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Motor Vehicle Collisions in British Columbia
Did you know...
There are approximately 400 deaths due to motor vehicle crashes in BC each year.
The age group with the greatest percentage of deaths are those aged 15-24 years, representing over 25% of deaths.
There are approximately 36 deaths due to motorcyclist collisions with vehicles each year. Those aged 20-29 years are at greatest risk.
There are approximately 66 deaths per year due to motor vehicle collisions with pedestrians each year. Those aged 75-84 years are at greatest risk.
There are approximately 4,200 hospitalizations due to motor vehicle crashes in BC each year.
The age group with the greatest percentage of hospitalizations are those aged 15-24 years, representing 23% of deaths.
There are approximately 700 motorcyclist injuries that require hospitalization each year. Those aged 20-24 years are at greatest risk.
There are approximately 600 injured pedestrians that require hospitalization each year. Those aged 15-19 years are at greatest risk.
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Preventing Motor Vehicle Occupant Injuries
Some important tips:
All children aged 12 and under should ride in the back seat when in a car.
Infants (0-1 year old):
- Use infant-only car seat or rear-facing convertible until the infant weighs at least 20-22 lbs.
- Harness straps should be at and below shoulder level.
- Never put an infant in the front seat of a car with passenger side airbags.
Toddlers (1-2 years old):
- Convertible / Forward -facing car seat for toddlers weighing over 20 - 40 lbs.
- Harness straps should be at and above shoulders.
- Most seats require top slot for forward-facing.
Preschoolers (3 - 4 years old):
- Forward-facing car seat until preschooler weighs 40 lbs.
- Forward-facing belt positioning booster seat for preschoolers over 40 lbs.
- Belt positioning booster seats must be used with both lap and shoulder belt.
5-14 Years Old
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Young children should graduate from car seats to booster seats. Booster seats are required until the child is age 9 and 4'9" tall and 80 lbs.
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Older children and teenagers wear seatbelts. The lap belt should fit low and tight across the lap/upper thigh area and the shoulder belt should fit snug crossing the chest and shoulder to avoid abdominal injuries.
15+ Years Old
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Obtain training to get a driver's license through the Graduated Licensing Program (GLP).
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Seat belts to be worn at all times. The lap belt should fit low and tight across the lap/upper thigh area and the shoulder belt should fit snug crossing the chest and shoulder to avoid abdominal injuries. Sit at least 25 centimeters away from the steering wheel.
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Strict adherence to the speed limits at all times, special attention to speed limits on school and playground zones.
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Refraining from impaired driving. Plan ahead to get home safely. Take the bus, call a cab, arrange for a designated driver or call a friend or a family member for a ride.
Factsheet: Seat Belt Use for All Ages in British Columbia
In BC every Driver and Passenger MUST Wear a Seat Belt
In 2007, BC implemented legislation that requires every driver and passenger travelling on provincial roads to wear a seat belt. BC joined Ontario and New Brunswick who implemented similar legislations. This is a very positive step forward from the previous requirement of seat belt use by a vehicle occupant only if there was an assembly in that seating position.
(NATIONAL OCCUPANT RESTRAINT PROGRAM 2010 (NORP, 2010), Annual Monitoring Report, 2007).
Motor vehicle collision related head injuries are causing longer stay in hospital
A recent British Columbian study analyzed 48,753 admissions due to an incident involving head injuries. The mean length of hospital stay was 7.4 days. The diagnosis with the longest mean length of stay was a "Fractured Skull" while of the top five E-code categories, "Motor Vehicle Traffic" had the highest mean length of stay with 12.2 days. Further this study indicated that there are certain "at risk" groups for head injuries - in particular, younger men with lower socioeconomic standing.
Phillips LA, Voaklander DC, Drul C, Kelly KD. The epidemiology of hospitalized head injury in British Columbia, Canada. Can J Neurol Sci. 2009; 36(5):605-11.
Motor Vehicle Crashes and Spinal Cord Injuries
A recent study published in the Journal of Neurosurgery (2010) shows that motor vehicle crashes (MVCs) were the leading cause of spinal cord injuries. Motor vehicle crashes accounted for 66% of spinal cord injuries reported from the largest Canadian adult trauma centre.
