|Year : 2016 | Volume
| Issue : 2 | Page : 110-113
Sociodemography of musculoskeletal injuries due to roadside accidents: A register-based study from North-West India
Sunil Kumar Raina1, Lokesh Thakur2, Bhanu Awasthi2, Naveen Kumar2, Vipin Sharma2, Sandeep Kalia2
1 Department of Community Medicine, Dr. RPGMC, Kangra, Himachal Pradesh, India
2 Department of Orthopaedics, Dr. RPGMC, Kangra, Himachal Pradesh, India
|Date of Web Publication||5-Jul-2016|
Sunil Kumar Raina
Department of Community Medicine, Dr. RPGMC, Tanda, Kangra, Himachal Pradesh
Introduction: Majority of musculoskeletal injuries are attributed to roadside accidents (RSAs) due to vehicular traffic. In India, over 1.2 million are seriously injured and about 300,000 disabled permanently in road traffic crashes annually. Materials and Methods: The study was planned with a view to identifying the sociodemographic factors influencing roadside accidents and thereby leading to musculoskeletal injuries. It was a prospective, descriptive hospital-based study, conducted over a period of 1 year at a tertiary care center in a rural area of Himachal Pradesh, a sub-Himalayan state of India. Results: Musculoskeletal injuries due to RSAs were common in age group 16-30 years (n = 93, 49%), although no statistically significant association could be identified between age and RSA. Of all the vehicles involved in RSA, two-wheelers were the most common. Males and individuals engaged in government employment were more commonly involved in RSA. Importantly, no statically significant association could be found between RSA and education or income. Discussion: Majority of RSAs could be attributed to two-wheelers. Therefore, a policy framework on the prevention of musculoskeletal injuries due to RSA should focus on two-wheelers as an important factor. Conclusion: A policy framework on the prevention of musculoskeletal injuries due to RSA should focus on two-wheelers.
Keywords: Injuries, North-West India, register, roadside, sociodemography
|How to cite this article:|
Raina SK, Thakur L, Awasthi B, Kumar N, Sharma V, Kalia S. Sociodemography of musculoskeletal injuries due to roadside accidents: A register-based study from North-West India. Trop J Med Res 2016;19:110-3
|How to cite this URL:|
Raina SK, Thakur L, Awasthi B, Kumar N, Sharma V, Kalia S. Sociodemography of musculoskeletal injuries due to roadside accidents: A register-based study from North-West India. Trop J Med Res [serial online] 2016 [cited 2019 Aug 20];19:110-3. Available from: http://www.tjmrjournal.org/text.asp?2016/19/2/110/185429
| Introduction|| |
Road traffic injuries account for about 50 million people every year worldwide.  Low- and middle-income countries account for up to 90% of disability-adjusted life years lost globally due to road traffic injuries.  Injuries account for approximately one-third of the acute patient load in many hospitals in low- and middle-income countries, and road traffic injuries constitute the majority of such admissions.  Most of the injuries on the road are attributed to the vehicular traffic.
In India, over 1.2 million are injured seriously, and about 300,000 are disabled permanently in road traffic crashes annually. 
This study was therefore planned with a view to identifying the sociodemographic factors influencing roadside accidents and thereby leading to musculoskeletal injuries.
| Materials and Methods|| |
The study was a prospective, descriptive hospital based, conducted over a period of 1 year at a tertiary care center in a rural area of Himachal Pradesh, a sub-Himalayan state of India. For the purpose of the study, a hospital-based register was established in the Department of Orthopedics of the Tertiary Care Center. Patients of all age groups presenting to the Department of Orthopedics with musculoskeletal injuries secondary to trauma due to a roadside accident (RSA) and willing to participate in the study were included in the register. Sociodemographic variables relating to the patient were entered in the register after eliciting information on the same from the patient on a structured pro forma. In case of disoriented and minor patients, a history of injury and sociodemographic variables was collected from guardian/parent of the patient. A detailed survey was conducted on each patient and to establish the diagnosis, X-ray of part of interest was performed. A total of 189 patients were recruited over a period of 1 year from June 1, 2012 to May 31, 2013 for this study.
Patients with soft tissue injury without fracture, dislocation, strain, and sprain and patients with head injury were excluded from the study. The patients of head injury were excluded because our institution did not have a neurosurgeon during the period of the survey, and for this purpose, most of the patients of head injury were referred to other centers after preliminary workup.
The study was approved by the Institutional Ethics Committee.
