ROAD TRAFFIC INJURIES

ROAD TRAFFIC INJURIES INTRODUCTION Road traffic injuries are a significant cause of injury-related hospitalizations and mortality in the Winnipeg Heal...
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ROAD TRAFFIC INJURIES INTRODUCTION Road traffic injuries are a significant cause of injury-related hospitalizations and mortality in the Winnipeg Health Region. Between 2000 and 2010, road traffic injuries were responsible for 16.7% of all unintentional injury-related deaths and 12.2% of all unintentional injury-related hospitalizations. This section of the report describes trends for a subset of road traffic injuries which contributed to the majority of road traffic related deaths and hospitalizations. These are occupant-related injuries (occupants of motor vehicles who were injured or killed), cyclist-related injuries (cyclists who were injured or killed in a transport accident, who may or may not have been in a collision with an automobile), and pedestrian-related injuries (pedestrians who were injured or killed in a transport accident, who may or may not have been struck by an automobile). In this section, a number of data exclusions were applied to ensure that the chapter focused on preventable road traffic injuries involving private automobiles, pedestrians and bicycles (refer to Methods). As a result of these exclusions, the number of deaths and hospitalizations in this chapter may differ slightly from those reported elsewhere in the report. For road traffic mortality, it is important to note that the number of occupant-related deaths is under-reported. In discussions with Manitoba Health and Manitoba Vital Statistics, it appears that many (75%) of the transport-related deaths may have been classified as “unspecified” and therefore do not appear in a specific category. Upon comparison to other Manitoba data sources, motor vehicle occupant deaths are considerably under-represented. Over the study period 2000 to 2010, only 43 occupant deaths were reported for the Winnipeg Health Region, as compared to an average of 18.6 deaths per year (range 11-25), or 186 deaths over the study period, as reported by the City of Winnipeg1.

EPIDEMIOLOGICAL HIGHLIGHTS a. Injuries by Type • Occupants injured in motor vehicle accidents were the greatest contributor to road traffic injury-related hospitalizations, contributing 1932 hospital admissions and 34,274 hospital days between 2000 and 2010. Pedestrians and cyclists contributed 925 and 910 hospital admissions respectively.

• Over the study period, there were 86 pedestrians and 14 cyclists killed while on a roadway in the Winnipeg Health Region. Given the caveats outlined above, the data presented for motor vehicle occupants represent a significant underestimate. The number of motor vehicle occupants who died over the study period in Winnipeg was reported by the City of Winnipeg as 186 deaths. Note that some of these deaths may have included non-Winnipeg residents.

b. Temporal Trends • Three year moving averages were calculated for road traffic injury deaths because of the small number of events occurring in each year. Over the study period, rates of pedal cyclist-related deaths remained relatively stable, with pedestrian-related deaths decreasing slightly. It is difficult to meaningfully interpret the decrease observed in the rates of occupant related deaths since occupant deaths are under-reported to such a large degree in this report. • Three year moving averages were also calculated for road traffic injury hospitalizations. Over the study period, occupantrelated hospitalizations decreased from a high of 32/100,000 in the years 2000-2002 to a low of 20.5/100,000 in the years 2008-2010. Both pedestrian-related and pedal-cyclist related hospitalization rates decreased over the study period.

c. Age and Gender • Road traffic deaths by age and gender are difficult to analyze because of the small number of events. However, for occupantrelated deaths, the highest proportion of deaths occurred in 20 to 24 year old males. For pedestrian-related deaths, the highest proportion of deaths occurred in middle age and older adults, with a similar number of deaths in males and females. For cyclist-related deaths, the majority were males 45 years and older. • The highest proportion of occupant-related hospitalizations occurred in 15 to 44 year olds, with a higher rate observed in males than in females. For pedal cyclists, the highest proportion of hospitalizations were observed in 35-54 year old adults with lower rates observed in females (all ages combined). The highest proportion of pedestrian-related hospitalizations were observed in adults 25-54 years of age, with slightly higher rates observed in males than in females. Older adults (65 years of age and older) had higher rates of pedestrian-related hospitalization compared to younger age groups.

1 City of Winnipeg 2010 Annual Collision Report http://www.winnipeg.ca/publicworks/Transportation/Collision_reports/2010collisions/Section1_2010.pdf.

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d. Place and Income • For occupant-related injuries, the highest rate of hospitalization observed in the Point Douglas community area (39.9/100,000) was 1.85 times higher than the lowest rate observed in the St. Boniface community area (21.4/100,000), representing an absolute rate difference of 18.5/100,000. • For pedal-cyclist related injuries, the highest rate of hospitalization observed in the Downtown community area (23.2/100,000) was 3.05 times higher than the lowest rates observed in the Inkster and Seven Oaks community areas (7.6/100,000), representing an absolute rate difference of 15.6/100,000. • For pedestrian-related injuries, the highest rate of hospitalization observed in the Point Douglas community area (34.9/100,000) was 7.12 times higher than the lowest rate observed in the Fort Gary community area (4.9/100,000), representing an absolute rate difference of 30/100,000.

IMPLICATIONS On-going efforts to prevent deaths and injuries due to road traffic injuries in the Winnipeg Health Region is recommended.

