Epidemiology of Multiple Casualty Incidents from Road Accidents in Thailand, 2006-2011

Abstract

Investigations that focus on multiple casualty incidents (MCIs) can identify factors which can determine a very high burden of injury and death. Five MCI investigations were carried out in Thailand using surveillance data, physical investigation data from the scenes and vehicles, in-depth interviews with survivors and witnesses, and extraction of medical information from hospital records. Haddon’s matrix was utilized to structure results in three phases (pre-event, event and post-event) which were stratified into four agents (human, vehicle, physical and socio-economic environment). The five MCIs involved 113 people, nine pickup trucks, four sidecar motorcycles and one each of a car, bus, prime mover truck and prime mover truck with a flatbed semi-trailer. Ten (8.8%) people died and 81 (71.7%) people were injured. Many amenable risk factors were human-related (inexperience, falling sleep, dangerous driving, non-use of seat belts, riding in the cargo area or on the rear platform). Vehicle-related factors were also present (poor tire treads and lack of safety devices), and environmental factors were prominent (wet and slippery roads, poor signage and lighting). Other notable facts included delay in contacting emergency services, lack of cutting equipment and limited first aid support. Many modifiable risk factors were identified, highlighting the need to reform roads and vehicles, and educate passengers and drivers.