World Health Day 2004 is dedicated to road safety - a recognition of
the burden of injuries and deaths to road users world-wide, and the need
for collective action to address this problem. This fact sheet presents an
overview of injuries and deaths caused by motor vehicle traffic collisions
in Canada, prepared by the injury surveillance program in Health
Canada and the road safety program in Transport Canada.
Although Canada is one of the largest countries in the world, its
population density is among the lowest. Geographical expanse combined with
limited public transportation in many parts of the country leads Canadians
to rely heavily on private motor vehicles. With almost 19 million vehicles
on our roads and over 21 million drivers operating vehicles across more
than 900,000 kilometres of roads, road transportation is important to
virtually every Canadian.1 Unfortunately,
motor vehicle traffic collisions are associated with a large number of
deaths and serious injuries each year.
Profile of the Problem
There were 2,778 deaths due to motor vehicle traffic collisions in the
year 2001 - a rate of 8.9 deaths per 100,000 population.1,2
In 2000-2001 there were 24,403 hospital admissions for traffic-related
injuries, corresponding to a rate of 79 hospitalizations per 100,000
population.3 Many victims are young and
traffic collisions are a leading cause of premature death and long term
disability.
Since Canada has one of the highest per capita vehicle ownership rates
in the world, it is not surprising that vehicle occupants account for
approximately three quarters of all road users killed and seriously
injured each year. The remaining victims are vulnerable road users:
pedestrians, motorcyclists and bicyclists.1
When health care costs, property losses and other factors are considered,
the economic cost of traffic collisions to Canadians is as high as $25
billion annually.
In a recent comparison of traffic fatality rates among the 30
Organisation for Economic Cooperation and Development (OECD)
member-countries, Canada had the fifth lowest rate on the basis of traffic
deaths per billion vehicle kilometres travelled and the thirteenth lowest
rate when measured as deaths per 100,000 population.4
While Canada's traffic injury statistics are comparable to those of other
developed countries there remains room for improvement. Fatality rates for
selected countries are shown in Figure 1.
Figure 1: Traffic deaths per billion vehicle kilometres
travelled, OECD, selected countries, 2001
In recent decades, deaths and hospitalizations due to motor vehicle
traffic collisions have declined markedly in Canada. For example, since
1982 the road traffic death rate has declined by almost 50%.1,2
This decrease has occurred despite increasing numbers of vehicles and
licensed drivers on our roads (see Figure 2).
Figure 2: Motor vehicle traffic collision death rate*
(all ages ,both sexes), Canada,1982-2001
Government interventions such as laws mandating the use of seat belts
and child restraints, as well as more stringent drinking and driving
sanctions, public education and enforcement campaigns, safer vehicles and
road infrastructure enhancements have all contributed to the increased
safety of Canadian road users. Improvements in emergency medical response
and trauma care have also helped to reduce fatalities.
In spite of these impressive advances in road safety in Canada, many
serious problems still exist and the rates of death and hospitalization
associated with traffic collisions remain unacceptably high.
Risk Factors and Preventive Measures
Drivers account for more than half of all road users killed.1 Driver
inexperience, and health limitations common among elderly drivers increase
risk. Other factors often associated with fatalities are single-vehicle
crashes on undivided rural roads, drinking and driving, and non-use of
seat belts often resulting in ejection (see Figure 3). Approximately 40%
of all fatally injured occupants are unrestrained and, of these, almost
half are ejected from their vehicles.5
Alcohol and excessive speed are recognized as important contributing
factors in many collisions and emerging factors such as driver distraction
(e.g., use of cellular telephones) are also of concern. Canadian road
users also face increased risks associated with driver fatigue and winter
road conditions. Multiple risk factors are simultaneously in play in many
fatal traffic collisions.
Figure 3: Drivers fatally injured in single vehicle crashes on
rural roads and undivided highways, Canada, 1993-1997 average
Young drivers, aged 16-19 years, and elderly drivers, 75 years and
older, have the highest risk of being killed in a traffic collision, at 27
deaths and 20 deaths per billion vehicle kilometres travelled,
respectively 6 (see Figure 4). With regard
to young drivers, seven provinces and one territory in Canada have
instituted graduated licensing programs, which have proven effective in
reducing collisions causing injury among novice drivers.7
Figure 4: Drivers fatally injured per billion vehicle
kilometres travelled*, by age, Canada, 2001
Although surveys estimate current use of seat belts at almost 90% in
mainly urban areas, 8 promotion of seat belt
use and appropriate child restraint systems remains important in
prevention efforts. Ejection from a vehicle during a collision greatly
increases the risk of severe injury or death. The combination of seat belt
use and air bag deployment during collision remains the best protection
for adults. For children, correctly installed and size appropriate
restraint systems (rear facing infant car seats, front facing car seats,
booster seats and lap belts) are required. Children under 13 years of age
should not be restrained in front seats equipped with air bags.