Reference: Pirouzmand F. Epidemiological trends of spine and spinal cord injuries in the largest Canadian adult trauma center from 1986 to 2006. J Neurosurg Spine. 2010;12(2):131-40.
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Preventing Child Occupant Injuries
What's the Rush? SafeKids Canada and Johnson & Johnson sponsor the “What's the Rush“ campaign to explore speed and surviveability of children in a car crash. Click here for more information.
Child Restraint Seats
Canada's Road Safety Vision 2010 recognizes the contribution of seat belt use and child safety seats to the reduction of traffic fatalities. The proper use of occupant restraints remains the most cost-effective method available to reduce death, injuries and economic loss resulting from motor vehicle collisions. The Canada Road Safety Vision set an enhanced target to all motor vehicle occupants in 2001 to achieve and/or maintain a 95% seat belt wearing rate by all vehicle occupants and proper use of child restraints by 2010.
Less than 10% of child safety seats in use throughout British Columbia are properly installed according to data collected in recent inspections. Although many parents know child safety seats are important, more than 90% of seats are misused. Despite recent advancements in technology and education, the British Columbia Automobile Association (BCAA) recently reported that only 7% of seats were found to be installed or used correctly.1 Misuse of child restraint systems is exceedingly high and can result in serious injury and death in a crash. Unintentional injuries account for the majority of deaths to children and young adults in BC. The largest portion of these deaths is attributed to motor vehicle crashes. Proper use of protective devises will significantly affect death and disability from motor vehicle crashes. More recent studies suggest that appropriately installed child safety seats can reduce serious injury by up to 67% and mortality by as much as 71%. Increased education for parents regarding proper use of child safety seats can protect children from potentially fatal crash forces.
1http://autonet.ca/Maintenance/Accessories/story.cfm?story=/Maintenance/Accessories/2004/05/31/480502.html
Important points for the appropriate use of child restraint seats
(1) Make sure your child restraint seat is properly fitted every time you use it.
(2) Allow plenty of time when fitting a child restraint in your car and always follow the manufacturer's instructions carefully.
(3) Children must not be placed in the front seat of a vehicle in which there is an air bag. The preferred seating site for children is in the back seat. The American Academy of Pediatrics (AAP) recommended that all pre-adolescent children ride (properly restrained) in the back seat of the automobile. Such a simple maneuver will significantly reduce the risk of death and serious injury to the child.
(4) Child restraints come in a wide variety - baby seats, child seats, booster seats and booster cushions. Injuries to children can be significantly reduced if they use a suitable child restraint.
(5) Beware of old or secondhand restraints which may be damaged or worn out and which may not have the correct fitting instructions. They may not provide the best level of protection.
(6) A seat that is more than 10 years old should not be used, and it is best practice not to use a seat that is more than six years old. Older seats are not designed to the same safety standards as current seats.
(7) An adult belt is designed for someone with an adult bone structure and who is 150 cm (approximately 4'11") or taller. It is not designed for a child. A booster seat or cushion may not be popular with older children but it puts them in the right position so that they get the maximum protection from the adult belt. If the shoulder-lap seat belt is not properly positioned, the child may slip forward under the belt (termed submarining); the child's abdomen and neck then bear the force of the crash. Submarining can cause the lap belt to rupture or lacerate internal organs. Only children heavier than 81 pounds and taller than 58 inches may use an adult seat belt.
Booster Seats
For more information view the Booster Seat Fact Sheet
Booster Seat Laws are Effective
A recent longitudinal study published in the Archives of Pediatric and Adolescent Medicine found that children in states with laws requiring booster seats up to age 7 years were 39% more likely to be appropriately restrained than children in states without such laws. Within those groups, the 6- and 7-year-olds in states with booster seat laws were twice as likely to be in child restraints as children of the same age in states without those laws. Four- and 5-year-olds were 23 percent more likely to be appropriately restrained if they lived in a state with booster seat laws.
