1. Urban Road Safety in India :
Current scenario, Opportunities
and Challenges
Dr.G.Gururaj
Professor and Head
WHO CC for Injury Prevention and Safety Promotion
Centre for Public Health
National Institute of Mental Health and Neuro Sciences
Bangalore 560 029
Epiguru@yahoo.com

2. Everyday, roads / vehicles are used by millions
of people for number of activities. These people
are in different states of mind, who are in a
hurry, who are preoccupied, whose behaviour is
uncertain, who are sick / accompany sick, who
are disabled, who are unfamiliar with road
environment, who are elderly, who come from
rural areas, who use different vehicles, who
travel varying distances, who are
inexperienced, who are adventurous, who are in
sorrow ……

3. 9th September 2013 13th September 2013 8th September 2013
9th September 2013
8th September 2013
11th September 2013

5. Changing patterns of population, infrastructure, motor
vehicles and income levels in India
36.00
38.00
40.00
42.00
44.00
46.00
48.00
2007 2008 2009 2010 2011
Road Length
1020.00
1040.00
1060.00
1080.00
1100.00
1120.00
1140.00
1160.00
1180.00
1200.00
1220.00
2005 2006 2007 2008 2009 2010 2011
Population in million
0
10000
20000
30000
40000
50000
60000
70000
80000
2004 2005 2006 2007 2008 2009 2010 2011
Income levels (Rs)
0
20000
40000
60000
80000
100000
120000
140000
160000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Motor vehicles (In Thousands)

7. Number of registered vehicles in metro
cities of India until 2012
0
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
7,000,000
8,000,000
Bengaluru Chennai Delhi Gr Mumbai Hyderabad Kolkota
total registered vehicles till 2012
total two wheelers registered till 2012
Source: MORTH. Road Transport year book 2011-12. Available from: http://morth.nic.in/showfile.asp?lid=1131

8. 703761
1682111
737740
803007
280,615
4,156,132
828,569
1,058,408
3,767,294
1,386,129
7,350,120
461,923
444,685
524,971
2,028,500
489,516
3,386,575
1,337,956
605,488
1,871,049
682,077
868,451
1,067,440
480,338
496,306
952,531
1,314,705
1,336,866
679,510
419,941
1,237,099
444,389
742,889
2,267,123
578,519
759,573
729,146
201,006
1,145,492
521,378
838,750
587,533
553,413
683,355
0
1000000
2000000
3000000
4000000
5000000
6000000
7000000
8000000
total registered transport vehicles total registered non transport vehicles total registered vehicles (both transport and non-transport)
Number of registered vehicles in million plus cities of India
until 2012
Source: MORTH. Road Transport year book 2011-12. Available from: http://morth.nic.in/showfile.asp?lid=1131

9. RTI deaths in India, 1980-2012 (in 000’s)
In 2012, 1,39,091 road deaths and 469900 persons injured as per official reports.
Estimated deaths 175,000 deaths in 2011
More than 2,00,000 deaths as per GSRRS and GBD 2010.
24.6
28.4
30.7 32.8
35.1
39.2 40
44.4 46.6
50.7
54.1
56.4 57.2
60.7
64
70.6
74.6
77
79.9 82
78.9 80.9
84.7 86
92.5
98.4
105.2
109.3
112.6
126.9
133.9
136.9 139
0
20
40
60
80
100
120
140
160
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012

10. 0
50000
100000
150000
200000
250000
300000
350000
1980
1981
1993
1992
1991
1990
1988
1987
1986
1985
1984
1983
1982
1994
1995
2003
2002
2001
2000
1999
1998
1997
1996
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2019
2020
1989
3%
5%
8%

