Background. Road traffic crash fatalities in the United States are at the lowest level since 1950. The reduction in crash injury burden is attributed to several factors: public education and prevention programs, traffic safety policies and enforcement, improvements in vehicle design, and prehospital services coupled with emergency and acute trauma care. Globally, the disease burden of road traffic injuries is rising. In 1990, road traffic injuries ranked ninth in the ten leading causes of the global burden of disease. By 2030, estimates show that road traffic injuries will be the fifth leading causes of death in the world. Historically, emergency medicine has played a pivotal role in contributing to the success of the local, regional, and national traffic safety activities focused on crash and injury prevention. Objective. We report on the projected trend of the global burden of road traffic injuries and fatalities and describe ongoing global initiatives to reduce road traffic morbidity and mortality. Discussion. We present key domains where emergency medicine can contribute through international collaboration to address global road traffic-related morbidity and mortality. Conclusion. International collaborative programs and research offer important opportunities for emergency medicine physicians to make a meaningful impact on the global burden of disease. 1. Introduction Deaths caused by road traffic injuries (RTI) in the United States are at their lowest number since 1950, with a nearly 10 percent decline in such fatalities between 2000 and 2009 alone [1]. Though the National Highway Traffic Safety Administration (NHSTA) cites several factors in the reduction of road traffic fatalities, including economy, unemployment, and improvements in vehicle design, success can be attributed to the attention focused on prehospital services and emergency medicine (EM) in the last half century, as well as the attention paid to injury prevention efforts within the field of EM itself. The passage of the 1966 Traffic and Motor Vehicle Safety and Highway Safety Acts set unprecedented federal safety standards for motor vehicles and state highway safety programs [2]. In establishing such standards at federal and state levels, road safety compliance became a greater and more tangible priority. The next few decades saw an increase in federal funding, which was applied toward mass media awareness campaigns and research grants, as well as driving while intoxicated (DWI) regulations, and seatbelt and drinking-age laws [2]. With the increase in federal funding and the sense of
References
[1]
National Highway Traffic Safety Administration, Highlights of 2009 Motor Vehicle Crashes, U.S. Department of Transportation, 2010.
[2]
The National Road Safety Foundation, “Legislative Timeline,” 2011, http://www.nationalroadsafety.org/page.php?id=28.
[3]
American College of Emergency Physicians, “EMS: Where We've Been and Where We're Going. EMS Week Planning Guide,” 2006, http://www.dsf.health.state.pa.us/health/lib/health/ems/week04/2004_planning_kit_final.pdf.
[4]
World Health Organization, “Global Status Report on Road Safety: Time for Action,” 2009, http://www.un.org/ar/roadsafety/pdf/roadsafetyreport.pdf.
[5]
World Health Organization, “World Report on Road Traffic Injury Prevention,” 2004, http://www.who.int/violence_injury_prevention/publications/road_traffic/world_report/en/.
[6]
R. Koppaka, “Ten great public health achievements—United States, 2001–2010,” Morbidity and Mortality Weekly Report, vol. 60, no. 19, pp. 619–623, 2011.
[7]
World Health Organization, “2nd Global Status Report on Road Safety,” 2011, http://www.who.int/entity/violence.../global_status_report/flyer_en.pdf.
[8]
C. Murray, T. Vos, R. Lozano, et al., “Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010,” The Lancet, vol. 380, no. 9859, pp. 2197–2223, 2012.
[9]
Pan American Health Organization, “PanAmerican Conference on Road Safety: The Health Sector Answers to the Challenge of Safer Roads in America,” 2005, http://www.bvsde.paho.org/bvsacd/cd51/respuestaseng.pdf.
[10]
The World Bank, “World Bank Global Road Safety Facility Strategic Plan,” 2009, http://siteresources.worldbank.org/EXTTOPGLOROASAF/Resources/2582212-1265307800361/GRSF_strategic_plan.pdf.
[11]
United Nations Road Safety Collaboration, “Terms of Reference of the United Nations Road Safety Collaboration,” 2011, http://www.who.int/roadsafety/about/en/.
[12]
Global Road Safety Partnership, July 2011, http://www.grsproadsafety.org/.
[13]
International Road Safety Academy Association, July 2011, http://www.irsa-association.eu/.
[14]
International Road Federation, July 2011, http://www.irfnet.org/.
[15]
International Road Federation, “Fifty Years of Service,” 1997, http://www.irfnet.org/about.php.
[16]
Association for Safe International Road Travel, July 2011, http://www.asirt.org/.
[17]
Global Road Safety Forum, July 2011,http://www.globalroadsafety.org/.
