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| ORIGINAL ARTICLE |
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| Year : 2022 | Volume
: 29
| Issue : 1 | Page : 56-62 |
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Analysis of deaths and injuries related to road traffic crashes in al-najaf governorate of iraq from 2017 to 2019
Miaad K Alkhudhairy1, Ali A Aldhalemi2, Morteza Saki3
1 Department of Health Community Techniques, Health and Medical Technical College, Al-Furat Al-Awsat Technical University, Kufa, Iraq
2 Department of Building and Constructions Techniques, Engineering Technical College/Al-Najaf, Al-Furat Al-Awsat Technical University, Kufa, Iraq
3 Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| Date of Submission | 27-Sep-2021 |
| Date of Decision | 06-Nov-2021 |
| Date of Acceptance | 10-Nov-2021 |
| Date of Web Publication | 28-Jan-2022 |
Correspondence Address:
Dr. Miaad K Alkhudhairy
Health and Medical Technical College, Al-Furat Al-Awsat TechnicalUniversity, Kufa
Iraq
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/npmj.npmj_681_21
Background: This study aimed to determine the rates of road traffic injuries and deaths as well as the factors affecting their levels in the Al-Najaf governorate for 3 years (2017–2019). Materials and Methods: Data were collected and analysed from the annual report of traffic crashes statistics of the Iraqi Ministry of Planning/Central Statistical Organisation. Al-Najaf governorate was selected as the study model for the period between 2017 and 2019. This selection was based on its urban growth, important location and standing for religious tourism. Results: Of the 8824, 9852 and 10,753 crashes reported in Iraq in 2017, 2018, and 2019, Al-Najaf governorate recorded 1057 (12%), 1041 (10.6%) and 1148 (10.7%), respectively. The percentage of injuries in Al-Najaf governorate to the total of injuries in Iraq decreased as follows: (11.9%), (10.2%) and (9.9%) for 2017, 2018 and 2019 respectively, while the mortality rate decreased as follows: (8.4%), (7.7%) and (7.1%), respectively. The number of deaths and injuries on main roads and highways was higher. Besides, the rates of injuries and deaths among males were higher than in females. Driving at excessive speed was the most statistically significant factor leading to a high proportion of deaths and injuries. Conclusion: This study showed a decrease in the deaths and injuries caused by road traffic crashes during the 3 years 2017–2019 in the Al-Najaf Governorate, Iraq. It seems that driving rules and regulations need to be revised so that they can have more deterrent power in preventing injuries and deaths from driving accidents.
Keywords: Deaths, injuries, Iraq, road traffic crashes
How to cite this article:
Alkhudhairy MK, Aldhalemi AA, Saki M. Analysis of deaths and injuries related to road traffic crashes in al-najaf governorate of iraq from 2017 to 2019. Niger Postgrad Med J 2022;29:56-62 |
How to cite this URL:
Alkhudhairy MK, Aldhalemi AA, Saki M. Analysis of deaths and injuries related to road traffic crashes in al-najaf governorate of iraq from 2017 to 2019. Niger Postgrad Med J [serial online] 2022 [cited 2023 Mar 31];29:56-62. Available from: https://www.npmj.org/text.asp?2022/29/1/56/336741 |
| Introduction | |  |
Road traffic crashes (RTCs) are very serious and their degree of danger is comparable to the terrorist operations that have recently occurred in Iraq.[1] In addition to social problems and loss of human capabilities, RTCs are a cause of concern and obsession for all members of society. Therefore, it is necessary to find proposals and solutions to address the causes of these accidents or mitigate their effects and identify the main elements that cause RTCs, including the driver, the road and the vehicle.[2]
