Trends in Road Traffic Fatality and Injury in Victoria...This edition of Hazard examines general trends in road traffic fatality and injury, providing a broad overview of a complex

VICTORIAN INJURY SURVEILLANCE SYSTEM HAZARD 36 page 1

Hazard(Edition No. 36)September 1998

Victorian InjurySurveillance SystemMonash UniversityAccident Research Centre

V.I.S.S.

by Lei Li*, Virginia Routley

SummaryMotor vehicle crashes are a major causeof death and injury, with enormoushealth and financial impacts. In recentyears they have been ranked the secondmost important cause of injury/deathand hospitalisation, after suicide andfalls respectively. Over the study period(1984 to 1996) the highest fatality andinjury rates in Victoria were observedin 1989, with 776 motor vehicleoccupants killed and 35,000 injured(rates of 18 and 801 per 100,000population respectively). These fatalityand injury rates declined rapidlybetween 1989 and 1992, to the level ofabout 9 and 479 per 100,000 population

respectively. Since 1992 and 1993fatality and injury rates appear to havelevelled off.

Fractures were the most commoncause of hospital admission for allroad user groups, especially to thelower limbs. Intracranial, openwounds and internal injuries werefrequent but less common. Injuriesdiffered by road user type. Pedest-rians and motorcyclists had relativelyhigher proportions of fractures;pedalcyclists and pedestrians, intra-cranial injuries (not skull fractures)and motor vehicle occupants injuriesto the chest, abdomen and pelvis.Neck sprain/strains were common foremergency department presentations.

In 1996, passenger vehicle occupantsrepresented 73% of road users involved

in motor vehicle crashes, pedestrians16%, motorcyclists 8% and bicyclists3%. Decreasing rates were experiencedby all road user groups, especiallypedestrian fatalities after 1989. Fatalityand injury rates have declined for allage groups and the decline has beengreatest for those aged 15-24 years, theage group with the highest rates.

Similarly hospital admission rates andlength of stay have declined and thenlevelled off for all road user and agegroups. Length of stay and reductionsin length of stay have been greatestfor pedestrians and persons aged 65years and over. The decline in bothadmission rates and hospital stayscould result in savings of as much as$17 million hospital expenditure ayear in Victoria.

This edition of Hazard examines general trends in road traffic fatality and injury, providing a broad overview of acomplex area. The improvement in road safety over the past decade and future countermeasures are discussed briefly.Resource contacts and MUARC research activities are listed.

Trends in Road Traffic Fatalityand Injury in Victoria

* Lei Li is a Research Fellow with MonashUniversity Accident Research Centre


IntroductionMotor vehicle crashes are a majorcause of death and injury, withenormous health and financialimpacts. More than half a millionmotor vehicle crashes occurred inAustralia in 1993, of which over 1,700resulted in death, 17,000 in hospital-isation and 47,000 in injury requiringmedical treatment (Bureau ofTransport and Communications,1993).

Despite much progress throughsuccessful road safety programs,motor vehicle crashes still cause about360 deaths per year in Victoria andare ranked the second most importantcause of hospitalisation due to injury,after falls (VicRoads and TAC, 1997;Watt, 1995). The total annual cost ofroad casualty for Victoria is estimatedto be well over $1 billion (includingproperty damage) and the totallifetime medical and associated costsfor motor vehicle traffic relatedinjury, which occurred in 1993/94,totalled $570 million (VicRoads andTAC, 1997; Watson and Ozanne-Smith; 1997).

This issue of Hazard describes thetrends in and nature of motor vehiclecrash fatality and injury in Victoriausing the latest available data.Fatality and injury rates resultingfrom motor vehicle crashes arecalculated for the period 1984 to 1996,and admission rates to Victorianpublic hospitals are calculated forthe period 1987/88 to 1995/96.

The data bases used for this analysisinclude the State Traffic AccidentRecord (STAR), ie the VicRoadsenhanced database of police reportedcrashes and the Victorian InpatientMinimum Dataset (VIMD) forhospital admissions data (see Box 1,page 9). The STAR database contains

motor vehicle crashes resulting inpersonal injuries. The VIMD data-base includes admissions to publichospitals due to injury in Victoria,and admissions to private hospitalsin later years. Only admissions topublic hospitals are used in thisanalysis.

Fatality and Injury RatesIn the VicRoads STAR database,occupant injury severity is recordedon a four-level scale - fatal, serious,other and non-injury. In 1995, 1% ofcases were fatal, 13% serious, 38%other injury and 48% non-injury. Inthis analysis fatality and injury ratesare calculated using frequencies fromVicRoads STAR data as thenumerator and mid-year population

estimates, by age group whereappropriate, as the denominator.Serious and other injury have beencombined.

Motor vehicle crashesTrends in fatality and injury rates forall road users involved in motorvehicle crashes and those forpassenger vehicle occupants only(car, station wagon, taxi, mini-bus)are shown in Figure 1.

The fatality rate due to motor vehiclecrashes was 16.1 per 100,000population in 1984. The highestfatality rate was observed in 1989,with 776 motor vehicle occupantskilled (18 per 100,000 population).The fatality rate declined rapidlybetween 1989 and 1992 to the level

Motor Vehicle Crash Fatality Figure 1and Injury Rates, 1984-96, Victoria

02468

101214161820

84 85 86 87 88 89 90 91 92 93 94 95 96

Year

Fat

ality

Rat

e (/1

00,0

00)

All Motor

Passenger

0

100

200

300

400

500

600

700

800

900

84 85 86 87 88 89 90 91 92 93 94 95 96

Year

Inju

ry R

ate

(/100

,000

)

All Motor

Passenger

Source: State Traffic Accident Record database of police reported crashes.


of about 9 per 100,000 population,and appears to have levelled off sincethen. This recent level correspondsto about 400 motor vehicle occupantskilled each year in Victoria.

More than 50% of all road usersinvolved in motor vehicle crashesnotified to Victorian police sustainan injury (22,000 to 35,000 per year).The injury rate increased annuallybetween 1984 and 1989 from 623 to801 per 100,000 population, and thendeclined rapidly to 479 per 100,000in 1993. The injury rate appears to beincreasing slightly from 1993.

