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Original Research (Original Article) 


Sulaiman Mohammed Alahmad et al, 2020;4(3):687–694.

International Journal of Medicine in Developing Countries

Population perception of the management of road traffic accidents

Sulaiman Mohammed Alahmad1, Abdullah Mansour Alswilem1*, Abdulaziz Mohammed Alhussain1, Ekab Jurays Alotaibi1, Muath Ali Alshehri1, Sultan Mohammed Alhussain2, Abdulmanea Mohammed Alwaeli1

Correspondence to: Abdullah Mansour Alswilem

*Almaarefa University, Riyadh, Saudi Arabia.

Email: abdullah.m.alswailem [at] gmail.com

Full list of author information is available at the end of the article.

Received: 23 December 2019 | Accepted: 04 January 2020


ABSTRACT

Background:

Saudi Arabia is having a high incidence of Road Traffic Accidents (RTAs) leading to a high death rate. Therefore, it requires an evaluation of the risk factors for RTAs and guidelines to decrease the prevalence of road traffic injuries and reduce healthcare burden. This survey analysis aimed to explore the population perception of the management of RTAs in Riyadh, Saudi Arabia.


Methodology:

A self-administered structured questionnaire was distributed to the general public in Riyadh, Saudi Arabia. The questions were in Arabic. The survey consisted of sections including the socio-demographic variables, in addition to questions about population perception and practices related to road traffic safety. Data analysis was done through SPSS program version 22.


Results:

The mean score for the whole sample was 54.80 ± 7.181, with a minimum score of 22 and a maximum score of 66. The average score for participants, who did not have accidents previously (55.02 ± 7.274) was non-significantly higher (p = 0.623) than those who had previous accidents (54.70 ± 7.146). There was a significant difference between participants' opinions regarding the most important cause of road accidents (p = 0.033). Also, a significantly higher number of participants who had previous car accidents strongly agree that drivers should be obligated to have car maintenance in particular centers (59.3%) compared to those who did not have previous accidents (p = 0.011).


Conclusion:

The general public in Riyadh, Saudi Arabia, showed a satisfactory level of awareness toward RTAs. Further studies in other regions of Saudi Arabia should be performed to figure out the real estimation of perception toward RTAs.


Keywords:

Perception; management; Road Traffic Accidents.


Introduction

The road traffic accidents (RTAs) are a leading cause of all trauma admissions in hospitals, globally [1]. The World Health Report in 2010 reported that road traffic injuries had been identified as the ninth most common cause of disability-adjusted life years lost for all age and gender categories [2].

The World Health Organization (WHO) reported that an estimate of around 1.24 million individuals had lost their lives on the road, and up to 50 million individuals were injured globally, and the number of road traffic mortalities is expected to increase further by 2020. Approximately 75% of overall road deaths occur in developing countries, and road mortalities are common in developed countries [3,4].

In the Kingdom of Saudi Arabia, road traffic fatality accounts for 4.7% of all deaths, while road traffic fatalities do not exceed 1.7% in Australia, the United Kingdom (UK), or the United States of America (USA) [5].

Similarly, road fatalities in Saudi Arabia have increased over the last decade; with around 4–24 per 100,000 population compared with 10 in the USA, and 5 in the UK, where road safety has been taken earnestly, and all primary and secondary preventive measures are performed appropriately [6].

Saudi Arabia has a higher number of deaths from RTAs among high-income states and is considered to be the country’s leading cause of mortality for 16- to 30-year-old males [7]. Road injuries are recorded to be the most serious in Saudi Arabia with an accident to injury ratio of 8:6 as compared to the international ratio of 8:1 [8]. The rate of RTA caused by four-wheeled vehicle accidents is the highest of all worldwide crashes [9].

In Saudi Arabia, motor vehicles are the primary means of transportation. More than 6 million vehicles are found on the roads of Saudi Arabia [10]. The Ministry of Health morbidity and mortality indicated that 20% of beds are occupied by RTA patients, and 81% of mortalities in the hospitals are because of Road Traffic Injuries [11].

