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Citation |
Haddon W. Isr. J. Med. Sci. 1980; 16(1): 45-65. |
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Copyright |
(Copyright © 1980, Israel Journal of Medical Sciences) |
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DOI |
unavailable |
PMID |
7358516 |
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Abstract |
A logical system for preventing injury and death in motor vehicle crashes is based on the sequence of events (precrash, crash, and postcrash) and types of factors involved (human, vehicle and equipment, physical environment and roadway, and socioeconomic environment). By forming a matrix, various options and evidence of their effectiveness can be individually evaluated. Although screening for high-risk drivers has not been generally effective, young drivers with previous crash records have exceptionally high fatal crash involvement which suggests that these drivers should lose their driver's license after the first violation. High school driver education programs have been linked to increased licensing of 16-17 year old drivers, resulting in increased fatalities for this age group. No favorable results from high school driver training have been shown, even for drivers over 18 years of age. Alcohol abuse is a significant contributor to injury and death. Although data on vehicle safety inspection are inconclusive, evidence indicates that adding a simple, midline rear brake light will greatly reduce rear-end collisions. Vehicle crash phase programs include designing vehicle fronts less hostile to pedestrians and others, designing trucks to prevent under-ride by impacting cars and greatly improving the crash packaging of vehicle occupants. Crash packaging improvements encompass laminated windshields firmly anchored in place, steering assemblies and dashboards that cushion impacting occupants, doors that stay shut in crashes, protected fuel tanks, and limiting vehicle speeds to levels within the vehicle's capability to protect occupants. Passive restraints will augment the already demonstrated protection provided by seat belts, and further reduction in fatalities is expected in 1982 when these systems will be required on every new car. Precrash, physical environment, and roadway factors include nonskid road surfaces, the elimination of pedestrian crossings on highways, and the separation of vehicle and pedestrian pathways. Crash, physical environment, and roadway actions involve design, installation, and maintenance of guardrails; provision of clear roadside deceleration areas; removal of fixed poles from the roadside; provision of energy-absorbing systems where objects intrude on traffic flow; and use of breakaway sign, light, and telephone poles in high accident areas. Consideration is given to such socioeconomic factors as the quality of emergency medical care, laws affecting alcohol use, public information campaigns, and motorcycle crash helmet use. |