Abstract of this article is available at: http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17339508
Evidence from a systematic review showed that legislation coupled with education campaigns successfully increases the use of optimal restraints:
Zaza S, Sleet DA, Thompson RS, et al; Task Force on Community Preventive Services. Reviews of evidence regarding interventions to increase use of child safety seats. Am J Prev Med 2001; 21 (4 Suppl): 31-47.
This systematic review was published by the Task Force on Community Preventive Services-an independent, nonfederal panel of community health experts-to develop recommendations on the use of these interventions. In November 2001, the reviews and recommendations were published in a supplement of the American Journal of Preventive Medicine. To access the full text articles and learn more about The Guide to Community Preventive Services, visit www.thecommunityguide.org.
According to the best evidence from the above community guide systematic review and the recent Cochrane systematic review the following initiatives will increase booster seat use:
- schemes that provide free or discounted booster seats with education on their use have the most benefit
- education-only schemes are also successful.
Reference: Ehiri JE, Ejere HOD, Magnussen L, et al. Interventions for promoting booster seat use in four to eight year olds travelling in motor vehicles. Cochrane Database Syst Rev 2006; (1): CD004334.
For more information on the law on child restraint wearing, please refer to the following web sites:
The American Academy of Pediatrics (AAP) guide to choosing appropriate car seats
http://www.aap.org/family/carseatguide.htm
http://aappolicy.aappublications.org/cgi/content/full/pediatrics;109/3/550
Canadian Pediatric Society’s position statement on child safety seats
http://www.cps.ca/english/statements/IP/IP08-01.htm
Transport Canada-Child safety
http://www.tc.gc.ca/roadsafety/childsafety/menu.htm
SAFE KIDS Canada
http://www.sickkids.ca/safekidscanada/
Child restraint seat laws in British Columbia
http://www.icbc.com/road_safety/carseat_law.asp
BCAA Traffic Safety Foundation-child safety seat information
http://www.tsf-bcaa.com/Content/links_and_resources
Safe Start First Ride-Safe Ride
http://www.injuryresearch.bc.ca/admin/DocUpload/3_20100223_170558first%20ride%20safe%20ride.pdf
Safe Start at BC Children’s Hospital-child safety seat information
http://www.bcchildrens.ca/KidsTeensFam/ChildSafety/SafeStart/default.htm
St. John Ambulance-child safety seat information
http://www.sja.ca/splash.aspx
Effectiveness of incentive and education programs for use of child restraint seats- Systematic literature review and evidence based recommendations
http://www.thecommunityguide.org/mvoi/
Child passenger safety seat program at National Highway Traffic Safety Administration (NHTSA)
http://www.nhtsa.dot.gov/portal/site/nhtsa/menuitem.9f8c7d6359e0e9bbbf30811060008a0c/
Children's Hospital of Philadelphia (CHOP)-Partners in Child Passenger Safety
http://www.chop.edu/carseat
For more information concerning these child passenger safety topics, please visit the following websites:
Obese children and car safety seats
The Importance of Appropriate Child Safety Seat Use
Kids don’t like to sit still. But in a car, they not only have to stay in the seat, it has to be the right seat. At the Centers for Disease Control and Prevention, Dr. Arlene Greenspan says buckling a child into an adult seat belt isn’t good enough.
http://www.hhs.gov/news/healthbeat/2009/12/20091208a.html
Child safety seats in cabs
A recent cross-sectional survey of 35 taxicab companies from large Canadian cities found that over 80% of companies do not provide child safety seats for their clients. Lack of government regulation was cited as the main reason for their unavailability. Other perceived barriers included inconvenience, cost and lack of demand. Many companies would accommodate a child safety seat provided by the caregiver.
Reference: Zwiers N. Pearlman L. Campbell C. Child restraint devices in Canadian taxi cabs. Pediatric Child Health 2009; 14 (98) 503-508.
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Preventing Young Drivers/Teens and Occupant Injuries
A recent US study reports that compared with teen drivers with shared access, teen drivers with primary access to vehicles have more than twice the crash risk (risk ratio [RR]: 2.05 [95% confidence interval [CI]: 1.41-2.99]) and higher likelihoods of using cellular telephones while driving (RR: 1.23 [95% CI: 1.12-1.35]) and speeding > or = 10 mph above the posted limit (RR: 1.24 [95% CI: 1.11-1.40]).
