Introduction to Road Safety

Road safety can be defined as the absence of risk of harm to road users in the road transportation system, including sidewalks and pathways. In a perfectly safe system, no injuries would be sustained. However, due to a multitude of interdependent factors, collision-related injuries and loss of life continue, and road injury prevention remains a major public health issue. In 2019, the social cost of Canadian motor vehicle collisions was estimated at $41 billion, or around $112 million each day (in 2010 dollars). https://www.itf-oecd.org/sites/default/files/canada-road-safety.pdf

Labeling road traffic collisions and injury events as “accidents” suggests that they cannot be prevented or reduced in severity. However, the vast majority of these events are not “accidents” because they are both foreseeable and preventable. A large body of evidence demonstrates that public health interventions have dramatically reduced fatalities and injuries in most high-income countries. https://jamanetwork.com/channels/health-forum/fullarticle/2760052. Therefore, we refer to injury or property damage events as “collisions” or “crashes”.

Due to the complexity of interactions in the system (infrastructure/environment, human behaviour, and mode of transportation), achieving safer roads involves a wide range of disciplines. These disciplines include infrastructure planning and engineering, behavioural and health sciences, law and law enforcement, road safety advocacy, vehicle manufacturing, driver training and licensing, insurance and policy development, and post-crash response.

The clinical needs of the trauma patient can be complex, and international research has shown that in order to achieve improved clinical outcomes for the patient, a time interval of 60 minutes (the Golden Hour) from the time of the incident to arrival at the appropriate hospital for on-going treatment should be achieved. The first ten minutes of the Golden Hour, known as the Platinum ten minutes, sets the bar for the response time for the highest performance EMS systems.

The total post-crash response comprises three phases:

  • Phase1 -  Pre-hospital,
  • Phase 2 - In Hospital,
  • Phase 3 - Rehabilitation and discharge.

In order to become a national priority, several bodies must be involved to ensure the success of road safety programs and campaigns. Therefore, in its global report on road traffic injury prevention, the World Health Organization (WHO) suggests a model for multi-sectorial collaborations. (see below Figure from WHO)

Model for Multi-sectorial Collaborations
WHO Model for Multi-sectorial Road Safety Collaborations
(https://apps.who.int/iris/bitstream/handle/10665/42871/9241562609.pdf;jsessionid=0F731E75878023B3952F8865DCB6A8E8?sequence=1)