J Punjab Acad Forensic Med Toxicol 2011; 11(1)
FATAL ROAD TRAFFIC ACCIDENT IN MOTORCYCLISTS NOT WEARING HELMETS Dr. Harnam Singh, Associate Professor, Muzaffarnagar Medical College, Muzaffarnagar Dr. ADAggarwal, Assistant Professor PGIMS, Rohtak Article history
Abstract
Received 5 January, 2011 Received in revised form 11 Feb, 2010 Accepted on 12 Feb, 2010 Available online March 25, 2011 Corresponding author Dr. Harnam Singh Associate Professor, Muzaffarnagar Email: Phone:
Muzaffarnagar
Medical
104 Cases of road accident deaths in motorcyclists were studied over a period of one year. Out of which 99 (95.2%) cases were males and 5 cases (4.8%) were females. Motorcyclists were the third commonest type of road users killed in traffic accidents accounting for 23.1% of all accident deaths. Majority of accidents occurred between 6-8 PM (16.3%) followed by 12-2 PM (14.4%). None of the victim was wearing helmet at the time of accident. The commonest age group involved was 21-30 years (48.9%). None of the victim was above age 60 years. 36.6% of motorcyclists were hit by Heavy Vehicles and 31.7% by car & jeeps. Head injury was the single most common fatal injury seen in 66.3% cases followed by thoraco-abdominal and multiple injuries seen in 12.5% cases each. None of the victims received any treatment or first aid at the site of accident. 22.1% of victims were rushed to hospital after 30-45 min of accident. About half of the victims (48%) died within 6 hours, 61% by 24 hours and about the quarter (72.1%) by 48 hours. All the motorcyclists were dead by 14 days of injuries. ©2011 JPAFMAT. All rights reserved
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Keywords: Motorcyclists; road accidents; injuries, death
Introduction
year out of which 104 cases were motorcyclists. The details of victim, vehicles, accidents and environment were recorded from the relatives, friends, eye witnesses, police records and hospital records available. The postmortem examination was conducted to know the type, distribution, pattern of injuries, fatal injuries and cause of death in each case. The data thus obtained was analysed statistically.
Motorcycle and scooters are extremely popular form of transport in our country due to its cost effectiveness, better mileage and ease of travel in congested and remote areas. But riding a motorcycle is more dangerous than riding a car because the riders body is fully exposed, without protection of car frame & body.[1] According to NCRB 2007 survey, 1,14,590 persons were killed during 2007 while travelling by various modes of transport on roads. Out of which 21.5% were occupants of trucks and lorry & 19.1% were riding two wheelers. 11.2% were killed while travelling in buses & 8.8% were pedestrians. So motorcyclists are the second most common groups of road users killed on Indian roads every year.[2] The present study was undertaken to know epidemiology, fatal injuries, and survival period in nonhelmeted motorcyclists and suggest suitable measures for their prevention.
Observation 450 cases of road accidents death occurred in 1 year period out of which 104 cases (23.1%) were riders of motorcycle / Scooter. (Table 1) The commonest age group involved was 21-30 years (48.9%) followed by 31-40 years (23.2%). Males outnumbered females in ratio of 19.8:1 (Table 2). Majority of accidents occurred during 6-8 PM (16.3%) followed by 8 – 10 PM (13.5%). Heavy vehicles were responsible for 36.6% cases followed by cars and jeeps 31.7% cases of fatal accidents (Table 3). Out of 104 motorcyclists none was wearing helmet. None of the victim received any treatment or first – aid at the site of accident. Head and face injury was the most common regional injury seen in 80.8% cases followed by lower limb injuries seen in 40.4% cases (Table 4).
Material & Methods The present study was a prospective study carried out for a period of one year. All the cases of death due to road accidents brought for post mortem examination to the mortuary of a tertiary care hospital were included in the study. A total of 450 cases death due to road accidents were brought for PM examination in one
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J Punjab Acad Forensic Med Toxicol 2011; 11(1)
Head injury alone was cause of death in 63.3% cases followed by multiple injuries and thoraco-abdominal injuries in 12.5% cases each (Table 5). Fracture of skull and face were in seen in 52.9% cases. Subdural and subarachnoid haemorrhages in 45.2% and 35.8% cases respectively and laceration brain was seen in 26% cases. Fracture of ribs and laceration of lung was seen in 24% and 17.3% cases respectively. Laceration of liver and spleen was seen in 21.1% and 17.3% cases respectively. Fracture of both bones upper limb was seen in 23.1% and lower limbs in 32.7% cases respectively. 32.7% victims died in half an hour of accident, 14.4% within 1 to 6 hour and 10.6% within 24 to 48 hours of accident (Table 6). Cumulative percentage of death at various times rd after accidents shows that 1/3 (32.7%), victims succumbed to the injuries with in 0.5 hour, about half rd th (48%) in 6 hours, 2/3 (61.5%) in 24 hour and 3/4 (72.1%) in 48 hours, 91.3% by one week and all were dead by 2 weeks (Table 7).
