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Monday, 8 August 2011

Motor Vehicles Collisions – A risk we live with.

Motor Vehicles Collisions – A risk we live with.
The death rate from Motor vehicle collisions (MVCs) has declined about 50% since 1980 Canadian motor vehicle deaths 1980-2005 by gender .  A success of  numerous activities from better road and vehicle construction, improved driving performance, and higher gas prices resulting in lower vehicle use. 
Looking at hospital admissions over a shorter space of time of only 10 years, the reduction is about 35% MVC hospital admissions 1995-2005 .  
The improvement in young male drivers is even more pronounced MVC deaths 15-24 year olds by gender 1980-2005.   The PHAC injury surveillance site can be used to explore more.  These graphs represent rates and not absolute numbers.   The good news is that absolute numbers of deaths have decreased about 40% from 1990-2009, hospitalizations by 56%, and any injury by 34%.     If we looked at Transport Canada collision statistics there is some information on numbers of collisions to compare the trends in injuries and fatalities.  Between 1988 and 1997, the number of collisions decreased 22%. Roughly ¾ of collisions are property damage only, ¼ involve injuries and only 1 in 200 result in a fatality.
There may be a debate as to why. The success of interventions directed at engineering solutions and at driving performance should be celebrated for the large reduction in both deaths and hospitalizations Driving performance related improvements in Canada include a downward trending in the proportion of  MVCs deaths that are alcohol related, graduated licensing that restricts and protects new drivers,  and possibly driver education. Seat belts, air bags and engineered passenger spaces (reinforced sections of vehicle) are major contributors to reduction in severity of injury when a collision occurs. Road design though better intersection design, turning lanes, divided highways, and rumble strips are further engineering successes.
There are another three groups that likely would claim a share in the reductions; Emergency responsers, trauma management specialists and, enforcement agencies.   Had better care and emergency service contributed to the reduction in deaths, one would have expected less of a reduction  in hospital admissions as injured persons would still require hospitalization.  So the major improvements are in reductions in the numbers of persons being injured, particularly with more severe injuries. On the enforcement end, it is on the continuum of education activities that ultimately contribute to better prevention, but only a small fraction of persons committing a traffic offense will be caught and penalized.
In the end, half of the reduction is achieved through a reduction in collisions, most of the remainder of the reduction is in the severity of injury at the time of a collision.  That is,  injuries are less likely to be severe when a collision occurred. 
Kudos to Transport Canada who have issued a good comprehensive overview of motor vehicle safety for the Canada Year of Road Safety Road Safety in Canada 2011 as part of the UN Decade of Action on Road Safety
There is a long way to go to making motor vehicles less risky and safer.  But, where are the public health, transportation advocates and design engineers in celebrating the huge successes which they have achieved?  Some days I get the impression that the reduction is due to emergency air transport systems, trauma teams and high tech emergency intervention.  The data just don’t support it, but our pocket books do. 

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