Over the past two decades, Saudi Arabia has reported 86,000 deaths, and 611,000 injuries in RTAs with 7% permanent disabilities [12]. The economic impacts of RTAs estimated in terms of potentially productive year's life lost were reported in a study and it showed a 31.6% increase in mortalities due to RTA among men in 1997–2002, as compared to a 1.3% increase in mortalities due to RTA among women [13,14].

Therefore, this study aimed to assess the population perception of the management of RTAs in Riyadh, Saudi Arabia.


Subjects and Methods

This is a cross-sectional, qualitative prospective study that was carried out in Riyadh, Saudi Arabia. Only adult participants having age 18 years old and older, who filled the survey, were included in the analysis.

A self-developed questionnaire was distributed to the general public in Riyadh, Saudi Arabia, age 18 years old and older. The questions were in Arabic because the majority of the participants understand the Arabic language. The survey consisted of questions identifying socio-demographic variables, in addition to questions about population perception and practices related to road traffic safety.

Data were represented in terms of frequencies and valid percentages for categorical variables. Chi-square analysis was used to compare categorical variables between the subgroups. All p-values < 0.05 were considered statistically significant. T-test analysis was used to compare means among different groups. IBM SPSS (Statistical Package for the Social Science; IBM Corp, Armonk, NY) was used to perform all statistical calculations, version 21 for Microsoft Windows.


Results

A total of 554 participants responded to the online questionnaire in this study. Only participants who completed all the questions in the survey were included. Socio-demographics of participants and analysis of the questionnaire are shown in the following.

Out of 554 participants, age was subcategorized into four groups, starting with 18–30 years old and ending with more than 60 years old. Most of the responders (35.9%) belonged to the age group between 18 and 30 years. On the other hand, the age group with responders who were more than 60 years old had the least number of responses (8.5%).

Turning to the gender of the participants, males constituted 69.1% of participants, while females were 30.9%. The educational level was also evaluated; 0.4% had a primary school certification, while 84.8% had a university degree. All socio-demographic data are shown in detail in Table 1.

In addition, participants were asked about their monthly income; it was revealed that 52.2% of the responders had a monthly income of more than 10,000 SAR, while only 8.8% had a monthly income of 5,000–7,000 SAR, as shown in Figure 1.

Also, participants were asked if they had any previous RTAs. Among the participants, 69% mentioned that they had previous accidents, while 31% mentioned that they did not have previous accidents, as shown in Figure 2.

Table 1. Socio-demographic characters of participants.

Frequency Percent
Age
18–30 199 35.9
31–45 142 25.6
46–60 166 30.0
>60 47 8.5
Gender
Female 171 30.9
Male 383 69.1
Education level
Primary education 2 0.4
Intermediate 6 1.1
Secondary school degree 76 13.7
University degree 470 84.8
Marital status
Divorced 10 1.8
Married 345 62.3
Single 196 35.4
Widowed 3 0.5

Moreover, participants were asked questions to evaluate their perception toward the prevention of RTAs. It was demonstrated that 79.2% of the participants believed that the most important cause for RTAs is the driver’s mistake and 51.1% of participants agreed that cars with good maintenance can reduce the number of accidents. In addition, 43.3% of responders agreed that drivers should be obligated to get rid of old cars and to maintain cars in particular centers to reduce the number of accidents as shown in Table 2.

Figure 1. Monthly income of participants.

Figure 2. History of previous RTAs.

Furthermore, participants were asked about their opinion regarding the road conditions. It was shown that 78% of participants strongly agreed that roads must be well maintained; also, 74% of responders strongly agreed that appropriate pedestrian and pedestrian crossings should be available. In addition, 52.3% of participants strongly agreed that slow and fast-moving vehicles should have separate tracks, as shown in Table 3.

