Disability related to road traffic crashes among adults in Spain

Abstract

Background: Road traffic accidents cause substantial morbidity and disease burden; few studies have examined their impact on disability. Objective: To estimate the magnitude and distribution of disability due to road traffic accidents according to socio-demographic variables, and its main socioeconomic and health determinants. Methods: A cross-sectional study was conducted in community-dwelling participants in the “2008 Spanish National Disability Survey”, a representative sample of 91,846 households with 20,425 disabled persons older than 15 years; 443 had disability due to road traffic accidents. Results: The prevalence was 2.1 per 1000 inhabitants (95% CI:1.8-2.3), with no differences by sex. Risk was highest among persons aged 31 to 64 years, and onset of disability showed a sharp inflection point at age 16 years in both sexes. Odds ratios (ORs) were higher (OR = 1.3; 95% CI:1.1- 1.7) for participants with secondary education than for those with the lowest educational levels and were lower (OR: 0.5; 95% CI:0.3-0.8) for participants with the highest household income levels than for those with lowest. Only 24% of disabled participants were gainfully employed. As compared to other sources of disability, traffic crashes caused greater disability in terms of mobility (OR = 3.1;p < 0.001), a greater need for health/social services (OR = 1.5;p = 0.003), and more problems with private transportation (OR = 1.6;p < 0.001), moving around outside the home (OR = 1.6;p < 0.001) and changes in economic activity (OR = 2.4;p < 0.001). Conclusions: The prevalence of disability due to road traffic accidents in Spain is lower than in other developed countries, with middle-aged and socio-economically underprivileged persons being the most affected. Disability due to road traffic accidents is related to a greater demand for social/health care support, problems of accessibility/commuting, and major changes in economic activity

Antecedentes: Los accidentes de tráfico causan importante morbilidad y carga de enfermedad; su impacto sobre la discapacidad ha sido poco estudiado. Objetivo: Estimar la magnitud y distribución de la discapacidad por accidentes de tráfico según variables socio-demográficas, y sus principales condicionantes socio-sanitarios y económicos. Métodos: Estudio transversal en participantes de la Encuesta Nacional de Discapacidad, Autonomía Personal y Situaciones de Dependencia 2008; muestra representativa de 91.846 hogares con 20,425 discapacitados mayores de 15 a˜nos, 443 causados por accidentes de tráfico. Resultados: La prevalencia fue de 2,1 por 1000 (IC 95%: 1,8-2,3), sin diferencias por sexo y mayor riesgo entre 31-64 a˜nos. La discapacidad tuvo inicio abrupto a los 16 a˜nos (ambos sexos). Aquellos con educación secundaria tuvieron un mayor odds ratio OR (OR = 1,3; IC 95%: 1,1- 1,7) que aquellos con menor nivel educativo; los discapacitados con mayores ingresos tuvieron menor OR (OR = 0,5; IC 95%: 0,3-0,8) que aquellos con ingresos más bajos. Sólo un 24% tenían empleo remunerado. Comparado con otras causas de discapacidad, los accidente de tráfico generaron mayor discapacidad en movilidad (OR = 3,1;p < 0,001) y necesidad de asistencia socio-sanitaria (OR = 1,5;p = 0,003); mayores problemas con el transporte privado (OR = 1,6;p < 0,001), los desplazamientos fuera de casa (OR = 1,6;p < 0,001) y cambios en la actividad económica (OR = 2,4;p < 0,001). Conclusiones: La prevalencia en Espa˜na es baja comparada con otros países desarrollados. La población de mediana edad y con desventajas socio-económicas fue la más afectada. La discapacidad por tráfico se relaciona con mayor demanda de servicios socio-sanitarios, problemas de accesibilidad y movilidad e importantes cambios en la actividad económica