Assessment of Perception of Risk and Knowledge of Medical Students towards Road Safety Measures and Occurrence of Road Accidents

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1 Original article: Assessment of Perception of Risk and Knowledge of Medical Students towards Road Safety Measures and Occurrence of Road Accidents Chilgunde Chandrakant Ramrao 1, Nanaware Balkrishna Dattatray 2 1Assistant Professor, Department of Community Medicine, Chennai Medical College Hospital & Research Centre, Trichy, Tamil Nadu, India. 2Assistant Professor, Department of Community Medicine, Fathima Institute of Medical Sciences, Kadapa, Andhra Pradesh, India. Corresponding Author: Dr. Chilgunde Chandrakant Ramrao, Assistant Professor, Department of Community Medicine, Chennai Medical College Hospital & Research Centre, Trichy, Tamil Nadu, India. Abstract Background: One of the unfortunate incidents happening in day to day life resulting in damage and injury is the road accident. The commonest and most frequent cause of occurrence of road accidents is the drastic increase in the number of road vehicles, mixing of drinking with driving, over-confidence of the drivers, and ignorance of the general population. Hence; we planned the present study to assess the knowledge and practice of medical students towards road safety measures and incidence of road accidents. Materials & methods: The present study included assessment of knowledge and practice of 600 medical students towards road safety measures. A pre-tested, structured questionnaire were distributed to the selected participants and asked to complete the questionnaire and collected on the same day. The participants were asked to complete the questionnaire without leaving any un-attempted or incomplete questionnaire that was relevant. Results: 100 percent of the subjects had knowledge score of 13 to 18 in case of drinking and driving. In case of use of mobile phone while driving, 39.1 percent of subjects agreed with this in the score group of 7 to12 while in score group of 13 to 18, 60.9 percent of the subject population agreed with mobile usage with driving. Non-significant results were obtained while comparing the practice of mobile phone usage in terms of gender, mean age and mean knowledge score among the study subjects. Conclusion: High knowledge of road safety measures exists among medical students except for few aspects where improvement of the knowledge is necessary Key words: Knowledge, Medical, Road, Safety. INTRODUCTION One of the unfortunate incidents happening in day to day life resulting in damage and injury is the road accident. The commonest and most frequent cause of occurrence of road accidents is the drastic increase in the number of road vehicles, mixing of drinking with driving, over-confidence of the drivers, and ignorance of the general population. 1 Industrialization and urbanization has enormouslyincreased the number of vehicles on the roads. Road traffic accidents are cause of death of more than one million of person s death annually as reported by WHO. WHO also reports that non-fatal injuries because of road accidents affects upto half a million persons annually. Pedestrian users, cyclists and two-wheeler drivers comprise of more than 50 percent of population of such road accidents deaths. 2 Especially among young populations, road accidents form one of the leading cause of road 434

2 accidents. It forms the second most common cause of death among all age group of patients. More than thirty five teenagers die due to road accidents every hour. 3 By 2030, it is estimated that road accidents might come in the top six position of the leading cause of deaths. 4 UN General Assembly has been taking specific awareness measures for increasing the knowledge of people towards road safety measures in order to decrease the toll caused by road accidents, especially among young teenagers. 5 Hence; we planned the present study to assess the knowledge and practice of medical students towards road safety measures and incidence of road accidents. MATERIALS & METHODS The present study was conducted in the Department of Community Medicine, Chennai Medical College Hospital & Research Centre, Trichy, Tamil Nadu (India) and included assessment of knowledge and practice of medical students towards road safety measures. The present study included assessment of 600 medical students. Simple and clustered sampling procedures were used for the selection of the candidates for the present study. A pre-tested, structured questionnaire were distributed to the selected participants and asked to complete the questionnaire and collected on the same day. The questionnaire had three parts, the first part included the general information related to the participants, and the second part contained the questions related to knowledge and third part related to practice on road safety measures. Simple questionnaire was used in which answerable options were available in simple yes or no. Each item with correct answer was given 1 (one) and wrong answer 0 (zero) with minimum of 0 (zero). The knowledge level had been scored into three categories viz. poor knowledge (0 6); average (7 12), and good (13 18). The participants were asked to complete the questionnaire without leaving any un-attempted or incomplete questionnaire that was relevant. Ethical clearance was taken from the institutional ethical committee and written consent was obtained after explaining in detail the entire research protocol. All the results were analyzed by SPSS software. Chisquare test was used for the assessment of level of significance. P-value of less than 0.05 was taken as significant. RESULTS Table 1 and Graph 1 Correlation of knowledge with practice of vehicle driving. 100 percent of the subjects had knowledge score of 13 to 18 in case of drinking and driving. In case of use of mobile phone while driving, 39.1 percent of subjects agreed with this in the score group of 7 to12 while in score group of 13 to 18, 60.9 percent of the subject population agreed with mobile usage with driving. Table 2 and Graph 2 shows the predictors of mobile phone usage with driving. Non-significant results were obtained while comparing the practice of mobile phone usage in terms of gender, mean age and mean knowledge score among the study subjects. 435