11. India RTI pyramid
Deaths (1) 175000
Serious
Injuries (40)
7,000,000
Minor
Injuries
(70)
12,250,000

12. Leading causes of death among males in Bangalore, 2010
Sl No 0- 4 yrs 5 - 14 yrs 15 - 24 yrs 25 - 34 yrs 35 - 44 yrs 45 - 54 yrs 55 - 64 yrs Above 65 yrs All ages
1 Perinatal deaths Neoplasms Transport crashes Transport crashes Liver Diseases
Ischemic heart
diseases
Ischemic heart
diseases
Ischemic heart
diseases
Ischaemic heart
diseases
2
Congenital
malformations
CNS infections Poisoning Liver Diseases Transport crashes Liver Diseases Neoplasms Neoplasms Neoplasms
3
Diarrhoeal
diseases
Viral diseases Burns Tuberculosis
Ischemic heart
diseases
Neoplasms Diabetes Mellitus Diabetes Mellitus
Respiratory
diseases
4 Neoplasms
Congenital
malformations
Tuberculosis Burns Tuberculosis Diabetes Mellitus Liver Diseases
Hypertensive
diseases
Liver diseases
5 CNS infections Transport crashes Suicide
Ischemic heart
diseases
Neoplasms Tuberculosis
Hypertensive
diseases
Cerebrovascular
diseases
Diabetes mellitus
6 Viral diseases
Other CNS
disorders
Rheumatic heart
diseases
Poisoning Burns Transport crashes
Cerebrovascular
diseases
Pulmonary heart
diseases
Hypertensive
diseases
7
Rheumatic heart
diseases
Rheumatic heart
diseases
Neoplasms Suicide
Hypertensive
diseases
Cerebrovascular
diseases
Tuberculosis
Lower respiratory
diseases
Transport crashes
8 Pneumonia
Haemopoeitic
disorders
Viral diseases Neoplasms Diabetes Mellitus
Pulmonary heart
diseases
Pulmonary heart
diseases
Urinary system
disorders
Cerebrovascular
diseases
9 Transport crashes
Diarrhoeal
diseases
CNS infections
Urinary system
disorders
Urinary system
disorders
Hypertensive
diseases
Lower respiratory
diseases
Tuberculosis Tuberculosis
10
Other CNS
disorders
Pneumonia
Other CNS
disorders
CNS infections
Pulmonary heart
diseases
Urinary system
disorders
Urinary system
disorders
Liver Diseases
Pulmonary heart
diseases
11 Tuberculosis Tuberculosis
Other bacterial
diseases
Diabetes Mellitus Pneumonia
Lower respiratory
diseases
Transport crashes Pneumonia Perinatal deaths
12
Haemopoeitic
disorders
Other bacterial
diseases
Haemopoeitic
disorders
Pneumonia Suicide Pneumonia Pneumonia
Other CNS
diseases
Urinary System
disorders
13
Urinary system
disorders
Liver diseases
Diarrhoeal
diseases
Rheumatic heart
disease
Diarrhoeal
diseases
CNS infections
Other CNS
diseases
Transport crashes
Other CNS
disorders
14 Burns Suicide Malaria
Pulmonary heart
disease
Viral diseases
Other CNS
diseases
Other bacterial
diseases
Other circulatory
diseases
Burns
15 Miscellaneous Miscellaneous Miscellaneous Miscellaneous Miscellaneous Miscellaneous Miscellaneous Miscellaneous Miscellaneous
Total 959 144 690 1410 2071 2941 3741 7970 21373

13. Impact of RTIs
 Health. Social, psychological
 Economic
 Human suffering
 Rehabilitation needs and
services
 Speed of interventions

14. Urban road crashes
• Transport, safety, infrastructure, enforcement
independent and fragmented issues
• Greater presence of vehicles and extent of travel
• Congested and chaotic traffic
• Heterogeneous traffic environments
of nearly 25 types of vehicles
• Road infrastructure – limited and unsafe
• Risk of exposure high
• Limited enforcement of road safety laws
• Violations galore

15. The rising vehicle numbers in the city have not only led to frayed
nerves and road rage, but also resulted in a host of problems such as
choked roads and increased travelling time

16. Urban vs. Rural
In 2012, The 53 mega cities accounted for
 All crashes 17.48%
 Persons Killed 11.8%
 Persons Injured 14.7%
In most of the major metros, there has been a
slow reduction or plateauing of road crashes
due to increase in population and vehicles and
decrease in travel speeds. RTIs are only
shifting to Grade B and C cities and into
districts and highways.

