Hawaii Pacific GIS Conference 2012: GIS for Environmental, Community and Public Health - Mapping...
-
Upload
hawaii-geographic-information-coordinating-council -
Category
Technology
-
view
262 -
download
0
Transcript of Hawaii Pacific GIS Conference 2012: GIS for Environmental, Community and Public Health - Mapping...
Mapping Motor Vehicle Crashes in Hawaii:
GIS applications for injury prevention
Dan Galanis
EMS & Injury Prevention System Branch
Hawaii Department of Health
Overview of presentation
Overview of injuries
Importance of GIS for prevention of motor vehicle crashes and drownings
GIS applications in prevention of injuries from motor vehicle crashes
North Hawaii Outcomes Project • Mapping of fatal crashes on Big Island
Hawaii Emergency Medical Services Information System (HEMSIS)
• Mapping of all motor vehicle crashes on Oahu
Drownings in the state
…are the 4th leading cause of death in Hawaii (>700 per year) …the leading cause of death for ages 1 to 40;
more than all other diseases combined
…cause ~14% of all hospitalizations in Hawaii
…cause ~88,000 emergency department visits a year
…account for 33% of EMS emergency calls …~35,000 calls per year
…ARE PREVENTABLE
Injuries…
Causes of fatal injuries in Hawaii, 2006-2010
injury-other
undetermined intent
machinery
natural/environmental
fire/burn
mvc*-bicyclist
other-transport
assault
mvc*-pedestrian
mvc*-motorcyclist
suffocation
drowning
mvc*-occupant
poisoning
falls
suicide
33 (4%)
66 (9%)
2 (0%)
2 (0%)
4 (1%)
4 (1%)
6 (1%)
25 (4%)
29 (4%)
31 (4%)
32 (4%)
64 (9%)
73 (10%)
90 (12%)
108 (15%)
155
(21%)
0 50 100 150
annual number (% of total)
seniors: 84 (12%)
Leading Causes of Injury Mortality and Morbidity
among Hawaii residents, 2006-2010
Fatal injuries
Hospitalizations
EMS calls
1 Suicide 155 21% Falls 2,674 49% Falls 10,112 35%
2 Falls 108 15% Car occupant 471 9% Car occupant 5,332 18%
3 Poisoning 90 12% Suicide
attempt
378 7% Assault 3,440 12%
4 Car occupant 73 10% Assault 302 6% Poisoning 2,073 7%
5 Drowning 64 9% Motorcyclist
277 5% Struck by
object
1,201 4%
North Hawaii Outcomes Project
Started efforts at motor vehicle crash reduction in 2001, given high fatality rates in Hawaii County
• 1st step was to identify locations of fatal crashes
• Later published poster-sized maps, distributed to:
All middle and high schools, police stations, health facilites, etc. Highlighting prevalence of drunk driving
• Also shared with media to increase awareness
• Web site: www.nhop.org
HEMSIS data (EMS reports)
Advantages: Real time, detail on mode (car occupant vs. motocyclist vs. pedestrian, etc.), protective factors (seat belts, helments), substance use, and street address/site of crash
Problem is data entry/errors vs. geocoding:
• "H1 WEST EAST OF LUNALILO OFF"
• "swanzy beach park"
• "91-1000 GEIGER RD."
