Status of road safety and injury burden: Europe.

Abstract

Road traffic injuries are an ongoing global health burden and cause more than 1.2 million deaths per year.1 In Europe, the annual socioeconomic impact accounts for €130 billion.2 In 2011, the United Nations set a special focus on road safety and injury prevention by the proclamation of the “Decade of Action for Road Safety.” This initiative focuses mainly on developing countries.3 In Germany, many measures have been undertaken to improve the mortality rates associated with traffic injuries.4 Among these are countrywide mandatory helmet laws for motorcyclists, speed limits on the Autobahn, speed limit reinforcements associated with fines in and outside the cities, and a network of overlapping rescue helicopter coverage throughout the country5 (Table 1). Despite a general decrease in mortality, the European Commission in 2001 set a new law to reduce the number of road traffic fatalities by another 50%.6 Until 2009, a reduction of more than one third (38%) was achieved7 (Fig. 1). The improvements observed seem to be a result of improvements in education, engineering, and technical improvements in active and passive car safety. These have had effects for cyclists and pedestrians, as well.1 In addition, a 1% reduction of distance traveled by motorized vehicles has occurred, which may have contributed to a decreased incidence of accidents (1.8%).1TABLE 1: Injury Prevention and Road Fatalities in Germany Since 1955FIGURE 1: Road fatalities in Europe since 2001.Based on these prerequisites, this article provides an overview on the current situation in Europe and focuses on 2 questions: How can the improvements in road traffic–associated fatalities in Europe be explained? Is there a special patient group that should be aimed at in the future? The observed decline of fatalities over the last decades can be explained by different factors. The highest number of fatalities was observed in the age group between 15 and 29 years.7 Furthermore, most pronounced decrease in fatalities was found for children younger than 14 years of age (55%). The age group between 15 and 24 years demonstrated a decrease of 40%. In elderly persons, the reduction was only 9%.7 This may be explained by the fact that more elderly people continue to drive. Moreover, if involved in a car accident, their chances of death are higher than in all other age groups. Over the last 2 decades, Germany has been setting the path in terms of road safety in Europe in several ways. Multiple safety measures have been instituted to help reduce the number of road traffic injuries. Within Europe, Germany is the only country that has a complete coverage of helicopter air rescue services.4,8,9 In Germany, by law, every injured patient is required to be seen by an emergency physician within 30 minutes after the accident. Further measures are documented in Table 1 and include rigorous speed limits (including the Autobahn), mandatory helmet laws in every county, and other measures to improve passive driver safety. Based on the available literature, the questions addressed initially can be answered as follows: A significant reduction in mortality rates across Europe has been successfully achieved. Germany seems to have gained, in particular, from overlapping coverage of helicopter emergency rescue systems, speed limits on the Autobahn, and passive car safety. According to current data, elderly patients are at special risk to sustain unsurvivable injuries. Although no clear cut data are available, multiple factors might play a role, such as impairment of hearing and vision, as well as reduced reactivity toward speed and other changes in traffic patterns. Therefore, a major focus should lie on age adaptions of vehicles for the retired drivers.