17. 0
2.5
4.9 5.1
6.4
6.9 7.1 7.4 7.4 7.4 7.4 7.5 7.8 8 8.2
9
9.7
10.2
10.8
11.511.5
1212.212.3
12.813.1
13.814.1
15.715.816.116.5
17.117.517.7
23.8
0
5
10
15
20
25
Lakshadweep
Nagaland
Andaman&…
Bihar
Manipur
WestBengal
Sikkim
Chandigarh
Tripura
UttarPradesh
Assam
Mizoram
Jharkhand
Meghalaya
Uttharakhand
Orissa
Delhi
Daman&Diu
Arunachal…
India
MadhyaPradesh
Jammu&…
Maharashtra
Kerala
Chattisgarh
Gujarath
Rajasthan
Dadra&Nagar…
Karnataka
Puducherry
Himachal…
Goa
Punjab
AndhraPradesh
Haryana
Tamilnadu
Road traffic deaths (State/UT-Wise) per Lakh Population
during 2012

18. Road deaths in select major cities of India, 2000-2012
0
200
400
600
800
1000
1200
1400
1600
1800
2000
2000 2005 2009 2012

19. Age and sex wise RTI death rate per lakh
population (2012)
0.44
3.06
3.43
2.03
0.81
0.15
0.46 0.52
0.35
0.21
0
0.5
1
1.5
2
2.5
3
3.5
4
Upto 14 yrs 15-29 30-44 45-59 Above 60
RTIdeathrateperlakhpopulation
Age
MALE
FEMALE

20. Road user categories (%)

21. Road user category in Epidemiological studies
0 20 40 60 80 100
Jammu
New Delhi
Bangalore' 98
Bangalore'04
Bangalore '11
Pedestrian Motorcyclist Bicyclists
Car Occupants Public TV Others

22. Collision of vehicles with Pedestrians
Urban
30.9
19.4
3.7
11.7
17.4
2.3
13.1
4 Wheeler 2 Wheeler 3 Wheeler Truck / Lorry
Bus Tractor Unknown
26.1
0.7
48.3
10.1
3.6
6.1 1.4 3.8
4 Wheeler Cycle 2 Wheeler 3 Wheeler
Truck / Lorry Bus Tractor Unknown
Fatal Non Fatal

23. 62.4
6.6
5.5
25.4
Standing on the Road Unspecified
Crossing the Road Walking on the Road
Pedestrian activity at the time of crash

24. Location of fatal pedestrian crashes,
40.9
7.5
6.1
5.5
3.9
3.3
3
2.8
2.5
2.2
1.7
0.8
0.6
19.3
0 10 20 30 40 50
Middle of the Road
Walking on straight Road
T-Junction
Cross Road
Round about
At Signal light
Bridge / culvert
Sudden narrowing of road
Y-Junction
Road inside campus
Curved road
Bus stop
Road humps / rumble strips
Unspecified

25. Road crossing behavior among pedestrians
: Results of observational study (%)
Crossing at the
right time, 43.1
Crossing during
red light, 33.9
Did not cross
during green
light, 6.2
Crossing at all
locations, 16.8

26. Pedestrian safety
• 63% follow traffic signals (wherever /
whenever present)
• 80% prefer to use footpaths (20% do
not)
0 5 10 15 20 25 30
Others
No control by traffic police
Vehic1e parked on foot path
Lack of traffic rules knowledge
Absence of foot path
Careless
They are in hurry
Uneven footpath
Encroachment of foot path
Reasons for not
using footpaths