This study concludes that primary access of novice teen drivers to vehicles is highly prevalent in the US and this practice is a dangerous norm, because primary access is associated with risky driving behaviors. The study appeals to healthcare providers and schools to counsel parents to discourage giving novice teen drivers primary access to vehicles.
Reference: Garcia-Espana JF, Ginsburg KR, Durbin DR, Elliott MR, Winston FK. Primary access to vehicles increases risky teen driving behaviors and crashes: national perspective. Pediatrics 2009; 124(4): 1069-75.
While Caution is Warranted, Child Passengers Are Safer When Teen Driver Is
Their Sibling-Study has implications for "family exemption" to graduated driver licensing laws
Abstract available at: http://injuryprevention.bmj.com/cgi/content/abstract/13/3/207
The above study found that while children driven by teens are twice as likely to suffer crash injury as those driven by adults, their risk is 40 percent lower if the teenaged driver is their older brother or sister.
The research, published in the journal Injury Prevention, may offer insights for parents, as well as for state lawmakers involved in setting standards for graduated driver licensing (GDL) laws for young drivers.
Previous findings from the ongoing research alliance between CHOP and State Farm have proven that young children riding with newly licensed teenagers are at a much higher risk for injury in a crash than they are with adult drivers. This and other studies have led lawmakers in many states to impose restrictions on the number of passengers young drivers are allowed to carry without adult supervision. However, many states allow exceptions for family members.
The study, conducted as part of the Partners for Child Passenger Safety project, included accident and injury data on 16,233 children below age 16, who were riding with 15 -19 year-old drivers in 16 states and Washington, D.C. These crashes were reported to State Farm from December 2000 through December 2005.
"Busy parents have come to rely on their older children helping with shuttling siblings to various commitments," says Dr. Winston. "By allowing family member exceptions, passenger restrictions may be readily accepted by both parents and policymakers." Researchers say this may be an important first step for states which currently have no passenger restrictions for young drivers.
Rather than restrict sibling passengers, Dr. Winston recommends GDL programs provide appropriate education and disincentives, such as postponement of full-driving privileges if all child passengers are not properly restrained.
The researchers also caution parents to make sure there is a specific destination involved with the trip. Crash risk increases dramatically among teen drivers when there is no predetermined destination. Dr. Winston offers this advice to parents who are deciding whether to allow their teens to drive younger brothers and sisters: "Parents should pay attention to their children's risk-taking tendencies before allowing them to ride together without an adult. In some cases, siblings can have a negative influence on one another's risk-taking behaviors that can be stronger than parental or peer influence."
Source: http://stokes.chop.edu/programs/injury/
For the latest research and information for parents about teen driving, visit http://www.chop.edu/youngdrivers.
The Science of Safe Driving among Adolescents: A special supplement to the journal Injury Prevention
The Children’s Hospital of Philadelphia and State Farm Insurance Companies convened the world’s leading experts on teens, driver safety, and teen driving in the fall of 2005 and late summer of 2006. The findings of the expert panel resulted in an evidence-based roadmap for the exploration of effective interventions to reduce teen driver-related crash and injury risk. These findings were published in a special June 2006 supplement to the journal Injury Prevention and abstracts are available: http://injuryprevention.bmj.com/content/vol12/suppl_1/
What is the Current "Best Practice" Young Driver Intervention? -The findings of the expert panel on the science of safe driving among adolescents by -Dr. Senserrick http://injuryprevention.bmj.com/cgi/content/full/12/suppl_1/i56
The collective papers of this supplement provide several clear recommendations. Examples include, a minimum learner period and night-time and passenger restrictions, as well as a zero alcohol requirement and stricter penalties or demerit point systems for moving violations.
Supporting programs that currently show promise include: parent-teen agreements which can enhance the management of exposure to novices’ highest risk driving conditions beyond the impact of GDL; hazard perception training programs and social marketing campaigns such as the successful TRUTH anti-smoking campaign, which can persuasively address underlying motivational orientations specific to young people.