Passenger vehicle occupants repres-ent about 75% of road users involved

in motor vehicle crashes in Victoria.The trends in their fatality and injuryrates show similar patterns to thosefor all motor vehicle crashes (Figure1). Upward trends were observedbetween 1984 and 1989, and thehighest fatality and injury rates forpassenger vehicle occupants were in1989 (10.3 and 581 per 100,000respectively), with 445 occupantdeaths and 25,116 occupants injured.After sharp declines between 1989and 1992, the fatality rate stabilisedand the injury rate showed a moderateincrease from 1993.

Motor Vehicle Crashes duringHigh Alcohol HoursFigure 2 shows the fatality and injuryrates in motor vehicle crashes duringhigh and low alcohol hours, aspreviously defined (Harrison, 1990)1.High alcohol hours were defined byHarrison as those two hour blocksduring which more than 15% of alldrivers who were killed or seriouslyinjured had a Blood Alcohol Concent-ration (BAC) over 0.05%. It can beseen that the fatality rates during thehigh alcohol hours were higher thanthose during the low alcohol hoursbetween 1984 and 1989. Afterdecreasing considerably between1989 and 1992, the fatality rate duringthe high alcohol hours converged withthat of the low alcohol hours. Thedecrease may be in part related to adecrease in alcohol related crashes.

The injury rate during the high alcoholhours was significantly lower thanthe injury rate during low alcoholhours but showed a similar trend tofatalities. Unlike fatalities howeverthere was no convergence of theinjury rates between high and lowalcohol hours. The injury ratesincreased annually between 1984 and1989 and then turned downwardbetween 1989 and 1993.

Young and Older PersonsFigure 3 shows the trends in fatalityand injury rates by age group. Youngpersons of years 15-24 had the highestfatality and injury rates. They alsoshowed the greatest decrease in thefatality rate during the period from1984 to 1996 (33.8 to 18.3 per100,000). Although they demon-strated a pattern of injury rates similarto that of the 25-64 age group, their

Fatality and Injury Rates during High Figure 2and Low Alcohol Hours, 1984-96, Victoria

0

2

4

6

8

10

12

84 85 86 87 88 89 90 91 92 93 94 95 96

Year

Fat

al R

ate

(/10

0,00

0)

High Low

0

50

100

150

200

250

300

350

400

450

500

84 85 86 87 88 89 90 91 92 93 94 95 96

Year

Inju

ry R

ate

(/10

0,00

0) High Low

Source: State Traffic Accident Record database of police reported crashes

1 Low alcohol hours: Mon – Thurs 6.00- 17.59,Friday 6.00 - 15.59, Saturday 8.00 – 13.59,Sunday 10.00 – 15.59. High alcohol hoursare those which are not low alcohol.


injury rate decrease was greaterduring 1989-1991. Prior to 1989 theinjury rate of the 15-24 age groupwas about 2.5 times as high as that ofthe 25-64 group, but after 1991, thisratio decreased to about 2. Amoderate upward trend of the injuryrate can be seen between 1992 and1996.

Older persons (65 years and over)also had a higher fatality rate thanthat of the 25 - 64 age group. Afterexperiencing a large increase in thefatality rate up to 1988 they had showna decreasing fatality rate, with themost rapid decrease occurringbetween 1988 and 1992. As a result,the ratio of their fatality rate to that ofthe 25 to 64 age group decreased

from 1.7 in 1984 to 1.4 in 1996.However, their injury rate was muchlower than that of the 25-64 age group.The injury rate of the 25-64 groupwas nearly twice as high as that ofolder population.

Although children aged 5-14 yearshad slightly higher injury rates before1987 than older persons, their injuryrate was lower after 1988.

Pedestrians, Bicyclists andMotorcyclistsSimilar to motor vehicle occupants,other major road users in Victoria,including pedestrians, bicyclists andmotorcyclists (motorcycle/moped/motor scooter) experienced decreas-ing fatality and injury rates during

the period from 1984 to 1996, tovarying degrees. Figure 4 summarisesthe trends of their fatality and injuryrates.

A sudden decline in the fatality rateof pedestrians was observed between1989 and 1990. The fatality rate forpedestrians had been well above 3per 100,000 population with about150 pedestrian fatalities per yearbefore 1990, but after 1990 the fatalityrate fell to below 2 per 100,000population, which represents about80 pedestrian fatalities per year inVictoria. The injury rate of pedes-trians also showed a substantialdecrease between 1988 and 1993.The injury rate of pedestrians wasabove 50 per 100,000 populationbefore 1990 and remained at the levelof 40 per 100,000 population after1990. This decrease translates intoabout 500 pedestrian injuries beingavoided, i.e. a decline from about2,300 to about 1,800 pedestrianinjuries per year.

The fatality rates of bicyclists andmotorcyclists fell more than 50%between 1984 and 1996, from 2 per100,000 population and 0.7 per100,000 population in 1984 to 0.9per 100,000 population and 0.3 per100,000 in 1996 respectively. Therewere 28 bicyclists and 80 motor-cyclists killed in 1984, but only 13bicyclists and 39 motorcyclists werekilled in 1996. There were 1,429bicyclists injured in 1988 and 1,318in 1996. The injury rate of motor-cyclists had been decreasing continu-ously since 1987. It was 56 per100,000 population in 1987 and 36per 100,000 population in 1996.

Admissions to PublicHospitalsPublic hospital admissions appear tohave been strongly influenced by the

Motor Vehicle Crash Fatality Figure 3and Injury Rates by Age Groups, 1984-96, Victoria

0

5

10

15

20

25

30

35

40

84 85 86 87 88 89 90 91 92 93 94 95 96Year

Fat

ality

Rat

e(/1

00,0

00) 5-14 15-24

25-64 65+

0

200

400

600

800

1000

1200

1400

1600

1800

84 85 86 87 88 89 90 91 92 93 94 95 96

Year

Inju

ry R

ate(

/100

,000

)

5-14 15-24

25-64 65+



casemix funding policy that tookeffect on 1st July, 1993 (Watt, 1996;Carr, 1995). Since the admission ofcases whose length of stay in publichospitals was one day or less mightbe influenced by casemix fundingpolicy, these cases were excludedfrom the analysis. There were 60,261motor vehicle crash injury cases inthe VIMD who were admitted intopublic hospitals during the nine yearperiod from 1987/88 to 1995/96. Ofthese 38,546, ie 64%, stayed morethan one day.

