Key Health Data for the West Midlands 2002
CHAPTER EIGHT: ROAD TRAFFIC ACCIDENTS
List of Tables
List of Figures
Main Body
1: The Geography of the West Midlands
2: Life Expectancy and Inequalities
3: Drinking Water Quality
4: Chemical incidents in the West Midlands
5: Landfill Sites
6: IPPC
7: Fires in the West Midlands
8: Road Traffic Accidents
9: Drownings
10: Access to a healthy diet
11: National Health Service Priority Areas
12: Communicable Disease
13: Older People
8.1 Introduction
Road traffic accidents (RTAs) are now at their lowest level for 40 years. However they are still the leading cause of death from injury, and are of great public health concern. Every year around 3,500 people are killed on our roads and 40,000 are seriously injured. (Department of Health, 1999)
Hospital based studies of RTAs can provide information on casualties from both police reported and unreported incidents, and therefore can go further than police data alone in reflecting the incidence of RTAs. However, police RTA data contains more detailed information about each incident and the types of vehicles involved.
This chapter uses two sources of health data (hospital admissions and mortality data) and police data to describe the incidence of RTAs in the West Midlands NHS region. The health data have been analysed to look at geographical and demographic variation. The police data have been analysed to look at more specific aspects, for example the numbers and types of vehicles involved and the distribution of accidents occurring throughout the day.
8.2. Geographical variation in RTA rates
Figures 8.1 to 8.3 show the age/sex standardised rates of all admissions, admissions with a stay of more than three days (as a proxy for serious injuries) and mortality after an RTA for each PCT. Looking at all admissions, the rates were highest in Herefordshire (173.9 per 100,000) and lowest in South Stoke (49.6 per 100,000). The pattern for serious injuries was similar with the highest rates in Herefordshire (45.2 per 100,000) and the lowest in North and South Stoke (16.8 per 100,000). When looking at mortality the highest rates were again found in Herefordshire (9.4 per 100,000) and the lowest in South Stoke and Wednesbury and West Bromwich (3.5 per 100,000). In general the rates were higher in the rural areas and lower in the urban areas. One of the main reasons for this is that the roads, which pass through rural areas generally, have higher speed limits, and severity of injury tends to increase with the speed of the vehicle.
8.3. Demographic variation in RTA rates
Figures 8.4 through to 8.6 show the age/sex specific rates of all admissions, admissions with a stay of more than three days (as a proxy for serious injuries) and mortality after an RTA. As can be seen from the three graphs the rates were consistently higher in males than females. For all admissions the rate was highest in males aged 10-14 and 15-19 (1,561 and 1,471 per 100,000). Looking at serious injury, the rate was highest in those aged over 85 for males and females (494 and 285 per 100,000). Mortality was highest in males aged over 85, where the rate was over double that of any other age group (228.8 per 100,000). In females the pattern was similar but the rates were lower (the highest rate was 65.3 per 100,000 in the over 85s). Previous studies have found that admission and mortality rates are highest among older people. (Peng and Bongard, 1999, Demetriades et al, 1998) Their risk of being killed or suffering a serious injury is between two and five times greater than that of a younger person because of their increased frailty. (Holland, 2001)
8.4. Police reported incidents
The following analyses have been performed using road traffic accident data (STATS19) as recorded by West Midlands Police.
Vehicles involved
The majority of RTAs (61.4%) involved 2 vehicles and 28.5% involved one vehicle. (Figure 8.7) Cars were involved in 80.4% of incidents, and goods vehicles involved in 6.4%. (Figure 8.8) Pedal cycles and motorcycles were involved in 3.7% and 3.1% of incidents.
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Figure 8.7. Number of vehicles involved in police reported road traffic accidents (2000/2001) |
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Figure 8.8. Type of vehicle involved in police reported road traffic accidents (2000/2001) |
Timing of accidents
The greatest proportion of accidents occurred between 12:00 and 20:00 peaking between 16:00 and 18:00. (Figure 8.9) There was also a smaller peak in the morning between 08:00 and 09:00. These are the times when there is an increased amount of traffic on the road and the peaks coincide with journeys to and from work. The proportion of incidents was lowest throughout the night from 00:00 to 07:00.
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Figure 8.9. Distribution of police reported road traffic accidents by time of day (2000/2001) |
Casualties
Of the incidents that resulted in casualties, 57.1% resulted in one casualty, 24.5% two casualties and in 10.0% there were three. (Figure 8.10) In 44.6% of cases the casualty was a driver (of any type of vehicle), in 26.7% a passenger, in 17.6% a pedestrian and in 11.1% a rider (including pedal cycle, motorcycle, moped and other non-motor vehicles). (Figure 8.11) 89.2% of casualty cases were recorded as slight, 10.3% as serious and 0.5% were recorded as fatal.
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Figure 8.10. Number of casualties resulting from police reported road traffic accidents (2000/2001) |
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Figure 8.11. Road user type of casualties from police reported road traffic accidents (2000/2001) |
Drivers
Over half of the drivers involved in an RTA were aged between 20 and 39 (58.1%), with a peak in the 30-34 year age group. (Figure 8.12) In those aged 35 and over the number of drivers involved decreased as age increased. Four percent of incidents involved drivers over the age of 65. However, the numbers of drivers in each age group and the number of miles driven need to be taken into consideration. The number of miles driven decreases with age, for example in 1996/98 males aged 25-49 drove 8,612 miles per person per year compared to 2,006 miles per person per year in males aged 75-79. (Noble, 2000)
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The datasets used in this chapter give an indication of the incidence, types and severity of RTAs in the West Midlands region. However an unknown proportion of accidents and casualties go unreported. Police data are likely to underestimate the number of accidents and the number of casualties, since they generally attend the more severe incidents where there is an obstruction to the road or where an ambulance is required. In the less severe cases the police are only informed of a casualty after the event. Previous work comparing police and A&E data found that levels of under-recording in police data were greatest for slightly injured casualties and vehicle occupants. (Simpson, 1996) Hospital admissions data only contain information on the more seriously injured patients. However these data are likely to be accurate as the patient is in a stable environment and relatives are available to give information. Mortality data are accurate and represent the true number of deaths from RTAs.
Accident and Emergency (A&E) department data are a potentially useful source of RTA casualty information. These data are collected by the Department of Public Health & Epidemiology but have not been provided by all Trusts in the region, therefore were not included in this chapter as no meaningful comparison with the other datasets could be made.
References
Demetriades D, Murray J, Sinz B, et al. Epidemiology of major trauma and trauma deaths in Los Angeles county. Journal of the American College of Surgeons 1998; 187: 373-383.
Department of Health. Saving lives: Our Healthier Nation. London: HMSO, 1999.
Holland CA. Road Safety Research Report No.25. Older drivers: A literature review. London: Department for Transport, 2001.
Noble B. Travel characteristics of older people. London: Department for Transport, 2000.
Peng RY, Bongard FS. Pedestrian versus motor vehicle accidents: An analysis of 5,000 patients. Journal of the American College of Surgeons 1999; 189: 343-348.
Simpson H. National hospital study of road accident casualties. Transport Research Laboratory. 1996.
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