• "Frntg Waianae McDonalds 85-726 farrington hwy"
• "879 Honalua St Hobo, HI 96826"
Solution was to obtain 911 dispatch data from City & County
• CAD interface captures 911 caller's latitude and longitude
• Re-merge with larger EMS database
EMS-attended injuries from motor vehicle crashes on Oahu, 2007-2010
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
# #
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
##
##
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
#
##
#
##
#
#
#
#
#
##
#
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
## #
##
#
#
#
#
#
#
#
#
#
#
#
##
##
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
##
#
#
#
# #
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# ##
#
#
#
#
#
##
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
###
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
##
###
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
## #
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
###
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
# #
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
##
#
#
##
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
##
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
# #
#
#
#
#
#
##
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
##
#
#
#
#
#
#
#
###
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
###
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# ##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#### #
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
#
# #
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
## #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
###
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
##
#
#
#
#
# #
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
# ##
#
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
##
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
###
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
# #
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
# #
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
# ##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
###
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
##
##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
##
# ##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
##
##
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
# # #
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
#
##
#
#
## #
# #
#
#
#
##
#
#
#
#
#
#
#
#
###
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
# #
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
##
#
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
# #
#
#
#
#
#
#
#
##
#
#
#
#
#
#
# ##
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
###
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
## #
#
#
#
#
#
#
#
#
# ##
#
#
#
#
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
#
#
#
# #
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
##
#
#
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
# #
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
##
#
#
#
##
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
##
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
# #
#
#
#
#
#
#
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
# ##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
##
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
##
##
#
#
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
##
#
#
#
#
# #
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
###
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
##
#
#
# #
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
## #
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
# ##
#
#
# #
#
#
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
## #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
##
#
# ##
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
###
#
##
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
## #
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
###
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
###
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
# ##
# #
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
# #
#
#
#
##
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
# ##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
##
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
##
##
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
##
##
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
##
#
#
#
#
#
##
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
##
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
###
#
#
##
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
###
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
# #
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
###
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
# #
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
## #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
##
#
#
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
#
##
#
#
#
#
#
#
#
# ##
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
## #
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
# ##
#
#
#
#
#
###
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
##
#
#
#
##
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
##
#
#
#
##
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
## #
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# ##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
####
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
###
##
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
###
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
# ##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
Waianae (593)
North Shore (435)
Pearl City (703)
Makakilo/Kapolei (605)
Airport (449)
Koolauloa (208)
Wahiawa (418)
Aiea (542)
Waipahu (755)
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# ##
##
#
#
#
# #
# #
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
##
#
#
##
#
#
#
#
#
#
#
#
#
#
## #
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
# #
#
#
##
#
##
#
#
##
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
# #
#
# #
#
#
#
#
#
##
#
##
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
## #
#
#
#
#
#
#
#
##
#
#
#
# #
##
#
#
#
#
#
#
#
# #
#
##
#
##
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
## #
#
#
#
#
##
#
#
#
#
##
#
# #
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
###
#
# # #
#
#
#
#
#
#
#
##
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
##
#
#
#
## #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
###
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
###
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# ##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
##
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
##
#
#
#
#
# #
#
#
#
##
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
##
#
#
#
#
#
#
#
#
# # #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
# ##
#
#
#
#
##
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
# #
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
###
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
# #
#
#
#
#
# #
# #
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
##
#
#
#
#
#
#
# #
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
# #
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
##
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
###
##
#
#
#
#
#
#
#
#
#
# #
#
#
#
###
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
##
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
##
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
###
#
#
#
#
#
#
#
#
#
#
#
#
#
# #
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
##
##
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
##
#
#
#
#
#
#
#
#
#
#
##
#
#
#
##
#
#
#
##
#
#
#
#
#
#
#
#
#
#
#
#
#
#
#
## #
#
# #
#
#
#
#
Kalihi-Palama (857)
Downtown (509)
Ala Moana (560)
Number of crashes per district
low (0 - 150 crashes)
medium (151 - 400)
high (410 - 1100)
Motor vehicle crashes, by type
car crash#
moped#
motorcycle#
School-based pedestrian safety initiative (School Traffic Safety Committee of the
City and County of Honolulu, Department of Transportation Services)
• Using HEMSIS data to
map ped/bicyclist
injuries
• Locate prime areas for
"ped heads" and
flashing red lights
– 100-300 safety
devices
• Implementation
~September, 2011
Applications of HEMSIS maps
DTS School Traffic Safety Committee
Complete Streets Coalition • Used for Neighborhood Board presentations in support
of Complete Streets Ordinance
10 Neighborhood Boards, 7 City Council members
Safe Routes to School, managed by Hawaii State DOT • Used for review of RFP's
• Supported SRTS 2012 application from UH
%U
%U
%U
%U
%U
%U
%U
%U
%U
#S
#S
#
#
#
#
#
#
#S
#S
#S
#S#S
#S
##
#
# #S#
#
#
#
#S
#S#S
#S
##
#
#S
#S
##
#
##
#
#
#
#S
#S
#
#
#
#S
#S #S
#S
#S
#S
#S
#
#
#
#
#S
#S#S
#S#
#
##
#S#S
#
#
#S#S
#S
#S
#S
#S
#
#
#
#
#S #S#S
KauaiKauai
Lifeguard towers%U
Ocean drownings, by season
April - September#
October - March#SNorth Shore (Polihale-Lighthouse): 35
-23 (63%) from Oct-March
East Shore (Larsens - Lihue): 23 -14 (61%) from April-Sept.