Participants were also asked about the human factor in RTAs. Among the participants, 59% strongly agreed that issuing a driving license should be dependent on the minimum competency levels. Also, 63.4% strongly agreed that all drivers should be properly trained by trainers who have a certified trainer license. Moreover, 61.9% strongly agreed that both drivers and pedestrians should be educated about traffic rules periodically, while 42.6% agreed that drivers should be obligated to take training in first aid, as shown in Table 4.

Regarding traffic rules, 69.9% of participants strongly agreed that wearing helmet or seat belts should be mandatory. Also, 61.6% strongly agreed that there should be strict traffic rules, and 76% strongly agreed that random parking of vehicles should be prevented especially in busy roads. In addition, 50% strongly agreed that heavy fines should be applied to those who violate the rules, as shown in Table 5.

Turning to accident victim management, 45.5% of participants strongly agreed that victims should be treated by trained healthcare professionals and not the public. Also, 65.5% strongly agreed that medical care facilities should be available on highways, and 59.4% strongly agreed that increasing the awareness of the society about treating victims with empathy can reduce mortality, as shown in Table 6.

Table 2. Most important causes for RTAs.

Frequency Percent
In your opinion, what is the most important cause of road accidents? defect in the car engine 8 1.4
defect in road 90 16.2
driver mistake 439 79.2
pedestrians mistake 11 2.0
weather condition 6 1.1
Cars with good maintenance and break will reduce the number of accidents. Disagree 40 7.2
Agree 283 51.1
Strongly Agree 231 41.7
Obligating drivers to get rid of old cars and those causing strong pollution will reduce accidents Disagree 145 26.2
Agree 240 43.3
Strongly Agree 169 30.5
Obligating drivers to make car maintenance in particular centers will reduce car accidents Disagree 173 31.2
Agree 241 43.5
Strongly Agree 140 25.3

Table 3. Responses for questions related to road condition.

Frequency Percent
Road condition [roads must be well maintained with frequent paging of road surfaces and marking of safety on all roads] Disagree 10 1.8
Agree 112 20.2
Strongly Agree 432 78.0
Road condition [provision of appropriate pedestrian and pedestrian crossings at all secondary and major intersections] Disagree 7 1.3
Agree 137 24.7
Strongly Agree 410 74.0
Road condition [provide completely separate tracks for slow-moving and fast-moving vehicles] Disagree 76 13.7
Agree 188 33.9
Strongly Agree 290 52.3

Table 4. Responses for questions related to human factors.

Frequency Percent
Human factor [the issuance of a driver's license must be strictly dependent on the minimum competency acquired by learners from designated driving schools] Disagree 34 6.1
Agree 193 34.8
Strongly Agree 327 59.0
Human factor [all drivers must be properly trained by trained instructors who have a certified training license] Disagree 25 4.5
Agree 178 32.1
Strongly Agree 351 63.4
Human factor [drivers and pedestrians must be educated about traffic rules periodically] Disagree 22 4.0
Agree 189 34.1
Strongly Agree 343 61.9
Human factor [requiring drivers to conduct a periodic medical examination, especially vision and hearing for drivers to obtain or renew the license] Disagree 62 11.2
Agree 243 43.9
Strongly Agree 249 44.9
Human factor [requiring drivers to provide training in first aid as well as health education and traffic education to the public to prevent accidents and be a condition for obtaining or renewing the license] Disagree 87 15.7
Agree 236 42.6
Strongly Agree 231 41.7

Table 5. Responses for questions related to traffic rules.

Frequency Percent
Laws [mandatory helmet wear by two-wheeled vehicles and seat belts by four-wheeled vehicles shall apply] Disagree 19 3.4
Agree 148 26.7
Strongly Agree 387 69.9
Laws [impose strict traffic rules by the concerned authorities] Disagree 14 2.5
Agree 199 35.9
Strongly Agree 341 61.6
Laws [prevent random parking of vehicles on busy roads and intersections to ensure free flow of traffic] Disagree 7 1.3
Agree 126 22.7
Strongly Agree 421 76.0
Laws [imposing heavy fines on anyone who violates traffic laws] Disagree 81 14.6
Agree 196 35.4
Strongly Agree 277 50.0

Table 6. Responses for questions related to accident victim treatment.