Hospitalisation RateFigure 5 shows the rates of admissions(more than one day) to public

hospitals of all road users and ofpassenger vehicle occupants.

It can be seen that the admission ratescontinued to decrease until the 1991/92 financial year and then stabilised.The hospitalisation rate of all roadusers was 131 per 100,000 populationin 1987/1988 and 41 per 100,000population in 1991/1992. In terms ofthe number of admissions, this decline(in the hospitalisation rate) corres-ponds to a reduction of 2,183admissions (from 5,528 to 3,345)whose length of stay was more thanone day. The hospitalisation rate forpassenger vehicle occupants had asimilar trend. However, the decreasein the early period seems less steep.

Figure 6 presents the trend in thehospitalisation rate by age group androad user type other than passengervehicle occupants.

Similar to the differences in overallfatality and injury rates, the 15 to 24age group had the highest hospitalis-ation rate, ie about twice that of those25-64 years. The hospitalisation rateof 15-24 age group decreased nearly

Pedestrian, Motorcyclist and Bicyclist Figure 4Fatality and Injury Rates, 1984-96, Victoria

0

0.5

1

1.5

2

2.5

3

3.5

4

84 85 86 87 88 89 90 91 92 93 94 95 96

Year

Fat

ality

Rat

e(/1

,000

,000

)

Pedestrians

Motor Cycle/Moped/Scooter

Bicyclists

0

10

20

30

40

50

60

70

84 85 86 87 88 89 90 91 92 93 94 95 96Year

Inju

ry R

ate(

/100

,000

)

PedestriansMotor Cycle/Moped/ScooterBicyclists


Admissions of Motor Vehicle Crash Injuries Figure 5to Public Hospitals, July 1, 1987-June 30, 1996, Victoria

0

20

40

60

80

100

120

140

87/88 88/89 89/90 90/91 91/92 92/93 93/94 94/95 95/96

Financial Year

Rat

e(/1

00,0

00)

All Motor Vehicles

Passenger Vehicles M t V hi l C h

Source: Victorian Inpatient Minimum Dataset

Fat

ality

Rat

e (/

100,

000)


50% during the nine year period.Nonetheless, the gap in the 15-24 andthe 25-64 hospitalisation ratesreduced only moderately. Olderpersons and those 25-64 years alsohad substantial decreases in theirhospitalisation rates. Older personsdid not have a higher hospitalisationrate than the 25-64 group before 1992but they appeared to have a slightlyhigher hospitalisation rate afterwards.Children of 5-14 years had a muchlower hospitalisation rate than otherage groups. Additionally they alsoexperienced a 50% decrease in thehospitalisation rate during the period1987/1988 to 1991/1992.

In the VIMD data, bicyclists and othercyclists are coded together as pedalcyclists. In Figure 6, it can be seenthat the hospitalisation rates of theseroad users decreased notably duringthe study period. The hospitalisationrate of pedal cyclists decreased twothirds from 6.3 to 2.1 per 100,000population between 1987/88 and1995/1996. The greatest decrease inthe hospitalisation rate of pedestriansoccurred between 1988/89 and 1991/92, while the hospitalisation rate ofmotorcyclists decreased more con-sistently over the time period.

Nature and Body Regionof InjuryFractures were the most common typeof principal injury caused in motorvehicle crashes admitted to hospitalover the study period, accounting for60% of hospitalised cases. Othercommon injuries included intra-cranial (not skull fracture) (9%), openwounds (6%) and internal (chest/abdomen/pelvis) (6%). Injury bybody part for hospital admissions isshown in figure 7.

Injury by Body RegionFigure 7


Trunk injuries included abdomen/pelvis (11%), chest (11%) and spine/back (4%). The head included faceand eye (9%) and neck (3%). Amongthose with fractures, the body regionof injury shows a slightly different

Admissions to Public Hospitals Figure 6by Age Groups and Road User Types,July 1, 1987-June 30, 1996, Victoria

0

5

10

15

20

25

87/88 88/89 89/90 90/91 91/92 92/93 93/94 94/95 95/96

Financial Year

Rat

e(/1

00,0

00)

pedestrian motorcyclist pedalcyclist

0

50

100

150

200

250

300

350

400

450

500

87/88 88/89 89/90 90/91 91/92 92/93 93/94 94/95 95/96

Financial Year

Rat

e(/1

00,0

00)

5-14 15-24 25-64 65+


lower limb 29%

head 27%

upper limb 13%

trunk 26%

other/unspecified 5%


pattern to injuries overall. Lower limbinjury was most common (40% offracture cases), followed by upperlimb (17%) and chest injury (15%).

Over the study period, pedestriansand motorcyclists incurred morefractures than other road user groups(68% and 67% respectively cf 62%for pedalcyclists, 57% for motorvehicles and 49% others). Pedal-cyclists and pedestrians incurredhigher proportions of both intracranial(not skull fractures) and head injurythan other road users. Lower limbinjuries were most common to motorcyclists (49% of injuries by bodypart), pedestrians (48%) and pedal-cyclists (41%). Injuries to the chest,abdomen and pelvis were morecommon to motor vehicle occupantsthan other injury groups. Over thestudy period, apart from a decline inhead injuries for pedalcyclists, theproportions of injury by road usergroup did not indicate any clear trend.

