An EU Road Safety Strategy

Focusing on serious road traffic injuries, and better traffic injury data in all Member States, are among the recommendations of a new Commission document on road safety.

The Commission is pushing for an EU road safety strategy, as it believes that too many serious traffic accidents still take place on European roads.

In 2011, almost 1 500 000 people were reported to have been injured on EU roads - around one sixth of these were estimated to be serious.

To understand the real magnitude of this problem, the Commission is proposing common definitions and data collection procedures in all Member States.

Context

Reducing serious road traffic injuries was one of the seven strategic objectives set by the Commission in 2010 in its road safety policy orientations for the period 2011-2020.

The most commons injuries are head and brain injuries, followed by injuries to the legs and spine. Vulnerable road users, like pedestrians (and especially elderly), cyclists and motorcyclists are primarily affected.

Young car drivers account for around 24% of all accident victims, although they only make up around one tenth of the total population. More than half of all serious injuries and almost 70% of all slight injury accidents happen in urban areas.

During the last strategy period, 2001-2010, the number of fatalities on EU roads was reduced by a total of 43%, coming close to the strategic objective of reducing fatalities by half in ten years. However, for serious injuries the data reported by Member States showed only a 36% decrease; just a 26% decrease when considering both slight and serious injuries together.

Serious injuries are costly and problematic for society at large. The annual socio-economic cost of serious road traffic injuries over the last ten years is estimated to be around 2% of GDP in the EU.

Towards a Strategy of Action

The Commission says three things are needed in a first phase: a common definition of "serious injury", improved road accident data collection by Member States, and an EU target for reducing serious injuries.

A Common Definition

In road safety data, different Member States apply different practices. The severity of an injury is sometimes defined on the basis of medical classifications, sometimes in terms of the long-term effects of the injury. Many Member States define an injury as serious considering the length of hospitalisation needed (usually when more than 24 hours in hospital).

Without a harmonised definition no comparisons are possible, nor can the magnitude and true nature of the problem be fully understood.

A common definition is needed, and it should be based on an already established medically classified standard, in order to avoid arbitrary diagnoses and any extra administrative burden. The already existing international trauma scale ‘Maximum Abbreviated Injury Score’ (MAIS) was seen as the preferable option by the EU High Level Group on Road Safety at its meeting in June 2012. With the MAIS scale, injury score is determined at the hospital with the help of a detailed classification key. The score ranges from 1 to 6, with levels 3 to 6 considered as serious injuries.

Reliable Data Collection

A large proportion of non-fatal injuries are not reported, and some injuries are reported as serious although they are not, or vice-versa. Moreover, although collecting important pieces of information such as type and number of vehicles involved, the police do not perform a medical assessment; their diagnosis is only a rough on-the-spot estimate, which is not always checked against subsequent medical reports about injury severity.

The High Level Group on Road Safety identified different ways Member States might choose to proceed.

The first possibility would be to continue to use police data but apply national correction coefficients to allow for misreporting and underreporting. Another possibility would be to use the data from hospitals, which would ensure correct assessment of injury severity.

The last possibility, and the one preferred by the Commission, would be to create a link between police and hospital data, which would provide a more complete picture of each accident. Manual or automatic systems may be considered to complement the on-the-spot reports by the police with hospital verification regarding injury severity.

The High Level Group on Road Safety considered that Member States could be in a position to collect the more correct data using the common definition of serious injury by 2014, reporting the first data set during 2015.

Setting a Target

Setting targets for improved road safety is recommended as effective practice by several expert organisations, for example the WHO and the OECD. By publicly committing to ambitious but realistic targets the likelihood is that programmes will be better designed and public resources effectively used.

A long-term strategic outcome target should be supported by interim targets, concrete actions and measures for follow-up and monitoring. All this is already being done at EU level when it comes to road fatalities, and in fact, several Member States already went one step further adopting also national targets for the reduction of serious injuries.

Future Development of a Strategy

A comprehensive strategy on serious road injuries should address the different phases regarding a traffic accident.