Frequency Percent
Accident Victim Management [appropriate treatment should be given to injured accident rescue victims by health practitioners only and not public] Disagree 61 11.0
Agree 241 43.5
Strongly Agree 252 45.5
Accident Victim Management [providing medical care / first aid facilities on highways and busy roads] Disagree 9 1.6
Agree 182 32.9
Strongly Agree 363 65.5
Accident Victim Management [ambulance driving should be limited to health practitioners trained in transporting the injured to nearby hospitals only] Disagree 65 11.7
Agree 219 39.5
Strongly Agree 270 48.7
Accident Victim Management [creating awareness among all sectors of society to treat accident victims with empathy and without fear so that disease and mortality can be reduced] Disagree 16 2.9
Agree 209 37.7
Strongly Agree 329 59.4

Table 7. Responses for questions related to first aid.

Frequency Percent
First aid in road accidents. First Aid's primary goals are life-saving Disagree 10 1.8
Agree 126 22.7
Strongly Agree 418 75.5
First aid in road accidents. The primary goals of first aid are to protect the victim from further injury, Disagree 8 1.4
Agree 144 26.0
Strongly Agree 402 72.6
First aid in road accidents. The primary goals of first aid are to alleviate pain and set treatment priorities. Disagree 22 4.0
Agree 189 34.1
Strongly Agree 343 61.9

Participants were also asked about their opinion about first aid. Among the participants, 75.5% strongly agreed that the main goal of first aid is lifesaving. Also, 72.6% strongly agreed that first aid aims at preventing further injury for the victim, and 61.9% strongly agreed that first aid aims at alleviating pain and set treatment priorities, as shown in Table 7.

Finally, the total score for questions was calculated and compared with those who had accidents and who did not have accidents previously. The mean score for the whole cohort was 54.80 ± 7.181, with a minimum score of 22 and a maximum score of 66. The average score for participants who did not have accidents (55.02 ± 7.274) previously was non-significantly higher (p = 0.623) than those who had previous accidents (54.70 ± 7.146), using t-test.

By comparing all the responses over those who had previous accidents and those who did not, using the chi-square test at a level of significance p <0.05, it was revealed that there was a significant difference between participants’ opinions regarding the most important cause of road accidents (p = 0.033), where those who did not have previous accidents believed that it is a pedestrian mistake (63.6%), while those who had previous accidents believe that it is due to defects in roads (74.4%).

In addition, a significantly higher number of participants who had previous car accidents strongly agreed that drivers should be obligated to have car maintenance in particular centers compared to those who did not have previous accidents, as shown in Table 8. All other responses did not significantly vary between both groups.


Discussion

RTAs are a significant health hazard with 19 individuals killed daily, and 4 injured every hour in Saudi Arabia. The economically productive age groups and the young generation are the most affected [9]. In industrialized countries, the devastating loss because of accidents is 1 ± 2% of the national income, while for Saudi Arabia, this loss has been estimated to be between 2.2% and 9% [8,15].

The present study investigated the perception of the Saudi public toward RTAs. It was shown that the mean score for the whole sample was 54.80 ± 7.181, with a minimum score of 22 and a maximum score of 66. The average score for participants who did not have accidents previously (55.02 ± 7.274) was non-significantly higher (p = 0.623) than those who had previous accidents (54.70 ± 7.146).

In addition, there was a significant difference between participants’ opinions regarding the most important cause of road accidents (p = 0.033), where those who did not have previous accidents believed that it is a pedestrian mistake (63.6%), while those who had previous accidents believe that it is due to defects in roads (74.4%).