In order to compare emergencydepartment presentations withadmitted cases, the Victorian Emerg-ency Minimum Dataset (VEMD) wasexamined. Over the period 1996 and1997, approximately 20% of the28,682 emergency department roadtraffic presentations to VEMD (VISS)hospitals (page 15) were admitted tohospital (one day admissions cannotbe excluded). The most commoninjuries for presentations only (inorder of frequency and excludingadmissions of four hours or more)were neck sprains/strains, openwounds to the face (excluding eyes),no injury detected and multiplesuperficial injuries (excluding eyes).These injuries differed considerablyfrom those of hospital admissions.

Length of HospitalisationAlong with the decrease in thehospitalisation rate, the length of stayin public hospitals also decreasedconsistent with the general trendtowards shorter hospital stays. Themean length of stay in public hospitalswas 14 days in 1987/1988 and 8.9days in 1995/1996 (Table 4). Sincethe frequency distributions of thelength of hospital stay are skewedvery much towards short stays, themedian length of hospital stay is alsopresented (7 days in 1987/1988, 6days in 1995/1996). The median isless sensitive to changes in extremelylong or short hospital stays whichaffect the mean greatly. The lower

reduction in median hospital staysmay be caused by the decrease incases with extremely long hospitalstays.

As shown in Figure 8, the mean lengthof hospital stay by age group alsodecreased. The mean length ofhospital stay of older persons andover decreased by nearly 40%, ormore than a week. Although youngpersons had the highest hospital-isation rate, they tended to behospitalised for shorter periods thanolder persons. Older persons werehospitalised for the longest period.Length of stay for older persons isinfluenced by slower healing times,interaction with other conditions,

Length of Stay in Public Hospitals by Age Group and RoadUser Types, July 1, 1987-June 30, 1996, Victoria Figure 8

789

1011121314151617181920

87/88 88/89 89/90 90/91 91/92 92/93 93/94 94/95 95/96

Financial Yea r

Num

ber

of D

ays

PedestriansMotorcyclistsPedalcyclists

56789

1011121314151617181920

87/88 88/89 89/90 90/91 91/92 92/93 93/94 94/95 95/96

Financial Yea r

Num

ber

of D

ays

5-14 15-2425-64 65+



increasing frailty, and a higherincidence of complications.

Figure 8 also shows the trend of meanlength of stay by road user types.Pedestrians were hospitalised longerthan other road users. They sustainedmore head and lower extremityinjuries, and more fractures. Theyhad the greatest reduction in the meanlength of hospital stay from 19 daysin 1987/1988 to 10 days in 1994/1995. Motorcyclists and passengervehicle occupants had almost thesame mean length of hospital stay,and their mean length of hospital staydeclined nearly five days over thestudy period. The mean length ofhospital stay of motorcyclists wasslightly shorter than those ofpassenger vehicle occupants andpedal-cyclists.

DiscussionThe improvement in road safety inVictoria has been very impressiveover the past decade. One of thesuccesses has been the sharp reversein the upward trend of fatality andinjury rates. The drop in the fatalityrate of road users during this periodimplies that more than 350 lives mayhave been saved per year. Similarly,hospitalisation rates and length ofstay in public hospitals, which can beindicators of injury severity andfinancial impact, also decreasedsubstantially. Assuming that theaverage cost of one bed day in aVictorian public hospital was $450,the reduction in the hospitalisationrate from 131 per 100,000 populationin 1987/88 to 41 per 100,000population in 1991/92 and thereduction in the average length ofstay from 13 days to10 days wouldresult in savings of more than $17million hospital expenditure a yearin Victoria (Australian Institute ofHealth & Welfare, 1994). Additional

savings generated from road userswho had not stayed more than oneday in hospital and were not includedin this analysis should also besubstantial as they made up aboutone third of hospital admissions.

Factors that may have contributed tothese successes are numerous andcomplex, including behaviourchanges of road users e.g. reductionin drink driving; improvements inroad conditions eg roundabouts,shoulder sealing; and vehicle crash-worthiness. A series of road safetyprograms including publicitycampaigns and enforcement programsagainst drink driving and speedinginitiated by Transport AccidentCommission (TAC), Victoria Policeand VicRoads, from 1989 to 1992may have been the most importantfactors (Vulcan in Ozanne-Smith,Williams, 1995; Cameron andNewstead, 1996; Cameron, Newsteadand Vulcan, 1994). It was estimatedthat nearly one third of the reductionsin serious road casualties between1989 and 1992 in Victoria could beattributed to the intensive publicitycampaigns against drink driving andspeeding, and to the random breathtesting programs.

As revealed in this analysis, however,motor vehicle fatality and injury rates,as well as admission rates to publichospitals, did not continue to declineafter 1992, and some of theseindicators have actually showed amoderate upward trend since. Thisfeature may be related to increasedroad traffic induced by the economicrecovery early this decade. Never-theless, it also poses a challengingquestion: how to sustain furtherimprovement in road safety inVictoria? The answer to this questionis demanding increased sophisticationin research design and counter-

measure implementation. However anumber of pertinent issues areoutlined below.

Safety belt usage is almost universal,with a wearing rate of 97%(Diamantopoulou, Dyte and Cameron1996). Involvement of alcohol andexcessive speed in motor vehiclecrashes has been greatly reduced. Theextent of the benefits gained from thepublicity campaigns aimed at thechange of road user behaviours during1988-1992 is unlikely to be replicated.In addition, some emerging issues inroad safety, such as the rapid increasein the number of very old drivers,associated with an aging Victorianpopulation, will make furtherimprovement in road safety moredifficult.

On the other hand, some opportunitiesexist to facilitate further improvementin road safety. Among them arenational and state strategies whichserve to focus the commitment of allrelevant bodies and organisations.The Victorian government releasedits road safety strategy “Safety First”in 1995, under which related agencies,research organisations and localcommunity groups have joined forcesto promote road safety throughresearch, better co-ordination, educa-tion and enforcement. The goal is tocontinue the long-term downwardtrend in road trauma in Victoria. Mainfocuses are drink driving, speeding,fatigue, restraint wearing, roadquality, drivers in high risk agegroups, motor cycle, bicycle andpedestrian safety, heavy vehiclecrashes, drugs and driving andoccupant protection. Nationally thereis the National Road Safety Strategy(1992-2001) which aims to reducethe road toll to below 10 per 100,000by 2001 ie a 30% reduction. Keypriorities are similar to Safety First


i.e. alcohol and drug abuse, speeding,protection of vehicle occupants,driver fatigue, road hazards, heavyvehicles, novice drivers and ridersand improved trauma management.