Vehicle technologies that can benefit specific young driver issues include existing and soon to be available technologies. Intelligent seat belt reminder systems have the potential to have a dramatic impact on youth fatalities and serious injuries in the event of a crash, given current trends of lower usage among youth. Driver and passenger frontal and side curtain air bags can also afford greater occupant protection. Excessive speeds and poor selection of travel speeds and following distances can be targeted with Intelligent Speed Adaptation and Adaptive Cruise Control. The impact of poor driving skills, including perception and attention, can be addressed by anti-lock brakes, electronic stability control, advanced forward collision warning systems, and distraction limiters. Alcohol interlocks are effective in reducing recidivism and should be considered for all DUI offenders. In addition to the above mentioned advances in vehicle technologies, the new range of in-vehicle monitoring systems available on the market may benefit some families although to what extent and for what proportion of families is unknown.
Young and Youth Motor Vehicle Fatalities in Canada
Despite a large reduction Canadian’s road fatality since 1989, the 15 to 24 year age group remains vastly over-represented in road trauma statistics:
Average annual rate of death as occupant of motor vehicle or pedestrian, by age group, Canada, 2000 to 2004
Source: Statistics Canada, Health Report, Motor vehicle accident deaths. (Available at)-http://www.statcan.ca/english/freepub/82-003-XIE/2008003/article/10648/findings-en.htm
Youth and Road Crashes – Magnitude, Characteristics, and Trends
Traffic Injury Research Foundation (TIRF) released a new report on young drivers entitled, Youth and Road Crashes – Magnitude, Characteristics, and Trends. The report reveals that one-third of all deaths and injuries among young people aged 15 to 24 are due to road crashes and that motor vehicle collisions are the leading cause of hospital admissions among youth.
The report can be downloaded at:
http://www.trafficinjuryresearch.com/publications/pub_details.cfm?intPubID=263.
The TIRF’s Young and New Driver Resource Centre can be accessed through:
http://www.trafficinjuryresearch.com/yndrc/default.asp
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Preventing Middle Aged Drivers and Occupant Injuries
Did you know:
Each year approximately 2,900 people are killed and more than 220,000 are seriously injured on Canadian roads. Information and Tips from Transport Canada can help make your driving much safer.
Unlicensed Driving is a Significant Traffic Safety Issue on our Roads
A joint study by MADD Canada, Ontario Ministry of Transport and Transport Canada highlights that unlicensed drivers convicted of an alcohol-related Criminal Code offense represent the highest risk group. This group is almost three-and-a-half times more likely to be involved in a fatal rather than an injury crash and more than 16 times more likely to be cited as having been drinking/impaired by alcohol or drugs at the time of the crash compared to provincial trends.
[View the full text of this report: http://www.madd.ca/english/news/pr/20070531report.pdf]
This study confirms that the convicted impaired drivers, who continue to drive without their licenses, are the worst drivers on our roads and they are involved in more hit and run crashes compared to licensed drivers. So, effective policies should target this group to reduce the number of motorists involved in crashes and killed and injured on our roads. In addition, the report highlights the following recommendations to curtail the problem:
- Provide the police with better resources for apprehending hit and run drivers.
- Place greater emphasis on police roadside checks for the purpose of identifying whether the driver has a valid license.
- Place greater emphasis on monitoring high risk groups.
- Ensure better use of driver licensing data in identifying drivers with suspended/revoked licenses who are involved in a crash – these drivers should be automatically charged with driving while disqualified.
- Broaden police powers relating to impoundment of vehicles being driven by unlicensed drivers (vehicle impoundment for an unlicensed driver caught driving).
- Introduce vehicle forfeiture and incarceration for unlicensed drivers caught driving more than once.
Transport Canada seat belt and cell phone use survey (2006)
In September 2006, Transport Canada conducted an observational survey of seat belt use in rural communities across Canada. In 2006, for the first time, data on cell phone use by drivers was also collected. 1.6% of BC drivers reported cell phone use while driving. Compared to the rest of rural Canada, rural British Columbia lies slightly below the national average of 88.3% seat belt use. Restraint use in British Columbia was 87.5%. View the full report.