Also, a significantly higher number of participants who had previous car accidents strongly agreed that drivers should be obligated to have car maintenance in particular centers (59.3%) compared to those who did not have previous accidents (p = 0.011).

The perception of RTAs has been evaluated in different settings. Mansuri et al. [16] performed a systematic review based on evidence of RTAs in the kingdom of Saudi Arabia over the last 2.5 decades. RTAs represented 83.4% of all trauma admissions in 1984-1989, and no such overall trend was studied thereafter. Excessive speeding was the substantial common cause reported in all recent and past studies. The disparity was common in the type of reporting of RTAs, outcome measures, and possible causes over a period of 2.5 decades. All research exclusively looked into the drivers' errors. Sentinel surveillance of road accidents should be kept in place in the secondary and tertiary care hospitals for all provinces of the kingdom [16].

Similarly, the present study evaluated the most common cause of RTAs from the perspective of the general public. It was shown that there was a significant difference between participants opinions regarding the most important cause of road accidents (p = 0.033), whereas those who did not have previous accidents believed that it is a pedestrian mistake (63.6%), while those who had previous accidents believed that it is due to defects in roads (74.4%).

Also, Alshammari et al. [17] carried out a cross-sectional study on randomly selected drivers in Arar City, Northern Saudi Arabia. RTAs were frequent with individuals aged <20 years, with a percentage of 36.9%, followed by 33.9% between the age of 20 and 35 years and just 1.7% aged above 50 years. Distraction habits on driving were as follows: 49.6% use the cellphone while they drive and 30.5% smoke. Most of the RTAs happened during sunny weather and rainy weather [17].

Table 8. Comparison between groups depending on the history of RTAs.

No Yes p value
In your opinion, what is the most important cause of road accidents? defect in the car engine 62.5% 37.5% 0.033*
defect in road 25.6% 74.4%
driver mistake 30.8% 69.2%
pedestrians mistake 63.6% 36.4%
weather condition 33.3% 66.7%
obligating drivers to make car maintenance in particular centers will reduce car accidents] Disagree 25.4% 74.6% 0.011*
Agree 29.5% 70.5%
Strongly Agree 40.7% 59.3%

*p value at a level of significance <0.05.

In the present study, participants were asked about the most common cause of RTAs. Only 1.1% of responders agreed that it can be due to weather conditions, while 79.2% of the participants agreed that it is commonly the driver’s mistake.

Moreover, Aldwsari et al. [18] performed a prospective study on 237 patients of RTAs from 2013 to 2018. The majority of RTA patients were young men and adults. A total of 59.1% of patients had cerebral damage, 38% of patients had at least one scalp laceration, and 43.5% of patients had some degree of shock, whereas 27.8% of the RTA victims needed at least one unit of blood transfusion. A total of 14.3% of the patients died as a result of their injuries, and the survival rate was 85.7% [18]. It was demonstrated that 69% of the participants of the present study had previous RTAs; however, the type of injury was not investigated.

In addition, the present study had some limitations; these include the absence of detailed data on those who had a previous history of traffic road accidents. To our knowledge, this is the first study to evaluate the perceptions toward RTAs in Riyadh, Saudi Arabia, among the general population.


Conclusion

The general public in Riyadh, Saudi Arabia, showed a satisfactory level of awareness toward RTAs. Educational programs and awareness campaigns should be held in schools, universities, and public events to reduce the incidence of RTAs. Further studies in other regions in the Saudi kingdom should be performed to figure out the real estimation of perception toward RTAs.


List of Abbreviations

RTA Road Traffic Accidents
UK United Kingdom

Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this article.


Funding

None.


Consent for publication

Informed consent was obtained from all the participants.


Ethical approval

The research was conducted by using online survey after the verbal approval of research supervisor from Almaarefa University, Riyadh, Saudi Arabia.


