Facts of Life
Facts of Life:
Issue Briefings for Health Reporters
Vol. 9, No. 5
May 2004
On the Road to Improving Traffic Safety
The Issue
The Facts
In the Driver's Seat
Expert Sources
References
The Issue:
In 2002,
42,815 people died and 3 million were injured in more than 6 million crashes
on American roads, streets and highways, at a cost of more than $230 billion.
This may seem a huge toll, but the number of fatalities per 100 million vehicle
miles has actually declined steadily for 10 years and is now at an all-time
low. [1] Nevertheless, a focus on driver factors can reduce deaths and injuries
even more.
Dangers of Aging
Drivers?
Some functional
abilities involved in driving, like vision, reaction and cognitive processing
times, decline with age, but older people are generally underrepresented
in crashes. However, they are more likely to die in a crash than the middle-aged
because they are frailer and suffer more chest injuries and medical complications.
[2] Screening and education may help older drivers and their families.
Across-the-board restrictions on all old drivers are inappropriate, says
Jane Stutts, Ph.D., associate director of the University of North Carolina
Highway Safety Research Center. “Regardless of age, what counts is
that driver’s individual capabilities." [3]
There’s no one culprit
making the roads dangerous. The refrain may be familiar, but much of the
death and injury from automobile crashes is still attributable to lack of
seat belt use, alcohol and driver drowsiness and distraction.
The Facts:
- Traffic crashes
are the leading cause of workplace deaths, accounting for 1,347 (23.5 percent)
of civilian worker deaths in 2000, according to the National Institute
for Occupational Safety and Health. More than half of these victims were
not wearing seat belts at the time of the crash. [13]
- Worldwide, 1.26 million people worldwide died as a
result of road traffic injuries in 2000. The economic cost of road
traffic injuries is $518 billion
per year, according to the World Health Organization.[8]
- Roadway
fatalities increase when speed limits are raised. States that raised
limits to 75 mph in 1995-96 recorded 38
percent more deaths than
states that didn’t change their limits. Meanwhile, automakers
have increased the average horsepower of new cars by 65 percent since
1980.
[9]
- Traffic calming measures—speed humps, raised
crosswalks, road narrowing and traffic circles — reduce
speed and injuries. [5]
- Alcohol involvement in fatal crashes fell from
47 percent in 1992 to 41 percent in 2002. [6]
- Only 75 percent of drivers wear seatbelts.
In fatal crashes, 30 percent of occupants not wearing seatbelts
are ejected from the car and 73 percent
of them are killed. But only 1 percent of occupants wearing seatbelts
are ejected in crashes. [11, 14]
- Children should graduate from child safety
seats to belt-positioning booster seats at 40 pounds and
use them until they are 4 feet, 9 inches
tall. Booster seat use reduced injuries to children by 59 percent
compared to seat belts alone. [12]
- Teenagers
drive less than all but the very oldest drivers, but
their numbers of crashes and crash
deaths are disproportionately
high, largely
because of young drivers’ immaturity combined with
driving inexperience. Sixty-one percent of teenage passenger
deaths in 2002 occurred when another
teenager was driving. [10]
- An analysis of randomized controlled
trials found that driver education courses led to earlier
licensing but not to a reduction in road crashes.
A similar analysis found no benefit to post-licensing driver
education. [7]
- Given that “most injuries and
their precipitating events are predictable and preventable,” the
British Medical Journal decided to ban the word “accident.” The
journal editors say that “crash” is
a statement of fact while “accident” draws
a conclusion about cause. [4]
In
the Driver's Seat
Driver
behavior factors such as seat belt use, getting distracted and driving
under the influence of alcohol or while tired play a big part in
motor vehicle safety.
Overall
seat belt use rose to 75 percent nationwide by 2002. Each year, 7,000
lives could be saved if all passengers wore seat belts
all the time, says Bella Dinh-Zarr, Ph.D., M.P.H., director of traffic
safety policy at AAA. “Most people fail to buckle up because
they forget or think it’s inconvenient just for a quick trip
to the store.”
Most
seat belt laws apply only to front-seat passengers. However, when
back-seat
passengers don’t use seat belts, they not only
endanger themselves but can increase risk of death or injury to front
seat passengers by 20 percent. Teenagers have especially high crash
risk but low seat belt use. [15]
Even if they buckle up, drivers too often let their attention wander
from the road. Besides cell phones, drivers get distracted by radios,
DVD players, food, small children and even new computerized navigation
systems installed in some cars, says Mike Goodman, Ph.D., a human engineering
psychologist at the National Highway Traffic Safety Administration.
To understand real-world driving behavior, Goodman has outfitted 100
vehicles with five cameras, a radar system and sensors to measure braking,
steering and acceleration. The resulting data may reveal better ways
to alert a driver before crashes occur. The study is not yet complete,
but Goodman says he is amazed at the many close calls and crashes,
most of which were not reported to the police.
“These are not the kind of things you’d think people would
do if they knew they were being filmed,” he says.
“Both distracted driving and drowsy driving are significantly
underreported, since there’s no objective measure as there is
for blood-alcohol levels,” says Jane Stutts, Ph.D., associate
director of the University of North Carolina Highway Safety Research
Center in Chapel Hill. “People do both all the time, so they
don’t think it’s dangerous.”
