Boys (%) Girls (%) TOTAL Four wheeler 17(2.83%) 17(3.76%) 34(3.24%) Two wheeler with gear 206(34.39%) 22(4.87%) 228(21.68%) Two wheeler without gear 159 (26.58%) 374 (82.74%) 533 (50.71%) Both 217 (36.20%) 39 (8.63%) 256 (24.37%) Total Table 2 shows out of 1051, 533 (50.71%) adolescents were using Two wheeler without gear, amongst these 533, 374 (70.17%) were girls, whereas 159 (29.83%) were boys. and 228 (21.68%) were using Two Wheeler with gear, amongst these maximum were boys i.e. 206 (90.35%) and 22 (09.65%) were girls. Only 34 (3.24%) were using Four Wheeler and in this boys to girls ratio was 50-50%. Table 3: Awareness of signals amongst adolescents: Signal Boys Girls Total Chisquare p- value Don t Know Total Don t Know Total Don t Know value Know Know Know RED (0%) (0%) (0%) 335 P=0.0 YELLOW 92 (15.4%) 507 (84.6%) (14.8%) 385 (85.2%) (13.1%) 892 (86.9) 00 S GREEN 0 (0%) (0%) (0%) 831 Out of 1051 adolescents, all were aware about RED and GREEN colour Road traffic signals, about YELLOW colour, only 892 (86.9% ) were aware and 159 (13.1% ) were not aware.. Awareness for Red & Green signals colour was more compared to Yellow colour signal & this difference was statistically significant (p=0.000). Table 4: Awareness about Road Condition, vehicle & sign amongst Adolescents. Awareness about Road Condition Awareness about Condition of vehicle Awareness about Road Traffic signs Score BOYS (599) GOOD 88 (5-7) (14.69%) AVERAGE 320 (3-4) (53.42%) POOR 191 (1-2) (31.88%) GOOD 410 (5-7) (68.45%) AVERAGE 084 (3-4) (14.02%) POOR 105 (1-2) (17.53%) GOOD 298 (5-7) (49.75%) AVERAGE 249 (3-4) (41.57%) POOR 052 (1-2) (8.68%) GIRLS (452) 085 (18.80%) 211 (46.68%) 156 (34.51%) 255 (56.42%) 135 (29.87%) 062 (13.71%) 150 (33.18%) 198 (43.80%) 104 (23.00%) TOTAL (1051) Chi-square test p-value 173 (16.46%) 5.50 P= NS (50.52%) 347 (33.01%) 665 (63.27%) 219 (20.84%) 37.6 P= S (18.89%) 448(42.63%) 447(42.53%) 156(14.84%) 52.5 P= S International Journal of Current Medical And Applied Sciences [IJCMAAS] volume 4, Issue 1.

4 Above Table shows, score of awareness about road condition by which they travel daily. Out of 1051 adolescents, average score was observed in 531 (50.52%), poor in 347 (33.01%) and only 173 (16.46%) with Good score. Out of 173 with Good score 88 (50.87%) were boys & 85(49.48%) were girls. Out of 347 with poor score, 191(55.04%) were boys and 156(44.96%) were girls. But this difference was not statistically significant (p=0.064). It means that Boys as well as girls were less aware about the road condition. Out of 1051 students 665 (63.27%) had Good awareness, 219 (20.84%) had Average & 167 (15.89%) had poor awareness about their vehicle condition. Amongst these 665 adolescents with good awareness about vehicle condition, 410 Table 5: Behaviour of Adolescents while driving Vehicle: (61.45%) were the boys and 255 (38.35%) were girls.. It means boys awareness towards vehicle condition was more compared to girls and this difference shows statistical significance (p=0.000). The awareness about road traffic signs was good amongst 448 (42.63%) adolescents, average amongst 447(42.53%) and poor amongst 156 (14.84%) adolescents. Amongst these 448 students having good awareness, 298 (66.52%) were boys and 150 (33.48%) were girls and out of 156 adolescents, with poor awareness 052 (33.33%) were boys and 104 (66.67%) were girls. It means boys had good awareness towards Road Traffic Sign compared to girls and this shows statistical significant difference in their level of awareness. BOYS GIRLS TOTAL Chisquare value 1.LICENSE Learning 120 (20.00%) 85 (18.80%) 205(19.51%) Permanent 79 (13.20%) 52 (11.50%) 131(12.46%) Do not have 400 (66.80%) 315 (69.70%) 715(68.03%) 2.ACCESSORIES P-value 1.11 P=0.575 NS Working 399 (66.61%) 320 (70.80%) 719(68.41%) 2.09 P=0.148 NS Not Working 200 (33.39%) 132 (29.20%) 332(31.59%) 3.HELMET Yes 130 (21.70%) 78 (17.26%) 208(19.79%) 3.89 P=0.043 No 469 (78.30%) 374 (82.74%) 843(80.21%) S 4.SIGN Follow 213 (35.56%) 141 (31.20%) 354(33.68%) 2.03 P=0.154 Not Follow 386 (64.44%) 311 (68.80%) 697(66.32%) NS 5.SIGNALS Follow 412 (68.78%) 307 (67.92%) 719(68.41%) P=0.766 Not Follow 187 (31.22%) 145 (32.08%) 332(31.51%) NS 6. LANE DISCIPLINE Follow 469 (78.30%) 306 (67.70%) 775(43.74%) 14.9 P=0.000 Not Follow 130 (21.70%) 146 (32.30%) 276(26.26%) S 7.TAKE EXTRA SEATS Yes 212 (35.40%) 70 (15.49%) 282(26.83%) 52.0 P=0.000 No 387 (64.60%) 382 (84.51%) 769(73.17%) S 8.PERFORM STUNT Yes 105 (17.53%) 30 (6.64%) 135(12.84%) 27.3 P=0.000 No 494 (82.47%) 422 (93.36%) 916(87.15%) S 9.MUSIC Yes 208 (34.7%) 167 (36.90%) 375(35.68%) P=0.457 No 391 (65.3%) 285 (63.10%) 676(64.32%) NS 10.MOBILE Yes 217 (36.20%) 128 (28.30%) 345(32.83%) 7.31 P=0.007 No 382 (63.80%) 324 (71.70%) 706(67.14%) 11.DRINK AND DRIVE Yes 57 (9.50%) 10 (2.20%) 67(6.47%) 23.0 P=0.000 No 542 (90.50%) 442 (97.80%) 984(93.63%) S S 2014 Logic Publications, IJCMAAS,E-ISSN: ,P-ISSN: page I 33

