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April 2018, Volume 3, Number 3Research Paper: Investigation of the Accidents Recordedat an Emergency Management Center Using the ParetoChart: A Cross-Sectional Study in Gonabad, Iran, During2014-2016CrossMarkMohammad Hosein Beheshti1, Roohalah Hajizadeh2, Somayeh Farhang Dehghan3, Reza Aghababaei4, Sayed Mohammad Jafari5,Alireza Koohpaei6,7*1. Department of Occupational Health, School of Health, Gonabad University of Medical Sciences, Gonabad, Iran.2. Work Health Research Center, Qom University of Medical Sciences, Qom, Iran.3. Department of Occupational Health Engineering, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.4. Department of Occupational Health Engineering, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran.5. Department of Occupational Health Engineering, School of Medicine, Khatam Al-Nabieen University, Kabul, Afghanistan.6. Department of Occupational Health Engineering, School of Health, Qom University of Medical Sciences, Qom, Iran.7. Occupational Health Research Center, Qom University of Medical Sciences, Qom, Iran.Use your device to scanand read the article onlineCitation: Beheshti MH, Hajizadeh R, Farhang Dehghan S, Aghababaei R, Jafari SM, Koohpaei A. Investigation of the Acci-dents Recorded at an Emergency Management Center Using the Pareto Chart: A Cross-Sectional Study in Gonabad, Iran, During2014-2016. Health in Emergencies and Disasters Quarterly. 2018; 3(3):143-150. https://doi.org/10.29252/NRIP.HDQ.3.3.143:: https://doi.org/10.29252/NRIP.HDQ.3.3.143Article info:Received: 02 Nov. 2017Accepted: 28 Feb. 2018ABSTRACTBackground: This study investigated the accidents recorded at the Gonabad HospitalManagement Center for Hospital Management from 2014 to 2016, and identified importantcauses or parameters that influenced the incidence of accidents using the Pareto chart.Materials and Methods: This descriptive and analytic study examined 25,414 incidentsrecorded at the Gonabad Hospital Management Center. The key variables such as the typesof accident, age, time, types of lesion, and treatment, were collected for transport and nontransport accident. Data analysis was performed using Pareto chart as well as Minitabver v.16and SPSS v.21 software.Keywords:Results: Based on the results, the highest rate of the accidents (39.79%) were among peopleaged between 0-10 years. Transport accidents (17.61%) and heart attacks (10.92%) were themost common that occurred during the study. The spring had the highest rate of accidents,while the winter had the lowest.Pareto charts, Accidentanalysis, Emergency centersConclusion: Transportation accidents had the highest rate of incidents and injuries; therefore,the safety of transportation and vehicles should be taken more seriously.* Corresponding Author:Alireza Koohpaei, PhDAddress: Department of Occupational Health Engineering, School of Health, Qom University of Medical Sciences, Qom, Iran.E-mail: koohpaei19@yahoo.com143

April 2018, Volume 3, Number 31. Introductionoday, government allocates large portionsof resources to accidents and disaster management. Every day media reports various incidents that occur around the world.Climate changes, human handicaps in nature, and rapid technological growth haveincreased the level of human vulnerabilityand the occurrence of accidents [1].TThe statistics show the growth rate of around the worldis causing financial losses and casualties to nations everyyear. In the last decade, nearly one billion people in theworld, about one-sixth of the world’s population, havebeen directly or indirectly affected by the disaster. Iranis one of the countries with the highest casualties. According to the World Health Organization (WHO) annual report, more than 60 million people were injuredin road traffic crashes [2], and most road traffic crashesinvolved youngsters [3]. Road traffic crashes, in addition to physical and mental injuries, cause capital andeconomic losses [4].Millions of people suffer from various types of disabilities due to road traffic crashes every year, which leads tothe loss of active human resources and millions of hoursof useful work [5]. The damage caused by road trafficcrashes in human societies is far greater than the damage caused by diseases such as cancer, cardiovascular disease, Alzheimer’s and AIDS [6]. According to the WHO,worldwide 3.5 million people die every year in an accident. In addition, a huge amount of resources allocatedto the health sector is used to compensate for damagescaused by accidents [7]. In addition to economic loss, thepsychological and emotional impact of accidents on victims and their families is also unforgivable [8]. However,the studies show that 98% accidents can be prevented [9].To examine the conditions in any particular context isthe first step to identifying problems and implementingappropriate and proper planning. Findings from Knightet al. study revealed most of the road traffic deaths involved illiterate men in the age group of group 21-40years [10]. Fam et al. in a research conducted in Tehran, reported that 12.7% victims of traffic accidents weremotorcyclists [11]. Shibata and Fukuda, in its study toinvestigate the risk factors in motor vehicle accidents,reported that driving without license, driving under theinfluence, speeding, riding without helmets and seatbelts are leading causes of death in road traffic crashes[12]. Shankar and Mannering have proposed five levelsfor determining the severity of injuries in a five-year144study of motor vehicle accidents, which include financial