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 Global developments and
lessons learnt in Road Safety
The automobile changed our dress, manners,
social customs, vacation habits, the shape of
our cities, our consumer purchasing patterns,
common tastes and even ...

John Keats, British Writer

Seattle Plans To Improve Road Safety By Replacing Traffic
Signals With Stop Signs
Just this one trick works remarkably well in reducing speed, crashes, and pedestrian
fatalities. But for truly safe intersections, you need to remove the signs altogether
 According to the Seattle DOT, the city has over 1,000 traffic signals, and it
plans to replace up to ten of them of them with four-way stop signs, with
more to come if the trial works out. Not only do stop signs force drivers to
pay attention, and slow down, it also makes the area unattractive as a
through-route, so drivers may instead opt for a bigger, light-controlled road
nearby. If properly planned, this can be a powerful traffic-shaping tool.

In Philadelphia,
where 200 signaled
intersections were
replaced with stop
signs, crashes were
reduced by almost a
quarter, with
nighttime collisions
cut by almost half.
Source: Global Status Report on Road Safety-2015
Crashes are one of the effects of transport on health
 Motorized 2-3 wheelers in SEAR(%)
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 How safe are our road users ?
Helmet use
Seat belt use
Drink driving
Speeding beyond limits
Distracted driving -Cell phone use
Traffic rules violations
Pedestrian practices
Drugs and driving
Fatigue
Sleeplessness
Several others
As per WHO 2015, Vehicles sold in 80% of all countries
worldwide fail to meet basic safety standards.

Undoubtedly, Safety of vehicles manufactured

locally needs safety assessments
 The Multifactorial nature
Case 9:
Rider + not wearing helmet +
driving under the influence of
alcohol + uncontrolled speed +
unbalanced + presence of invisible
road hump + night time + skid +
delayed care = death.
 What lies behind this success ?
Understanding road crashes based on research

Moving beyond human errors and victim blaming

Understanding limitations of human behaviour

Issues of energy production transfer and absorption protection of

people

Strong national regulations

Making environment and vehicles safer

Shift from education alone to integrated approaches

Multifactorial causation of RTIs and risk exposures

An investment in science
 The Journey from 1920s - 2016
Example of Haddons matrix as applied to two wheeler road traffic injury

Human Vehicle Environment

Increase awareness about safe

Increase visibility of Implement safety features
Pre-event driving, helmet wearing, drink
vehicle on roads
driving etc.

Early transfer to hospital and Increase breaking systems Crash protective road side
Event
required care of two wheelers stationary objects

Improve safety
Rehabilitate and improve Facilities for early rescue
Post-event technologies and
services of injured persons
components
Four steps of Public health approach
 Safe system approach

Source: Towards zero: ambitious road safety targets and the Safe System approach. Paris, Organization for Economic Co-operation and Development, 2008.
Safe systems approach
People make mistakes that can lead to road crashes.
The human body has a limited ability to tolerate
crash forces before harm occurs.
While individuals have a responsibility to act with
care and within traffic laws, a shared responsibility
exists with those who design, build, manage and use
roads and vehicles to prevent crashes resulting in
serious injury or death and to provide post-crash
care.
All parts of the system must be strengthened in
combination to multiply their effects, and road users
are still protected if one part fails.
 Safe Roads
Road safety Audits
Design as per needs of road users
Separate traffic on all possible roads
Traffic calming measures
Manage appropriate speeds in cities, highways and rural
areas
Speed cameras
Red light at all traffic intersections
Strengthen pedestrian facilities
Improve visibility
 Safe Vehicles
Crashworthiness of vehicles
Design of vehicles to accommodate errors
Improved visibility of vehicles
Speed governors in public vehicles
ABS in two wheelers
Alcohol antilocks
Safe people legislative measures
Helmet laws
Seat belt laws
Drink drive laws
Child restraint laws
Speed control laws
Cell phone use laws
Traffic separation laws
Traffic calming legislations
All legislations are proven to work
Safe peopleeducational interventions
Mere education does not work
Works well when combined with other
measures
Should be targeted, focussed and
continuous
Post license driver education does not work
Education of children has limited effect
Done in number of areas
 International Scenario
First and second world wars
30-40% deaths are preventable
20-30% decline in trauma mortality (improved
health care interventions and establishment of
trauma care systems)
30% decline in trauma deaths in UK during
1989-1998 (trained staff and good emergency
care)
35% decline in USA due to regional trauma
systems
 Timing & quality of acute interventions
Advanced traumatic life support programme
Treat in Street vs Scoop & Run
Better hospital care
Better training & reorganization of accident &
emergecy services 16%
(early of severe injuries)
Regional trauma systems 20%
Injury rating systems
Post crash care Good practices
Early first aid
Training of police, doctors/ health workers, all drivers and
teachers
Safe and early transportation
Stabilization of injured
Assessment of injury
Referral based on triage
Preparedness of hospitals
Trauma care facilities
Early rehabilitation systems
 Elements of Effective Trauma Care System

Pre-hospital Hospital Referral Rehabilitation Outcomes

Call & control System System
Equipment
centre Transport
Evidence-based Appropriate
Ambulances guidelines Guidelines appliances
Trained staff Triage Training Occupational
therapy
Sensitised & Trained staff Specialized
trained public diagnosis Physiotherapy
Audit
Specialist care Work & Home
support

Dinesh Sethi et
al 2000