5 Table no.5 shows, 131(12.46%) students having permanent driving licenses while 205 (19.51% ) were driving with learning licenses. Maximum 715 (68.03% ) students do not have license and amongst these, 400 ( 55.94%) were boys and 315 ( 29.97%) were girls. Difference is not statistically significant ( P=0.575). Use of safety measures like helmet while driving was very less i.e. 208 ( 19.79% ) amongst these 130 (62.5%) were boys and 78 ( 37.5% ) were girls.amongst 843 (80.21%) non user of helmet, 469 ( 55.63%) were boys and 374 ( 44.37%) were girls. Percentage of using helmet was more amongst boys compared to girls and this shows statistical difference. When inquired about following traffic signs and signals. Similarly the percentage of driving with triple seats perform stunts, using cell phone while driving, driving in drunken state was significantly higher among boys 212 (75.18%), 105 (77.78%), 217 (62.90%)and 57 (85.09%) respectively as compared to girls i.e. 70( 24.82%), 30(22.22%), 128( 37.10%), 10(14.93%) respectively and difference was statistically significant. Vehicle accessories in working conditions were recorded in 719(68.41%) students. Signals and lane discipline followed by maximum students 719(68.41%) and 775 (73.74%) respectively but traffic signs are not followed by 697(66.32%) students. Boys drive the vehicle with risk taking behavior i.e. performs stunt, drive with triple seat drink and drive. This percentage was higher among boys compared to girls. Table 6: Accidents amongst Adolescents : Accident Boys Girls Total Chisquare value Yes 219(36.56%) 101 (22.35%) 320 (30.45%) No 380(63.44%) 351 (77.65%) 731 (69.55%) 24.6 Total p-value P=0.000 S According to table no.6 the total prevalence of accident among adolescent s drivers was 320 (30.45%) it was more amongst boy s i.e.. 219(68.44%) as compared to girls i.e. 101(31.56%) and this difference is statistically significant No.of Accidents Graph 1: Reasons of the Accidents among Adolecents BOYS GIRLS 2014 Logic Publications, IJCMAAS,E-ISSN: ,P-ISSN: page I 33

6 The Graph shows the main reasons for accident were listening music while driving 66 (20.62%),high speed 46(14.38%) others person mistakes 42(13.13%), not following signals 41(12.81), vehicles skid 33(10.31%), bad constructed road 24(7.50%), fault of pedestrian 29(9.06%). Amongst boys listening music was main reason 48( % ) followed by over limit33 (15.0% ), not following signals 31( 14.15%), vehicle skid etc were the reasons, while in girls listening music was the main reason 18(17.82%) and other persons mistake by pedestrians mistake 16(15.84 %) & bad constructed roads 13(12.87%). Discussion: Present study was carried out to assess the awareness and behaviour of adolescents towards RTAs. More than 50 percent participants were males and more than 70 percent participants were driving two wheelers, among these females prefer to drive two wheeler vehicles without gear whereas males prefer to drive vehicles with gear. All the study participants were aware about red and green colour traffic signals, but for yellow colour traffic signal awareness was 85 percent. According to Priyanka et.al., only 35 percent of students know the indication of yellow traffic signal, while after the intervention the number was increased to 63 percent. This difference might be due to different age group [ 8]. Chances of accidents are more during the yellow colour signal because of confusion to go or not to go. So awareness should be improved. Nearly ¾ of study participant showed good to average score in identifying traffic signs and score was more among males compared to females. Similar findings were recorded by Raj et.al. [9] in their Study. However in another study carried out by V. Kulkarni et.al. [10] and Swami et al. [11] and Gharaibeh et al. [12] awareness was much less than the expected satisfactory level. The better knowledge of traffic sign among participant may be due to more exposure to sign board while travelling. Awareness towards vehicles