Journal of Emergencies, Trauma, and Shock
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Year : 2014  |  Volume : 7  |  Issue : 2  |  Page : 69-70
What's new in emergencies, trauma and shock? studying traffic related injuries in India

Department of Trauma, Hannover Medical School, Hannover, Germany

Click here for correspondence address and email

Date of Submission23-Apr-2013
Date of Acceptance24-Apr-2013
Date of Web Publication16-Apr-2014

How to cite this article:
Zeckey C, Brand S, Krettek C, Mommsen P. What's new in emergencies, trauma and shock? studying traffic related injuries in India. J Emerg Trauma Shock 2014;7:69-70

How to cite this URL:
Zeckey C, Brand S, Krettek C, Mommsen P. What's new in emergencies, trauma and shock? studying traffic related injuries in India. J Emerg Trauma Shock [serial online] 2014 [cited 2022 Aug 11];7:69-70. Available from:

In urban India, cycle rickshaws are a significant mode of transport. Exact numbers are hard to obtain, but it is estimated that there are 2 million or more rickshaws on the road. Taken together, cycle rickshaws account for 6-8 billion passenger kilometer/year. [1] Recent research analyzed the workload of cycle rickshaw pullers. The investigators concluded that pulling the cycle rickshaw is heavy to very heavy, which also corresponds to the subjective assessment of the participants. [2] As known from other countries, pedestrians, cyclists, and other (motorized) two wheeled vehicle users are the most endangered road users to sustain accidents and corresponding serious injuries and death. [3],[4],[5] Said this, rickshaw pullers as well as rickshaw users have to be categorized into this "high-risk" group. So far, little is known about injury pattern and characteristics of cycle rickshaw pullers or users.

The study at hand presents new data of 84 patients, which were involved in a road traffic accident related to cycle rickshaws. A predominance of young men was evident with a peak between 20 years and 30 years of age. Crash characteristics were differentiated between single and multiple vehicle crashes. Interestingly, overturned vehicles were predominant in this group. The authors found an overload of the rickshaw in 28.5% which most likely contributes to that type of accidents with cycle rickshaws. In case of multiple vehicle crashes, the majority involved crashes with big vehicles like trucks. During hospital stay, three patients died from traumatic brain injury.

Another study dealing with injuries from cycle rickshaw accidents was performed by Jaiswal et al. [6] In their study, the majority of the participants were children or young adults. The majority of the injuries were soft-tissue injuries mostly due to the chain and the rear sprocket, but a number of fractures were also described. In summary, the authors described injuries related to rickshaws comparable to those of bicycles. The majority of patients travelled on rickshaws in a dangerous way, which also included overloaded rickshaws. The authors concluded that most of the rickshaw related injuries are preventable by restricting the number of persons travelling on cycle rickshaws and application of chain covers on new rickshaws.

Another form of transport, which is popular in Asia including India, is the motorized rickshaw. Although, these vehicles reach higher traffic speeds, motorized rickshaws may serve to compare injury patterns and characteristics to those of cycle rickshaws. A study of Schmucker et al. analyzed these items in a prospective trial. [7] In total, 60% of the reported accidents led to injuries of the rickshaw occupant. Of these the investigators were able to recruit a total of 139 patients including 82 injured motorized rickshaw occupants. Of these patients, 50% had multiple injuries and there was an alarming mortality of 12.2% in that group. This data demonstrates the need of further research to improve traffic safety in these road traffic users.

To compare data of the mentioned studies to other countries, further studies are required, which also include the preclinical management. Particularly, the organization preclinical emergency medicine has to be described and should be analyzed. Based on these data including multivariate analyses, an international comparison to bicycle or motorcycle accidents might be supposable. Possibly, some implemented safety features out of the research performed in accident research units world-wide are transferable to cycle rickshaws in order to improve the safety of this mode of transport.

   References Top

1.Rajvanshi AK. Electric and improved cycle rickshaw as a sustainable transport system for India. Curr Sci 2002;83:6.  Back to cited text no. 1
2.Pradhan CK, Thakur S, Mukherjee AK, Roychowdhury A. Energy expenditure of cycle rickshaw pullers in different places in India. Ergonomics 2008;51:1407-17.  Back to cited text no. 2
3.Juhra C, Wieskötter B, Chu K, Trost L, Weiss U, Messerschmidt M, et al. Bicycle accidents-do we only see the tip of the iceberg? A prospective multi-centre study in a large German city combining medical and police data. Injury 2012;43:2026-34.  Back to cited text no. 3
4.Wick M, Müller EJ, Ekkernkamp A, Muhr G. The motorcyclist: Easy rider or easy victim? An analysis of motorcycle accidents in Germany. Am J Emerg Med 1998;16:320-3.  Back to cited text no. 4
5.Abdulrazzaq H, Zarour A, El-Menyar A, Majid M, Al Thani H, Asim M, et al. Pedestrians: The daily underestimated victims on the road. Int J Inj Contr Saf Promot 2012; Epub ahead of print.  Back to cited text no. 5
6.Jaiswal A, Nigam V, Jain V, Kapoor S, Dhaon BK. Bicycle and cycle rickshaw injury in suburban India. Injury 2006;37:423-7.  Back to cited text no. 6
7.Schmucker U, Dandona R, Kumar GA, Dandona L. Crashes involving motorised rickshaws in urban India: Characteristics and injury patterns. Injury 2011;42:104-11.  Back to cited text no. 7

Correspondence Address:
Christian Zeckey
Department of Trauma, Hannover Medical School, Hannover
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0974-2700.130871

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