S-1990-04-1990_OVE

L’ASSDClATJON MEDICAU MDNDIALE. INC LA ASDCtAClDN MEDICA MUNDIALINC
P.o. BCD: 69
calli. AdCInSS
WOIlIDAS. FERNEY·VOLTAIRE
October 1990
Preamble
THE WORLD MEDICAL ASSOCIATION, INC.
2″ AVENUE DES ALPES ” 01210 FERNEY.VOLTAIRE • FRANCE
TllUftonl : ~O aa75 75
T…. : 385755′ WMASfVf
T…,.x: 50.5157
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Original: Enqlish
WORLD MEDICAL ASSOCIATl:01f S’l’ATEMEN’J.’
CD
T’llAPPXC INJURY
Adopted by the 42nd World Medical Assembly
Rancho Mirage, CA., aSA, October 1990
Serious injuries in road collisions are a pUblic health problem with
consequences equal to those of major diseases such as cancer and
cardiovascular diseases. In some nations such injuries are one of
the major causes of death amonq youth. At the present -t ime , about
~~f mi]Nl.t:iiliei’0~~ i\l:.ttP a’MbCftV ~.llXt: t~liiuCf?¥el};1m~hEtdi;l~~
half a million road deaths occur annually throuqhout the world and
about 15 million are injured.
Metor vehicle collisions are the result of sudden, unexpected,
sometimes disastrous encounters between people, vehicles and the
road. As with diseases, an understanding of the etiology of trauma
is an important step towards its prevention and control. ~he preventive
and protective approaches have an – enormous potential =or effective
prevention. Traffic crashes and their consequences can be reduced
by the systematic and widespread application of current knowledge
in the fields of vehicle de~ign, road design and traffic management,
supported by appropriate requlatory controls. Without doubt public
education also has a significant place.
Unfortunately, . while transportation issues are uf major concern to
the population generally, traffic safety seems to be of marginal
concern to the pUblic, although concern may be increasing. In motorized
countries, traffic injuries consume an estimated 10′ of total hospital
resources, excludinq the cost uf rehabilitation, the care of long
term and permanent disability.
While it is certainly true that user behavior contributes greatly
to traffic safety, the view point in more recent times has been
focussed en other components uf the system – especially the vehicle
and the road itself. Thus, it La also appropriate to address · the
practices and policies uf those whc have a central role in the
construction and safe operation of the:!:’::lad-vehicle operation system.
For instance, “,.,hen a vehicle goes ..:ut -:)f control and crashes, the
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severity of the collision depends on the size weight, rigidity, and
other characteristics of the object struck. Therefore, ‘barriers and
obstacles such as abutments, large trees, and boulders should be
kept far from the roadway.
The medical profession has the same obligation to confront road related
injuries as it has to confront any other pubLf.c health issue, and
physicians should be involved in questions concerning control and
prevention of this plague. National Medical Associations should be
active among governments and policy-makers in order to give this
issue first priority, and take appropriate measures at the human
factor level, the vehicle and the road.
Recommendations
L) One should act for the prevention of road accidents mainly by
improving road engineering; this includes road construction and
road maintenance. The infrastructure should be constructed and
maintained to accommodate the increase in the number of vehicles
using the road. This requires the investment of adequate pUblA
resources. One should improve traffic management . and whenev~
poss~ble enlarge the number of multi-laned divided highways,
grade-separated intersections and sealed shoulders to minimize
the risk of head-on-crashes. It is important to consider separating
traffic where possible, with effective separation of motor-traffic
and non-motor traffic, especially for pedestrian safety and
prevention of pedestrian deaths which account for 25% of total
motor-vehicle deaths.
2) One should act for modification of behavior especially by
edu~a::f=0f=~r+-;n:?~~,:~ng~l..~~
.n-;~oki,n~ ~ wh~l~ c:l~~~~~~~_ a~’tt:’gBr~rf}raEy
~8acation, ~ncluding non-smoking while driving, and concentrate
upon efforts which show detectable benefits in reducing crashes
in the context of an individual’s background and culture, a
country’s level of motorization, demography and cultural
differences. For example, education and strict enforcement of
laws prohibiting dri ving while under the influence of alcohol.
The properly used lapbelt shoulder harness is highly protective:
occupants should always use these, and laws requiring their use
have been helpful. e
3) One should protect pedestrian safety by all available means
including engineering legislation, enforcement, maintenance,
educational and zoning factors.
4) To assure injury control, the medical profession should act for
the introduction of safety measures such as: restraints, crash
helmets, safety-type glass windows and wind screens, safe door
locks, telescope steering wheels, and car interiors that are
.less likely to injure.
5) Manufacturers should design cars that will provide optionar
protection of their occupants. The periodic inspection of vehicles
for safety purposes should be implemented.
6) Post-injury management – in a large number of instances, survival
and the extent of recovery will depend more on the initial care
given at the roadside than at later stages of acute care. Emphasis
should be given t o developing communication systems that locate
persons quickly, transport services that can rapidly evacu~te
the victims and emergency medical care systems that can pzova.de
effective first services.
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