maintenance was good among study participants. Males were more aware than females. Present study shows that 68 percent participants drive the vehicle without valid driving license and 66% participants do not follow signs. While traffic signals were followed by more than 68 percent and lane discipline were followed by 43 percent participants. More than ¾ participants keep their vehicles in working condition. Traffic signals were followed by ¾ participants. Similar findings are observed by V. Kulkarni. They have observed that nearly half of participants always followed traffic rules and more than 2/3 had got their vehicles serviced regularly [10]. This better practices of vehicle maintenance are more among males compare to females and this practices should be improved in females too, as badly maintained vehicles are among the important reason for increasing road traffic fatalities in developing countries. Hajar Abdul Rehaman [13] also reported that more than 50% participants were not having license. Abhishek Singh and Anil Bhardwaj [14] also reported that more than 71% participants did not wear a helmet at the time of Road Traffic Accident and 16.25% were not having license. Nilamber Jha [16] had observed that 15% had no valid license. Ashish Trivedi also reported that 15% driver were driving without license. In present study percentage was quite high and this difference might be due to casual attitude of Traffic Police and overcrowded city roads so difficult to keep watch on defaulters. In present study risk taking behaviour like driving with triple seat, perform stunts, listening music, talking on cell phones was recorded amongst 40 percent of participant and in males percentage was higher compared to females. Similar findings were recorded by V Kulkarni et. al. that ¼ of study participant were involved in driving in drunken state [10]. Driving in drunken state is well known notorious combination responsible for increase in morbidity and mortality in association with RTAs. They had recorded that nearly 1/5 of participant were admitted to use mobile phones without hand free devices while driving further more nearly 2/3 participants agreed to having exceeding speed limit. Similar findings were also recorded by Gharaibeh et al. in Saudi Arabia [12]. Such high risk behaviour while with driving is not only dangerous to drivers but also to others. This behavioral pattern need to be addressed proper educative and legislative measures. Present study shows that only 19% participants wear helmet while driving. Ashish Trivedi reported that regular use of safety measures like helmet, while driving was less prevalent among young drivers. Only 11% were using helmet regularly. Unsafe driving practices like high driving speed, not using helmet while driving and using mobile phone while driving are very common International Journal of Current Medical And Applied Sciences [IJCMAAS] volume 4, Issue 1. Page 38

7 Logic IJCMAAS, E-ISSN: ,P-ISSN: among young drivers and higher prevalence of Road Traffic Accidents was observed among drivers with these kind of unsafe driving practices. Ashish Trivedi reported that 42% of young drivers use mobile while driving. He also reported that almost half of the participants drive with average speed of more than 50 km/hr [16]. In present study prevalence of accidents was more than 30% and it was more than double (68.44%) among males as compared to females (31.56%).(Male to Female difference was statistically significant.) Nilambar [15] reported that the accident rates were 4.9 times higher in males than in females. Similar results were also observed in Delhi (Mehta S.P.) [17] male to female ratio of Road Traffic Accidents was very high (9:1) according to Ghosh P.K. [18]. It shows that male drivers are much more exposed to RTA than female drivers. Present study shows that listening music while driving(20%), over speed limit (14%), not following signals(12%), bad constructed roads (7%), alcohol consumption (3%) were the main reasons of accidents. Abhishek Singh and Bhardwaj [14] reported that 18% gave history of having consumed alcohol within 6 hours before RTA..Majority (84.41%) of the victims responded that the road condition was the main reason for RTA. According to Ashish Trivedi [16] Fault of Pedestrian (37.4%) }, Poor road condition (34%), High speed Vehicles (8%) and Animal on Road (9%) were the Causes of Accidents. Nilambar [15] reported that 15% of driver involved in RTA had consumed