|Year : 2023 | Volume
| Issue : 1 | Page : 92-97
Prevalence of near-miss events and its impact among medical students using bikes and cars in Chennai: A cross-sectional study
Janakiram Marimuthu1, S Pravinraj2
1 Department of Community Medicine, Government Vellore Medical College, Vellore, Tamil Nadu, India
2 Department of Community Medicine, Sri Lakshmi Narayana Institute of Medical Science, Pondicherry, India
|Date of Submission||15-Feb-2022|
|Date of Acceptance||16-May-2022|
|Date of Web Publication||21-Jan-2023|
Dr. S Pravinraj
No. 203, 4th Cross, Thirupur Kumaran Nagar, Velrampet, Puducherry
Source of Support: None, Conflict of Interest: None
CONTEXT: The WHO's Global Status Report on road safety 2015 indicates that worldwide the total number of road traffic deaths has plateaued at 1.25 million per year, with the highest road traffic fatality rates in low-income countries. Urgent action is needed to achieve the determined target for road safety, reflected in the newly adopted 2030 Agenda for Sustainable Development (goals 3 and 11), and halving the global number of deaths and injuries from road traffic crashes by 2020.
AIM: This present study aims to estimate the prevalence of near-miss events among medical students using bikes and cars in Chennai.
MATERIALS AND METHODS: A total of 300 undergraduate and postgraduate medical students who were studying at the Government Medical College of Chennai were included in this cross-sectional study. A predesigned semi structured validated questionnaire was used to collect the data from the participants and was analysis was done.
STATISTICAL ANALYSIS USED: In this study, the data analyzed were qualitative data. Chi-square test was used to test the significance. Analysis was done using SPSS version 17.
RESULTS: More than half of the students (61.7%) participated in the study belonged to the age group 17–21 years and were pursuing 2nd year of MBBS. The prevalence of near-miss among medical students was found to be 56.3%. This study revealed that many students had been involved in the near-miss events due to violations of traffic rules and regulations. Most of the students showed corrective behavior after previous near-miss experiences to avoid road traffic accidents.
Keywords: Medical students, near-miss events, road traffic accidents
|How to cite this article:|
Marimuthu J, Pravinraj S. Prevalence of near-miss events and its impact among medical students using bikes and cars in Chennai: A cross-sectional study. Indian J Health Sci Biomed Res 2023;16:92-7
|How to cite this URL:|
Marimuthu J, Pravinraj S. Prevalence of near-miss events and its impact among medical students using bikes and cars in Chennai: A cross-sectional study. Indian J Health Sci Biomed Res [serial online] 2023 [cited 2023 Jan 28];16:92-7. Available from: https://www.ijournalhs.org/text.asp?2023/16/1/92/368314
| Introduction|| |
India is a middle-income country with a population of more than a billion and had witnessed 23.2% of road traffic deaths among 18–25 years individuals in the year 2017 as reported by the Ministry of Road and Transport Highway Transport Research Wing. According to the Global Status Report on road safety 2018, the number of annual road traffic deaths has reached 1.35 million. Road traffic injuries are now the leading killer of people aged 5–29 years. Refusal to follow traffic rules, drunken driving, and overspeeding are the main reasons for road accidents. The increasing number of road accidents coupled with the increasing vehicle population means an increase in the number of aggressive road users resulting in the incidence of road rage. Road traffic accidents (RTAs) are the main causes of death in the independent age group.
A near-miss is an unplanned event that did not result in injury, illness, or damage but had the potential to do so. A fortunate break of events prevented an injury, fatality, or damage. It is important to know the occurrence of near-miss events to reduce the further occurrence of RTAs. Urgent action is needed to achieve the determined target for road safety reflected in the newly adopted 2030 Agenda for Sustainable Development (goals 3 and 11) and to halve the global number of deaths and injuries from road traffic crashes by 2020. An Internet-linked study shows that near-miss events are the dangerous precursor to accidents. Hence, it is important to quantify the events and do further research. The present study aims to estimate the prevalence of near-miss events among medical students using bikes and cars in Chennai.