The initial aim is to prevent serious road accidents from ever happening. Much of the present road safety work on fatalities is focused on this, for example: infrastructure design separating vehicles from vulnerable road users, law enforcement to reduce occurrences of drink-driving and active safety vehicle applications such as lane departure warnings and emergency braking systems.

However, accidents cannot be completely avoided; the human factor, technical errors and unforeseen events in traffic cause many accidents. In those cases, there is a need to limit the consequences through what is sometimes referred to as secondary safety or crash protection.

Collision Impact

The use of protective measures is a typical example of an approach to reducing injury severity that is especially relevant to vulnerable road users. The use of airbags and the design of the seatback or headrest with anti-whiplash systems in cars, and the use of helmets by pedal cyclists, moped riders and motorcyclists, reduce the risk of serious injuries in case of accident.

Apart from the presence of protective devices, the factors determining the severity of a road traffic injury are the speed of the vehicles involved, the design and characteristics of vehicles and roadsides (for example the existence or not of fixed obstacles) and swift access to emergency medical systems to minimise the injury consequences.

As the vast majority of accidents causing serious injury occur on roads other than motorways, an action in line with an injury strategy could aim to promote road safety audits and inspections also on the secondary road network, as well as in the urban environment.

Emergency Services

The aid received in the first hour after a crash is crucial for reducing the risk of severe consequences. Intelligent Transport Systems (ITS) and in-vehicle technologies for improved road safety can help both prevent accidents and reduce their impact. Cooperative systems such as eCall bring substantial post-crash added value, by reducing the time taken to alert accident and emergency services; they can also play an important role in accident management, for example avoiding secondary accidents.

Further deployment of the eCall service functionalities as well as of other relevant ITS and in-vehicle safety devices could therefore be an area of specific interest for a comprehensive injury strategy.

Rehabilitation Process

Rehabilitation involves the medical services, post-hospital care, social support systems and society’s adaptation to the needs of people with different types of disabilities. It could include prosthetic support, psychological support and support for reintegration into society. There is a lack of data on the long-term consequences of car accidents.

Accident Management

Road safety is by nature cross-sectoral, and a system-wide approach to accident management is needed. Also an inclusive approach is necessary: civil society, the manufacturing sector, public authorities, law enforcement bodies, the health care sector, the insurance sector and road infrastructure managers must be active stakeholders.

Exchange platforms such as the European Road Safety Charter or the European eCall Implementation Platform can be useful in bringing various actors together to share best practices.

Unlike fatalities, serious road injuries occur more often within urban areas than on rural roads. Vulnerable road users are particularly at risk. Road safety should be an important consideration for city authorities. One tool for improving urban road safety is sustainable urban mobility planning; helping towns and cities to take a holistic and efficient approach to local challenges such as congestion, environmental impacts and road safety.

Further Research

Most road safety measures and applications promoted today have been selected because of their clear cost-benefit when it comes to avoiding fatalities. However, there might well be other tools which, though less obviously lifesaving, can still be of great assistance in reducing certain types of serious injuries, for example headrest positioning to minimise whiplash injury or the design of seatbelts to take into account the greater frailty of the elderly human body.

There may be knowledge gaps related to traditional methodology, for example the use of crash test dummies primarily with the characteristics and size of the average male body. It might be worthwhile diversifying collision impact studies to cover different kinds of bodies (size, age, gender) for a deeper understanding of the biomechanics that come into play in accidents.

Next Steps

Transport Ministers will discuss the Commission's approach towards a strategy for serious road traffic injuries in June 2013. Each Member State will decide which method suits them best for the data gathering and data reporting. They will be able to start applying the new common definition and data gathering procedures for the year 2014, and the Commission will be able to publish this data in 2015.

The Commission will propose an EU-wide target to be adopted for example for the period 2015-2020. It will then also be possible to begin exploring areas for actions to reduce the severity of accidents, leading to a future adoption of concrete measures.