Another is technological advances inintelligent transport system (ITS) andvehicle occupant protection. Afterdecades of conception and research,ITS is finally being realised inAustralia and overseas. It holds greatpromise for smooth and safe transport.ITS has the potential to reduce motorvehicle crashes through the imple-mentation of collision avoidancetechnology, while research on vehicleoccupant protection technology hasthe potential to further reduce theseverity of injury.

Although continued efforts aimed atbehaviour change and enforcementwill be necessary, these activities mayneed to be conducted in a morefocused manner to be effective.Technological advances have thepotential to make an importantcontribution to road safety. However,the full utilisation of this potentialwill depend on the accommodationof the new technology to humanfactors. In the future it will benecessary to conduct fundamentalresearch to better understandbehaviour and needs of specific roaduser groups and the mechanism ofmotor vehicle crashes. (Fildes, 1997).Since young and older persons hadthe highest fatality rates, currentresearch focusing on these age groupswill provide strategic input intoprevention programs. In addition, theneeds of bicyclists and pedestriansshould continue to be considered.

This Hazard analysis has includedonly hospital admissions of patientswho stayed in public hospitals morethan one day. Clearly these hospital-ised cases, who sustained the more

severe injuries, would represent onlya small proportion of motor vehiclecrash victims. According to policereports, about 13% of road usersinvolved in motor vehicle crasheswere admitted to hospital and morethan 99% of them sustained seriousinjuries. Currently it is very difficultto verify police reports on hospitaladmissions or to obtain informationon length of hospitalisation frompolice reports.

The hospital admissions data containreliable and detailed information onthe nature of injury and the length ofhospitalisation, which are essentialoutcome indicators used to gauge theimpact of injury and to exploreprevention methods. However VIMDdata do not provide information onthe causal process of injury, which isrequired for injury preventionresearch and included in the STAR

database. Recent advances instatistical computation have made itpossible to link data from differentsources without using information onsubject identity (NHTSA, 1996).Linkage of the VIMD, STAR andother databases would providenumerous new research opportunitiesfor injury prevention. Furthermore,the benefits of data linkage extendbeyond injury prevention researchand include efficient data collectionand improved data quality.

AcknowledgmentsStuart Newstead and KathyDiamantopoulou (MUARC) forassistance with the STAR databaseand road safety advice respectively,Lesley Day, George Rechnitzer andWarren Harrison (MUARC) foreditorial comment.

Data bases Box 1

• State Traffic Accident Record (STAR)

STAR is the VicRoads enhanced database of police reported crashes. Thedata are based on police accident reports at the scene of motor vehiclecrashes that resulted in personal injury. Information collected by policeincludes characteristics of crashes such as time and location, characteristicsof vehicles such as type of vehicle, model, year of manufacture, personaldetails of those involved such as age, gender, licence and injury severity, andevent information that depicts the process of crash occurrence. This data hasthe most complete coverage of motor vehicle crash fatalities and injuries,and would include a proportion of those admitted to hospital and therebyalso captured in the VIMD.

• Victorian Inpatient Minimum Dataset (VIMD)

The VIMD contains information on admissions to Victorian hospitals. Forthe period covered the data was collected by Health Computing ServicesVictoria under the direction of Human Services Victoria. Detailed informationon hospitalisation from admission to discharge is collected. The informationon the nature of injury is based on the diagnosis by physicians. The MonashUniversity Accident Research Centre has access to those records whichinvolve injury. This analysis used only transport transport-related injurycases which were restricted to ICD-9 “external cause” codes ranging fromE810.0 to E819.9.


Evaluations• Evaluation of the Country Random

Breath Testing and Publicity Programin Victoria, 1993-94

• Evaluation of the Deployment of LaserSpeed Detection Devices inMelbourne

• Evaluation of Moving Mode Radarfor Speed Enforcement

• Evaluation of the Queensland RandomRoad Watch Program

• Evaluation of the multi-actionpedestrian program

Road User Safety• Learner Driver Experience and Safe

Driving Skills

• The Driving Experiences of LearnerDrivers

• Transport Accident CommissionSimulator - Young Driver ResearchProgram

• Young Drivers and Speed Enforce-ment

• Older Driver Behaviour

• Older Road Users

• Older Pedestrian Road CrossingBehaviour

• Walk-With-Care Update

• Profile of the Speeding Driver

• Research on the Speed CameraProgram

• Promotion of Public Breath Testing

• Development of a Road Safety PublicEducation Plan for Western Australia

• The Relationship Between DemeritPoints Accrual and Crash Involvement

• Multi-action Pedestrian Program inthe City of Stonnington

• Personality and Drink Driving

• Development of the TheoreticalAccounts of Deterrence

• Novice Driver Subtypes

References• Australian Institute of Health & Welfare.

Health Services Series No. 5: Hospitalutilisation and costs study 1991-1992, Vol. 1.1994.

• Bureau of Transport and CommunicationsEconomics. Information Sheet 4: Costs ofroad crashes in Australia - 1993.

• Cameron, M. and Newstead S. (1996). Massmedia publicity supporting policeenforcement and its economic value. Publichealth association of Australia, 28th annualconference, symposium on mass mediacampaigns in road safety.

• Cameron M., Newstead S. and Vulcan P.(1994) Analysis of reductions in Victorianroad casualties, 1989 to 1992. Proceedings17th ARRB Conference, Part 5, 165-182.

• Carr,D, Skalova,M, Cameron,M.H. (1995).Evaluation of the Bicycle Helmet WearingLaw in Victoria During its First Four Years.Report No. 76. Melbourne: MonashUniversity Accident Research Centre.

• Diamantopoulou K., Dyte D. and CameronM. (1996). Seat belt wearing rates inVictoria: 1994. Monash University AccidentResearch Centre, Report No. 89.

