SoT-Oct2006

Handbook of WMA Policies
World Medical Association ½ S-1990-04-2006

WMA STATEMENT
ON
TRAFFIC INJURY
Adopted by the 42nd
World Medical Assembly, Rancho Mirage, CA., USA, October 1990
and revised by the 57th
WMA General Assembly, Pilanesberg, South Africa, October 2006
PREAMBLE
1. 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.
2. 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.
3. 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.
4. 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.
5. Speed is widely recognized as the most important determinant of road safety, af-
fecting 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.
6. However, efforts to decrease road crashes and injury also require a “systems ap-
proach” 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.
7. Human, vehicular and environmental factors interact before, during and after a col-
lision. Intervention at each of these stages will help reduce crashes and injury. Effec-
tive intervention requires public education as well as professional involvement in the
fields of engineering, law enforcement and medical care.
S-1990-04-2006½ Pilanesberg
Traffic Injury

8. 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 cur-
fews 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 appro-
priate speed limits, installing speed cameras, and optimizing road design and layout to
prevent crashes.
9. 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.
10. Post-crash intervention is aimed at maximizing life saving and injury reducing treat-
ment and includes improved pre-hospital and emergency trauma care and rehabilita-
tion.
RECOMMENDATIONS
1. 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 Na-
tional Medical Associations and their governments and relevant bodies.
2. Physicians must view traffic injury as a public health problem and recognize their res-
ponsibility in fighting this global problem.
3. 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.
4. National Medical Associations and physicians should be key players in public educa-
tion, and should include road safety in health promotion activities.
5. Physicians should be involved in the collection and analysis of data regarding road
crashes and concomitant injuries, including injury surveillance systems.
6. Physicians should work towards changing the public attitude toward road travel,
including pressing for improved public transportation, bicycle paths and proper side-
walks to encourage less car use and the adoption of healthier options such as walking
and cycling.
7. 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.
Handbook of WMA Policies
World Medical Association ½ S-1990-04-2006

8. 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.
9. 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.