Health of survivors and long term disability

While information on road traffic deaths is available in most European countries, there is no systematic information which can be compared on the health of survivors. There are a variety of definitions of ‘serious injury’; many serious injuries are not reported [45]; data on the long term health consequences of road traffic injury is not collected on a systematic basis; and while rating systems have been devised and are in use, there are no international standards for describing and quantifying the disabilities arising from traffic injuries, particularly those involving neurological trauma [27].

The World Health Organization uses a severity ratio guideline of 15 serious injuries (requiring hospital admission) and 70 minor injuries for every road death. The European Federation of Road Accident Victims has estimated that a minimum of 150,000 survivors in road crashes sustain permanent disability in EU (15) countries every year. Disability is usually defined as an individual’s inability to carry out a normal range of daily activities due to physical and/or psychological sequelae. Permanent disability, such as paraplegia, quadriplegia, loss of eyesight, or brain damage, can deprive an individual of the ability to achieve even minor goals and result in dependence on others for economic support and routine physical care. Less serious – but more common – injuries to ankles, knees and the cervical spine can result in chronic physical pain and limit an injured person’s physical activity for long periods. Serious burns, contusions and lacerations can lead to emotional trauma associated with permanent disfigurement. Road crashes can also result in a variety of long-term psychiatric and psycho-social problems [48].

In-depth studies indicate that:

• Motor vehicle crashes are the leading cause of traumatic brain injury [48]
• The majority of whiplash injuries are sustained by car occupants in crashes, and around 50% of these are in rear impacts [28]
• 22% of a sample of patients attending hospital with fractures tothe upper or lower limb, or a soft tissue injury to their cervical spine (“whiplash”) had some form of disability 4 years after the crash [37]
• Pedestrians and motorcyclists suffer the most severe injuries as a result of motor vehicle collisions, report more continuing medical problems and require more assistance, compared with other types of road user [48].