Trauma, road

Although road safety has seen significant improvements in many nations over the last half century, there remains much more that could be done. Worldwide in 2004, the number of people killed in road crashes per year was estimated at almost 1.2 million, and the number injured at up to 50 million—the equivalent of five of the world s largest cities (Peden et al., 2004). Recent trends in the rapid motorisation of developing countries, especially in Asia, make it imperative that lessons learned previously in more motorised jurisdictions be communicated effectively in order to minimise road trauma and the associated unnecessary suffering. 

Risk of Road Traffic Injuries for Pedestrians, Cyclists, Car Occupants and Powered Two-Wheel Users, based on a Road Trauma Registry and Travel Surveys, Rhone, France... 

Hospital-based crash data the Rhone road trauma registry... 

This study is among the first in France to study the risk of injury using crash and mobility data [GAB 05, MER 06, BER 11] and comparing road type nsers. This is one of the first studies that compares these risks based on crash data from the medical registry of the Rhone Coimty [LIC 11]. The Rhone road trauma registry is far more complete than the pohce crash data. The medical registry enables us to estimate the rates for various injury categories all-injury, hospitalization and serious-injury (MAIS 3+). 

Part 2 deals with detailed statistical analysis of accident data, in order to identify or understand road safety critical issues and develop accident models. The issue of the evolution of the nnmber of road fatalities in Poland, in relation to economic factors, is presented, along with an analysis aiming to identify the risk of road traffic injuries for pedestrians, cyclists, car occnpants and PTW riders in Rhone, France, based on a road trauma registry and travel snrveys. Fnrthermore, interesting accident prediction models for main rural roads in Hnngaiy are developed, with imminent and obvious practical applications. 

There is myriad empirical evidence confirming the level of both public and official complacency surrounding the public health problem of road trauma. Globally, malaria and road crashes result in about equal numbers of deaths, but the United States, for example, spends about 100 times more of its foreign aid on assisting with global prevention of malaria than it does on crash injury prevention. Globally, for every 1 spent on road crash injury prevention, around 26 is spent on HIV/AIDS. Four times as much is spent on cancer research as on road safety research in the... 

FIGURE 1.1 Touched by the Road Toll bumper sticker. These bumper stickers were introduced by Victoria s injury compensation insurer—the Transport Accident Commission (TAC)—in an attempt to raise awareness of the extent of road trauma. (Courtesy of TAC Australia.)... 

In reality, road trauma is something that cannot be predicted at the individual level we cannot know just who will be involved. For each of us personally, road trauma is unexpected, unpredictable, and life changing. As Mary Schmich famously pointed out in her Chicago Tribune colunm The real troubles in your life are apt to be things that never crossed your worried mind the kind that blindside you at 4 pm on some idle Tuesday. ... 

We have to try to understand why such a high level of road trauma is acceptable within our society if we are to progress beyond incremental improvements in the level of safety within our road and road transport system. 

While it is a tough goal just to limit the growth, it leaves absolutely unaddressed the question of why we are prepared to tolerate massive levels of road trauma now and well into the future. It reinforces our statement in Chapter 1 that we, as communities, accept the principle of collateral damage as the price for universal motorisation. 

For this reason this book focusses on Western motorised nations and the changes we need to make. At the same time, we acknowledge and wholeheartedly support the Decade of Action if motorising nations adapt and adopt the successful measures we have developed, the growth in global road trauma can be slowed. 

Today I ask members to take the moral high ground. I ask members to refuse to accept that death and serious injury are an inevitable result of using our road system they are certainly not acceptable consequences. Towards Zero is our bold new road safety strategy for Western Australia, and its core theme is that we should never accept road trauma as a fact of life. It will challenge us to strive for zero deaths and serious injuries on our roads. °... 

Given this institutional setting, it was logical that the traditional measure of safety should be the number of deaths per unit road travel, an apparently simple measure of how safely the road transport system was operating. This rate measure has almost universally been confined to deaths because that is aU we have been able to count accurately and in a timely manner, despite it being less than 10% of road trauma. 

Measuring the position of road crash disabling injuries and deaths relative to other public health diseases using age-adjusted measures must also be an important adjunct to targets seeking reductions in absolute numbers. Road trauma is a disease related to our lifestyle, and it is time we conceptualised and treated it as such. 

Media reporting of road trauma doesn t help matters, as only deaths are routinely reported, and deaths are merely the tip of the iceberg. There are well over 10 serious injuries for every death, and injuries, as we saw in Chapter 2, have impacts weU beyond the injured person. Occasionally we read of the financial burden of the road toll, but this number—currently in the billions of dollars per annum in Australia— does not resonate with the public, as lobby groups and politicians are continuously quoting big numbers for every cause they want to promote, and most folk have little concept of what billions means. 

BOX 5.1 PRESS RELEASE FOR ROAD TRAUMA REDUCTION STRATEGY... 

Police will use tougher and more targeted enforcanent methods as part of a new strategy to cut road trauma in regional and rural Victoria. 

Acting Premier and Minister for Police (name deleted) launched the three-year Regional Victoria Road Trauma Reduction Strategy with Deputy Commissioner of Victoria Police (name deleted) today. 

Road trauma tears apart the lives of so many families and communities across regional Victoria and it needs to stop, Mr (X) said. 

What this introductory history implies is that there ranains a chasm between the findings from the science and its burgeoning evidence base about the true nature of the myriad problems and effective interventions and what the public and through them, their political leaders are prepared to accept. Such a conclusion is hardly surprising, given what we have seen in previous chapters of the role of the car in modem Western society and of the level of public ignorance about the size of the problem of road trauma. 

We reiterate, however, that it is crucial to understand that antisocial behaviours by a minority of road users account for a relatively small proportion of the aggregate of road trauma. The evidence presented earlier in this section is clear but not widely known. 

When we think of victims of road trauma, we tend to think of people like Jan and Noel, or Sam, or Abbey, people who (as we saw in Chapter 2) have been injured in crashes and who bear the physical and mental scars of their trauma. What we tend to overlook is that many more people are affected by each and every crash. In addition to family and friends, there are the unsung people who respond to road crashes, who are tasked with the job of telling parents that their child will never come home, or who try in vain to keep someone alive despite horrific injuries. For many emergency service personnel, despite it being part of the daily routine in their working life, they are deeply affected. Here are Richard and Kate s stories. 

Richard s story does not start with his role at MCIU, however. It starts when he was a 19-year-old rookie police officer. It was a Sunday morning and he attended a call at a local park. A 2-year-old child had run out between two parked cars and been killed by an oncoming car. The child s mother and aunt had witnessed the child being run over however, the father and uncle were in a different part of the park, and Richard was tasked with accompanying the child s mother to find the rest of the family and break the news. This was Richard s first experience with the devastation that follows road trauma, and to see a family torn apart in a split second is not something he can ever forget. 

What Kate took away most of aU from her experience in the road trauma unit is a sense that life is fickle it can be switched on and it can be switched off in the blink of an eye. And for all the young people that were wheeled through those doors covered in tubes and wires, they will never realise their dreams or become the people they imagined. 

Road trauma is not just about the injured people. It is not just about their families. It is not just about the cost. It is about the community, all the people that are directly and indirectly affected, the nurses, the doctors, the paramedics, the police, the tow truck drivers, the witnesses. In one way or another, we are all victims of road trauma. 

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