The present study aims to estimate the prevalence of near-miss events among medical students using bikes and cars in Chennai.
| Materials and Methods|| |
The present cross-sectional study was conducted among undergraduate and postgraduate medical students for the period of 3 months from February to April 2018 in the Government Medical College of Chennai. Medical students using bikes and cars in Government Medical College of Chennai were included as study participants, and those people who did not give consent were excluded from the study. A sample size of 300 was calculated based on a pilot study on near-miss reporting among 50 patients with a prevalence of 25% using the formula n = 4pq/d2 with an absolute precision of 5%. The participants were selected using simple random sampling from a line list of the students collected from the college using computer-generated random numbers. A predesigned and pretested semi-structured validated questionnaire in English was used which includes the characteristics of the participant and their particulars related to road traffic safety and near-miss events after obtaining informed verbal consent from each participant before the start of the interview. Expert validity for the questionnaire was obtained from an emergency medicine physician. A study information sheet was given to each student. The data collected through the face-to-face interview were entered in an MS Excel sheet and then analyzed using SPSS Inc. Released 2008. SPSS Statistics for Windows, Version 17.0. (Chicago, Illinois, U.S.: SPSS Inc.). The outcome variable was qualitative, and hence, Chi-square test was used as the test of significance.
Near-miss event definition
A near-miss is an unplanned event that did not result in injury, illness, or damage but had the potential to do so. Examples - Missing signages, taking a sudden turn, changing the lane without giving an indicator and such incidents which may lead to almost hitting a vehicle or person. Not noticing fallen trees or objects and continuing to drive may lead to almost hitting the tree or the objects, and other such unplanned events that had the potential to cause any injury but did not happen are considered near-miss events.
Ethical Clearance was obtained from Government Stanley Medical College and Hospital, Chennai - Institutional Ethical Committee dated 17.02.2018 with certificate number is 1989/2018.
Date of approval
February 17, 2018, at the Council Hall, Stanley Medical College, Chennai, at 10 A. M.
| Results|| |
A total of 300 participants were included in the study. [Figure 1] shows the distribution of participants according to their age; among them, 185 (61.7%) students belong to the age group of 17–21 years, 72 (24.0%) students belong to the age group of 22–26 years, 29 (9.7%) students belong to the age group of 27–31 years, 9 (3%) students belong to the age group of 32–36 years, and 5 (1.7%) students belong to the age group of >37 years.
[Figure 2] shows the distribution of medical students according to their study year, in which 31 (10.3%) students belong to the 1st year, 122 (40.7%) of them belong to the 2nd year, 41 (13.7%) students belong to the 3rd year, 27 (9.0%) belong to the 4th year, 20 (6.7%) students belong to CRRI, and 59 (19.7%) students were postgraduates.
The pattern of vehicle usage is shown in [Table 1]. Two hundred and forty-two (80.7%) were male students and 58 (19.3%) were female students. One hundred and forty (46.7%) had <4 years of driving experience, 62 (20.7%) had 4–6 years of driving experience, and 98 (32.7%) had >6 years of driving experience. The mode of transport to college used by 197 (65.7%) students was found to be two-wheeler, a few 14 (4.6%) students were using four-wheeler as their mode of transport, while the remaining 89 (29.7%) students used both types of motor vehicle. One hundred and forty-nine (49.6%) students were using the vehicle with gear, 56 (18.7%) were using without gear, and 95 (31.7%) were using both types of vehicles. Among 300 study participants, 236 students had the license for their vehicles, and maximum students about 223 (74.3%) students had permanent licenses, and only 13 (12.3%) had the temporary license. Thirty-seven (12.3%) were found to drive vehicles after the consumption of alcohol.
|Table 1: The distribution of pattern of vehicle usage among the medical students|
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[Table 2] shows the various aspects of road safety measures among medical students. It is observed that most of the students, 239 (79.7%), had all their vehicle accessories in working condition. The practice of wearing a helmet while driving a two-wheeler was followed among 214 (71.3%) medical students. Two hundred and forty-five (81.5%) medical students admitted that they follow traffic rules and regulations while driving at all times. The preference for taking an extra seat while traveling in a two-wheeler among medical students was considerably low as only 88 (29.3%) preferred taking an extra seat. Twenty percent of the students who were involved in performing stunts were crossing their speed limits.
|Table 2: The distribution of various aspects of road safety measures followed among medical students|
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In [Table 3], 111 (37%) study participants enjoy playing music while driving. Among them, 53 (17.7%) preferred listening musing with headsets, 34 (11.3%) students preferred listening to music through Bluetooth, while the remaining 24 (8%) students preferred listening in stereo.
