Epidemiological analysis of Road Accident Data Management System (RADMS) data in Tamil Nadu, India from 2011 to 2016: Future directions for an integrated national database

Introduction: Globally, road traffic injuries (RTIs) are the eighth leading cause of death, with an estimated 1.35 million deaths yearly. In India, road traffic accidents (RTAs) are one of the major causes of mortality among the younger generation. We analyzed Tamil Nadu's comprehensive Road Accident Data Management System (RADMS) data and described the epidemiological indicators of RTI in this setting. Methods: We obtained the data from the RADMS database for 2011-2016 and used 2011 population census data to project and standardize for different age groups and genders to calculate incidence. We calculated average annual percentage changes (AAPC) with a 95% confidence interval for the whole period. We computed Joinpoint regression analysis for trends and calculated the age-adjusted incidence rate with standard error (SE) using R statistical computing software. Results: We included 3,67,094 RTAs and 5,50,447 RTIs. We observed that the incidence of RTAs and RTIs declined between 2011 and 2016. Most injured were males (82%) and aged 20-39 years (49%). The highest number of accidents occurred on the state highways (65.2%) and on Sundays (17%). Age-adjusted incidence (per 1,00,000) declined from 121.87 (SE 0.4) in 2011 to 92.73 (SE 0.34) in 2016 (AAPC = -4.5% (95% CI = -7.8 to -1)). The age groups 30-39 and 20-29 were 9.82 (z = 8.98; P < 0.05) and 9.02 (z = 8.65; P < 0.05) times at a higher risk compared to 0-9 years old. The motorcyclists (14-27 times; P < 0.05) and pedestrians (12-23 times; P < 0.05) had the maximum risk of RTIs. Conclusion: Young adults, drivers, motorcyclists, and pedestrians remain vulnerable populations for RTIs. More accidents occurred in the state highways and on Sundays. The analysis provides insights on RTIs and RTAs, which will be used to reduce the burden of RTIs and save millions of lives.