Cost of traffic collisions in Ontario and Canada
Transport Canada's mandate is to promote road safety and evaluate national safety standards. The recent study measured the economic and social costs of collisions in Canada. The study estimated that collisions cost Canada $62.7 billion each year. This estimate represents about 4.9% of Canada's 2004 Gross Domestic Product (GDP). View the full report.
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Preventing Mature Drivers and Occupant Injuries
Older Driver Awareness Week in the United States
More information: http://www.aota.org/Older-Driver/Awareness.aspx
Older Car Drivers in Norway and Sweden: Studies of Accident Involvement, Visual Search Behavior, Attention and Hazard Perception
Swedish National Road and Transport Research Institute, has released a report that explores hazardous situations for older drivers, and examines older drivers’ accident involvement and visual behavior in complex traffic situations.
Full text is available: http://www.vti.se/EPiBrowser/Publikationer%20-%20English/R656A.pdf
Older Drivers - What Physicians Need to Know and How They can Help
Glenyth Nasvadi, MA. Older drivers—what physicians need to know and how they can help. BCMJ 2008; 50 (2) 66- http://www.bcmj.org/older-drivers-what-physicians-need-know-and-how-they-can-help
This article published in the BC Medical Journal highlights that Section 230 of the Motor Vehicle Act in BC requires that a medical practitioner (or a registered psychologist or an optometrist) to report to the superintendent of motor vehicles the name, address, and medical condition of a patient 16 years or older who: In the opinion of the psychologist, optometrist, or medical practitioner has a medical condition that makes it dangerous to the patient or to the public for the patient to drive a motor vehicle, and continues to drive a motor vehicle after being warned of the danger by the psychologist, optometrist, or medical practitioner.
The current version of the Guide for Physicians in Determining Fitness to Drive a Motor Vehicle which is being updated can be accessed:
http://www.drivesafe.com/guidecontent.html
Do Restricted Driver's Licenses Lower Crash Risk among Older Drivers?
A recent BC-based study shows that the risk of causing a crash was 87% lower for restricted older drivers compared with unrestricted older drivers after controlling for age and gender. The most common restriction was a combination of daylight driving only plus a speed maximum of 80 km/hr. Restricted drivers retained a driver's license for a longer period of time than unrestricted drivers and continued to drive crash-free longer than unrestricted drivers. The study findings suggest that driving restrictions may be effective for prolonging crash-free driving for older drivers, thus supporting their continued independence and delaying institutionalization.
Reference: Nasvadi G, Wister A. Do restricted driver's licenses lower crash risk among older drivers? A survival analysis of insurance data from British Columbia. Gerontologist 2009; 49(4):474-84.
Self-reported Visual Impairment in Elderly Canadians and its Impact on Healthy Living
A new study that appeared in the Canadian Journal of Ophthalmology describes the prevalence of self-reported visual impairment in elderly Canadians and examines its association with selected social demographics and health factors. According to this study visual impairment in elderly Canadians is common and is associated with increased odds of injuries and poor health. The current study substantiates findings in congruity with the findings of other authors in the literature - that good eyesight is important for traffic safety, fall prevention, good health and independence in the elderly. Click here to retrieve the article.
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Preventing Impaired Driving
Raising Alcohol Taxes Reduces Excessive Drinking, Motor Vehicle Crashes, and Other Alcohol-related Harms (CDC, 2009)
Raising alcohol excise taxes is a highly effective strategy for helping to prevent deaths due to excessive drinking in the United States, according to a systematic review published in the February 2010 issue of the American Journal of Preventive Medicine. The review evaluated 73 published articles and reports that examined relationships between the price of alcohol, excessive drinking, and harmful consequences of excessive drinking, including motor vehicle crashes and alcohol-impaired driving.
Higher alcohol prices or taxes were consistently related to:
- Fewer motor vehicle crashes and deaths,
- Less alcohol-impaired driving,
- Lower levels of underage drinking, and
- Lower rates of violent crime, including homicide, assault, robbery, and rape.
The review found that raising the price of alcoholic beverages by 10 percent would reduce consumption by about 7 percent. The review was led by CDC scientists and overseen by the Task Force on Community Preventive Services. Based on the strong evidence from this review, the Task Force recommends raising alcohol excise taxes to reduce excessive drinking and related harms.
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