South Shore (Kekaha-Poipu): 23 -15 (65%) from April-Sept.
Seasonality
%U
%U
%U
%U%U%U%U
%U
%U
%U
#
#
#S#
#S
#S
#
#S
#S
#S
#S
#S
#
#
#S
#S
#S
#
#S
#S
#S
#
##
#S#
#S
#S
#S
#S
#S
#S
#
#S
#S
#
#S
#
#S
#S
#
#
#
#
#S
#
##S
#S
#
#S
#
#S
#S
#
#
#S#S
#
#S
##
#
#
#S
#
#
#
#
#
#S
#S
#S
#S
#
#S
#S
#
#S
#
#S
#
#S
#S#S
#
#S
#S
#
#S
#
#
#S#
#S
#S
#S
#S
Lifeguard towers%U
HawaiiOcean drownings, by victim residence
non-resident#
Hawaii resident#S
west coast
(Mauna Kea-Milolii): -32 of 50 (64%) victims non-residents
south and windward coasts: -33 of 40 (83%) victims non-residents
Residence
Summary and next steps
GIS an important component of injury prevention
• Best applications in motor vehicle safety and ocean safety
Next steps • Expand HEMSIS geocoding capability to Neighbor Islands
• Produce crash atlases
Acknowledgements
• Dr. Sharon Vitousek & staff, NHOP
• Chief Wayne Kruse & staff, City & County of Honolulu EMS
• Dr. Linda Rosen and staff, Hawaii State EMS, DOH
• Kari Benes, Injury Prevention Program, DOH
EMS-attended injuries from motor vehicle crashes
on Neighbor Islands, by district, 2007-2010
South
Kohala (413)
North
Kona (1014)
South
Hilo (943)
Puna (742)
Kau (230)
Kawaihau (216)
Lihue (280)
Lahaina (397)
Wailuku (1044)
Makawao (515)
Number of crashes per district
low (0 - 150 crashes)
medium (151 - 400)
high (410 - 1100)
Causes of fatal injuries among Hawaii residents, 2006-2010
Rank
infants
(543)
1-9 y
(128)
10-19 y
(245)
20-29 y
(613)
30-39 y
(944)
40-64 y
(9,777)
65+ y
(34,639)
all ages
(46,889)
1
perinatal
conditions
298
unintent.
injuries
38
unintent.
injuries
96
unintent.
injuries
248
unintent.
injuries
216
cancer
3,154
heart
diseases
8,865
heart
diseases
11,145
2
congenital
anomalies
74
cancer
15
suicide
51
suicide
123
cancer
151
heart
diseases
2,091
cancer
7,440
cancer
10,835
3
unintent.
injuries
24
congenital
anomalies
8
cancer
26
cancer
48
heart
diseases
128
unintent.
injuries
712
CVD
2,624
CVD
3,157
4
respiratory
disease
9
homicide
7
congenital
anomalies
14
heart
diseases
45
suicide
125
CVD
488
CLRD*
1,264
unintent.
injuries
2,102
5
septicemia
7
heart
disease
6
homicide
8
injuries of
und. intent
33
CVD
34
diabetes
346
influenza/
pneumonia
1,122
CLRD*
1,461