In the year 2001, 38% of fatally injured drivers who were tested had
been drinking alcohol, and of these almost 85% had blood alcohol levels in
excess of the Criminal Code legal limit of 80 mg%. Although alcohol use
among drivers killed in collisions is less than what was seen even a
decade ago, current levels of impaired driving remain unacceptably high.1
Increased enforcement, tougher sanctions and innovative approaches such as
administrative license suspensions, alcohol ignition interlocks and
assessment/rehabilitation programs have been introduced in many
jurisdictions to further reduce impaired driving.
Other preventive efforts should also be encouraged. Use of bicycle
helmets is now mandated in six provinces. A recent study showed a
reduction in serious head injuries among cyclists after introduction of
this legislation. These findings may lead to similar legislation in other
jurisdictions.9 The automotive industry
continues to enhance vehicle safety features. As older vehicles are
replaced with ones equipped with crumple zones, anti-lock brakes and air
bags, our motor vehicle fleet becomes progressively safer. Similarly,
enhanced road infrastructure design and maintenance contribute to safety.
Creative approaches such as pedestrian countdown signals, pedestrian
islands, shoulder widening and pedestrian/cyclist pathways are being used
to improve separation of motor vehicle traffic from more vulnerable
pedestrians and bicyclists, especially in urban settings.
The Vision
Under the auspices of the Canadian Council of Motor Transport
Administrators, the nation's principal road safety stakeholders have
developed a national plan of action Road Safety Vision 2010 - Making
Canada's Roads the Safest in the World. This plan is supported by a number
of strategic objectives and quantitative targets including some associated
with increased seat belt wearing, proper use of child restraints, and
reduced fatalities and serious injuries associated with drinking drivers
and excessive speed. In order to have the safest roads in the world by
2010, Canada needs to reduce fatalities and serious injuries by 30%.
Road safety is the responsibility of both the transportation and health
sectors. Once a traffic injury occurs the health sector has
responsibilities in emergency response, trauma care and rehabilitation.
Public health and transportation experts work together to increase public
awareness, to promote safe behaviours on the road, and to establish road
safety programs. They engage in partnerships and receive support from the
automotive and insurance industries, legislators and law enforcement
agencies, and other sectors. This important work is carried out at all
levels of government: federal, provincial/territorial and municipal. The
dramatic reductions in traffic fatalities already achieved in Canada are
the result of the engagement, cooperation and sustained efforts of all
road safety stakeholders. This joint engagement must be strengthened and
sustained in order to achieve much needed further reductions in traffic
related deaths and injuries.
References
- Canadian Motor Vehicle Traffic Collision Statistics, 2001.
Transport
Canada
- Population Data, Statistics Canada. Analysis by Injury and Child
Maltreatment Section, Health Surveillance and Epidemiology Division,
Population and Public Health Branch, Health Canada, 2004.
- Hospitalization Data, Canadian Institute for Health Information (CIHI).
Analysis by Injury and Child Maltreatment Section, Health Surveillance
and Epidemiology Division, Population and Public Health Branch, Health
Canada, 2004.
- International Road Traffic and Accident Database, 2001. OECD
- Unbelted Fatally and Seriously Injured Drivers, 1993-1997. Transport
Canada.
- Traffic Accident Information Database, Canadian Vehicle Survey 2001.
Transport Canada, Statistics Canada.
- Simpson H. The Evolution and Effectiveness of Graduated Licensing.
Journal of Safety Research 2003: 34(1); p 25-34.
- Seatbelt Use in Canada Survey, 2001.
Transport
Canada
- Macpherson A, To T, Macarthur C, et al. Impact of Mandatory Helmet
Legislation on Bicycle-Related Head Injuries in Children: a
Population-Based Study. Pediatrics
2002: 110(5); e60.
Selected Resources
- Transport
Canada
- Health
Canada
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