The mortality and morbidity rates from road traffic accidents are increasing annually in nearly all the developed countries. The total number of deaths and injuries continues to increase despite the reduction in road casualties relative to the total number of motor vehicles and to the estimated annual number of kilometres driven, and to traffic density. A most important aspect of the problem is the disproportionate mortality rate and morbidity in the 15-24 age group (accounting in some countries for 40-50% of all deaths among males in this age group). In addition to the pain and suffering caused and the tragedy of death or permanent disability, a serious economic loss to the community arises from such accidents, due to the costs of medical treatment, to the loss of the services of the injured person, problems of afflicted families of the dead and injured, and to damage to property.
Among the accidents resulting from the development of air, land, sea and river transport, road traffic accidents predominate both in respect of their frequency and seriousness and in terms of human and economic cost. Road traffic accidents have killed ten million people this century and caused almost ten million casualties, including 250,000 killed and 6,000,000 injured every year. In 1997 it was estimated that each year there were 45,000 traffic deaths in the EU. In addition, about 150,000 victims are permanently handicapped and between 1.5 and 3 million are injured. If the trends remain unchecked, it is estimated that road accidents will reduce the life of one in 80 EU citizens by an average 40 years and will result in one in three going to hospital. The cost for police, ambulance, hospital and other services related to traffic accidents is estimated at 150 billion ECUs. In 1969 in the USA the total cost of motor vehicle accidents was estimated at $12,500 million.
Amongst OECD countries in 1989, there were large variations between countries regarding road safety. For instance, deaths per 10 million vehicles are in a ratio of 1 to 4 (Sweden 2,087 vs Portugal 8.616) and deaths per 100 million motor vehicle kilometres in a ration of 1 to 7 (Great Britain 13 vs Spain 88). Portugal had the highest death rate per 100,000 population and Norway the lowest (31.5 compared with 9.0). Specific factors such as population density, condition of the road network, topography, climate, local style of driving explain part of such differences but another part stems from differences in the seriousness with which individual countries treat road accidents.
Road traffic accidents are no longer the monopoly of rich countries. India, with fewer than five million motor vehicles, has 40,000 traffic fatalities a year. In Eastern Europe, increases in road accidents were one of the first consequences of the liberalization: in some countries, within a few months the fatality rate increased to a level comparable to countries with a car ownership ten times higher. In Poland it was estimated that for every 100 accidents in 1996, 11 people were killed, compared with 1.5 deaths for every 100 accidents in the UK.
Despite the shock reaction to aircraft disasters killing hundreds of people, the prospect of the daily slaughter on the roads is largely ignored by the general public. Since less harmful accidents occur when people are driving carefully in hazardous conditions than occur in so-called 'perfect' driving conditions, it appears that the principle of 'risk compensation' is involved. The answer is not necessarily, therefore, the imposition of speed limits and seat-belt regulations. Too many safety regulations may give a feeling of security, leading people to take more risks than they would if driving were less secure.
Vulnerable road users such as pedestrians and cyclists account for 30-35% of deaths. The severity of accidents among pedestrians is almost twice as high as that in car occupants.
Teenage driving accidents are not necessarily related to risk taking. The commonest group to have sleep car accidents are teenagers. Getting up early for school and going to bed late may be producing sleep deprivation.