PREVENTING ROAD TRAFFIC INJURY: A PUBLIC HEALTH PERSPECTIVE FOR EUROPE A PUBLIC HEALTH PREVENTINGTRAFFIC INJURY: ROAD PREVENTING ROAD TRAFFIC INJURY: A PUBLIC HEALTH PERSPECTIVE FOR EUROPE World Health Organization Regional Office for Europe Scherfigsvej 8, DK-2100 Copenhagen Ø, Denmark Tel.: +45 39 17 17 17 Fax: +45 39 17 18 18 E-mail: [email protected] Web site: www.euro.who.int Francesca Racioppi Lars Eriksson Claes Tingvall Andres Villaveces ISBN 92 890 1093 2 PREVENTING ROAD TRAFFIC INJURY: A PUBLIC HEALTH PERSPECTIVE FOR EUROPE Francesca Racioppi Accidents, Transport and Health European Centre for Environment and Health Rome Operational Division WHO Regional Office for Europe Lars Eriksson Advisory Aid Service Limited Borlänge, Sweden Claes Tingvall Swedish National Road Administration (SNRA) Borlänge, Sweden Andres Villaveces Consultant in Public Health and Epidemiology Geneva, Switzerland Abstract Road traffic injuries in the WHO European Region publication builds on and complements the World report represent a major public health problem. About 127 on road traffic injury prevention, analysing in depth the thousand people are killed and about 2.4 million injured burden of disease from road traffic injury in the European every year. The cost of road traffic injuries to society is an Region, framing the issue in the context of sustainable estimated 2% of a country’s gross domestic product. mobility, presenting a comprehensive systems approach to About one third of the victims are aged 15–29 years. road safety based on successful experiences developed by Nevertheless, effective preventive strategies exist and need some Member States in the Region and highlighting to be applied through multisectoral approaches, and the opportunities for the health sector to play a broader role. health sector has a unique role to play. This publication The publication calls for a multisectoral and evidence- has been prepared for World Health Day 2004 to raise based approach to preventing road traffic injuries, with awareness among the general public and enhance public health playing an important role, emphasizes the commitment among policy-makers to take immediate importance of a strong political commitment at all levels action towards preventing road traffic injury. The of government and makes recommendations for action. Keywords ACCIDENTS, TRAFFIC - mortality - prevention and control WOUNDS AND INJURIES - prevention and control TRANSPORTATION SUSTAINABILITY SAFETY - standards POLICY MAKING INTERSECTORAL COOPERATION EUROPE Photo Credits Cover: Text editing: David J Breuer Left: European Commission Audiovisual Library, Design and layout: Emilio Dotto EDB&RDB Centre: C. Piza Lopez Right: V. Shkarubo, WHO/Europe Address requests about publications of the WHO Regional Office to: • by e-mail [email protected] (for copies of publications) [email protected] (for permission to reproduce them) [email protected] (for permission to translate them) • by post Publications WHO Regional Office for Europe Scherfigsvej 8 DK-2100 Copenhagen Ø, Denmark ©World Health Organization 2004 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or trans- late its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. 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Contents 5 Foreword 6 Acknowledgements 9 CHAPTER 1 Introduction 11 CHAPTER 2 Road safety in Europe in the context of sustainable transport 27 CHAPTER 3 New thinking on road safety in Europe 33 CHAPTER 4 A broader perspective on road safety in Europe 39 CHAPTER 5 From knowing what is effective to making it work: a toolkit for road safety 59 CHAPTER 6 The health sector and road safety in Europe: embracing a broader role 69 CHAPTER 7 Conclusions, research needs and recommendations 77 ANNEX 1 Overview of highly effective measures for road safety from the recommendations of the World report on road traffic injury prevention 79 ANNEX 2 Statistical information 4 Foreword Road traffic injuries in the European Region are a to its specific political, economic and social major public health issue, claiming about 127 conditions. This publication also explores the thousand lives per year. This is equivalent to the synergy that can be obtained by linking road safety entire population of Grenoble, France; Perugia, to other political processes underway in the Region Italy; or Norilsk, Russian Federation. aiming at attaining healthier and more sustainable patterns of transport, such as the implementation of Next to this intolerably high number of lives lost, the Transport, Health and Environment Pan- about 2.4 million people per year are injured in road European Programme. traffic crashes. As a result, our societies bear a huge cost that is estimated to be about 2% of gross We hope that this publication can contribute to domestic product in several countries. Road traffic raising awareness about the importance of road injuries are the leading cause of death among young traffic injuries from a public health viewpoint and people in the Region and are predicted to increase in about the still largely untapped opportunities to act countries with low or medium income as they to reduce the burden of death and injury to our become more highly motorized. societies and the distinctive role the health sector can play in this. We also hope that this publication The fact that effective preventive strategies do exist can stimulate a broad debate at the regional and makes this situation all the more unacceptable. The national levels on how multisectoral and evidence- success of some Member States in reducing the toll based approaches can be used to improve road of deaths and injuries on their roads clearly safety. Finally, we hope that the experiences demonstrates that strong political commitment and developed by various Member States in 5 comprehensive measures provide substantial implementing comprehensive strategies and benefits in health gains for the resources invested. approaches to road safety will inspire others across Much can be learned from these experiences and the Region to act towards reducing deaths and innovative approaches and be reapplied and adapted injuries. to various situations across the Region. Road traffic injuries pose a global threat to health and the development of societies. The dedication of Marc Danzon World Health Day 2004 to the theme of road safety WHO Regional Director for Europe is an opportunity to be reminded of this and to become aware of the burden of disease on our communities and of the existence of successful approaches and policies to tackle the problem. World Health Day also provides an opportunity for the health sector to rethink its role and responsibilities and to become a more active player and partner of other sectors involved, such as transport, finance, the judiciary and the environment. This publication has been developed for the purpose of building on and complementing the World report on road traffic injury prevention WHO and the World Bank launched for World Health Day 2004. Its aim is to provide the European public health sector, policy-makers across different sectors and levels of government, decision-makers in the private sector and other readers with an in-depth analysis of the situation in the European Region, so that the recommendations and strategies advocated in the World report on road traffic injury prevention can be framed in the context of this Region and adapted Acknowledgements This publication was prepared with the support of Piero Borgia the Swedish Expertise Fund. Agency for Public Health - Lazio Region Rome, Italy The WHO Regional Office for Europe thanks the Swedish National Road Administration for Jeanne Breen accepting our invitation to support the preparation Consultant of the publication. In particular, we wish to thank London, United Kingdom Claes Tingvall, Director of Road Safety for coordinating the work of the Swedish National Road Carlos Dora Administration and for very valuable contributions Health Impact Assessment to the scientific and policy discussions that shaped World Health Organization the publication; Lars Eriksson for taking up the Geneva, Switzerland challenging task of developing the content of the publication; and Matts-Åke Belin, Roger Johansson Martine-Sophie Fouvez and Anders