For the purpose of this study, the following definitions were used to label (1) RSAs: Any accident occurring on a road open to public circulation, and in which at least one person is injured or killed not necessarily due to traffic crashes. Intentional acts (murder, suicide) and natural disasters are excluded, (2) Integrated Rural Development Programme (IRDP): It is a measure of poverty line and is used to identify the families eligible for financial assistance from the Government of Himachal Pradesh. An amount of Rs. 8500/year/family has been fixed as the cutoff point for eligibility of IRDP assistance.
Data were collected and entered in MS Excel 2007. The results have been expressed as percentages and analyzed using SPSS 11.5 (Statistical Product and Service Solution SPSS inc., IBM Armonk, New York, USA), and Chi-square test was used to find the significance of the study.
| Results|| |
The results of this study revealed that musculoskeletal injuries due to RSAs were common in age group 16-30 years (n = 93, 49%) [Table 1]. However, the relation between age and RSAs was not found to be statistically significant. Importantly, of all vehicles involved in RSA, two-wheelers were more frequently involved. As seen in [Table 2], RSAs were more common in male (n = 161, 85.2%) as compared to female (n = 28, 14.8%). However, RSAs in different sex were not found to be statistically significant. In terms of relation between musculoskeletal injuries and employment, majority of musculoskeletal injuries as a result of RSAs occurred in government employees (n = 50:26.45%) [Table 3]. The relation between RSAs and different employments was found to be statistically significant with P < 0.05. This study also reveals [Table 4] that 74 cases (39.2% age) of those injured in RSAs were educated up to graduate level. However, the relation between RSAs and education was not found to be statistically significant. [Table 5] shows the relation between RSA and type of family. It is seen that RSAs were common among individuals belonging to joint families (n = 117, 61.9%) as compared to individuals belonging to nuclear families (n = 59, 31.2%). However, this difference was not found to be statistically significant. As far as the relation between RSA and income is concerned, the study found that RSAs were common in non-IRDP group (n = 177, 93.6%) as compared to IRDP (n = 12, 6.35%) [Table 6], although the difference was not found to be statistically significant.
|Table 1: Age distribution of patients with history of roadside accidents |
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|Table 2: Sex distribution of patients with history of roadside accidents |
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|Table 3: Occupation status of patients with history of roadside accidents |
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|Table 4: Education status of patients with history of roadside accidents |
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|Table 6: Economic status of patients with history of roadside accidents |
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| Discussion|| |
A total of 189 cases of roadside injuries were registered in the Department of Orthopedics for the purpose of this study.
The highest number of cases (49%) were reported in the age group of 16-30 years. Similar findings were observed in other studies. , These results may be ascribed to the risk-taking behavior in this age group. It was also observed that 30% of the patients belonged to the productive age groups of 31-45 years. Similar observations were also reported in other studies conducted previously. ,, A higher proportion of males (85%) in comparison to females was reported with musculoskeletal injuries due to RSA in our study. These findings have been corroborated by similar observations reported by authors of other studies. ,, The ratio of male individuals with musculoskeletal injuries:female individuals with musculoskeletal injuries in our side was found to be close to ratio for musculoskeletal injuries for the country (4.5:1) as a whole.  A study conducted in Delhi reported on a ratio (9:1) which was higher than our study.  However, the predominant finding of all these studies points to a higher proportion of males reporting with musculoskeletal injuries due to RSA. The predominance of males in our study as also studies mentioned above can be due to more exposure and risk-taking tendency in males as compared to females.
This study recorded the highest number of crash cases among employees (40%), followed by students (24%). The reasons could again be attributed to the daily outdoor routine of employees and therefore higher probability of interacting with vehicular traffic. Similar observations have been observed in the previous study conducted in similar settings.  However, these observations are different from other studies, , wherein the laborers have been reported to be the largest group involved in road crashes. In some other studies, while employees were the second largest group in Puducherry,  students were the next in the order of involvement in Nepal. 
Importantly, majority of RSAs in our study could be attributed to two-wheelers. Another study from central India  has also highlighted the involvement of light transport vehicle as the major mode of travel by the victims of road traffic crashes. The very nature of instability associated with two-wheelers increases chances of RSA leading to musculoskeletal injuries.
| Conclusion|| |
A large majority of RSAs could be attributed to two-wheelers. Therefore, a policy framework on the prevention of musculoskeletal injuries due to RSA should focus on two-wheelers as an important factor.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]