Monira Mollazehi

PW 1424 Trends and patterns of work-related road traffic injuries involving heavy vehicles in qatar

Introduction Qatar is a rapidly developing high-income country in the Middle East with a rapidly growing expatriate worker population working on road and FIFA World Cup 2022 infrastructure projects. Heavy Vehicles (HVs) are a very common sight in Qatar but their effect/s on work-related road traffic injuries (WRTIs) in Qatar has not been reported previously. This study aims to analyze the work related injuries caused by HVs; it was conducted as part of a larger ‘A Unified Registry for Workplace Injury Prevention in Qatar’ grant [NPRP 7–1120–3–288] funded by the Qatar Foundation and designed to initiate and implement a targeted unified workplace injury registry to inform policies and programs to reduce the health burden, in terms of deaths and disabilities, and the healthcare costs from WRI’s in Qatar Methods A free text search using heavy vehicle terms like ‘crane’, ‘truck’, ‘bulldozer’ etc. was carried out on the Trauma Registry of the national trauma center of Qatar. All WRTI patients, from 1 January 2015 to 31 December 2016, were included and their data analyzed according to road user type and key epidemiologic characteristics. Results Forty percent (40%) of all WRTIs in Qatar involved heavy vehicles. 57% worked in the transportation industry, 83.8% were truck drivers and only 8% of them were restrained. The driver victims were involved in head-on collisions (32%) and fixed object crashes (22%). It was also found that pedestrians (20%) and falling object victims (4.6%) had more severe injuries when compared to other mechanisms. Conclusion HV-WRTIs are underappreciated as a major cause of severe WRTI in Qatar. Occupational safety programs should focus on decreasing operating hours by HV drivers and increasing restraint use, pedestrian worksite environmental modifications and HV maintenance and repair standards. The limited available evidence necessitates more focused data capture and analysis in the future.

Hospital Mortality Based on the Mode of Emergency Medical Services Transportation

OBJECTIVE We assessed the presentations and outcomes of trauma patients transported by helicopter emergency medical services (HEMS) versus ground emergency medical services (GEMS). METHODS A retrospective analysis of trauma registry data at a level I trauma center was conducted for patients transported by GEMS and HEMS between 2011 and 2013. Data were analyzed and categorized based on the mode of transportation. RESULTS A total of 4,596 trauma patients were admitted to the hospital with a mean age of 31 ± 15 years. Injured patients were transported to the trauma center by GEMS (93.3%) and HEMS (6.7%). The common mechanisms of injury were motor vehicle crash (37%) and falls (25%). Compared with GEMS, patients transported by HEMS were characterized by having a greater injury severity, more proportion of traumatic brain injury, on-scene intubation, and a 2.5-fold higher mortality. However, the impact of mode of transportation on the hospital mortality among severely injured patients has disappeared after adjusting for potential confounders. CONCLUSION Patients transported by HEMS may have different characteristic features and outcomes when compared with GEMS. However, further work is needed to identify the subgroups of trauma patients who clearly benefit from the use of HEMS.

786 In-hospital mortality based on the mode of EMS transportation in high-income developing middle Eastern Country

Background Helicopter emergency medical services (HEMS) have become a standard element of advanced pre-hospital care system. Positive outcomes in HEMS transportation were evident in different settings and certain types of patients. The present study assessed presentations and outcomes in trauma patients transported by HEMS and ground emergency medical services (GEMS) in Qatar. Methods A retrospective review of trauma registry data at Hamad Trauma Centre (HTC) was conducted for trauma patients transported by GEMS and HEMS in the duration from 2011 to 2013. Patients were classified into two groups based on the mode of transportation (HEMS vs GEMS). Injury severity score (ISS) was defined as severe/profound trauma (>15) and mild/moderate trauma (≤ 15). Mortality was defined as brought in dead (BID), within the first day, within the first week and more than 1 week. Results A total of 4596 patients with traumatic injuries were included (7% HEMS). When compared with GEMS, the mean ISS, Head AIS and scene GCS were greater in HEMS (p = 0.001). Nearly 12% of ISS > 15 and 5% of ISS ≤ 15 were transported by HEMS. The main mechanism of injury was motor vehicle crash (MVC) (37%) followed by fall (25%) and pedestrians (14%). MVC victims were more likely to be transported by HEMS whereas fall and pedestrians victims were frequently transported by GEMS (p < 0.05). On-scene rate of intubation was higher in HEMS irrespective of ISS score (p = 0.001). Overall mortality, in-hospital deaths and BID was 10.2%, 7.5% and 3%; respectively. The mortality was 2.5-fold higher in victims transported by HEMS compared with GEMS (10% vs 4%, p = 0.001). Mortality within the first day and more than one week were higher with HEMS, however, it was greater within the first week in GEMS. Age and mode of transportation -adjusted predictors of mortality were ISS and scene GCS. Conclusions MVCs are the main mechanism of injury in Qatar. Polytrauma and scene GCS play important prognostic role regardless the mode of transportation. These findings indicate the need of more effective preventive measure on the road

78 The pattern of road traffic deaths in the ramadan: the effect of multi-disciplinary road safety programs in QATAR

Increased motor vehicle crashes and resultant deaths during the Ramadan month have been reported in predominantly Muslim countries, especially those in the Middle East and the Gulf. In Qatar, the leading cause of death is road traffic injuries and a marked increase in road deaths was noted in the Ramadan month of 2013. In response, multiple government and non-governmental agencies implemented multi-disciplinary programs consisting of enhanced traffic enforcement, news and multi-media awareness campaigns starting 1–2 months before the Ramadan with specific safety messages for high-risk populations. Mortality data from the National Mortuary was extracted and compared between the 2 Ramadan periods. When compared with road traffic deaths in 2013, road traffic deaths in 2014 were reduced by 40% with the greatest reductions [>65%] in pre-hospital deaths, young fatalities [<30 years] and among Gulf Country nationals. The multi-disciplinary nature of the programs implemented were effective at reducing Ramadan road deaths but further analysis to isolate the most effective components must be done and those identified as effective must be repeated.