Globally, about 1.3 million people die annually from RTCs resulting in fatalities and about 20–50 million people suffer non-fatal injuries and many of them are disabled.[3] Rapid unplanned industrialisation and urbanisation, especially in developing countries have led to an unprecedented increase in the number of vehicles in these countries, which has always resulted in increased rates of RTCs and higher ratios of deaths, injuries and disabilities.[2],[3] Iraq is one of the countries in the Middle East where vehicular road transport is the crucial means of mobility. The occurrence, severity and recurrence of RTCs have been one of the most critical issues related to highway safety in Middle East countries in general and Iraq in particular for many years The implementation of safety laws became a major challenge, especially after the sharp increase in vehicle ownership and use after 2003. The recovery of the Iraqi economy after the gradual lifting of the economic sanctions has contributed significantly to the increase in the number of vehicles and imports have continued to increase despite the fragile security situation. It is estimated that one in ten Iraqis owns a car or vehicle, which has led to an increase in the number of accidents.[4],[5] The increase in the number of vehicles, combined with a lack of firm management, necessarily leads to a rise in the number of crashes.[3] Local studies and reports have often focused on crashes, deaths and injuries across Iraq and little is known about the Al-Najaf governorate. Al-Najaf governorate occupies a distinct geographical position as it is located in the centre of Iraq, and stands out for its role in historical and religious tourism, especially after 2003. The number of people in the Al-Najaf governorate has increased due to migration from other cities. This has led to overpopulation and increased the number of crashes, injuries and deaths.[6],[7] Hence, this study aimed to shed light on the major causes of RTCs, their types, distribution, as well as analysing the ratios of deaths and injuries in the Al-Najaf governorate. The present research will enable and urge the official authorities to take appropriate measures to control the number and type of RTCs and mitigate human and material losses.
| Materials and Methods | | |
Ethics
As no human and animal data were used in this study, no registered ethics code was assigned to the present study.
Data collection and study area
Data were collected and analysed from the annual report of traffic crashes statistics of the Iraqi Ministry of Planning/Central Statistical Organisation (CSO) from January 2017 to December 2019. Al-Najaf governorate was selected as a study model for the period between 2017 and 2019 due to its urban growth, vital location and importance in religious tourism. Al-Najaf governorate is located in the southwest of Iraq, on the border with Saudi Arabia. This governorate shares common borders with the Iraqi governorates of Al-Qadisiyah, Al-Anbar, Karbala, Babylon and Al-Muthanna. The area of Al-Najaf is 28,824 km2, and the population is 1,220,145. The population is distributed by 71.1% in urban areas and 28.9% in rural areas.[8] The data were statistically analysed using the Statistical Package for the Social Sciences (SPSS) software version 20.0 (IBM Corp., Armonk, NY, USA).
| Results | | |
Al-Najaf governorate, like other governorates in Iraq, is affected by political, organisational, legislative, executive and service realities and cannot be studied as a statistical model separately from the other governorates. This governorate is affected and influenced by the Iraqi reality. Therefore, the current study focused on some common and overlapping aspects of the Al-Najaf governorate with Iraq as a whole.
Distribution of road traffic crashes
Distribution of road traffic crashes in Al-Najaf governorate compared to Iraq governorates
Out of 8824, 9852 and 10,753 RTCs in 15 Iraqi governorates in 2017, 2018 and 2019, Al-Najaf governorate recorded a percentage of 1057 (12%), 1041 (10.6%) and 1148 (10.7%), respectively.
Distribution of road traffic crashes according to inside and outside the cities of Al-Najaf governorate
To find out the relationship between the ratios of RTCs, and demographic composition, the impact of traffic, the level of crashes occurring outside and inside the cities of Al-Najaf governorate was studied. A progressive increase was observed in the ratio of RTCs inside the cities of Al-Najaf governorate as a part of the total crashes. These percentages were as follows: 816 (77.2%), 819 (78.7%) and 945 (82.3%) for the years 2017, 2018 and 2019, respectively. Accordingly, a decrease was observed in the ratio of crashes outside the cities compared to the total crashes, and the percentages were as follows: 241 (22.8%), 222 (21.3%) and 203 (17.7%) for the years 2017, 2018 and 2019, respectively.