27. Understanding mechanism of RTIs -
Indian Scenario
More than 90 % of crashes are believed
to be due to human errors
Consequently, we aim at providing
information HOPING that people
change their behaviors

31. 57
19
3
33
2
12
Road
environment
Road
user
Vehicle
27
6
6
6
3
7
1 18
573 2
Road
environment
Road
user
Vehicle
27 6
3
Evans 2004, (Rumar),Treat
12
93
34

33. 57
19
3
33
2
12
Road
environment
Road
user
Vehicle
27
6
6
6
3
7
1
18
1933 12
Road
environment
Road
user
Vehicle
6 6
7
18
Stigson et al 2008
43
38
64

34. How safe are our roads and urban
Infrastructure?
One can only see outside
If traffic separation is a
solution, is it possible ?
Our
footpaths, subways, elevate
d pedestrian
crossings, traffic system

35. How strong is our enforcement – eg.,
Bangalore city
• 4 million adults in city – 30 % regular
drinkers
• Nearly 2000 alcohol selling outlets in city
• 62,000 cases booked in 2013
• 10 – 15 days of enforcement per month
• 5200 cases per month
• 350 cases per day from 40 police stations
• 8-10 cases per station
• Probability of getting caught = ?

36. Issues in Trauma care
• An emerging urban phenomena
• Absence of immediate or early first aid
• Transportation problems
• Absence of triage
• Delayed care
• Lapse of time between crash and def. care
• Medico legal barriers
• Lack of facilities in hospitals
• Referrals – Referrals – Referrals
• Cost of trauma care
• Several others….

37. The Road safety paradigm shift
ROAD INJURY PREVENTION AND CONTROL- THE NEW UNDERSTANDING
Road crashes are largely predictable and preventable
A problem amenable to rational analysis and counter measures
Moving beyond driver’s errors, human mistakes, crisis approaches, knee jerk
reactions and adhocism – Needs scientific and systematic approaches
Multisectoral issue – all sectors need to work together
Vulnerability of the human body and energy transfer
social equity issue- equal protection to all road users
Needs proactive approaches
Local knowledge needs to inform the implementation of local solutions
Better understanding over time – Haddon matrix, public health model , safe
systems approach

38. Denmark

40. Safe system approach
Source: Towards zero: ambitious road safety targets and the Safe System approach. Paris, Organization for Economic Co-operation and
Development, 2008.

41. We know some solutions for India
• Uniform implementation of helmet laws
• Implementation of drink drive laws
• Implementation of laws- seat belts and child restraints
• Speed management programmes
• Improving visibility of people, vehicles and roads
• Improved highway care programmes
• Safe pedestrian programmes
• Graduated driver licensing programmes
• Effective prehospital care programmes
• Better acute in hospital care programmes
• Safe public transportation systems
Need to find more based on good research

42. Some Unclear – controversial issues ( ? )
 Speed and extent of motorisation
 Design of national and state highways
 Urban development issues
 Impact of urban – transport – development –
infrastructure policies on health and safety of
people
 Operational issues on implementing IMV act
 Centre vs state issues
 Primary or tertiary care
 Responsibility and leadership for road safety
 Respect, value and safety rights of people

43. MAJOR Challenges
 Road safety not a priority
 Political barriers – 6 yrs after Sundar Committee
 Economic -Alcohol as a revenue earner
 Medico legal barriers
 Human, financial and technical resources
 Understaffed and overworked police force
 Lack of research, data and evidence
 Sustainability issues
 Leadership -Responsibility – Coordination ?

44. • Road safety is Science and needs
professional approaches
• Solutions need to be evidence based
and driven by data and research
• Adhocism and crisis management has
not given answers anywhere in the
world

45. People need not die and become disabled
in road crashes. We need to make our
roads and environments safe for
everyone