Paul
Rau, Ph.D., of NHTSA, tracks drowsiness in truck drivers using an
infrared sensor
that tracks when the driver’s eyelids are
closed.
“When you become drowsy, you underestimate the passage of time,” says
Rau. “Drivers are bad estimators of their level of alertness.
They’ll run off the road before they realize how sleepy they
are.”
Despite gains during the last decade, alcohol still accounts for up
to 40 percent of fatalities each year, Dinh-Zarr says.
“One
third of drivers arrested for [driving while intoxicated] are repeat
offenders,” she says. “And two-thirds of drunk
drivers who died in crashes had 0.15 blood alcohol level, almost twice
the legal limit [.08 in many states] and equal to seven or eight beers
in an hour."
Expert
Sources:
T. Bella Dinh-Zarr, Ph.D., M.P.H.
AAA National Office
(202) 942-2050
dinhzarr@national.aaa.com
National Transportation Safety Board
Elly Martin
Public Information Officer
(202) 366-9550
Elly.Martin@nhtsa.dot.gov
Judith Lee Stone, President
Advocates for Highway and Auto Safety
(202) 408-1711
jstone@saferoads.org
Jane C. Stutts, Ph.D.
Highway Safety Research Center
University of North Carolina
(919) 962-8717
jane_stutts@unc.edu
References
1. National Center
for Statistics and Analysis. Traffic Safety Facts 2002-Overview. National
Highway Traffic Safety Administration. DOT HS 809 612.
2. Insurance Institute for Highway Safety: http://www.iihs.org/safety_facts/fatality_facts/older_people.pdf
3. American Medical Association: http://www.ama-assn.org/ama/pub/category/10791.html
also: Messinger-Rapport BJ. Assessment and counseling of older drivers.
Geriatrics. 2003 Dec;58(12):16-24
4. Davis RM, Pless
B. BMJ bans “accidents”: Accidents
are not unpredictable. BMJ 2001 Jun 2;322:1320-1. Also JAMA, 1999 Aug
4. 281(5)427
5. Institute of Traffic Engineers. http://www.ite.org/traffic/tcdevices.htm
6. Insurance Institute for Highway Safety: http://www.iihs.org/safety_facts/fatality_facts/general.pdf
7. Ker, K., Roberts,
I., et al, Post-license driver education for the prevention of road
traffic
crashes. Cochrane Database Syst Rev.
2003;(3):CD003734. Also: Roberts I, Kwan I, et al. School based driver
education for the prevention of traffic crashes (Cochrane Review).
Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons,
Ltd.
8. United Nations General Assembly. Global road safety crisis. A/58/228.
7 August 2003. English. http://www.unece.org/trans/roadsafe/docs/SG_report_e.pdf
9. Insurance Institute for Highway Safety: http://www.iihs.org/srpdfs/sr3810.pdf
10. Insurance Institute for Highway Safety: http://www.iihs.org/safety_facts/fatality_facts/teenagers.pdf also:
http://www.cfah.org/hbns/news/license11-07-03.cfm
http://www.cfah.org/hbns/news/license12-10-03.cfm
11. Centers for
Disease Control and Prevention. Impact of Primary Laws on Adult Use
of Safety
Belts --- United States, 2002. MMWR. 2004
Apr 2;53(12):257-260 (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5312a2.htm also: USDOT. National Center for Statistics and Analysis: “Traffic
Safety Facts 2002” DOT HS 809 612)
12. Durbin DR, Elliott MR, Winston FK. Belt-Positioning Booster Seats
and Reduction in Risk of Injury Among Children in Vehicle Crashes.
JAMA. 2003;289:2835-2840. Also: www.chop.edu/carseat and http://www.upenn.edu/ldi/issuebrief5_9.pdf
13. Centers for
Disease Control and Prevention. Work-Related Roadway Crashes ---
United States,
1992—2002. MMWR. 2004 Apr 2;53(12):260
http://www.cdc.gov/mmwr/PDF/wk/mm5312.pdf
14. Center for Statistics and Analysis. Traffic Safety Facts 2002-Overview.
National Highway Traffic Safety Administration. DOT HS 809 612. 4
15. Williams AF. McCartt AT, Geary L. Seatbelt use by high school
students. Injury Prevention. 2003 Mar;9(1):25-28
The Center for the Advancement
of Health is an independent nonprofit organization that promotes
greater recognition of how psychological, social, behavioral,
economic and
environmental factors influence health and illness. The Center advocates the highest
quality research and communicates it to the medical community and the public. The
fundamental aim of the Center is to translate into policy and practice the growing body of
evidence that can lead to the improvement and maintenance of the health of individuals and
the public. The Center was founded by the John D. and Catherine T. MacArthur Foundation
and the Nathan Cummings Foundation, which continue to provide core funding. Funding for
this series was provided by the Robert Wood Johnson Foundation.
For Information Contact:
Kristina Campbell
Editor, Health Behavior News Service
Center for the Advancement of Health
2000 Florida Ave., NW, Suite 210
Washington, DC 20009
p. 202.387.2829 / f. 202.387-2857
press@cfah.org
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© Copyright 2004, Center for the Advancement of Health
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