3 Table 1: Correlation of knowledge with practice of vehicle driving Parameter Answer Knowledge score (%) Drinking and driving Yes No Mobile use while driving Yes No Driving above speed limit Yes No Regular service of vehicle Yes No Seat belt use while driving Yes No Helmet use while driving Yes No p-value Graph 1: Correlation of knowledge with practice of vehicle driving Yes No Yes No Yes No Yes No Yes No Yes No Drinking and driving Mobile use Driving above Regular service Seat belt use while driving speed limit of vehicle while driving Knowledge score (%) 7 to 12 Knowledge score (%) 13 to 18 Helmet use while driving

4 Table 2: Mobile phone usage with driving- Predictors Parameter Gender Male Female Practice (%) p-value 0.22 Mean age (years) 18 to to Mean knowledge score Graph 2: Mobile phone usage with driving- Predictors Male Female 18 to to 25 7 to to 18 Gender Mean age (years) Practice (%) Mean knowledge score DISCUSSION A dubious distinction has been achieved by road accidents in India. With over 130,000 deaths annually, the country has overtaken China and now has the worst road traffic accident rate worldwide.drunken driving and low use of helmets, seat belts and child restraintss in vehicles as the main contributing factors. 6 Theree has been a drastic increase in the number of deaths caused due to road accidents from 2009 to During the past ten years, there has been a compound increase in the number of vehicles accumulating on the roads increasing the chances for occurrence of road accidents. By 2000, the total estimated loss of the country s economy due to road accidents has been approximately 3 percent. 8 Hence; we planned the present study to assess the knowledge and practice of medical students towards road safety measures and incidence of road accidents. In the present study, we observed that better knowledge exits among males in comparison with females. Similar results have been reported by Raj et al. 9 There were few differences observed between the present and studies done by Swami et al. and that could be due to the urban and rural setting. 10 Al-Khaldi YM evaluated the knowledge,

5 attitudes and practices of male students at the Health Science College in Abha, towards road traffic regulations. They prepared a questionnaire of 28 different questions was distributed to all available students and responded to under the direct supervision of the heads of the six departments of the college. The questionnaire consisted of three main parts; the first was about the sociodemographic and scientific data of the students; the second on the knowledge of road traffic regulations and the third dealt with attitudes and practice of driving and the use of seat belts. They observed that 238 out of 297 students responded to the questionnaire in this study. The mean age of the participants was 21 years, 47% lived in cities, 70% and 72% had cars and driving licenses respectively. More than half of the students had been involved in road traffic accidents (RTAs), 22% of these had been injured in these RTAs and 13% admitted to hospital for an average of nine days. High speed was the main cause of their RTAs. The mean speed at which the students drove their cars within and outside the city boundaries were 81 KM/h and 127 KM/h respectively. The degree of knowledge of road traffic regulation was moderate to high in more than 75% of the students, while more than 90% of them believed in the importance of the use of seat belts. More than 75% of the participants mentioned that they had problems with the use of seat belts, the most common of which were forgetfulness and anxiety. From the results, they concluded that many students had been involved in RTAs as a result of driving at high speed. Most of the students had good attitudes towards the use of seat belts. 11 Ali Aba Hussein N et al evaluated the knowledge and behaviour of the fathers of a sample of female students. They conducted a random study on approximately 2500 drivers and collected their data based on a self-administered questionnaire which incorporated questions on driver's knowledge and behaviour regarding road traffic regulations. They observed that 52% of the sample had been involved in previous road traffic accidents, 75% were seat-belt compliant and 60% used mobile phones while driving. The drivers' knowledge about road traffic regulations and risks did not match their behaviour. 12 Iversen H et al identifiedthe determinants of risk behaviour and accident involvement in traffic. The results were based on a self-completion questionnaire survey carried out among a representative sample of Norwegian drivers drawn from the driver's licence register. The data was collected in year 2000 and 2001 (n=2614). The questionnaire included measures of attitudes, risk behaviour and involvement in accidents and near accidents. The results showed that attitudes towards traffic safety issues influenced involvement in risk behaviour in traffic, especially attitudes towards rule violations and speeding. Risk behaviour had an effect on involvement in near accidents and accidents. Variations in attitudes and risk behaviour were related to age and gender. 13 Lorini C et al demonstrated that increase the risk of traffic accidents, and such use has consequently been prohibited. Because of the lack of Italian data on the spread of this behaviour a study was done in June 2004 on drivers' use of hand-held mobile phones in the Florence Health Authority area. The study was performed by direct observation from 4 watching-points (1 for each zone) which allowed for observation of several types of vehicles, on varying road conditions, in 5 hour time bands. Overall, 9387 vehicles were observed and the prevalence of mobile phone use while driving was found to be 1.8%. The greatest prevalence of mobile phone use was found in the following conditions: in the Northwest zone (2.8%), in the city suburbs (2.8%), on Tuesdays (3.0%), among drivers not using safety belts (3.0%), and among