alcohol. This was a higher proportion compared to Ghosh P.K. [18] (4.6%) and Sood S. [19] (8%) as reported from Delhi. The role of alcohol in impairing driving ability is well documented. Also the impairment increases as the blood alcohol level rises. In addition, the risk of accident is higher in youngsters and elderly people for the same blood alcohol level [20]. Conclusion: Maximum adolescents were aware about green and red colour signals, but awareness towards yellow colour signal was less amongst boys and girls as well. Use of helmet and following traffic discipline was more amongst boys and risk taking behaviour like driving with triple seat, performing stunts, using cell-phones was also more amongst boys compared to girls. Percentage of road traffic accidents was more amongst boys and reasons were over-limit speed, listening to music, drinking alcohol and driving. RTA are totally avoidable in a sense that it is only needs to create a sense among people regarding road safety and to enhance its benefits in their own interests.prevention is better than rehabilitation and treatment in case of RTAs. Recommendations: A combined and conscious effort needs to be carried out by schools, colleges, coaching classes & RTO to create awareness about RTA & motivate adolescents for usage of road safety measures which will enhance its benefits in their own interests. Strict implementation of legislative measures is also need of the hour. References: 1. William Haddon: Advances in the Epidemiology of Injuries as a basis for public policy: Public Health Reports, 1980, 95: pp Road accidents in India, Transport research Wing, Ministry of Road Transport & Highways, Government of India, New Delhi. 3. Atubi, Augustus.O. (PH.D), Determinants of road traffic accident occurrences in Lagos state some lessons for Nigeria, Special Issue- March 2012, Vol.2, No.6, 4. Aworemi, A. and Alawode E.C. Roads to where? Newswatch, December 2009, 30, 17 (13)3. 5. Tambe M.P.: Raod Traffic overview: Journal of Community Medicine,2007, 9(2), pp: World Health Organisation (1989) Analysis of Achievements of Traffic Safety in Industrialized and Developed Countries. 7. Malhotra V.M., Prevention of road accidents role of health services. Swasth Hind, March-April 1990 Page Priyanka Mahawar et al : An Educational inevention to improve awareness on road safety : A study among school going teenager in Indoor : National Journal of Community Medicine :2013: 4(3):529: Raj CKP et al : Study of Knowledge & behavioral pattern with regard to road safty among heigh school children Rural Community in Tamilnadu.Indian Med specialist, 2011, 2, Vaman Kulkarni et al : Awareness & practice of safety measures amongst undergraduate medical students in a South India State: Journal Forensic & legal Medicine : 2012, 30, Swami H. M. et al: Road safety awareness and practices among schoolchildren of Chandigarh : Indian Community Medicine : 2006: 31: Gharaibeh S et al : Assessment of traffic safety and awareness among youth in Al-Ahsa Region Saudi Arbia : Journal of Emerging Trends in Eng & Applied sciences : 2011; 2; Hejar Abdul Rahman et al; Car occupants accidents and injuries among adolescents in a state in Malasysia ; 2005;5;1867; Abhishek singh & Anil Bhardwaj et al. An Epidemiological study of road traffic accident cases at a tertiary care hospital in rural Haryana, Indian Journal of Community Health July 2011, Vol 23, No.2,7-11. International Journal of Current Medical And Applied Sciences [IJCMAAS] volume 4, Issue 1.

8 15. Nilambar Jha et al., Epidemiological study of road traffic accident cases : A study from South Africa, Indian Journal of Community Medicine, Vol. XXIX, No.1, Mar Ashish Trivedi et al. Prevalence of Road traffic accidents and driving practices among young drivers. ISSN X, Volume-2 Issue-2, July December Mehta S.P.An Epidemiological study of Road Traffic Accidents cases admitted in Safdar Jang Hospital. New Delhi, Indian Journal of Medical Research,1968, 56(4): Ghosh P.K. Epidemiological study of the victims of vehicular accidents in Delhi. Journal of Indian Medical Association 1992; 90(12): Sood S. Survey of seven factors Influencing Injury among riders involved in motorized two wheeler accidents in India. A prospective study of 302 cases. Journal of Trauma 1988; 28(4): WHO. Road Traffic accidents in developing countries. Technical report series No. 73. World Health Organization, Geneva Logic Publications, IJCMAAS,E-ISSN: ,P-ISSN: Page 40