Others Unknown Total
3.8 6.7 100
Table 4 Frequency of major regional injuries in motorcyclist (n=104) Regional Injuries No of Percentage injuries Head injury 84 80.8 Cervical spine injury 10 9.6 Chest injury 28 30.0 Abdominal pelvic injury 22 21.2 Upper limb 30 28.8 Lower limb 42 40.4 Total 216 100 Major injury per cases = 216 / 104 = 2.1 Table 5 Distribution of fatal injuries in motorcyclist (n=104) Fatal Injuries No of Cases Percentage Head injury 69 66.3 Cervical spine injury 6 5.8 Thoraco-abdominal injury 13 12.5 Multiple injury 13 12.5 Limb fracture 3 2.9 Total 104 100
Table 1 Type of road – user killed in road accidents (n=450) Type of Road User Killed No of Percentage cases Pedestrian 129 28.7 Occupants of cars & jeeps 116 25.8 Motorcyclist 104 23.1 Cyclist 32 7.1 Occupants of medium Transport 19 4.2 vehicles Occupants of Trucks & Buses 20 4.4 Others 17 3.8 Unknown 13 2.9 Total 450 100
Table 6 Survival period in motorcyclist (n=104) Survival Period No of Cases 0 – 0.5 hrs 34 0.5 – 1 hrs 1 1 – 6 hrs 15 6 – 12 hrs 9 12 – 24 hrs 5 24 – 48 hrs 11 48 – 72 hrs 7 3 – 5 days 10 5 – 7 days 3 7 – 14 days 9 > 14 days 0 Total 104
Table 2 Age & Sex distribution of motorcyclist (n=104) Age Group Male Female Total Percentage (in years) (in No.) (in No.) (in No.) 0-10 2 1 3 2.9 11-20 15 0 15 14.4 21-30 41 3 44 42.3 31-40 23 0 23 22.2 41-50 15 0 15 14.4 51-60 3 1 4 3.8 >60 0 0 0 0 Total 99 5 104 100 Table 3 Vehicles responsible for accidents (n=104) Vehicle Involved No of cases Two Wheelers 11 Cars & jeeps 33 M.T.V 11 Heavy Vehicle 38
4 7 104
Percentage 32.7 0.9 14.4 8.7 4.8 10.6 6.7 9.6 2.9 8.7 0 100
Table 7 Cumulative percentage of dead by various times after accidents Death within Percentage 0.5 hrs 32.7 1 hrs 33.6 6 hrs 48.0 12 hrs 56.7 24 hrs 61.5 48 hrs 72.1 72 hrs 78.8 5 days 88.4 7 days 91.3 14 days 100
Percentage 10.6 41.7 10.6 36.6 10
J Punjab Acad Forensic Med Toxicol 2011; 11(1)
Discussion
site of injuries. To prevent these accidents, helmet should be worn by the riders of the motorcycles, and strict enforcement of helmet laws is mandatory. Design of two wheelers should be such as to give protection to lower limbs. Proper training of drivers and strict licensing norms are required. Majority of victims died on spot or within 6 hours of accidents, so proper immediate emergency medical care may prevent these young deaths.
Motorcyclists are the third commonest type of road user killed in road traffic accidents. The most common age group involved is 21 to 30 years and males outnumbered females in ratio of 20:1. The majority of fatal accidents occurred between 6 to 8 PM. Similar findings were seen by Jain et al [3]and Lee et al[1]. None of the victim was wearing helmet at the time of accident. [1] Majority of these fatal accidents were caused by collision with heavy vehicles and cars [1, 5]. Head and lower limbs are the most common sites of injuries in motorcyclists [1, 3, 4, 5]. Head injury alone was single most important fatal injury in non-helmeted motorcyclists followed by thoracoabdominal and multiple injuries [3,4,5,6]. In the cases of head injuries, fracture of skull and face was seen in 52.9% cases, subdural and subarachnoid haemorrhage was seen in 45.2% and 35.8% cases each and laceration of brain was seen in 26% cases [4]. Fractures of Tibia and Fibula are most commonly seen in lower limb injuries. [5] Since head injury alone is fatal in majority of cases, the use of helmet is important to prevent these deaths. Various studies suggest that helmet use significantly reduces the incidence of fatal head injuries [1,4,6]. A few studies have suggested that helmet may not protect the head against injury distal to the point of impact to the helmet and in some cases; helmets may cause certain head and neck injuries [7,8]. But the study by Sarkar et al [6] (1995) do not support this assertion and instead show that all types of head injuries are less frequent among helmeted injured riders than nonhelmeted injured riders. Moreover, the incidence of cervical spine injuries is almost nine times as common among non- helmeted riders as among helmeted riders.
Conflict of interest None declared References 1.
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7. Conclusions Fatal motorcycle accidents account for 23.1% of all traffic accidents, involving young male population. Further, none of the victim was wearing helmet at the time of accident. Head and lower limbs are most common
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Solagberu BA, Ofoegbu CKP, Nasir AA, Ogundipe OK, Adekanye LO, Abdur – Rahman. Motorcycle injuries in a developing country and the vulnerability of riders, passengers and pedestrian. Inj Prev. 2006 August; 12 (4): 266-68. NCRB - 2007 Jain A, Menezes RG, Kanchan T, Gagan S, Jain R. Two wheeler accidents on Indian roads – a study from Mangalore, India. J Forensic Leg Med. 2009; 16(3): 130-3. Lee Mc, Chiu WT, Chang LT, Liu SC, Lin SH. Craniofacial injuries in unhelmeted riders of motorbike. Injury. 1995; 26 (7): 467-70. Peek C, Braver ER, Shen H, Kraus JF. Lower extremity injuries from motorcycle crashes: A common cause of preventable injury. J Trauma. 1994; 37 (3): 358-63. Sarkar S, Peek C, Kraus JF. Fatal injuries in motorcycle riders according to helmet use. J Trauma. 1995; 38(2): 242-45. Krantz KPG. Head and Neck injuries to motorcycle and moped drivers – with special regard to the effect of protective helmets. Injury. 1995; 16: 253. Hitosugi M, Takatsu A, Shigeta A. Injuries to motorcyclists and bicyclists examined at autopsy. Am J Forensic Med Pathol. 1999; 20 (3): 251-5.