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Preventing the deaths and serious injuries of motor vehicle occupants should be a major focus of road traffic injury prevention programs since this is the primary cause of road traffic hospitalizations and the leading cause of road traffic deaths. Programs should focus on young males and target specific factors identified in traffic collision analyses. As mentioned in the introduction, this report has likely under-reported the number of occupant related deaths due to the number of transport-related deaths that are coded as unspecified.

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The high proportion of pedestrian and cyclist injuries in occurring in middle-aged adults deserves further analyses to identify potential prevention strategies.

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The elevated rates of pedestrian and cycling injuries occurring in the Downtown and Point Douglas community areas also deserve further analyses in order to identify potential prevention strategies.

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ROAD TRAFFIC INJURIES TABLES AND FIGURES 1. Injuries by Type a. Tables i.

Table 1: Summary Table of Deaths (Counts and Rates), 2000–2010

ii. Table 2: Summary Table of Hospitalizations (Counts and Rates), 2000-2010

2. Injuries by Time a. Figures i.

Figure 1: Road Traffic Injury Deaths by 3 Year Average, 2000–2010

ii. Figure 2: Road Traffic Injury Hospitalizations by 3 Year Average, 2000-2010

3. Injuries by Person a. Tables i.

Table 3: Occupant Deaths (Counts and Rates) by Age Group and Gender, 2000–2010

ii. Table 4: Pedal Cyclist Deaths (Counts and Rates) by Age Group and Gender, 2000– 2010 iii. Table 5: Pedestrian Deaths (Counts and Rates) by Age Group and Gender, 2000–2010 iv. Table 6: Occupant Hospitalizations (Counts and Rates) by Year, 2000–2010 v. Table 7: Pedal Cyclist Hospitalizations (Counts and Rates) by Year, 2000-2010 vi. Table 8: Pedestrian Hospitalizations (Counts and Rates) by Year, 2000–2010

4. Injuries by Place a. Tables i.

Table 9: Occupant Hospitalizations (Counts and Rates) by Community Area, 2000-2010

ii. Table 10: Pedal-Cyclist Hospitalizations (Counts and Rates) by Community Area, 2000–2010 iii. Table 11: Pedestrian Hospitalizations (Counts and Rates) by Community Area, 2000-2010

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FIGURE 1

Road Traffic Injury Deaths by 3-Year Average, Winnipeg Health Region Residents, 2000-2010

Rate per 100,000

1.5

1.0

0.5

0.0 2000

2002

2004

Occupant

2006

Year

Pedal Cyclist

2008

2010

Pedestrian

Rates are directly age-standardized to the 2006 Canadian Census population

FIGURE 2

Road Traffic Injury Hospitalizations by 3-Year Average, Winnipeg Health Region Residents, 2000-2010

35.0

Rate per 100,000

30.0 25.0 20.0 15.0 10.0 2000

2002

2004

Occupant

Year

2006

Pedal Cyclist

2008

2010

Pedestrian

Rates are directly age-standardized to the 2006 Canadian Census population

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TABLE 1

TableInjuries 1: Summary Table of Deaths due to–Road-Traffic Injuries (Counts and Rates), a Summary Table of Deaths due to Road-Traffic (Counts and Rates), 2000-2010 Winnipeg Health Region (WHR) residents a Winnipeg Health Region (WHR) residents

Occupant Cyclist Pedestrian

Cases Total 43 14 86

Male % 58.1 78.6 51.2

b

a

Total 0.6 0.2 1.2

Standardized Rate Females 0.5 0.1 1.1

Males 0.7 0.3 1.3

2000-2010

Total 1,430 359 2,022

All rates are per 100,000 population and age standardized to the 2006 Canadian population b Calculated as percentage of all cases, and not only those under the age of 75 c PYLL is derived using injuries occuring in those under the age of 75; therefore, not all injuries are captured d Calculated by dividing PYLL sum by number of injuries for that year.

PYLL (years)c

Avg. per Injuryd 37.6 29.9 30.6

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TABLE 2

SummaryInjuries Table of Hospitalizations to Road-Traffic (Counts andresidents Rates), 2000-2010 a Summary Table of Hospitalizations Table due to 2: Road-Traffic (Counts and Rates), due 2000-2010 – Winnipeg Injuries Healtha Region (WHR) Winnipeg Health Region (WHR) residents

Occupant Cyclist Pedestrian

Cases Total

Male %

Total

1,932 910 925

51.6 62.4 50.9

26.3 12.6 12.6 a

Standardized Ratea

Females

Males

Total

24.2 9.0 11.7

28.4 15.9 13.4

34,274 7,802 21,714

All rates are per 100,000 population and age standardized to the 2006 Canadian population b LOS data represent only the acute portion of the total LOS after 2008 (see Methods). c Calculated by dividing LOS sum by number of injuries for that year.

LOS (days)b

Avg. per Injuryc 17.7 8.6 23.5

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TABLE 3

Table 3:2000-2010 Occupant Deaths (Counts by Age and Gender, 2000-2010 Occupant Deaths (Counts and Rates) by Age and Gender, – Age-specific ratesand and Rates) 95% confidence intervals (95% CI) of Occupant-related injury, Winnipeg Health Region a,b Age-specific rates and 95% confidence intervals (95% CI) of Occupant-related injury, Winnipeg Health Region (WHR) residentsa,b (WHR) residents

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