Thursday, January 8, 2009

Safety Culture in a Perfect World

The next logical step toward an enhanced traffic safety culture is to build support for implementing known regulatory and legislative solutions. Although there are dozens of known solutions that can, and should be implemented, here are a few of my favorites.

Take for example graduated driver licensing (GDL): 16 and 17-year-old drivers are five times more likely to die on the road than adults, per mile driven. To combat these odds, every state in the U.S. has adopted some form of GDL; however, not all systems include the components believed to be the most effective. The comprehensive GDL programs that yield the greatest safety benefits include several provisions, such as a minimum age of 16 to obtain a learner’s permit; 30 hours of supervised driving practice; a restriction on driving unsupervised after 10 p.m.; and a restriction of no more than one passenger, among others.

Specifically, a 2007 AAA Foundation report found that the programs with five of the seven recommended provisions were shown to reduce deaths and injuries by nearly 40 percent. But, sadly today, only 8 states and Washington, D.C. currently have even 5 of the 7 recommended components.

Electronic Stability Control (ESC), one innovative technology solution, is not yet well known to most car buyers or motorists, but it should be. Using high-tech sensors, linked with anti-lock braking systems, ESC can sense when a car is about to go out of control and selectively apply the brakes to prevent loss of control and skidding. Past research in the U.S. and abroad has found that ESC can decrease deaths in single-vehicle crashes by as much as 56 percent. The federal government has recognized the benefits of this technology, but they will not be fully mandated in new vehicles until model year 2012. Why can’t we accelerate the implementation of this known solution? Why don’t consumers demand this feature in new cars?

Similarly, edge rumble strips, centerline rumble strips, and cable median barriers are quite effective in preventing vehicles from leaving respective travel lanes, actions that account for 25,000 deaths each year. For example, the state of Missouri has taken a systematic approach that addresses shoulder width, rumble strips, guardrails, and upgraded signage, and has seen a 25 percent reduction in fatalities resulting from lane-departure crashes over the past three years, and has reported a whopping 96 percent reduction in deaths caused by vehicles crossing the median into opposing traffic on two interstate highways where they have installed cable median barriers. Unfortunately, many jurisdictions have been slow to implement similar efforts.

Seatbelts save lives if worn and it is extremely encouraging that according to daytime observational surveys, over 80 percent of motorists are buckling up. Nonetheless, the National Highway Traffic Safety Administration (NHTSA), reports that 55 percent of passenger vehicle occupants killed in crashes in 2006 were not wearing them. And once again, there are known solutions we could implement. For example, primary seatbelt enforcement laws — laws that give police the right to stop and ticket someone for not buckling up — have reduced fatalities by nearly 10 percent in states with such laws compared to those that do not. And, enhanced seatbelt reminder systems — systems that beep, buzz, or otherwise annoy a driver into putting on their seatbelt — could play a vital role in getting more folks to buckle up. Some studies report a five to six percentage point increase in buckling up with just the use of belt reminders. That’s a lot of lives saved. In fact, NHTSA estimates that over 5,000 people who died in 2006 could have been saved if everyone had been wearing seatbelts.

Perhaps the most common, and illusive, dilemma faced on the road is speeding. We have essentially allowed ignoring the speed limit to become normative behavior. In the Foundation’s Traffic Safety Culture Index, 45 percent of drivers admitted to exceeding the speed limit by 15 mph on the highway in the month before the survey, including a handful that admitted doing so very often, and again, these were only the ones who were willing to admit it.

NHTSA cites speeding as a contributing factor in over 30 percent of crash deaths, equating to more than 13,500 deaths in 2006 alone. However, most traffic safety professionals believe these statistics substantially underestimate the true size of the problem. One large and prominent systematic review of published research on speed and speeding concluded that even just a one-percent reduction in traffic speeds on a road would reduce crashes by two percent overall and reduce serious and fatal crashes by three percent. This may not sound impressive, but again, this is for only a one-percent speed reduction — one percent — and the result would be an even greater decrease in road casualties than would be expected to result from an equivalent decrease in traffic volume, according to the study.

