Epidemiology of Fatal Road Traffic Accidents in North-Goa district, Goa, India, 2017-2020: A cross-sectional analysis

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Background
Globally, 1.3 million people die annually due to road traffic accidents (RTA). Accounting for one-tenth of global RTAs, India ranks first among fatal RTAs. Goa state is a coveted tourist destination in India. North-Goa district in the state reports a burden of RTAs higher than the national average. Our objective was to estimate the burden of fatal RTAs and describe them by human, vehicle and environmental characteristics in North-Goa.

Methods
We did a cross-sectional analysis of four-year (2017-2020) data obtained from the traffic authority of Goa. We classified the accident characteristics using Haddon’s matrix. We calculated mortality rate (per 100,000 population) and case fatality ratio (CFR) (per 1000 RTAs).

Results
Overall 6412 RTAs (487 deaths) were reported in North-Goa district during 2017-2020, with overall mortality rate of 17.7, decreasing from 25.7 (2017) to 15.4 (2020). Similar trend was observed in all subdistricts; highest in Pernem subdistrict (23.8). Average mortality rate across four years was higher among 25-34 years (22.6) and males (32.5). Overall CFR was 76, increasing from 76 (2017) to 82 (2020). Average CFR was highest in Pernem subdistrict (150) and on State highways (80). CFR was higher during peak tourism months (82) than rainy months (63). Average CFR was highest on Sundays (89) and during midnight to early morning hours (87). Among all fatalities, 60% were riders, 60% had two-wheeler as the impacting vehicle, 90% were over-speeding, 30% involved a head-on collision, 50% wore helmet (two-wheelers) and 70% wore seat belts (four-wheelers).

Conclusion
North Goa reported lower mortality but higher case fatality in 2020 during the lockdown subsequent to COVID-19 pandemic. We identified various pre-crash and crash factors influencing fatality among RTAs. There is a need to evaluate the implementation of traffic rules and design measures around the crash-related factors to mitigate fatal RTAs in the district.

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