Serious Road Traffic Injuries a perspective for Europe

Transcription

1 Serious Road Traffic Injuries a perspective for Europe Prof. Fred Wegman SWOV Institute for Road Safety Research and Delft University of Technology Ireland EU Presidency 28 March

2 .. and you, dear Tonio, I would rather not have written a requiem for you.. Libris Literatuurprijs 2012 NS Publieksprijs 2012,, All registers that belong to death and mourning, are played in a superior manner : from announcement and reconcilliation, from anger and resistance to acceptance. In the final chorus of this symphony of death even hope sounds through, no matter how merciless this seems in the light of previous events. Ireland EU Presidency 28 March

3 Human tragedies Ireland EU Presidency 28 March

4 Topics to cover Impacts of road crashes Trends in numbers of fatal and injury crashes Comparing the nature of fatal and injury crashes Reporting on serious road traffic injuries Conclusions and recommendations Ireland EU Presidency 28 March

5 Road crashes: the true scope and impacts Threat to life (threat of) Disability Quality of life Costs to individuals Hidden costs Costs partly compensated by insurances Costs to society Burden to health system Socio-economic costs Affecting deprived persons, the poor, breadwinner Leading cause of death/injury in younger age groups Ireland EU Presidency 28 March

6 Concensus on cost categories and valuation methods of road crashes Cost categories Medical costs Production loss Loss of quality of life Property damage Settlement costs 1-3% of GDP Although different methods/procedures are used, complicating international comparisons Information become meaningful when comparing with Ireland EU Presidency 28 March

7 Cost of road crashes in the Netherlands (2009) Consequences Billion of euro s Percentage (%) Fatal 2 15 Injuries 7 52 Damage only 4 33 Total Ireland EU Presidency 28 March

8 When it comes to injury crashes Quite a proportion of road crash costs are injuryrelated (NL > 50%) Quite a number of countries set targets for (serious) injuries and develop their own definitions However, injury crashes are underreported in official (police) statistics and costs of these crashes are underestimated Ireland EU Presidency 28 March

9 Injuries in official road crash statistics Statistics on medically treated injuries is incomplete Police reported statistics on injuries are incomplete, inaccurate and biased Injuries are misclassified by severity Underreporting (seriousness, transport mode, e.g. bicycle) Level of reporting varies between countries, so not comparable Definitions of injuries vary between countries and are not comparable Ireland EU Presidency 28 March

10 Injury severity: medical impacts Abbreviated Injury Scale (AIS) or the Maximum AIS (MAIS): life-threatening injuries (IRTAD recommends: use MAIS3+) However, long-term, and non-medical impacts are not included Brain, extremities, spinal cord injuries Loss of function Psychological impacts, e.g. post-traumatic stress disorder No instrument to evaluate this outcome is available Ireland EU Presidency 28 March

11 Long-term impacts of traffic injuries A white spot on the map (ETSC, 2007) Burden of injury Psychological impacts Job loss associated with long leaves Impacts on (income of) families Impacts of being prosecuted for negligence or even manslaughter It is recommended to create the true/full scope of impacts of injuries incl. long-term impacts by further (international) research; EU: Horizon 2020 Ireland EU Presidency 28 March

12 Reduction in number of injury and fatal crashes (IRTAD) Evolution in the number of fatality and injury crashes for 22 OECD countries Fatalities Injury crashes Ireland EU Presidency 28 March

13 Trends in the number of fatal and injury crashes in 4 countries (IRTAD, 2012) Ireland EU Presidency 28 March

14 Why do the developments of injury crashes and fatal crashes differ? Changes in reporting practices over time? Improvement of crash-worthiness of motorvehicles? Lower driving/impact speeds (Nilsson s power law!) Better trauma care? Or. I invite EC countries to study the wedge And I propose to carry out SUNflower-comparisons using data on serious injuries Ireland EU Presidency 28 March

15 Implications for strategies and research (If we assume implementation of road safety strategies had an impact, and if we assume reporting practices remained unchanged) Obviously, road safety strategies that were successful to reduce the number of fatalities, don t have the same effects on the number of injuries So, strategies to reduce (serious) injuries shoud be different than strategies to reduce fatalities So, ex-ante and ex-post research should differentiate between fatalities and injuries Ireland EU Presidency 28 March

16 Ireland EU Presidency 28 March

17 Research from South Australia Data source Extreme behaviour (%) Illegal system failure (%) System failure (%) Fatal crashes 2008 Non-fatal metropolitan injuries Non-fatal rural crashes % Lisa Wundersitz & Matthew Baldock: The relative contribution of system failures and extreme behaviour in South Australian crashes (2011) Ireland EU Presidency 28 March

18 Comparing fatal and injury crashes Fatal crashes and injury crashes are not telling the same story Fatal crashes are not telling the whole story It seems to be a wrong assumption to expect a reduction in injuries if reducing fatalities To reduce injury crashes requires another strategy than to reduce fatal crashes Ireland EU Presidency 28 March

19 IRTAD Group reported on serious injuries in 2011 Ireland EU Presidency 28 March

20 Reflects the state of the art in IRTAD member states Availability on information sources Definitions of serious injuries Methodologies used to link several sources of data Police and hospital data Ireland EU Presidency 28 March

21 Different definitions of serious injuries The length of hospitalizations The type of injuries The inability to work The length of discovery Long term disability Ireland EU Presidency 28 March

22 IRTAD recommendations Complement police data with hospital data Medics to assess severity of injuries, not police Classify injuries to international standards Use Maximum Abbreviated Injury Scale (MAIS) Link police and hospital data Methods for linking data exist (deterministic and probabilistic) Agree an international definition of serious injuries for research and benchmarking: Define seriously injured road casualty as injuries assessed at level 3 or more on the Maximum Abbreviated Injury Scale MAIS3+ Ireland EU Presidency 28 March

23 Conclusions Road safety strategies, research and data collection focused too much on fatalities, and overlooked injuries We have a poor understanding of the (long term) impacts of injuries; for victims, families and society Greater emphasis on road traffic injuries in road safety strategies and research is justified Strategies to reduce the number of fatalities were not equally effective for reducing number of injuries Ireland EU Presidency 28 March

24 Recommendations To serve policy making and research the completeness and accuracy of road crash injury statistics should be improved All (long term) impacts of injuries should be better documented International organizations (WHO, UNECE, OECD/IRTAD, EU, etc.) are invited to join forces to set standards for road crash injury statistics Strategies to reduce the number of (serious) injuries should be developed, next to strategies to reduce the number of fatalities Ireland EU Presidency 28 March