Distribution of road traffic crashes depending on road type
The crashes ratio on the main roads was significantly increased as follows: 613 (58%), 714 (68.6%) and 810 (70.6%) for the years 2017, 2018 and 2019, respectively. The rural roads in Al-Najaf Governorate have fewer crash ratios than other types of roads, and the ratios were not at the same pace, they were as follows: 78 (7.4%), 41 (3.9%) and 59 (5.1%) for the years 2017, 2018 and 2019, respectively, as shown in [Table 1]. | Table 1: Distribution of road traffic crashes according to the type of road in Al-Najaf governorate
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Distribution of road traffic crashes depending on the type of crash
The results of the current study showed the distribution of road accidents according to their types [Figure 1]. The years 2018 and 2019 recorded the highest percentage (53%) of collision crashes followed by the percentage (51%) for the year 2017. The ratio of run-over crashes was ranked second after collision crashes, they recorded percentages of 466 (47%), 500 (44%) and 466 (43%) for the years 2017, 2018 and 2019, respectively. The highest percentage of overturn crashes was recorded as 57 (5%) for the year 2017, followed by 34 (4%) for the year 2019 and finally 43 (3%) for the year 2018. | Figure 1: Types of crashes in Al-Najaf governorate in years 2017, 2018, and 2019
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Distribution of injuries and deaths
Distribution of injuries and deaths compared to other governorates in Iraq
[Figure 2] shows the trend of individual injuries and fatalities in the Al-Najaf governorate during the years under study (2017–2019). It can be seen that the number of fatalities has continuously decreased from 221 in 2017 to 187 in 2019. Besides, the proportion of the deaths in the Al-Najaf governorate to the total deaths in Iraq decreased from 8.4% in 2017 to 7.1% in 2019. On the other hand, RTCs injuries increased from 1115 in 2017 to 1151 in 2019, but the ratio to the total injuries in Iraq decreased from 11.9% in 2017 to 9.9% in 2019. It can also be noted that the total number of injuries in the Al-Najaf governorate was 5.34 times the total number of deaths during the 3 years. | Figure 2: Percentages of injuries and deaths in Al-Najaf governorate compared to the total number of Iraq
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Distribution of injuries and deaths among the total number of casualties in Al-Najaf governorate
[Figure 3] shows the percentages of injuries and deaths among the total number of casualties (injuries and deaths) in the Al-Najaf governorate in the years studied. For injuries, there were the following percentage changes: 1115 (83.5%), 1064 (83.3%) and 1151 (86%) for the years 2017, 2018 and 2019, respectively. For deaths, there were the following percentage changes: 221 (16.5%), 213 (16.7%) and 187 (14%), respectively. | Figure 3: Ratios of injuries and deaths to total casualties in Al-Najaf governorate
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Distribution of road traffic crashes, injuries and deaths according to the districts of Al-Najaf governorate
[Table 2] shows that 64% of RTCs in Al-Najaf governorate occurred in Al-Najaf Center District while Al-Kufa District during the studied period, while Al-Kufa district recorded 20% of the crashes during the same period. The table also shows that Al-Najaf Center and Al-Kufa districts had the highest number of injuries and deaths compared to the other districts. In Al-Najaf Center, 683 persons out of 1115 people (61.3%) were injured by RTCs in 2017, while 580 out of 1064 persons (54.5%) were injured in 2018, and over 626 out of 1154 people (54.4%) were wounded in 2019. The overall average of injury in Al-Najaf Center was two people per day during the 3 years. In Al-Kufa district 208 (18.7%) persons were wounded in 2017, 264 (24.8%) in 2018, and 307 (26.7%) in 2019, and the overall average was one person every 2 days during the period studied. | Table 2: Distribution of injuries, deaths, and road traffic crashes among districts of Al-Najaf governorate
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The data for the 3 years studied revealed a continuous decrease in the total annual number of deaths from RTCs for the whole governorate. In contrast, a different trend was observed in Al-Najaf Center and Al-Kufa districts. In Al-Najaf Center district, 115 (52%) persons died in 2017, 118 (55.4%) in 2018 and 101 (54%) in 2019. It appears that Al-Najaf Center is at the top of the deaths compared to the other districts with an average of one person dying every 3 days in the 3 years studied. The data showed that the death ratios in Al-Kufa district for the years 2017, 2018 and 2019 were as follows: 45 (20.4%), 40 (18.7%) and 43 (23%) respectively with an average of one person dying every 4 days in the 3 years studied.