• Diamantopoulou K., Skalova,M, Dyte D. andCameron M. (1996). Crash risks of road usergroups in Victoria, Monash UniversityAccident Research Centre, Report No. 88.

• Fildes, B. Speeding: Crashes, Environmentand Enforcement, a paper presented to theVicRoads Symposium, AccidentInvestigation and Prevention, 14-16 May,1995.

• Fildes B. (1997). Road safety into 21st

Century, paper presented at MonashUniversity Accident Research CentreSymposium on Future Directions in RoadSafety.

• Harrison,WA (1990) “Update of alcoholtimes as a surrogate measure of alcohol-related involvement in accidents”. ResearchNote, Monash University Accident ResearchCentre

• Safety First – Victoria’s Road Safety Strategy1995-2000. http://www.vicnet.au/~safeone/

• U.S. Department of Transportation NationalHighway Traffic Safety Administration(NHTSA). The Crash Outcome DataEvaluation System (CODES). TechnicalReport DOT HS 808 338. 1996.

• VicRoads and Transport AccidentCommission (TAC). Road safety in Victoria:trends and developments during 1997.

• Vulcan P, Road Trauma Prevention in InjuryResearch and Prevention: a Text, Ozanne-Smith,J, Williams,F (ed), MonashUniversityAccident Research Centre, 1995.

• Watt, G. M. (1995) Hospitalised injuriesVictoria, July 1987 - June 1993. MonashUniversity Accident Research Centre, ReportNo 67.

• Watt,G & Ozanne-Smith,J. (1996).Trends inpublic hospital injury admission rates,Victoria, July 1987 to June 1993, Australiaand New Zealand Journal of Public Health,Vol. 20 No. 4.

• Watson, W.L. & Ozanne-Smith, J. (1997).The cost of injury to Victoria. MonashUniversity Accident Research Centre, ReportNo 124.

Vehicle Safety• Benefits of a Hybrid Side Impact

Standard

• Airbag Effectiveness for GMH

• General Airbag Effectiveness Study

• Side Impact Research

• Consumer Advice on Vehicle CrashPerformance

• Correlation between NCAP and RealCrashes

• Correlation between U.S. Crash Testsand Real Crash Data

• Development and Testing of EnergyAbsorbing Rear Underrun Barriers forHeavy Vehicles

• Safe Carriage of Personnel in GeneralService Vehicles Study (AustralianDefence Forces)

Road and Traffic EngineeringSafety• Perceptual Countermeasures

• Evaluation of 1994/96 TAC FundedAccident Black Spot Program

• Injury Reduction Measures in AreasHazardous to Pedestrians

• Highway Design for Older Drivers

Road Safety Systems Analysis• Case-Control Study of Single Vehicle

Crashes

• Serious Injury Single Vehicle CrashStudy

• Case-Control Study of MotorcycleCrashes

• Motorcycle Inspections Survey

• Index to Measure Police TrafficEnforcement Effectiveness

• Modelling of Factors Influencing RoadTrauma Trends in Victoria

• Review of Reductions in the VictorianRoad Toll during late-1996/mid-1997

(Source: Monash University Accident ResearchCentre Annual Report, 1997, updated)

MUARC road safety research projects


Road Safety Resource Contacts• Monash University Accident Research Centre (MUARC)

http://www.general.monash.edu.au/muarc or phone 9905 4371 forresearch report publication list.

• Royal Automobile Club of Victoria (RACV) phone: 9790 2190 or1800 134 126 (rural areas) – numerous road safety programs andservices eg Years Ahead – Road Safety for Seniors, Traffic SafetyEducation delivered to pre-schoolers, primary and secondary schools,engineering investigation of road safety problem areas, restraint fittingstations. http://www.racv.com.au.

• VicRoads - Bookshop phone: 9854 2782; video lending library (nocharge) ph: 9854 2861. http://www.vicroads.vic.gov.au for Safety First,road accident, teacher and student information, Community RoadSafety Councils, Road Rules and Traffic Management.

• Transport Accident Commission (TAC) http://www.tac.vic.gov.au.Web site includes resources for secondary school curriculum. Toborrow TAC TV advertisements (no charge) ph: 9664 6658

• NRMA – http://www.nrma.com.au/community for Victorian and NSWcyclist, driver, passenger and pedestrian road safety information.

• Federal Office of Road Safety Ph: 1800 026 349 for pamphlets egdrink driving, child restraints, bicycle safety.http://www.dot.gov.au/programs/fors/forshome.htm

• Kidsafe – The Kidsafe guide to road safety in cars. Ph: 9836 4070

Do-It-Yourself Jobs: preventing injury brochuresEsso Australia Ltd. has supported MUARC to develop three brochures to raiseawareness about the patterns and causes of injury during Do-It-Yourself (DIY)activities and the preventative measures that can be taken to avoid such injuries.

Every year 15 Victorians are killed and at least 2,000 are seriously injured carrying out DIYwork at home. The home, yard and garden are the sites of 30% of all emergency departmentpresentations for injury to Victorian adults. Evidence suggests that home injuries result inmore lost days from work than workplace injuries.

The most hazardous DIY activities for men are grinding, welding andcar maintenance; gardening is the highest risk activity for women.Other high-risk DIY activities are lawn mowing and ladder use.

The three brochures are aimed at providing information to home handypersons, retailand hire outlets, and workplace managers.

Multiple copies of each brochure are available. For further information and to orderbrochures please contact Karen Ashby on (03) 9905 1805.


