V"OL"V"O This book was sponsored by VOLVO AB and the Swedish Foundation of Neurotrauma Springer Berlin Heidelberg New York Barcelona Hong Kong London Milan Paris Singapore Tokyo o Hans von Holst · Ake Nygren o Ake E. Andersson (Eds.) Transportation, Traffic Safety and Health - Prevention and Health Third International Conference, Washington, U.S.A, 1997 With 25 Figures and 21 Tables ==:::" ~P' ..",.. ~ Karolinska Institute Royal Institute of Technology WHO Collaborating Center for Neurotrauma Institute for Futures Studies Springer Volvo Prof. Hans von Holst, Royal Institute of Technology, Department of Aeronautics, 10044 Stockholm, Sweden Prof. Ake Nygren, Karolinska Institute, Department of Injury Prevention, Hantverkargatan 5, 11296 Stockholm, Sweden Prof. Ake E. Andersson, Royal Institute of Technology, Department of Infrastructure, 10044 Stockholm, Sweden ISBN 978-3-642-63162-7 ISBN 978-3-642-57246-3 (eBook) DOI 10.1007/978-3-642-57246-3 Cataloging-in-Publication Data applied for Die Deutsche Bibliothek - CIP-Einheitsaufnahme Prevention and health: Washington, USA, 1997; with 21 tables 1 Karolinska Institute ... Hans von Holst ... (ed.). - Berlin; Heidelberg; New York; Barcelona; Hong Kong; London; Milan; Paris; Singapore; Tokyo: Springer, 2000 (Transportation, traffic safety and health; 3) This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on mi crofilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permis sion for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under the German Copyright Law. Springer-Verlag is a company in the BerteismannSpringer publishing group. © Springer-Verlag Berlin· Heidelberg 2000 The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Hardcover-Design: Erich Kirchner, Heidelberg SPIN 10724046 42/2202-5 4 3 2 I 0 - Printed on acid-free paper PREFACE Rodney E. Slater Secretary of Transportation, U. S. Department of Transportation I know many of you have traveled great distances to be here. To me, that shows not only your dedication to the cause, but demonstrates how very important transportation safety is becoming throughout the world. So I am very thankful to the main organizers of this third annual conference -- all of whom are from Sweden: Dr. Hans von Holst of the Royal Institute of Technology; Dr. Ake Nygren of the Karolinska Institute; Dr. Ake E. Andersson of the Institute for Futures Studies; and finally, Dr. Arne Witt16v and Lars Anell from AB Volvo. And let me give a special welcome to our friends from Africa. I will be visiting a number of African nations in January. And while my main mission is to promote trade and investment with the United States, we will be talking about safety, too. Airline safety, for example, is a big concern, as Africa grows and prospers and the demand for air travel expands. We discussed it during recent meetings of the International Civil Aviation Organization in Montreal several weeks ago. And we will do so again during my trip. Also, we plan to talk about how my department can help the many nations of Africa improve highway safety. Africa relies heavily on road transportation. But highway fatalities are very high. And the economic costs are very steep, especially for Africa's fragile, emerging v market economies. So I am very much looking forward to my trip. Traffic safety, no matter the mode -- car, airplane, bicycle, train, bus -- is a serious global problem. And it is a problem that is killing and injuring too many people, while imposing a heavy economic cost on society. Clearly, this is not just an American problem or a European problem, or an African problem or an Asian problem. And it is not just a problem for industrial nations, nor for emerging countries. Make no mistake, every nation is affected. And if we don-t act with vigor and with fortitude, traffic accidents will be a leading killer, worldwide, in the 21st century, even surpassing the scourge or infectious disease. A recent study by the World Health Organization predicts that by 2020 -- just two decades from now -- highway traffic accidents will be the world-s third biggest cause of death and health problems, after heart disease and mental depression. For men under the age of 44, traffic accidents already are the grea,test health risk. That is a dire and troubling prediction. Traffic crashes are preventible. There are many things we can do to reduce the carnage, the pain and the suffering. That is our challenge at this year-s conference. Our safety needs, like our transportation systems, differ to varying degrees. But we have one thing in common: we are all human and we all suffer when a life is lost, no matter where it happens. Here in the United States, President Clinton-s top transportation priority is safety. It is my North Star at the Department of Transportation. In 1967, 50,000 people died on our highways. Today, 42,000 do. So after 30 years, 10,000 fewer die in spite of the enormous increase in traffic. VI Rodney E. Slater: Preface And if there had not been a vigilant Department of Transportation, if lawmakers had not enacted laws so Americans buckle up, if auto manufacturers had not worked to make cars safer, today we would be seeing 120,000 deaths a year. But in 10 years, Americans will be driving even more. And while this is a sign of prosperity, it