Distribution of deaths and injuries according to the gender of victim
As shown in [Figure 4], from 2017 to 2019, the number of RTC deaths among males decreased by 27% from 175 in 2017 to 128 in 2019, and the ratio of male deaths to total deaths also decreased from 79.2% in 2017 to 68.4% in 2019. On the other hand, the number of female deaths increased by 28% from 46 in 2017 to 59 in 2019. The number of injuries and their ratios in females were 231 (20.7%), 262 (24.6%) and 207 (18%) for the years 2017, 2018 and 2019, respectively, while the number of injuries and their ratios in males were 884 (79.3%), 802 (75.4%) and 944 (82%) for the same order of previous years. It was noted that during the studied years, the ratio of injured males to females was 3.8: 1 and the same ratio for deaths was 3:1. | Figure 4: Distribution of injuries and deaths depending on the gender of the victim in Al-Najaf governorate
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Distribution of deaths and injuries depending on driver behaviour
There are many driver-related factors that directly affect the occurrence of RTCs and resulting human casualties or property damage. These factors-as classified in the CSO reports-are lack of attention, driving without a driving licence, driving under the influence of drugs or alcohol, non-compliance with the traffic signal, noncompliance with traffic priorities, no allowed roundness, the wrong pass, driving reverse direction and high speed.
[Table 3] shows that driving with high speed was the first statistically significant cause of RTCs injuries and deaths during the studied period. The percentages of mortality due to high speed were (64.7%), (97.2%) and (95.2%), while the percentages of injuries were (49.6%), (89.5%) and (91.1%) for the years 2017, 2018 and 2019, respectively. It is worth noting that the ratios of deaths and injuries due to high speed increased by 30.5% and 41.5% between 2017 and 2019, respectively. The second statistically significant factor was noncompliance with traffic priorities and the last factor was driving without a licence. | Table 3: The main causes (related to the driver) of deaths and injuries in Al-Najaf governorate
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| Discussion | | |
Comparing the number of RTCs in the Al-Najaf governorate over 3 years with the rest of Iraq, we find that Al-Najaf governorate ranked second in terms of the number of crashes in 2017 and 2018, while it ranked third in 2019. This confirms the importance of studying the relationship between the increase in the number of crashes and their direct impact on the increase in material, moral and human losses. It was noted that the Al-Najaf governorate recorded a high number of RTCs for many years and ranked third after Baghdad and Babylon during the period 2005–2011.[9],[10] In 2012, Baghdad, Babylon and Al-Najaf governorates recorded the highest number of traffic crashes.[11] According to CSO data for 2013–2016, Al-Najaf governorate ranked third in the number of crashes. Al Saad and Sondorp[12] emphasised that reliable data on RTCs in Iraq are scarce and more reliable data on the causes of crashes need to be documented.
In this study, it was found that the proportion of RTCs inside the cities of the governorate increased steadily compared to crashes outside the cities. The centre of Al-Najaf governorate is known for its congestion, narrow roads and lack of urban planning, as well as the increase in commercial and religious tourism. Al-Jamil and Al-Muzhar[13] stated that there are secondary causes of congestion on the main roads in the centre of the Al-Najaf governorate. The most important ones are the widespread phenomenon of illegal parking, the increase of private vehicles and the lack of smart transportation.
The present study showed that the percentage of RTCs ratios escalated on the main roads as follows: 58%, 68.6% and 70.6% for the years 2017, 2018 and 2019, respectively. The rural roads in the Al-Najaf governorate had lower ratios than other types of traffic roads. It was not possible to compare the number of crashes, deaths and injuries in the current study in an absolute comparison with the countries of the world because each country has certain characteristics, such as population, geographical distribution of population, road engineering and road type.