Fatality and Injury Rates by Age Group, 1984-96, Victoria (/100,000) Table 1y j y y g p, , ( , )

Fatality Rate Injury RateYear 5-14 15-24 25-64 65+ 5-14 15-24 25-64 65+84 6.4 33.9 13.4 23.1 334.6 1324.9 538.5 313.485 6.3 35.2 13.3 23.9 317.2 1371.1 576.2 318.986 5.7 35.2 13.1 22.5 357.4 1490.0 626.8 347.587 5.7 32.5 14.6 25.6 371.6 1545.5 649.9 368.288 5.3 30.3 14.3 27.5 378.1 1624.2 731.9 391.689 6.1 31.8 17.2 24.7 369.8 1612.2 755.7 376.390 4.2 24.6 10.3 20.9 308.4 1311.9 588.2 322.291 4.3 23.1 9.8 16.1 232.2 1044.2 491.7 282.992 3.2 17.3 7.4 13.4 234.4 998.3 484.5 282.793 3.4 19.8 8.5 13.3 231.9 999.9 457.5 279.894 1.8 15.2 7.4 15.6 239.1 1008.1 478.2 284.495 2.9 17.1 8.8 12.7 250.2 1034.9 499.8 315.696 2.4 18.3 8.4 11.9 250.9 1075.5 535.5 332.1


Fatality and Injury Rates of Pedestrians, Bicyclists and Motorcyclists, Table 21984-96, Victoria (/100,000)

, ( , )Fatality Rate Injury Rate

Year Pedestrians Bicyclists Motorcyclists Pedestrians Bicyclists Motorcyclists84 3.4 0.7 2.0 53.6 35.1 56.685 3.3 0.6 1.7 54.3 33.7 52.986 3.3 0.4 1.8 55.4 34.8 51.787 3.2 0.6 1.6 55.7 43.8 55.788 3.6 0.4 1.5 59.0 46.5 53.889 3.7 0.8 1.5 55.2 45.4 51.490 2.1 0.5 1.3 46.6 40.8 47.391 2.1 0.3 1.3 43.3 30.0 41.892 2.0 0.3 1.3 40.3 29.7 41.393 1.6 0.3 1.0 38.6 29.2 39.794 1.4 0.2 1.0 40.1 29.4 37.895 1.8 0.2 1.0 40.8 26.9 35.596 1.7 0.3 0.9 41.4 28.9 35.5



Length of Stay in Public Hospitals by Road User type, Table 5July 1, 1987-June 30, 1996, Victoria (Days)

y , , , ( y )Financial Year Passenger Vehicles Pedestrians Motorcyclists Pedalcyclists

1987/88 13.2 19.0 13.3 12.21988/89 12.9 18.1 13.6 11.51989/90 13.1 18.2 13.8 12.21990/91 12.3 15.7 12.1 9.91991/92 11.6 12.7 12.4 9.01992/93 11.1 15.9 10.7 10.61993/94 10.3 12.4 10.5 9.01994/95 10.3 12.1 9.6 8.41995/96 8.3 10.1 8.6 10.3


Admissions of Motor Vehicle Caused Injuries to Public Hospitals Table 3by Age Group and Road User type, July 1, 1987-June 30, 1996, Victoria (/100,000)

Financial Age Group Road User TypeYear 5-14 15-24 25-64 65+ Pedestrian Pedalcyclist Motorcyclist87/88 129.6 501.8 227.2 225.2 20.2 6.3 22.488/89 116.8 482.2 220.8 236.2 19.1 5.6 21.089/90 111.9 412.7 187.9 180.4 15.9 5.3 18.690/91 82.6 332.3 156.1 168.3 13.6 3.5 16.791/92 61.3 285.9 134.5 147.8 11.7 2.7 15.892/93 65.7 301.9 131.3 167.6 11.7 2.5 15.193/94 70.9 269.6 128.2 158.4 11.8 3.0 12.694/95 57.3 255.9 136.8 163.5 10.7 2.4 13.395/96 63.7 256.7 129.9 155.5 11.8 2.1 12.6


Length of Stay in Public Hospitals of Motor Vehicle Caused Injuries, Table 4July 1, 1987-June 30, 1996, Victoria (Days)

g y p , y , , , ( y )All Hospitalisations Mean by Age Groups

Financial Year Mean Median 0-4 5-14 15-24 25-64 65+87/88 14.0 7 8.7 13.8 12.7 14.1 18.688/89 13.7 7 6.7 12.4 12.8 13.5 18.189/90 13.8 7 13.1 13.0 12.3 13.6 18.690/91 12.6 7 12.8 11.2 12.0 12.0 17.591/92 11.6 6 7.6 8.7 11.4 11.7 14.292/93 12.0 7 16.1 11.3 10.5 11.9 15.593/94 10.7 6 10.4 10.4 9.8 11.0 11.794/95 10.6 6 7.8 9.4 9.5 9.9 14.995/96 8.9 6 5.5 7.8 8.4 8.6 11.4



- INDEX -Subject Edition PagesBabywalkers, update .........................................................................................................................16,20,25,34...................1-4,12-13,7-8,7-8Baseball ............................................................................................................................................................ 30 ......................................10-12Bunkbeds ...........................................................................................................................................................11 ............................................ 12Bicycles - Bicycle related injuries .................................................................................................................6,34 ..................................1-8,8-12

- BMX bikes .......................................................................................................................................31 ........................................9-11- Cyclist head injury study ...................................................................................................................2 .............................................. 2- Cyclist head injury study updates ............................................................................................7,8,10......................................8,13,9

Burns - Scalds............................................................................................................................................3,25 ....................................1-4,4-6- Burns prevention .............................................................................................................................12 ........................................1-11

Car exhaust gassings ..............................................................................................................................11,20,25............................. 5-6,2-4,3-4Chainsaws.......................................................................................................................................................... 22 ......................................13-17Child care settings .............................................................................................................................................16 ........................................5-11Client survey results .......................................................................................................................................... 28 ............................................ 13Data base use, interpretation & example of form .............................................................................................. 2 .......................................... 2-5Deaths from injury (Victoria) ...........................................................................................................................11 ........................................1-11Dishwasher machine detergents - Update .......................................................................................................18 ............................................ 11Dogs - Dog related injuries ...........................................................................................................................3 .......................................... 5-6

