Adopted by the 42nd World Medical Assembly
Rancho Mirage, CA., USA, October 1990 and
revised by the WMA General Assembly, Pilanesberg, South Africa,
October 2006
Preamble
- Serious injuries and mortality in road collisions are a public
health problem with consequences similar to those of major diseases
such as cancer and cardiovascular disease. Worldwide, about
1.2 million persons are killed each year on the roads and an
additional 20-50 million are injured. By 2020, road traffic
injuries are expected to be the third largest contributor to
the global burden of disease and injury.
- In addition to the immeasurable personal and social price
paid by the victims of road crashes and their relatives, traffic
injury has a significant economic impact. The direct and economic
cost of injury and disability resulting from traffic injuries,
including emergency and rehabilitative health care, costs of
disability, disability adjusted life years (DALYs) and other
costs, amount to 1% of the GDP in poorer countries and 1.5-2%
in wealthier countries. Much of this burden is borne by the
health sector.
- Road injuries continue to increase in many countries, particularly
low and middle-income nations that currently account for 85%
for all road traffic deaths, and are the second leading cause
of death among youth worldwide.
- Most traffic injuries could be prevented by better countermeasures.
Combating traffic injury is the shared responsibility of many
bodies, groups and individuals, including governments, NGOs,
industry, international, national and community groups, public
health professionals, engineers and law enforcement personnel.
- Speed is widely recognized as the most important determinant
of road safety, affecting the likelihood that a crash will occur
and the severity of resulting injuries if a crash does occur.
An average increase in speed of 1 km/h is associated with a
3% higher risk of a crash involving injury and a 5% higher risk
of serious or fatal injury.
- However, efforts to decrease road crashes and injury also
require a "systems approach" that recognizes and addresses
the many factors that combine to increase the risk of traffic
accidents and resulting injury, including human, vehicle and
road design variables.
- Human, vehicular and environmental factors interact before,
during and after a collision. Intervention at each of these
stages will help reduce crashes and injury. Effective intervention
requires public education as well as professional involvement
in the fields of engineering, law enforcement and medical care.
- Pre-collision intervention is aimed at preventing crashes
and reducing risk factors. Examples include: preventing drivers
from driving when fatigued (especially drivers of heavy vehicles),
distracted (including prohibiting the use of hand-held cellular
phones) or under the influence of drugs or alcohol, and measures
such as night curfews or graduated licensing for young drivers.
Pre-collision intervention also includes setting vehicle design
standards that ensure that vehicles are roadworthy and cannot
be driven at excessive speeds. Other interventions include setting
and enforcing appropriate speed limits, installing speed cameras,
and optimizing road design and layout to prevent crashes.
- A second level of intervention is aimed at preventing or reducing
injury during the crash. Such interventions include: enforcing
the use of seat belts and child restraints, requiring helmets
for cyclists, manufacturing vehicles equipped with safety devices
and crash-protective design, lowering and enforcing speed limits
and removing heavy, rigid objects such as concrete or metal
dividers, light posts and abutments from the sides of roads.
- Post-crash intervention is aimed at maximizing life saving
and injury reducing treatment and includes improved pre-hospital
and emergency trauma care and rehabilitation.
Recommendations
- The WMA adopts the findings and key recommendations of the
WHO Report on road traffic injury prevention (2004) and calls
for their implementation by its member National Medical Associations
and their governments and relevant bodies.
- Physicians must view traffic injury as a public health problem
and recognize their responsibility in fighting this global problem.
- National Medical Associations and their member physicians
should work to persuade governments and policy makers of the
importance of this issue and should assist in adapting empirical
and scientific information into workable policies.
- National Medical Associations and physicians should be key
players in public education, and should include road safety
in health promotion activities.
- Physicians should be involved in the collection and analysis
of data regarding road crashes and concomitant injuries, including
injury surveillance systems.
- Physicians should work towards changing the public attitude
toward road travel, including pressing for improved public transportation,
bicycle paths and proper sidewalks to encourage less car use
and the adoption of healthier options such as walking and cycling.
- Physicians should be active in addressing the human factor
and medical reasons for road crashes, including, but not limited
to, the use of prescription drugs or medical conditions that
may impair driving ability, and explore ways to prevent and
reduce the severity of injuries.
- Physicians should lobby for the implementation and enforcement
of the measures listed above, which have been shown to decrease
the risk and severity of vehicle crashes, and the evaluation
of their impact.
- National Medical Associations and their member physicians
should encourage research and development of improved training
systems and medical care at all stages, including effective
communication and transport systems to locate and evacuate the
victims, emergency medical care systems to provide life-saving
first aid services, and expert trauma and rehabilitative care,
and should lobby for increased resources to help provide these
services.
14.10.2006
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