Road safety: serious injuries remain a major unsolved problem

Ben Beck, Peter A Cameron, Mark C Fitzgerald, Rodney T Judson, Warwick Teague, Ronan A Lyons and Belinda J Gabbe
Med J Aust 2017; 207 (6): 244-249. || doi: 10.5694/mja17.00015


Objective: To investigate temporal trends in the incidence, mortality, disability-adjusted life-years (DALYs), and costs of health loss caused by serious road traffic injury.

Design, setting and participants: A retrospective review of data from the population-based Victorian State Trauma Registry and the National Coronial Information System on road traffic-related deaths (pre- and in-hospital) and major trauma (Injury Severity Score > 12) during 2007–2015.

Main outcomes and measures: Temporal trends in the incidence of road traffic-related major trauma, mortality, DALYs, and costs of health loss, by road user type.

Results: There were 8066 hospitalised road traffic major trauma cases and 2588 road traffic fatalities in Victoria over the 9-year study period. There was no change in the incidence of hospitalised major trauma for motor vehicle occupants (incidence rate ratio [IRR] per year, 1.00; 95% CI, 0.99–1.01; P = 0.70), motorcyclists (IRR, 0.99; 95% CI, 0.97–1.01; P = 0.45) or pedestrians (IRR, 1.00; 95% CI, 0.97–1.02; P = 0.73), but the incidence for pedal cyclists increased 8% per year (IRR, 1.08; 95% CI; 1.05–1.10; P < 0.001). While DALYs declined for motor vehicle occupants (by 13% between 2007 and 2015), motorcyclists (32%), and pedestrians (5%), there was a 56% increase in DALYs for pedal cyclists. The estimated costs of health loss associated with road traffic injuries exceeded $14 billion during 2007–2015, although the cost per patient declined for all road user groups.

Conclusions: As serious injury rates have not declined, current road safety targets will be difficult to meet. Greater attention to preventing serious injury is needed, as is further investment in road safety, particularly for pedal cyclists.

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  • Ben Beck1
  • Peter A Cameron1,2
  • Mark C Fitzgerald2,3
  • Rodney T Judson4
  • Warwick Teague5
  • Ronan A Lyons6
  • Belinda J Gabbe1,6

  • 1 Monash University, Melbourne, VIC
  • 2 Emergency and Trauma Centre, The Alfred Hospital, Melbourne, VIC
  • 3 National Trauma Research Institute, Melbourne, VIC
  • 4 Private Medical Centre, Royal Melbourne Hospital, Melbourne, VIC
  • 5 Royal Children's Hospital, Melbourne
  • 6 Farr Institute, Swansea University, Swansea, Wales, United Kingdom



The Victorian State Trauma Registry (VSTR) is funded by the Department of Health and Human Services, the State Government of Victoria, and the Transport Accident Commission. Ben Beck received salary support from the National Health and Medical Research Council (NHRMC) Australian Resuscitation Outcomes Consortium (Aus-ROC) Centre of Research Excellence (1029983). Peter Cameron was supported by an NHMRC Practitioner Fellowship (545926) and Belinda Gabbe by an NHMRC Career Development Fellowship (GNT1048731). Warwick Teague’s role as director of trauma services at the Royal Children’s Hospital, Melbourne, is supported by a grant from the Royal Children’s Hospital Foundation. We thank the Victorian State Trauma Outcome Registry and Monitoring (VSTORM) group for providing VSTR data. We also thank Sue McLellan for her assistance with the data, Pam Simpson for her statistical support, and David Attwood from the Transport Accident Commission for his suggestions and advice.

Competing interests:

No relevant disclosures.

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