- Dog bite injuries ..............................................................................................................12,25,26,34.......................12,13,7-13,2-5Domestic architectural glass ....................................................................................................................7,22,25.............................9-10,1-5,12Domestic Violence ......................................................................................................................................21,30....................................1-9,3-4Drowning/near drowning, including updates ....................................................................................2,5,7,30,34.......................3,1-4,7,6-9,5-7Escalator injuries ...............................................................................................................................................24 ........................................9-13Exercise bicycles, update .................................................................................................................................5,9 ...................................6,13-14Farm injury..................................................................................................................................................30,33.....................................4,1-13Finger jam injuries ............................................................................................................................10,14,16,25......................5,5-6,9-10,9-10Home injuries ..............................................................................................................................................14,32...............................1-16, 1-13Horse related injuries .....................................................................................................................................7,23 ..................................1-6,1-13Infants - injuries in the first year of life .............................................................................................................8 ........................................7-12Injury surveillance developments .....................................................................................................................30 .......................................... 1-5Intentional injuries ............................................................................................................................................ 13 ........................................6-11Latrobe Valley - The first three months .............................................................................................................9 ........................................9-13

- Latrobe Valley injuries ....................................................................................... * March 1992 .......................................... 1-8- Injury surveillance & prevention in the L. V. ........................................................ *Feb 1994 ........................................1-14

Lawn mowers .................................................................................................................................................... 22 .......................................... 5-9Martial arts ........................................................................................................................................................ 11 ............................................ 12Motor vehicle related injuries, non-traffic .......................................................................................................20 .......................................... 1-9Needlestick injuries ................................................................................................................................11,17,25..............................12,8,10-11Older people, injuries among ...........................................................................................................................19 ........................................1-13Off-street parking areas .................................................................................................................................... 20 ......................................10-11Playground equipment ..............................................................................................................3,10,14,16,25,29................7-9,4,8,8-9,13,1-12Poisons - Child resistant closures...........................................................................................................2 .............................................. 3

- Domestic chemical and plant poisoning ...............................................................................28 .......................................... 1-7- Drug safety and poisons control .............................................................................................4 .......................................... 1-9- Dishwasher detergent, update ............................................................................................10,6 .....................................9-10,9

Power saws........................................................................................................................................................ 28 ........................................8-13Roller Blades ..........................................................................................................................................15,25,31............................11-13,12,12School injuries .................................................................................................................................................. 10 .......................................... 1-8Shopping trolleys ........................................................................................................................................22,25................................ 10-12,8-9Skateboard injuries ........................................................................................................................................2,31 ....................................1-2,3-7Smoking Related injuries .......................................................................................................................21,25,29................................ 10-12,6-7Sports - Sports related injuries.............................................................................................................. 8 .......................................... 1-6

- The 5 most common sports .....................................................................................................9 .......................................... 1-8- Adult sports injury .................................................................................................................15 ........................................1-10

Tractor injuries .................................................................................................................................................. 24 .......................................... 1-8Trail bikes.......................................................................................................................................................... 31 .......................................... 7-9Trampolines .......................................................................................................................................................13 .......................................... 1-5Venomous bites and stings ...............................................................................................................................35 ........................................1-13VISS: early overview .......................................................................................................................................... 1 .......................................... 1-5VISS: goes electronic .......................................................................................................................................26 .......................................... 1-5VISS: how it works .............................................................................................................................................1 .......................................... 6-8Work Related Injuries .................................................................................................................................17,18................................ 1-13,1-10

* Special edition


Editorial BoardProfessor Claes Tingvall, Monash University Accident Research CentreProfessor Joan Ozanne-Smith, Monash University Accident Research CentreAssoc. Professor Terry Nolan, Dept. of Paediatrics, Melbourne UniversityMr. Jerry Moller

VISS StaffDirector: Professor Joan Ozanne-SmithCo-ordinator: Virginia RoutleyDatabase Administrator: Dr. Mark Sinclair StokesResearch Assistant: Karen AshbyAdministrative Assistant: Christine ChestermanAssociate Director: Assoc. Prof. Terry Nolan(Child Injuries)

General AcknowledgementsParticipating Hospitals

How to AccessVISS Data:VISS collects and tabulates informationon injury problems in order to lead to thedevelopment of prevention strategies andtheir implementation. VISS analyses arepublicly available for teaching, researchand prevention purposes. Requests forinformation should be directed to theVISS Co-ordinator or the Director bycontacting them at the VISS office.

VISS is located at:Building 70Accident Research CentreMonash UniversityWellington RoadClayton, Victoria, 3168

Phone:Reception (03) 9905 1808Co-ordinator (03) 9905 1805Director (03) 9905 1810Fax (03) 9905 1809

Email:[email protected]@general.monash.edu.au

Alfred HospitalAngliss HospitalAustin and Repatration Medical CentreBallarat Base HospitalThe Bendigo Hospital CampusBox Hill HospitalDandenong HospitalEchuca Base HospitalFrankston HospitalThe Geelong HospitalGoulburn Valley Base HospitalLatrobe Regional HospitalMaroondah Hospital

Mildura Base HospitalMonash Medical CentreThe Northern HospitalRoyal Children’s HospitalRoyal Melbourne HospitalRoyal Victorian Eye and Ear HospitalSt Vincent’s HospitalWangaratta Base HospitalWarrnambool and District Base

HospitalWestern HospitalThe Williamstown HospitalWimmera Base Hospital

Coronial ServicesAccess to coronial data and links with the development of the Coronial Service’sstatistical database are valued by VISS.

National Injury Surveillance UnitThe advice and technical back-up provided by NISU is of fundamental importance toVISS.

Recent issues of Hazard, along with other information andpublications of the Monash University Accident Research Centre,can be found on our internet home page:

http://www.general.monash.edu.au/muarc


VISS is a project of the Monash University Accident Research Centre.

Hazard was produced by the Victorian Injury Surveillance Systemwith the layout assistance of Glenda Cairns, Monash University Accident Research Centre.

Illustrations by Jocelyn Bell, Education Resource Centre, Royal Children’s Hospital.

ISSN-1320-0593

Printed by Sands and McDougall Printing Pty. Ltd., Brunswick

Project Funded byVictorian Health Promotion Foundation

Documents

Trends in Road Traffic Fatality and Injury in Victoria...This edition of Hazard examines general trends in road traffic fatality and injury, providing a broad overview of a complex