Consistency between police-reported and health registration data
Police-reported data were extracted from police records on a standardized, data collection form. The national Road Traffic Department is responsible for the design of the forms and other means to collect and register such data in Saudi Arabia, and for releasing it annually. All individuals who died of injuries in a road traffic collision within 7 days of the incident are recorded as road traffic fatalities. Police-reported data are published and accessible in the statistical yearbook of transportation. The diagnosed causes of death come from death certificates issued by health offices of the Ministry of Health, which are forwarded to the various municipal local and national organizations. Physicians classify deaths resulting from road traffic injuries in accordance with the International Classification of Diseases (ICD, 10th revision).
Using the χ2 test, we compared death rates from road traffic injuries based on police-reported data with those based on death registration data from the local health office for the period from 2005 to 2010. We used linear regression to check for statistically significant trends in mortality rates over the study period, and we used the percent change in the death rate between 2005 and 2010 to measure the linear trend.
shows that between 2005 and 2010, the road traffic death rate based on death registration data was almost twice as high as the rate reported by the police (P < 0.05). Comparing the death rates obtained from the two sources, it was found that for every year from 2005 to 2010 the police-reported rate of death from road traffic injuries was consistently no more than 60% of the rate obtained from health registration data. In 2010, the death rate based on police reports was only 35% of the rate based on death registration data.
Comparison of road traffic death rates based on police report and on health registration data
Police-reported data and health registration data showed different trends in road traffic death rates. Linear regression showed a significant decline of 27% according to police-reported data during 2005–2010, as opposed to a non-significant increase of 8% according to health registration data.
Population Survey Information
Of the 900 eligible participants, 835 (92.8%) participated and responded to the questionnaire. Of the participants, 545 (65.3%) were males and 290 (34.7%) were females. The participation rate was 95.6% (545 out of 570) for males and 87.9% (290 out of 330) for females.
Annual non-fatal RTI incidence
During the last 3 months, 126 (15.1%) non-fatal RTI were reported by participants. The overall age-sex-adjusted rate for non-fatal RTI was 20.7 (95% CI, 20.0 – 21.3)/100 persons/year. The adjusted rate for RTI requiring recovery period of ≤7 days and >7 days was 13.0 (95% CI, 12.6 – 13.4) and 7.0 (95% CI, 6.7 – 7.3), respectively ().
Estimated annual non-fatal road traffic injury (RTI) incidence rate per 100 persons for three-months recall period in population aged 5–49 years in Qassim.
The overall rate for non-fatal RTI is higher in the 10–19 years age group (17.3%). Males had twice or more incidence rate for RTI requiring recovery period of ≤ 7 days as compared with females, however, RTI incidence for recovery period of >7 days is more than twice in females as compared with males. The decline in RTI incidence from 3-months to 12-months recall period was 51.8%
The non-fatal RTI incidence requiring recovery period of less than 7days was similar in the 2 groups of monthly income (≤ 10.000 SR & > 10.000 SR), 13.7% and 13.6% respectively. However, people with lower monthly income had slightly higher incidence for RTI requiring recovery period more than 7 days or more (6.0% vs. 5.3%).
Data on treatment were available for 120 (95.2%) of the non-fatal RTI in the last 3 months. Of these 120 non-fatal RTI, medical treatment outside home was sought for 75 (62.5%) RTI of which 70 (93.3%) received treatment in the out-patient departments and emergency rooms of the hospital. The overall annual incidence of non-fatal RTI for which medical treatment outside home was sought was 12.5 (95% CI, 11.7 – 13.3)/100 persons/year, and that as out-patient and in-patient was 12.1 (95% CI, 11.4 – 12.9) and 0.4 (95% CI, 0.3 – 0.6)/100 persons/year, respectively. Among the 5 people who were treated as in-patient, 1 patient was pedestrians and 4 patients were motor vehicles users. The mean length of stay in the hospital was 4.6 days (median 3 days, range 1 to 10 days).
