National Road Safety Week

Across the country, from 15 to 22 May governments at all levels lit up some of Australia’s most prominent buildings, bridges and structures in yellow to raise awareness of the importance of road safety. Now in its 10th year, National Road Safety Week highlights the impact of road trauma – principally road-related injuries and accidents – and looks at ways it might be reduced.

This year, people were asked to “Pledge to drive so others survive”, with four pillars to the pledge:

  • I will drive as if my loved ones are on the road ahead.
  • I will remove all distractions and never use my mobile phone while driving.
  • I will not put other people at risk by speeding, driving while tired or under the influence of alcohol or drugs.
  • I will protect all vulnerable road users, especially those whose job places them in harm’s way, by slowing down and giving them the space they need to be safe.

The role of the TAC

The Victorian Transport Accident Commission (TAC) is a Victorian government-owned organisation set up in 1986 to pay for treatments and benefits for people injured in transport accidents and to promote road safety. (Together with its sister organisation, WorkCover, it’s the Victorian equivalent of New South Wales’ icare.) Their messages for staying safe on the roads – often through confronting advertising campaigns – align closely with these pillars: avoid driving while drink- or drug-affected, while tired or while distracted, and take particular care around roadworks and workers. Because Victoria became the first jurisdiction in the world to introduce mandatory seatbelt use more than 50 years ago, it’s fitting that the TAC also still focuses on the importance of wearing a seatbelt, which reduces the risk of serious or fatal injury by 50%. It has also run the long-standing “Wipe off 5” campaign, highlighting the fact that driving even a few kilometres per hour over the speed limit increases the risk of accidents.

Some statistics

According to the Australian Road Deaths Database, deaths due to road accidents have remained relatively steady over the past 10 years or so at about 1200, which is, thankfully, less than half the total of road deaths in the late 1980s and early 1990s. Road fatalities have been dropping steadily since about 1980, when there were just over 22 deaths per 100,000 population, until 2018 when there were just 4.8 deaths per 100,000 population. By comparison, in the same time period the USA has managed to reduce the rate from just over 22 deaths per 100,000 population to 11 or 12, while we are on a par with countries such as Canada, France and Austria. In short, we’re doing pretty well!

But it’s not all about deaths. Some 44,000 people are seriously injured every year on Australian roads, and this is where road safety is so relevant to people who sustain a spinal cord injury, and where the demographic data are telling.

According to the Australian Institute of Health and Welfare, in 2018–19 transport injuries resulted in around 64,000 hospitalisations, with males and young people particularly at risk. Tellingly, two thirds of hospitalisations (and three quarters of deaths) were of males, with young people aged 15–24 having the highest rates of hospitalisation, and the 25–44 age cohort in second place. Data also show that the severity of transport injury hospitalisations – measured by the percentage of cases that included time in ICU – is much higher than the average for all hospitalised injuries. What’s more, the head and neck are the body parts most often identified as the principal site of injury in transport hospitalisations.

Traumatic SCI

Now let’s look at the statistics around traumatic SCI. Since 1989, 15,000 females as compared with 38,000 males sustained a spinal cord injury, but males outnumber females by over 4 to 1 for traumatic SCI. According to the Australian Spinal Cord Injury Register, in 2017–18, 46% of traumatic SCI were the result of a land transport crash, while 36% were the result of a fall. But breaking it down by gender, the leading cause of traumatic SCI for males was a land transport crash (33%), while for females it was a high fall (32%). Unprotected land transport users – such as motorcyclists, cyclists and quad bike riders – accounted for the majority of traumatic SCI. This is in line with general hospitalisation data: although over a third of transport injury hospitalisations were for car occupants, almost a quarter were for motorcyclists, with cyclists, at 20%, coming a close third.

Delving deeper, we find that land transport crashes as a motor vehicle occupant was the leading cause of traumatic SCI for cases aged 15–24 (33%), while in the 25–64 year age group, land transport crashes as an unprotected land transport user was the leading cause (33%). Over one-third of male cases were motorcycle drivers at the time of their injury, whereas 42% of females were motor vehicle passengers at the time of their injury. Of the unprotected land transport user SCI cases, a staggering 91% were male, with more than half of them being motorcycle drivers, and cyclists accounting for a further 30%. The remaining cases were quad-bike riders. A traumatic SCI at the cervical level was most frequent for cyclists (75% of cases – which includes my personal experience as a C4/5 quadriplegic) and quad-bike riders (50%), while thoracic-level injuries were most numerous for motorcycle drivers (50%). Notably, 25% of motor vehicle occupants who sustained a traumatic SCI said they were not wearing a seatbelt, a figure that may well be higher because information on the use of seatbelts was not available in 50% of cases.

What this all boils down to is confirmation of overwhelming anecdotal evidence. Most people who have been through spinal rehab – myself included – will tell you, “Yeah, I went through rehab with a lot of young blokes who were in traffic accidents.” The key message is clear: younger males need to take more care on the roads, in particular by adhering to the four pillars of the road safety pledge! Motorbike riders and cyclists need to take particular care to avoid ending up like me, a quadriplegic. And if you’re travelling in a car, wear a seatbelt!

The costs

Finally, while the physical and emotional costs to the individual and their families are immense and to some extent incalculable, there is also an economic cost to society. Spinal Cure Australia estimates the total cost of SCI in Australia to be $2 billion annually. Unsurprisingly, given the above analysis, the 15–24 age cohort accounts for approximately 23% of total lifetime costs ($17.6 billion), as they have up to 51 years of life remaining. The 25–34 age cohort accounts for another $14.7 billion. With the under 35s making up almost one quarter of people with SCI, and this cohort being most likely to sustain a spinal cord injury from a road accident, the potential savings to the economy from improved road safety practices are huge.