Author details

Sulaiman Mohammed Alahmad1, Abdullah Mansour Alswilem1, Abdulaziz Mohammed Alhussain1, Ekab Jurays Alotaibi1, Muath Ali Alshehri1, Sultan Mohammed Alhussain2, Abdulmanea Mohammed Alwaeli1

  1. Almaarefa University, Riyadh, Saudi Arabia
  2. Alfaisal University, Riyadh, Saudi Arabia

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How to Cite this Article
Pubmed Style

Alahmad SM, Alswilem AM, Alhussain AM, Alotaibi EJ, Alshehri MA, Alhussain SM, Alwaeli AM. Population perception of the management of road traffic accidents. IJMDC. 2020; 4(3): 687-694. doi:10.24911/IJMDC.51-1577135184


Web Style

Alahmad SM, Alswilem AM, Alhussain AM, Alotaibi EJ, Alshehri MA, Alhussain SM, Alwaeli AM. Population perception of the management of road traffic accidents. http://www.ijmdc.com/?mno=79150 [Access: March 28, 2020]. doi:10.24911/IJMDC.51-1577135184


AMA (American Medical Association) Style

Alahmad SM, Alswilem AM, Alhussain AM, Alotaibi EJ, Alshehri MA, Alhussain SM, Alwaeli AM. Population perception of the management of road traffic accidents. IJMDC. 2020; 4(3): 687-694. doi:10.24911/IJMDC.51-1577135184



Vancouver/ICMJE Style

Alahmad SM, Alswilem AM, Alhussain AM, Alotaibi EJ, Alshehri MA, Alhussain SM, Alwaeli AM. Population perception of the management of road traffic accidents. IJMDC. (2020), [cited March 28, 2020]; 4(3): 687-694. doi:10.24911/IJMDC.51-1577135184



Harvard Style

Alahmad, S. M., Alswilem, . A. M., Alhussain, . A. M., Alotaibi, . E. J., Alshehri, . M. A., Alhussain, . S. M. & Alwaeli, . A. M. (2020) Population perception of the management of road traffic accidents. IJMDC, 4 (3), 687-694. doi:10.24911/IJMDC.51-1577135184



Turabian Style

Alahmad, Sulaiman Mohammed, Abdullah Mansour Alswilem, Abdulaziz Mohammed Alhussain, Ekab Jurays Alotaibi, Muath Ali Alshehri, Sultan Mohammed Alhussain, and Abdulmanea Mohammed Alwaeli. 2020. Population perception of the management of road traffic accidents. International Journal of Medicine in Developing Countries, 4 (3), 687-694. doi:10.24911/IJMDC.51-1577135184



Chicago Style

Alahmad, Sulaiman Mohammed, Abdullah Mansour Alswilem, Abdulaziz Mohammed Alhussain, Ekab Jurays Alotaibi, Muath Ali Alshehri, Sultan Mohammed Alhussain, and Abdulmanea Mohammed Alwaeli. "Population perception of the management of road traffic accidents." International Journal of Medicine in Developing Countries 4 (2020), 687-694. doi:10.24911/IJMDC.51-1577135184



MLA (The Modern Language Association) Style

Alahmad, Sulaiman Mohammed, Abdullah Mansour Alswilem, Abdulaziz Mohammed Alhussain, Ekab Jurays Alotaibi, Muath Ali Alshehri, Sultan Mohammed Alhussain, and Abdulmanea Mohammed Alwaeli. "Population perception of the management of road traffic accidents." International Journal of Medicine in Developing Countries 4.3 (2020), 687-694. Print. doi:10.24911/IJMDC.51-1577135184



APA (American Psychological Association) Style

Alahmad, S. M., Alswilem, . A. M., Alhussain, . A. M., Alotaibi, . E. J., Alshehri, . M. A., Alhussain, . S. M. & Alwaeli, . A. M. (2020) Population perception of the management of road traffic accidents. International Journal of Medicine in Developing Countries, 4 (3), 687-694. doi:10.24911/IJMDC.51-1577135184