6 subjects driving alone (2.1%). Logistic regression analysis has shown a statistically significant association between mobile phone use and the zone, the number of persons in the vehicle, and seat belt use. Mobile phone use while driving is therefore a diffused practice that is particularly common among drivers who engage in other highrisk driving behaviours. 14 CONCLUSION From the above results, the authors concluded that high knowledge of road safety measures exists among medical students except for few aspects where improvement of the knowledge is necessary. Future educational training programs are required for increasing the awareness of the road safety rules among general population. REFERENCES 1. Siviroj P, Peltzer K, Pengpid S, Morarit S. Helmet Use and Associated Factors among Thai Motorcyclists during Songkran Festival. Int J Environ Res Public Health 2012;9: Raj CKP, Datta SS, Jayanthi V, Singh Z, Senthilvel V. Study of knowledge and behavioural patterns with regard to road safety among high school children in a rural community in Tamil Nadu. Indian J Med Specialities 2011;2: Kulkarni V, Palanivel C, Kumar N. Awareness and practice of road safety measures among undergraduate medical students in a South Indian state. Journal of Forensic and Legal Medicine 2012;30: Al-Khaldi YM. Attitude and practice towards road traffic regulations among Students of health Sciences College in Aseer region. J Fam Community Med 2006;13: Al-Tukhi MH. Road Traffic Accidents: Statistics and Data Comparing Gulf Countries and Riyadh Area. Saudi Medical Journal. 1990;11(1): India has the highest number of road accidents in the world. Dated: Available at: 7. Badawi IA, Alakija W, Aziz MA. Road Traffic accidents In Asir Region, Saudi Arabia: Pattern and Prevention. Saudi Medical Journal. 1995;16(3): Bener A, Arar E, Chemma MY. Injury Risk Reduction from Safety Seats Use. Saudi Medical Journal. 1992;13(3): Pace BW, Thailer R, Kwiatkowski TG. New York State Seatbelt Law: Patterns of Seatbelt use before and after Legislation. Journal Trauma. 1986;26: Mufti MH. Medico-legal Aspects of Seat Belt Legislation in Saudi Arabia. Saudi Medical Journal. 1986;7(1): Al-Khaldi YM. Attitude and practice towards road traffic regulations among students of health sciences college in aseer region. J Family Community Med Sep;13(3): Ali Aba Hussein N, El-Zobeir AK. Road traffic knowledge and behaviour of drivers in the Eastern Province of Saudi Arabia. East Mediterr Health J Mar-Apr;13(2): Iversen H, Rundmo T. Attitudes towards traffic safety, driving behaviour and accident involvement among the Norwegian public. Ergonomics Apr 15;47(5): Lorini C, Bonaccorsi G, Mersi A, Baroncini O, Ciampi G, Boddi V et al. Mobile phone use while driving in Florence health district area. Ann Ig Jul-Aug;18(4):