[18]
“Make Roads Safe: The Campaign for Global Road Safety,” July 2011, http://www.makeroadssafe.org/.
[19]
World Health Organization, “Decade of Action: Saving Millions of Lives,” 2011, http://www.who.int/violence_injury_prevention/publications/road_traffic/decade_booklet/en/index.html.
[20]
F. E. Vaca, R. Sayegh, M. J. Mello, and S. W. Hargarten, “Historical parallel evolution of injury prevention and control science and emergency medicine,” Academic Emergency Medicine, vol. 16, no. 11, pp. 1049–1053, 2009.
[21]
World Health Organization, “Prehospital Trauma Care Systems,” 2005, http://www.who.int/violence_injury_prevention/publications/services/39162_oms_new.pdf.
[22]
J. Tintinalli, EMS: A Practical Global Guidebook, People’s Medical Publishing House, Shelton, Conn, USA, 2010.
[23]
R. M. Smith and A. K. Conn, “Prehospital care—scoop and run or stay and play?” Injury, vol. 40, supplement 4, pp. S23–S26, 2009.
[24]
I. G. Stiell, L. P. Nesbitt, W. Pickett et al., “The OPALS Major Trauma study: impact of advanced life-support on survival and morbidity,” Canadian Medical Association Journal, vol. 178, no. 9, pp. 1141–1152, 2008.
[25]
M. Liberman, D. Mulder, and J. Sampalis, “Advanced or basic life support for trauma: meta-analysis and critical review of the literature,” Journal of Trauma, vol. 49, no. 4, pp. 584–599, 2000.
[26]
S. Chekijian and N. Truzyan, “Practices, attitudes and perceptions toward road traffic safety in Yerevan, Reublic of Armenia,” Annals of Advances in Automotive Medicine, vol. 56, pp. 191–200, 2012.
[27]
J. A. Razzak, A. A. Hyder, T. Akhtar, M. Khan, and U. R. Khan, “Assessing emergency medical care in low income countries: a pilot study from Pakistan,” BMC Emergency Medicine, vol. 8, article 8, 2008.
[28]
The American College of Surgeons Trauma Programs, “Advanced Trauma Life Support,” October 2013, http://www.facs.org/trauma/atls/.
[29]
The American College of Surgeons Trauma Programs, “Advanced Trauma Operative Management,” October 2013, http://www.facs.org/trauma/atom/.
[30]
The American College of Surgeons Trauma Programs, “Advanced Surgical Skills for Exposure in Trauma (ASSET) Course,” October 2013, http://www.facs.org/trauma/education/asset.html.
[31]
The American College of Surgeons Trauma Programs, “ATLS International Promulgation,” October 2013, http://www.facs.org/trauma/atls/promulgation.html/.
[32]
National Association of Emergency Medical Technicians Programs, October 2013, http://www.naemt.org/education/PHTLS/whatisPHTLS.aspx.
[33]
Department of Emergency Medicine, Emory University, “Selected Core Projects,” Website Project List, December 2012, http://www.em.emory.edu/services/international_health/section_activities/core_projects.html.
[34]
World Health Organization, “Injury Surveillance Guidelines,” 2001, http://whqlibdoc.who.int/publications/2001/9241591331.pdf.
[35]
B. C. Nwomeh, W. Lowell, R. Kable, K. Haley, and E. A. Ameh, “History and development of trauma registry: lessons from developed to developing countries,” World Journal of Emergency Surgery, vol. 1, no. 1, article 32, 2006.
[36]
Transport Division (TD), “Asia-Pacific Road Accident Database (APRAD) User Manual,” 2001, http://www.unescap.org/publications/detail.asp?id=457.
[37]
National Institutes of Health, “International research training program in trauma and injury prevention,” Project Reporter, December 2012, http://projectreporter.nih.gov/project_info_description.cfm?aid=7780441&icde=0.
[38]
National Institutes of Health, “International collaborative trauma and injury research training,” Project Reporter, December 2012, http://projectreporter.nih.gov/project_info_description.cfm?aid=8087708&icde=8373934.
[39]
S. A. Felknor, G. L. Delclos, D. Gimeno et al., “Funding of pilot projects in Latin America: a tool for capacity building in occupational health research,” International Journal of Occupational and Environmental Health, vol. 12, no. 4, pp. 408–414, 2006.
[40]
H. Waseem, L. Carenzo, J. Razzak, and R. Naseer, “Epidemiology of major incidents: an EMS study from Pakistan,” International Journal of Emergency Medicine, vol. 4, no. 1, article 48, 2011.
