17th Chapter Directors’ Conference

April 15-18, 2005 New Orleans, LA

Michele Naddeo, MD

Nikolaos Paidakakos

Who are we? Italian National Association Brain and Spinal Cord Injury Prevention Supported by the SiNch (Italian Neurosurgical

Society) and the SNO (Italian Neurological Science Society)

Non-for-profit Volounteering (neurosurgeons and other medical doctors,

med students, allied health professionals, psycologists, epidemiologists, teachers, civilians)

Donations and sponshorships

Short autobiography

1996 Bip Bip Project – regional

Oct 2003 Dr. M. Naddeo assumes responsibility

7 Jan 2004 Associaton’s birth - national

It is the prevailing cause of

DEATH

and

DISABILITY

In the young adult/adult population

EPIDEMYHead Trauma is a downright

Prevention Levels LEVEL I actions put to use in order to prevent the accident

LEVEL II actions put to use to minimize the consequences of the accident during its unwinding

LEVEL III actions put to use to minimize the consequences of the accident after the latter has occured (short/middle term)

LEVEL IV actions put to use in order to minimize negative outcome (long term)

44%

5%21%

11%

6%

12% 1%

CARS

MOTORBIKES

DOMESTIC

WORK

SPORTS

OTHER CAUSES

UNKNOWN

Head Injury – When/Where

Mortality and Morbidity Causes

70

20

5

2

2

1

OTHER

SPORTS

AGGRESSIONS

ACCIDENTS ATWORK

FALLS

TRAFFICACCIDENTS

Traffic Accidents in numbers

European Union (EU data) 50.000+ deaths / yr 150.000 impaired for life

Worldwide (UN data) 1.26 million people dead / yr 2.2% of global mortality 9° cause of death and disability, could become 3°

by 2020

Social Cost: $518 billion/yr in the world (1-3% of GIP)

Traffic Accidents in numbers Italy, year 2004

225.411 accidents

6.015 deaths 16 died every day 1 died every 78

mins

318.961 wounded

50% deaths < 40 yrs

25% deaths < 25 yrs

1° cause of death < 40 yrs

Prevailing cause of death at the age of 18

The most part of street accidents and wounded within city limits.

Traff ic Accidents in numbers Brain and Spinal Cord Injuries, Italy

300 cases / 100.000 / yr (males > females)

1.578.000 ER admissions / yr (2.768 / 100.000 inhabitants)

150.000 hospitalized / yr (4,5% head fractures, 24,1% intracranial)

25 deaths / 100.000 / yr

25.000 / yr heavily impaired

FIRST CAUSE OF DEATH BETWEEN 15 – 35 YRS

0

10

20

30

40

50

60

70

DRI V PASS PEDES

DEADWOUNDED

Traff ic Accidents in numbers Brain and Spinal Cord Injuries, Italy

0

5

10

15

20

25

30

%

0 1011 2021 3031 4041 5051 6061 70> 70

AGE

Traff ic Accidents in numbers Brain and Spinal Cord Injuries, Italy

Traff ic Accidents in numbers Brain and Spinal Cord Injuries, Italy Causes Part I

Erroneous driving behavior mortality rate 2,2%

Altered psycho-physical state of driver (alcohol, narcotics, drugs, ecc.) mortality rate 6,6%

Traffic Accidents in numbers Brain and Spinal Cord Injuries, Italy Causes Part II

Not keeping safety distance from vehicles ahead

Distracted driving High speed Not granting priority to vehicles coming from

the right Not respecting precedence signaling

Traffic Accidents in numbers Brain and Spinal Cord Injuries, Italy

JUNE – JULY, higher risk months FRIDAY, higher accident number 18.00 HOURS, accident peak Mortality index during NIGHT: 5% Rest of the day: 3% FRIDAY and SATURDAY NIGHTS: 45%

of the whole week

Night Incidence

0

10

20

30

40

50

60

FRI / SAT NI GHTS REMAI NI NGNI GHTS

1980-2003Traff ic Accidents in numbers Brain and Spinal Cord Injuries, Italy

48% overall decrease of mortality Improvement of the emergency response system Progress in anesthesiology Safer vehicles and roads Increase in use of helmets, belts, child restraints, ecc. Establishment of a “legal” blood alcohol level &

controls Stricter speeding controls Driving license point system

Minimal to none decrease in ages 15 – 29 (likely due to lack of danger consciousness)

Traffic Accidents in numbers Italy, Social Costs

€ 34 million / yr (2,7% of Italian GIP)

calculated in terms of: Productive capacity loss Human costs Health costs Tangible property damages

What do we do? Part I

Primary level prevention (actions in order to prevent the accident)

Secondary level prevention (actions put to use to minimize the consequences of the accident during its unwinding)

Accident related data collection from ERs and Depts of Neurosurgery nationwide

Population behavior analysis

Design, evaluation and promotion of prevention schemes

What do we do? Part II

Prevention Education nursery schools elementary schools

Prevention Teaching junior high schools high schools university sports centers (CUS) driving schools professional drivers

What do we do? Part III

Collaboration with implicated State Departments, Agencies and Offices

Collaboration with law enforcement agencies (especially traffic police)

Follow up on all activities

Epidemiological studies and research, database building

How… Level I Prevention

Road maintenance Intelligent road designing/redesigning Periodic vehicle inspection Training towards a defensive and “UNSURE”

driving Expanded speeding controls Expanded blood alcohol levels controls Traffic education from as early as

nursery/elementary school

How… Level II Prevention

Safety equipment (driving, work, sports) Helmets Safety belts Child restraints Head rests Air bags, ecc.

Correct handling and maintenance of the above

Car Accidents

29

71

BELT NO BELT

Motorbike Accidents

58

42

HELMET

NO HELMET

Being young…

Also means… Seeking risk…

…and strong emotions…

On the other hand, loving thri l l means…

recklessness

safety?

or

How… Ongoing Projects Part I

Prevention lessons: education and teaching (schools and elsewhere)

Theatrical interactive performances

Video clip projection in clubs/pubs/bars

Research on the “clubbing effect” (in collaboration with the Dept. of Neuropsycology,

Faculty of Psycology, Turin Univ.)

How… Ongoing Projects Part II

Monitoring of newly licenced drivers

Contacts/interaction with authorities

Press pubblications and releases

Internet (institutional site & prevention promoting portal) www.bip-bip.org www.brividamente.it (brividamente = in a thrilling way)

Campaigns, events, stands, gadgets

National Headquarters

at Turin

Vision for the future Nationwide expansion – reach every single child in the

country

TV program for children 4 – 8 yrs old

Cartoon/comics series

Solid epidemiological database – national neurotrauma registry

Post traumatic mortality and morbidity rates reduced

Affi l iation with ThinkFirst “The Making Of” Lisboa, Portugal – Sept 2003 EANS Congress

Dr. Naddeo meets with Dr. Deleo San Francisco, CA – Oct 2004 CNS Meeting Dr.

Naddeo meets with Mrs. Zirkle and Dr. Lobosky and invites them to the oncoming Bip Bip Conference at Turin

Turin, Italy – Dic 2004 Bip Bip Conference Mrs Zirkle and Dr. Lobosky present ThinkFirst for the first time in Italy

During conference “afterhours” the affiliation goal is being elaborated

Affi l iation with ThinkFirst “The Making Of”

Internet – the parallel world Via e-mail, affiliation details are taken care of, paperwork done, all confirmed

New Orleans, LA – Apr 2005, ThinkFirst Conference We proudly announce integration

Bip Bip – ThinkFirst

Italy