The various practices of using mobile phones while driving are shown in [Table 4]. One hundred and one (33.7%) students admitted that they make phone calls while driving. Among them, 54 (18%) preferred making calls with the help of headsets/Bluetooth, 24 (8%) students preferred making calls by placing mobile phones inside their helmets, while the remaining 23 (7.7%) students use mobile phones without freeing hands by tilting their heads.
The prevalence of near-miss events experienced by nearly 56% of the medical students at Government Medical College while driving is shown in [Figure 3].
[Figure 4] describes that 80% of the medical students had experienced 0–5 events, 11.7% of them had experienced 6–10 events, and the remaining 8.3% had experienced >10 near-miss events.
|Figure 4: The number of near-miss events experienced by medical students|
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[Table 5] shows that 69% of the medical students corrected their mistakes from their previous near-miss event experiences to reduce future road traffic injuries. About 141 (47%) medical students had an opinion of obeying traffic rules and regulations to reduce RTAs and the remaining 49 (16.3%) students stated to refrain the mobile phone usage while driving.
[Table 6] shows the association between near-miss events and selected variables. Near-miss events with variables such as years of driving (P = 0.040), type of vehicle used for driving (P = 0.001), taking extra seat (P = 0.001), stunts and overspeed while driving (P = 0.003), alcohol consumption while driving (P = 0.000), and talking while driving (P = 0.001) show a statistically significant association (between the above factors and near-miss events).
|Table 6: Cross-tabulation between near-miss events and selected variables|
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| Discussion|| |
Near-misses and accidents almost share the same causal factors. Investigating and addressing the event of near-misses with their causal factors helps in the reduction of accidents in future. And thus, near-miss reporting is important for better safety performance. According to an earlier study, major injuries and near-misses share almost equal causes. Although the bike, car, and the road contribute to some extent, driver errors remain the most significant factor in increasing or decreasing the rate of RTAs.
This study found the prevalence of near-miss events and awareness of road safety measures. The prevalence of near-miss events among medical students is 56.3%. Eighty percent of the students experienced 0–5 near-miss events. Sixty-nine percent corrected their mistakes from the previous near-miss event. At the same time, medical students are willing to follow the rules and road safety measures and the near-miss reporting will provide a step to move forward.
A study conducted in Nigeria shows around 50.3% of the occurrence of near-miss events which is almost similar to the present study. Another study conducted among adolescents in Sri Lanka by Gong shows that the prevalence of near-miss was 27.8% which was lower than the present study.
In this present study, other factors such as years of driving, type of vehicle used, doing stunts and speed driving, alcohol consumption while driving, and talking while driving also had a statistically significant association with near-miss events. A study conducted by Miyama et al. shows that drivers who consume alcohol had higher near-miss events.
A report prepared for presentation at the 8th Global Congress on Process Safety, Houston, TX, concludes that it is important to recognize and address each barrier causing near-miss events. To find out the cause and act according to them is required. Terum and Svartdal's study also concluded that learnings from near-misses are theoretically interesting and important for understanding safe driving behavior.
Limitations of the study
Confounders are not addressed in this study. It may be subject to recall or information bias while recollecting past events.
| Conclusion|| |
It is noted that a major proportion of students were found to have near-miss experiences. Twenty-four percent of the medical students had been involved in RTAs as a result of overspeeding. Sixty-nine percent of the students have corrected their behavior after experiencing near-miss events. Years of driving type of vehicle, stunt/speed during driving, alcohol consumption, and cell phone talk during driving had statistically significant differences. This can also be addressed with aggressive enforcement of the regulation by the road traffic police and also equal participation from the public
It is recommended that students have to be educated to consider the speed limit as per guidelines given by the government. Alcohol consumption while driving has to be strictly avoided among medical students, and self-discipline has to be greatly encouraged among them. Using a cell phone while driving has to be avoided. Students should follow traffic rules and proper training should be given about the same. They should not take an extra seat while driving. Performing any stunts should be avoided which puts their lives in danger. There is a wide range of opportunities for training the students is seen. Continuous feedback regarding their driving skills should also be obtained. Students' commitment on improving their driving skills should be monitored. Educating the driver himself to look into near-miss incidents and finding out the root cause has to be done. Using the obtained results, institutions can do improvements to safety systems, hazard control, and risk reduction. Near-miss reporting is extremely important in preventing serious, fatal, and catastrophic incidents where the frequency of occurrence is less but is more harmful than other incidents.
Financial support and sponsorship
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], [Table 4], [Table 5], [Table 6]