also means a greater risk of traffic accidents. The number of deaths will rise by 50 percent by the year 2020, if we fail to improve our current safety performance. Clearly, this is unacceptable. This is a public health problem that we must and will keep pounding at every day and in every way. We have a very active national safety program. We work very closely with state and local transportation officials, police officers, safety groups, private businesses, and many others. Ours is a community-based, team effort because we believe a bottom-up approach is most effective. We also believe in national leadership. So early next year I plan to announce new Department of Transportation goals for reducing the number of highway-related fatalities. And we are working on a federal strategic safety plan for all surface transportation. By working to reduce crashes involving trains and motor vehicles, for example, we are taking bigger picture approach. We are coordinating the effort among the different modes of transportation. And this is good because in today's world I believe all transportation issues must be approached this way. I am proud that President Clinton has taken an active role in promoting highway safety. He wants to spend 25 percent more on safety over the next six years. Early this year, the President called for a plan ton increase seat belt use nationwide. We looked around the world -- at Canada, at Australia and at Western European nation -- and saw that 90 percent of their citizens wear belts. Sadly, one in three Americans do not buckle up. So in April we announced a bold strategy to increase seat belt VII use to 90 percent by 2005. Our strategy focuses on increased public education and more active enforcement of seat belt laws. Seat belts, as most of you know, are the number one way to save lives, so we are asking everyone to buckle up for life. Let me also note that President Clinton is backing a national campaign for tougher drunk-driving laws. This would require all states to reduce the legal blood alcohol limit to .08 percent from .10 percent. Some of our states already use the tougher limits. And they are significantly reducing the number of alcohol-related accidents. This new law would save many lives, and President Clinton is ready to sign this legislation. Let me end on this. I believe transportation is about more than concrete, asphalt and steel. It is truly about people and providing them the opportunity to be successful, responsible individuals. But what good is that opportunity if it is unsafe and costs lives? This is the challenge: providing opportunity for all and to all, a safe journey. Working together, as global partners we can rise to this calling, because I believe our best days are yet to come. VIII TABLE OF CONTENTS v Preface ........................................ Rodney E. Slater, U.S. Department of Transportation Table of Contents ...............................I X. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Hans von Holst, Ake Nygren, Ake E. Andersson, Royal Institute of Technology, Karolinska Institute, Institute for Futures Studies, Sweden Traffic Safety as an Economic Issue of Developing and Industrialized Countries ...........................9 Stein Hansen, Nordic Consulting Group A.S., Norway Responsibility and Accountability of Government ....... . 23 J W van der Spuy, National Trauma Research Programme, South African Medical Research Council The Politics of Traffic Safety in Russia - Some Sociological Observations ...................................3 3 Victor Sergeyev, The Russian Academy of Sciences, Russia An Overview of World Bank Experience in Road Safety ... . 39 Stein Lundebye (SASIN), World Bank, U.S.A. Driving the Message Home - The Role of Communication in Traffic Sarety ................................. .51 Cees Wildervanck, The Netherlands The Role of Communication in Road Safety ........... . 65 Peter Vulcan, Monash University, Australia IX Future Integration of Knowledge - The Role of Industry ... . 79 Arne Witt16v, AB Volvo, Sweden Safety is Everybody· s Business ..................... . 85 Andrew H. Card, Jr., American Automobile Manufacturers Association, USA More Resources for Prevention, Critical Care or Rehabilitation ..................................9 1 Wilson Odero, Moi University, Kenya A European Perspective on the Efficient Application of Resources to Diminish Transport Related Trauma ...... . 105 Murray Mackay, University of Birmingham, United Kingdom Rehabilitation and Traffic Related Injuries ........... . 115 Bruce M. Gans, Wayne State University School of Medicine, Detroit Medical Center, U. S.A. Some Perspectives on the DRAG Approach and Family of National Road Safety Models ..................... . 123 Marc Gaudry, Universite Louis Pasteur, Strasbourg, University of Montreal, Canada Development of Realistic Safety Target and Strategic Safety Programmes in Malaysia ........................ . 169 Radin Umar Radin Sohadi, Road Safety Research Centre, University Putra, Malaysia The Association for the Advancement of Automotive Medicine: Its Mission, Purpose and Challenge ......... . 189 Elaine Petrucelli, The Association for the Advancement of Automotive Medicine, USA Contributors to this volume ...................... . 193 x