Annual RTI mortality and disability rates
A total of 12 deaths due to RTI were reported in 5–49 years age group in the last 3 years, representing an estimated annual RTI mortality rate of 35.4/100,000 (95% CI 16.6 – 57.8). Among these 12 deaths, 6 (50%) were on cars, 4 (33.3%) in 4wheel drive cars, and 2 (16.6%) were pedestrian.
A total of 11 participants reported RTI related disabilities in the last 3 years representing an estimated annual RTI disability rate of 34.1/100,000 population (95% CI 11.4 – 55.7). Eight of the eleven participants with disability (72.7%) were aged 30–49 years, 6 (54.5%) were males. Of them, 2 (18.2%) were pedestrian, 9 (81.8%) were motor cars users. Four out of the eleven participants with RTI related disability (36.4%) reported body structure related disabilities and 7 (63.6%) reported body function related disabilities.
Epidemiology of RTA in Qassim
The records of Qassim Traffic Police Department showed that 18623 accidents occurred throughout the year 2010. These accidents involved 23178 persons, and resulted in the injury of 2025 people and the deaths of 369. In contrast, the reports from the health care system showed that 4232 people had been injured and 1054 had died.
The monthly distribution of RTA in Qassim Region during the period of study showed that the highest rate of accidents (13.1%) occurred during December, while the lowest rate (5.8%) occurred during March. Records also showed that the last three days of the week (Wednesday, Thursday and Friday) had the highest proportion of accidents (15.62%, 15.74% and 14.91% respectively) while Mondays showed the lowest rate of accidents (13.2%). Almost half of the accidents (51.2%) occurred during the day, while the other half 48.8% occurred at night. In addition, 62.98% occurred in town, while 37.02% occurred out of town.
Qassim traffic authorities reported seven main types of RTA; they are in order of frequency: collision with another vehicle(s) (80.75%), collision with a pedestrian (1.06%), over-turning of the vehicle (6.41%), collision with a fixed object (5.82%), collision with animals (3.31%), leaving the road (2.19%) and fire in the vehicle (0.08%), in addition to other types (0.38%).
illustrates the different causes of RTA as reported by the traffic authorities; they are in order of frequency: very high speed (43.11%), incorrect turning of the vehicle (14.69%), vehicles proceeding incorrectly (14.52%), incorrect stopping of the vehicle (13.69%), violating the traffic signals (1.77%), and driver under the influence of drugs (0.01%), in addition to other causes (12.21%).
Different Causes of RTA in Qassim During 2010
According to the statistics of the traffic police department in Qassim, 23178 persons involved in the RTA during the year 2010. The age distribution of those involved was 2146 (9.3%) of persons less than 18 years old, 7477 persons (32.26%) were 18–30 years old, 7638 persons (32.95%) were 30–40 years, 3763 persons (16.24%) were 40–50 years, while 2154 persons (9.29%) were above the age of 50 years. As regards nationality, about two-thirds of drivers were Saudi nationals (14481 persons, 62.48%), while non-Saudis constituted one-third (8797 persons, 37.52%). Finally, 93.42% of those involved in the accidents were literate and 61.71% were married
Traffic police illustrated that the great majority of cars involved in accidents (89.30%) were in good condition, while the minority (10.37%) had some sort of defects. These defects were in the form of faulty lights, faulty brakes, faulty steering devices and sudden unpredictable defects.
Medical reports obtained from the hospital of the regions showed that the head and neck were affected in about two-thirds of victims (63.19%), the lower limbs in 27.87%, the upper limbs in 18.62%, the trunk in 14.11% and the internal viscera in 1.61%
Comparison with local & Arab Rates
The number of road traffic accidents in Qassim region during the year 2010 was 18623. Qassim is among the highest 5 regions in the kingdom regarding the number of RTA after Riyadh, Jeddah, Makkah, and Madinah. shows that Saudi Arabia is having a very high level of road traffic clashes compared to some other Arab countries. Saudi Arabia has RTA rate that is almost 6 times higher than the rate in Algeria which is a more populated country. Death rate is also higher in Saudi Arabia compared to other Arab countries.
Total number of road traffic crashes, morbidity and mortality recorded in some Arab countries in 2004