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Abstract
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Our approach to this field has followed the common lines of epidemiology as well as of its dynamic modification shown in Fig. 1. However, we feel it equally important to point out the source of responsibilities for the various events and possible improvements. Our approach to the problem is similar to that of William Haddon (1972) in stressing the importance of etiology or prevention, and modification and treatment.
However, in analysis of pre-traumatic, traumatic and post-traumatic conditions etiological approaches can be made at all these stages and yet they are linked
together (Fig. 3). Therefore, we have regarded the problem as consisting of more or less connected sections, where attack may be direct and practical and responsibility can be pointed out.
Thus among the primary traumatic factors are the general pattern of people involved and the physical environment of the accidents. Then there is the resulting injury pattern.
Related factors involve the most responsible factor, the individual. His age, general behavior and pre-traumatic circumstances as well as neuropsychiatric deficit from previous injuries will influence his capacity as a road user.
When accident types with high percentage of head injuries are particularly common in a community the patterns of injuries in general and of head injuries in particular, will show a similar trend. With increasing motorization the pro- portion of head injuries could be expected to be higher than in communities
with either low traffic density or with highly developed safety measures ,particularly with respect to car occupants. Of course, in districts and time periods when cars with low speed fill the roads more brain damage may occur from carbon monoxide than from impacts.
The sex distribution of injuries and head injuries will also be influenced in communities with different percentage of women working in heavy industries, etc.
Studies and prevention of traffic injuries must be accepted as part of occupational medicine, particularly when professional drivers are involved. This will provoke a better recording, especially of the late effects of injuries and the effects on the community.
Finally, there are the demands of the last resort for the hazard of living and for head injured, the medical care. |