Law-enforcement could substantially reduce fatal traffic crashes

June 26, 2003

Canadian research published in this week's issue of THE LANCET highlights how the consistent implementation of traffic laws could reduce the 3000 daily deaths worldwide from road-traffic crashes. The key finding from the study shows that conviction for driving offences could reduce the risk of the same driver being involved in a fatal road crash in the following month by around 35%.

One million people worldwide die in road-traffic collisions every year; a further 25 million people are permanently disabled. Few data exist about the effect of traffic-law enforcement-a popular belief is that such enforcement can actually increase crashes as drivers are more preoccupied with the whereabouts of traffic police than with hazards on the road.

Donald Redelmeier from Sunnybrook and Women's hospital, Toronto, Canada, and colleagues prospectively studied traffic statistics over 11 years (1988-1999) in Ontario, Canada, an area with around 6.8 million drivers. 8975 licensed drivers had fatal crashes during the study period. 21 501 driving convictions were recorded for all drivers from the date of obtaining a full licence to the date of fatal crash, equivalent to about one conviction per driver every 5 years.

The risk of a fatal crash in the month after a conviction was about 35% lower than in a comparable month with no conviction for the same driver-however this reduction in risk declined after one month and was not statistically significant for a reduction in fatal crashes three or more months after a driving conviction.

The reduction in risk of fatal accidents was not influenced by the severity of the original conviction, but the awarding of penalty points for driving convictions reduced the risk of fatal crashes more than convictions without penalty points.

Donald Redelmeier comments: "Our data suggest that about one death is prevented for every 80 000 convictions, one emergency department visit for every 1300 convictions (assuming the benefits apply to crashes of all severity), and $1000 in societal costs for every 13 convictions (including property damage and lost time). The observed 35% relative risk reduction in death is greater in magnitude than the roughly 20% relative risk reduction from all mandatory vehicle improvements of the past 50 years, yet enforcement effects are transient. Policies of more frequent enforcement could yield more net savings and could also be revenue neutral if designed efficiently. A small relative risk reduction could immediately prevent a large amount of death, disability, and health-care demands."

In an accompanying Commentary (p 2168), Mark McCarthy from the University of London, UK, states how future campaigns are being planned to address the effect of road crashes on public health. He comments: 'In Europe, WHO member states signed a Declaration on Transport and Health in London in 1999, and will report on progress at the fourth Ministerial Conference on Environment and Health in Budapest in June, 2004. Recognising the challenge of road deaths specifically, WHO has designated World Health Day in 2004 with the theme of "safe roads". The world report on prevention of road-traffic injury, to be published at the same time, will call for increased and sustained action in policy, programmes, funding, and research. As road deaths rise up the global burden of disease, interventions for prevention are also rising up the international health-policy agenda.'
-end-
Contact: Dr. Donald Redelmeier, Sunnybrook & Women's Hospital, G-151, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada; T)+ 1-416-480- 6999; F)+ 1-416-480-6048; E) dar@ices.on.ca.

Lancet

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