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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]

Behavioral Issues

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
http://www.cfah.org

© Copyright 2004, Center for the Advancement of Health

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