CHAPTER 1

IMPORTANCE OF ROAD TRAFFIC ACCIDENTS

Mortality and morbidity from road traffic accidents assume greater importance as a country
becomes more highly developed—partly because of the increase in numbers of accidents, but also
because their relative importance increases as mortality and morbidity from other causes, such as
infective and parasitic diseases, decline. Countries and territories with currently low rates of road traffic
accidents, and in which motorization is beginning to expand, have the opportunity to learn from the
tragic experience of countries already highly motorized.

HUMAN LOSS

The size of the problem is indicated by the fact that, in 1957, in the 47 Member States of the
World Health Organization that completed separate returns for motor vehicle accidents (Group BE47),
102.552 people (79.810 of them males), in a total population of some 650 million, were killed in such
accidents (World Health Organization, 1960). No records are available of the much larger numbers who
were injured, many of them seriously and some permanently crippled or disabled. The present position is
that well over 100.000 people are killed in road traffic accidents in the world annually and this number is
increasing. The situation arises from man’s own activities and amounts to the casualties of a moderate-
scale war—every year.

The tragedy of road traffic accidents is that they particularly involve the young, perhaps the
young and adventurous. Males aged 15-30 are especially involved; fatal accidents in this group represent
not only tragic family losses but also a serious economic loss to the community, for their education and
training have been wasted. In highly motorized countries, road traffic accidents are the commonest cause
of death in this group. The total of potentially active and productive years of life lost through such
accidents is enormous. Harris (1955) estimated that in Canada, among those children who reach their first
birthday and who would normally survive to the present life expectancy of 70 years, the loss from road
traffic accidents each year is more than 105.000 years of normal life expectancy. The estimated man-
years lost in the United States in 1955 by persons aged 20-29 from motor vehicle accidents, compared
with certain other causes, are given in Table 1. Among these young people, motor vehicle accidents
account for a greater loss of potential life than any other single cause.
 The pattern of mortality from infectious and certain other diseases and from road traffic accidents
is striking. Table 2 puts the mortality from such accidents and certain other causes into perspective and
calls attention to the fact that in Canada, the United States, Austria, the Netherlands, Australia, and New
Zealand, deaths from motor vehicle accidents in males in 1958 exceeded those due to tuberculosis (all
forms), acute poliomyelitis, typhoid fever, diphtheria, and diabetes mellitus added together. Among
females in these countries fatal road traffic accidents were fewer but were still prominent among the
causes of death. It is evident that as a country becomes more highly developed and therefore more highly
motorized, road traffic accidents assume an increasingly important part in national mortality.

Loss of life from road traffic accidents has increased to such an extent that in highly developed
countries such accidental deaths exceed the combined deaths from all infectious and communicable
diseases: in the United States in 1957, deaths at all ages from all infectious and communicable diseases
were 24 256; those from road traffic accidents were 38,702 (World Health Organization, 1960).
 The death rates per 100000 population again reveal the major importance of road traffic
accidents. The high death rates from such accidents compared with certain other causes, in males aged
20-24, in a group of highly motorized countries are shown in Table 3.
 In
the
total
field of
health, not
only

mortality must be considered, but also the temporary and permanent incapacity resulting from road traffic
accidents. For example, in Britain for every person killed there are 10-15 seriously injured and 30-40 who
receive minor injuries (Great Britain, Ministry of Trans-port and Civil Aviation, 1960), and in the United
States there are 35-40 persons disabled beyond the day of the accident for every death (National Safety
Council, 1960).

ECONOMIC LOSS

In addition to the pain and suffering caused and the tragedy of death or permanent disability, a
serious economic loss to the community arises from road traffic accidents. This is due to the actual costs
of medical and surgical treatment, which tend to increase as techniques advance; to the loss of the
services of the injured person; and to damage to property. The fact that many accident victims are in the
younger age groups implies an enormous loss to the productive resources of a country. The American
Medical Association found in a survey in 1955, for example, that accident cases of all kinds occupied 7
per cent of the total available beds in general and special hospitals, excluding mental and tuberculosis
hospitals; the average hospital stay for each patient was 10.7 days; the actual cost of treatment of accident
cases was estimated at $310.565.000. In the United States, the National Safety Council (1958) estimated
that road traffic accidents caused wage losses of $1.550.000. 000, property damage of $1.850.000.000,
medical expenses of $150.000.000, and overhead costs of insurance of $1.750.000.000. These direct
costs, omitting loss of production, amounted to some $5.300.000. 000. In Japan (Japanese Police Board,
1954) the cost of property damage alone due to road traffic accidents in 1954 was 2.019.000.000 yen.
(About 1000 yen equals one poundsterling.) According to Trafik Kazarli 1957 (Turkey, Nafia Vekaleti,
1959) the cost of property damage due to road traffic accidents in Turkey in 1957 was 5.383.800 Turkish
lire. (About 25 Turkish lire equals one poundsterling.)

But we are here concerned with health; and it is clear from what has been written above that road
traffic accidents now constitute a public health problem of the first magnitude. It is a problem that appears
likely to increase still further.