losses, probable damage, obvious damage, damageleading to disability and death. They have also stated thatthe severity of injuries depends on factors such as environment, status of the rider, features of the vehicle, andcharacteristics of the driver [13].One of the major problems in the application and implementation of management and engineering measuresis the lack of knowledge about causes and its impact onaccidents. To provide a solution to eliminate or reduceincidents, it is important to identify and investigate thecauses behind them. Therefore, providing reality-basedcontrol strategies is only possible if critical points andfactors affecting the occurrence of accidents are identified. Hence, the allocation of cost-control in a useful andscientific way requires research into accident recordsat government departments and agencies. In the recentyears, relatively a huge amount of money has been spentto control and reduce injuries caused by accidents insideand outside the city. However, there is no significantreduction in the safety and reduction of injuries causedby accidents. The most important reason for this issue isspending costs without taking into account the prioritiesand key factors affecting the occurrence of accidents. Onthe other hand, few studies are being undertaken to identify the causes that contribute to the incidents.In this study, we have tried to investigate the recordsat the Gonabad Medical Accident and Emergency Management Center during the period 2014-2017 in an analytical and descriptive manner using the Pareto chart andidentify the reasons behind the accidents using the Pareto chart, and can propose and implement effective andtargeted control strategies.2. Materials and MethodsThis descriptive-analytic study analyzed records of accidents at the Gonabad Emergency Management Center from 2014 to 2016 using Pareto chart. Pareto chart,named after Italian scientist Wilfred Pareto who observedthat 80% of the wealth is received by 20% of the peoplein Italy. Pareto charts illustrate frequency distribution ofclassified descriptive data. The chart places the class onhorizontal axis and frequencies on the vertical axis. Todraw the Pareto chart, all steps are required to draw acolumn graph. The events are represented in descending order and the cumulative record is represented by theline. By using this method, the area with the maximumproblems (80%) is determined [14].Beheshti MH, et al. Accidents Recorded at an Emergency Management Center Using the Pareto Chart. HDQ. 2018; 3(3):143-150.

April 2018, Volume 3, Number 3After determining the frequency, the chart is drawnbased on frequency and percentage of inclusion. Toachieve frequency, it is necessary to prepare a registration form based on needs and analyze them. Althoughcalculations can be done manually but using the softwareincreases speed and accuracy [14].In this study, we investigated the data during the period of 2014-2016, and other variables such as number of crashes, causes, age and sex of crash victims,time, marital status, type of incident, drugged driving,which is separated for incidents related to transportationand unrelated to transportation. The research receivedethical approval by the Research Ethics Committee ofGonabad University of Medical Sciences (Code of Ethics: IR.GMU.REC.1394.58). Finally, data were analyzedusing the SPSS software version 21 and Excel 2010 withthe help of Minitab v.16 software (Figure 1). The datawere analyzed using the correlation coefficient and logistic regression test at a significant level of 5%.3. ResultsIn this study, 25414 incidents, recorded at the Emergency Management Center of Gonabad city, Iran, wereinvestigated. The type of accident and age group areshown in Figure 2. Based on the findings of this study,the highest rate of the accidents (39.79%) was observedfor individuals aged between 0-10 years. In addition,62.3% of the victims were in the age group of 40-55,55-75, and 0-10 years. It was observed that the cardiovascular events and blood pressure were the most common incidents. The transportation-related accidents andcardiovascular events were 16% and 10%, respectively.Figure 3 shows the Pareto chart of transport accidentsbased on the type of vehicle, and Pareto chart for transportation accidents on the basis of injured people. According to the Pareto charts, more than 90% accidentsare related to motorcycles and cars. The analysis of theinured people in transportation accidents indicates thatthe highest percentage of injuries was related to the driver, passengers and pedestrians.The treatment of the injured people and the outcome ofthe mission are shown in Figure 4. Among the adoptedtherapeutic measures, prescription of medications wasthe highest at the 39.4%. The outcome of the missions ofthe emergency center is often different. After categorizing these results and analyzing them, it was observed that46.6% of the mission results in the transfer of injured tothe health centers. Outpatients were ranked second with32.8% of the mission’s results. Other accidents recordedin the emergency management center were poisoningand burns. The causes of burns were divided into several categories; nearly 80% (76.4%) burns were causedby hot and flammable liquids. Food, medicine and drugcaused more than 80% of poisoning incidences. Paretochart about the type of poisoning and burn incidents areshown in Figure 5.Figure 1. Using the Minitab software to draw Pareto chartsBeheshti MH, et al. Accidents Recorded at an Emergency Management Center Using the Pareto Chart. HDQ. 2018; 3(3):143-150.145