There are lots of known ways to discourage speeding, but so far their implementation in the U.S. has been limited. For example, studies show that speed cameras are proven to reduce injury crashes by 20 to 25 percent from fixed, conspicuous locations. Yet only six states and Washington, D.C. currently have laws specifically authorizing speed cameras.

Moreover, new intersection designs, such as roundabouts, have yielded substantial, positive results in the prevention of crashes. A well-controlled study of the effect of converting several traditional intersections into roundabouts in eight states found that the roundabouts reduced fatal crashes and crashes resulting in serious injuries by 90 percent – 90 percent. Fortunately, more and more municipalities have seen the success stories from Europe where roundabouts are more common, and are starting to construct them around the country. But, there are still many jurisdictions that have not been converted.

Some solutions are even more obvious, like helmet laws. The facts are staggering. Motorcycle fatalities have more than doubled since 1996, and over 40 percent of those killed do not wear helmets. NHTSA predicts that 750 motorcyclists who died in 2006 could have been saved if they had simply covered their head. In addition, various studies report that once the laws are enacted, motorcyclists obey, typically at a rate of 83 to 90 percent. Enacting helmet laws in states without them has resulted in increases of use from 50 to 90 percent. The proof is there.

Alcohol is arguably the deadliest element that can be coupled with driving. According to NHTSA, in 2006, 13,470 fatalities occurred in crashes involving a driver with a BAC of .08 or higher, and almost 16,000 occurred with the driver’s BAC of .01 or higher. The Traffic Safety Culture Index found that nearly 10 percent of people polled admitted to driving when they believed they were legally drunk, in the past month. Furthermore, eight percent of drivers involved in fatal crashes had prior DWI convictions. Thus, people are knowingly repeating destructive behavior.

Alcohol ignition interlocks — devices preventing a vehicle from starting if its driver blows a BAC over the legal limit — are proven to be effective. So effective, in fact, that research has shown that roughly 1,100 lives could be saved if all drivers with any prior DWI conviction in past three years were prevented from driving with any alcohol in their system; and nearly 800 lives could be saved if only drivers with priors could be prevented from driving with BACs over the legal limit of .08. And, the Foundation’s Traffic Safety Culture Index found that four of every five Americans supported or strongly supported requiring all DWI offenders to use interlocks before they could start their vehicles. So why don’t we require them?

Furthermore, studies on physicians screening for alcohol abuse have shown general reductions in both drinking and alcohol-related crashes and injuries. In fact, over time, alcohol intervention groups have proven to decrease hospitalized injuries by nearly 50 percent. It is estimated that 30 to 50 percent of the 2 million patients entering trauma centers in the U.S. have alcohol problems, yet screenings are not mandatory. Patients entering an emergency room or trauma center have their blood pressure checked — why not an alcohol screening as well?

And those are just a handful of the many known countermeasures that are proven to work.

One death is too many, and allowing over 40,000 a year, or one every thirteen minutes is an outrage. The roadway death toll equates to 9/11 occurring monthly for over a year, yet no change is seen. And, despite the fact that the numerous solutions exist, many remain unimplemented. How many more crosses and flowers will be raised before a change is finally made?

8 comments:

waldito said...

Lots of teenagers now a days are very clumsy. When they drink alcohol they are much more violent and angst.

Al C said...

The sad truth, which no one will acknowledge, is that the state governments don't want to improve traffic safety. It's a money maker. States make tons of money from the transactions that flow from a car crash, e.g purchase of a new car or repair the old one, doctor bills, legal fees, hospital costs,etc., etc.

Even the laws that are put in place are a joke. In NY, teens are supposed to have 20 hours of driving time before going for a road test. All the parent has to do is sign a form attesting to that fact and its a done deal even if the teen only had five hours of practice.

Then, of course, there is the scandalous and fraudulent cell phone law which allows talking on a phone while driving. You just have to keep it a secret and don't let the cops know you're doing it by sticking something in your ear. Talking on the phone while driving is the main problem, not holding the phone. But, that doesn't seem to matter as long as the state can give the impression that it cares about safety.

Jaz said...

After an alcohol intervention and rehabilitation, an alcoholic can benefit from the positive influence of a sober buddy during their recovery care management plan.

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