Road Trauma

The road trauma epidemic in the United States continues without letup and accounts for over 34,000 deaths and 4.6 million people seriously injured each year. Why do we accept this unacceptable epidemic, as a similar morbidity and mortality rate from a medical epidemic would demand and get the nation’s attention and resources until it was over? Indeed, road trauma deaths exceed the disastrous and unacceptable firearm deaths.

A look back at the various measures to reduce road trauma finds that they can be grouped under two headings:

The first group contains measures to reduce the number and severity of the injuries sustained during the accident, such as restraints, air bags, steering wheel and interior design, vehicle design with crumples zones and body design, gas tank location, safety glass; and of course, steps to improve the management of road trauma injuries such as helicopter evacuation and advances in trauma care at trauma centers. Those mechanical measures can be demonstrated during the crash tests to which we all pay attention.

Perhaps all this to say quite rightly— “Accidents are going to happen. Let’s reduce the number and severity of the injuries.”

Or: “People are going to fall off the cliff, so let’s make a softer, safer landing and have an ambulance waiting there.” A very worthwhile idea.

The second group contains measures attempting to prevent the accident occurring in the first place, such as road design, better brakes, vehicle stability control, speed limits, driver instruction, reducing driver distraction, blood alcohol and drug monitoring, camera warning systems and vehicle lighting and warning systems. The long road to safe driver-less cars highlights this approach.

While we wait, I suggest adding a rather simple measure of a “Coasting Warning System” (CWS) to alert drivers that the vehicle in front is coasting and therefore slowing as soon as its driver has taken his/her foot off the accelerator, and before applying the brakes. The interval between taking their foot off the accelerator and applying the brakes is small, but at 75 mph, each second accounts for distance travelled of 132 feet.

However, this goal of reducing or preventing accidents is similar to the cliff metaphor:

“Let’s build a fence to prevent people falling off the cliff in first place.” Maybe an even better idea as “Prevention is better than cure.”

Let’s continue and further develop all these measures as we all continue to reduce the number and severity of road accidents.


-Anthony Dwyer, M.D.

(The opinions stated in this blog are those of the author Dr. Anthony Dwyer and not necessarily those of the American College of Spine Surgery).

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