The risk of dying from road traffic injury is highest in Africa, and pedestrians account for 38% of all RTCs fatalities.[10] Most deaths on the nation's highways are cyclists, pedestrians and drivers and occupants of two-wheeled vehicles and tractors. Therefore, the problem of road quality needs to be addressed by providing better facilities for road users and developing appropriate approaches to traffic in residential areas.[14] The data from the study of Mohan and Tiwari[15] showed that vulnerable road users are the main victims on both urban and rural roads, while Tiwari and Saraf[16] found that the victims of vulnerable road users often suffer relatively severe injuries, especially in low-speed crashes. In contrast to the current study, according to which most crashes occurred on highways, Lee and Jeong[17] documented about 61.4% of crashes on rural roads and 38.6% of crashes on highways. The percentage of crashes that resulted in minor or severe injuries was 89.1%, while 10.9% of crashes were frequently fatal, and the highest death ratio was on highways.
The results of the present work showed that the collision type was the more frequent crash type than the running over and overturning types. The current study was in agreement with some local studies where collision crashes were more than other types of crashes, such as the study conducted by Mohammed et al.[18] Recently, Abd Abas and Al-Jameel[19] found that the collision crashes were the most common in the Al-Najaf governorate and the run over crashes were least common among the other types of crashes. Overall, it is observed that collisions are the most common crashes among RTCs. There is an extensive study on the types of crashes in the European Union countries: Czech Republic, Austria, Netherlands, France, Germany, England, Sweden, Italy and Spain for the period from 2000 to 2014. The study found that the most frequent crashes are collision crashes and the proportion ranged from 34% to 45%, while the ratio of single collision crashes was 22%–49%.[20] In India, Singh et al.[21] found a similar result to the current study and the ratio of the collision was 42.7% while 4.7% of crashes were caused by overturning and 4.7% were caused by running over.
In this study, the percentages of deaths decreased as follows: 8.4%, 7.7% and 7.1% for the years 2017, 2018 and 2019, respectively. The ratio of injuries decreased as follows: 11.9%, 10.2% and 9.9% for the years 2017, 2018 and 2019, respectively. The percentage of injuries was higher than the percentage of deaths in a ratio of 2.93 for the same years. The reason for the decrease in the number of deaths and injuries could be due to the start of construction of new roads with more width and more traffic signs, increased supervision by the traffic police and also increased parking lots in the city to reduce traffic. However, these measures are still in their infancy and need to be increased.
According to Singh,[22] Iraqis with RTCs die at an average rate of 7000 people per year, which means that about two people die per hour. Twenty-five Iraqis leave their homes every day and never return because they become victims on the road. Jrew et al.[23] have confirmed that the number of Iraqis killed in recent wars is less than the number of Iraqis dying in RTCs. This increase is directly related to the increase in the number of vehicles, lack of traffic awareness, weak engineering structures and indifference in the application of laws.
It should be noted that the reliability of CSO data based on reports from the General Directorate of the Iraqi Traffic Police is a problem, especially in terms of death data, as most crashes are recorded at the scene without cross-checking them with hospital statistics. Moreover, some of those injured in crashes die as a result of crashes and their complications but are recorded as natural deaths. The number of traffic injuries is also inaccurate in some cases because Iraqi society is tribal and subject to social guidelines. Tribes often apply the principle of reconciliation to end problems related to RTCs. These often end with reconciliation before the arrival of official authorities and are not recorded at all. Abd Abas and Al-Jameel[19] confirmed the role of reconciliation in the inaccuracy of official statements. ESCWA[24] clarified that the data on traffic crashes in Iraq were taken from statistical bulletins and include only those crashes that were actually recorded, taking into account that many crashes may not have been recorded and may not have organised a statistical form, for reasons including conciliation between the parties or the fact that the injuries are very slight. Hussain and Lafta[25] stated that the official records are incomplete and it is likely that most of the injuries are minor so they were not recorded.
