Keeping safe

Stephanie Pratt, National Institute for Occupational Safety and Health (USA), looks at global initiatives to prevent road traffic injury at work

Prevention of road traffic injuries is gaining recognition as a public health imperative. In the general population, deaths from road traffic injuries are projected to increase from 1.2 million in 2002 to 1.9 million in 2030, with low- and middle-income nations bearing most of the increase. If effective interventions are not implemented, the World Health Organisation and the World Bank estimate that by the year 2030, road traffic injuries will become the 8th leading cause of mortality worldwide.
    
Most of the deaths and disabilities from road traffic crashes occur in low- and middle-income countries, where the majority of those affected are in their most productive years of life. The death or disability of a wage-earner, or the loss of a vehicle, can cause a family to slide into poverty from which it may not recover for generations.  More broadly, in low-income countries the direct costs of road traffic crashes are estimated to be one per cent of the gross national product, exceeding the funds received in development assistance.

Sufferers
In many countries around the world, road traffic crashes are a leading cause of workplace death, injury, and disability. Workers, families, businesses, and society all suffer the consequences of workplace crashes through physical and emotional suffering, lost earnings and productivity, medical costs, and potentially catastrophic liability costs. In the  (USA), road traffic crashes on public highways accounted for over 20,000 worker deaths between 1992 and 2006, and 23 per cent of all occupational fatalities in 2006. The vast majority of those who die in crashes at work in the USA are operators of motorised vehicles, over 87 per cent for the years 1992-2000.
    
Because economic development and rapid motorisation go hand in hand, workers in the developing world are becoming increasingly vulnerable to the risk of road traffic crashes. Traffic safety risks are different for workers in low- and middle-income nations, where road networks frequently do not route higher-speed traffic and larger vehicles onto separate highways, as is done in higher-income nations. Therefore, victims of roadway crashes, occupational and non-occupational, are frequently pedestrians or operators of two-wheelers, three-wheelers, or non-motorised vehicles.
    
Road safety at work is a public health issue, not just a workplace safety issue. For example, throughout the world, conflicts between work vehicles and the motoring public frequently involve trucks. In the USA, 803 drivers of large trucks (i.e., those weighing more than 10,000 pounds) died in road traffic crashes during 2005, and 27,000 were injured. In the same year, an additional 3,944 occupants of other vehicles and 465 pedestrians and other non-motorists were killed in large-truck crashes. In India, trucks were involved in 21,772 of the 91,376 traffic fatalities recorded in 2004 (24 per cent).
    
The importance of workplace driving and vehicle fleets is underscored by the recent United Nations General Assembly Resolution A/62/244 on ‘Improving Global Road Safety’. This resolution, sponsored by more than 90 countries and adopted unanimously on 31 March 2008, includes encouragement for "organisations in both private and public sectors with vehicle fleets to develop and implement policies and practices that will reduce crash risks for vehicle occupants and other road users". For the first time, a UN resolution includes specific language that notes the importance of fleet operations to worker safety and public safety. This gives strong justification for corporations, governments, and others to take action to improve road safety for workers around the world.

Activities to promote road safety
The U.S. National Institute for Occupational Safety and Health (NIOSH), part of the Centers for Disease Control and Prevention, is working with other leaders in occupational safety and health in the USA and globally to reduce the toll of road traffic injuries at work. NIOSH, the World Health Organization (WHO), and the International Labour Organization (ILO) are co-sponsoring the International Conference on Road Safety at Work, 16-18 February 2009, Washington, DC, USA. This event will bring together business and labor representatives, policy makers, and the research community to address road traffic injury prevention at work. The conference will summarise current international knowledge about road safety in the workplace and serve as a forum for discussion of initiatives to promote road safety for workers around the globe. For further information about the conference, please visit www.cdc.gov/niosh/programs/twu/global, or contact Jane Hingston of NIOSH at JHingston@cdc.gov.
    
NIOSH and partners are developing the ’Road Safety at Work’ online library to house resources from around the world related to prevention of road traffic injuries and deaths while at work. The library, which may be accessed at www.roadsafetyatwork.org, contains employer policies and guidance documents on road safety at work, research reports on risk factors for work-related crashes, and statistics about worker injuries and fatalities on roads. For more information, or to contribute materials to the library, please contact Jane Hingston of NIOSH at JHingston@cdc.gov.
    
NIOSH research and educational materials address a number of topics related to road safety, including occupational health and safety of truck drivers, truck cab design, screening of truck drivers for sleep apnea, motor vehicle crashes among military personnel, injuries to emergency medical technicians working in ambulances, crash injuries to highway construction workers, and use of safety belts by workers in the oil and gas industry.
    
Through linkages with international partners, NIOSH encourages research and data collection that will promote road safety in workplaces outside the USA. Products include an international review of data sources on road traffic injuries at work, and road safety fact sheets available in both English and Spanish. Work is currently in progress with groups such as the WHO, Pan American Health Organization, ILO, United Nations Road Safety Collaboration, and Indian Council of Medical Research.

For more information
For more information about NIOSH road safety research and to obtain NIOSH publications on road safety, please visit www.cdc.gov/niosh/topics/motorvehicle/ and www.cdc.gov/niosh/programs/twu/, or contact Stephanie Pratt of NIOSH at SPratt@cdc.gov.