The current study also discussed the relationship between RTCs, deaths, and injuries with the gender of the victims, and found that the percentage of injuries and deaths was higher for males than females in Al-Najaf governorate during the study period with a ratio of (3.8: 1) in injuries and (3:1) in deaths. Leidman et al.[4] mentioned that about 8 out of 10 Iraqi RTCs victims were male. The proportion of males in RTCs mortalities reported from Egypt (80%), Lebanon (77%), United Arab Emirates (89%), Jordan (81%), Turkey (77%) and Iran (79%) showed similar patterns, suggesting that males are more directly affected than females.[4],[26] In Iraq, vehicle drivers are known to be frequently male. Asad[5] believes that local society views female driving as socially unacceptable behaviour, although the percentage of women driving has increased. The second reason for the increase in death and injury rate among males is that the man is the breadwinner and therefore often uses the car and there is no need for a second car used by women. Sorenson[27] concluded that men are more at risk because they have a different lifestyle due to male socialisation and found that the high mortality rate in males is related to social, biological, demographic and behavioural characteristics.
This study showed a sharp increase in the ratio of injuries and deaths due to high-speed driving compared to other factors. The percentage of mortality due to the high speed was 64.7%, 97.2% and 95.2%, while the ratio of injuries was 49.6%, 89.5% and 91.1% for the years 2017, 2018 and 2019, respectively. Human behaviour studies showed that people directly cause 70%–95% of crashes because they violated traffic rules.[21] Aldoski et al.[28] summarised the main reasons for the occurrence of RTCs by the driver, namely ignoring traffic rules and reckless driving, wrong traffic passing, distracting the driver by talking to passengers or eating, talking and texting on the mobile, distraction and playing around with the radio while driving.
According to the results of the current study, noncompliance with traffic rules was the most effective factor after the high-speed factor. Many reports and studies linked the speed factor to noncompliance with traffic rules. In a previous study, it was reported that the relative risk of not crossing the marked areas was eight times higher than crossing the legal crossings at signalised intersections, and this risk increases, especially when high-speed vehicles are involved.[29] Reports indicate that non-compliance with traffic rules by pedestrians and drivers is one of the critical factors associated with pedestrian crashes.[29],[30] The third factor that had a direct impact on the increase in the number of deaths and injuries in Al-Najaf governorate is driving without a licence. The lack of a driver's licence means that the driver is either not authorised to drive a vehicle, has not yet reached the minimum legal age, or does not comply with traffic laws. Therefore, the Iraqi Traffic Law needs to be updated to reflect the rapid development in Iraq and it needs to raise the ceiling of the conditions for issuing driving licences to ensure the safety of the citizens.
It was noted that the Iraqi traffic law contains some critical issues, such as the permission to drive a motorcycle when one reaches the age of 16. The age of the driver cannot be measured by the type of vehicle, but by the degree of maturity. Furthermore, it is necessary to consider the application of the conditions for the issuance of a driver's licence, as many studies have found the ignorance of drivers about traffic signs and the priority of crossing and traffic.[31] The main limitation of the current study was that not all RTCs are available in the statistics of the Iraqi Ministry of Planning/CSO. Due to the conflict and insecurity in Iraq, there is the possibility of unreported deaths.
| Conclusion | | |
All findings of this study span from 2017 to 2019 and showed Al-Najaf governorate had high ratios of RTCs and ranked third among governorates in Iraq. There has been a steady increase in the number of road crashes ratios in the cities of Al-Najaf governorate compared to the cities outside the governorate. The number of deaths and injuries on the main roads and highways was high compared to other roads. It was found that the percentage of collision crashes was highest, followed by running over and overturning, and Al-Najaf Center and Al-Kufa districts recorded the highest ratios of deaths and injuries compared to the other districts. The injuries ratio was three times higher than the deaths ratio. In addition, the percentage of injuries and deaths was higher among males than females. Statistically, high speed, non-compliance with traffic priorities and driving without a licence were among the most important factors leading to an increase in the deaths and injuries ratio.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4]
[Table 1], [Table 2], [Table 3]
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