Speaking the same language for road safety
Comparing data across different countries can be awkward. There are differing methodologies and ways of doing things. You have to do a lot of ground work to agree a lot of details before you can be sure that you are making valid comparisons. Even so you would think that we could all agree what a death is. Not so. Death it seems, like taxes, differs considerably from country to country. Last week I attended an excellent conference on serious road injuries at Dublin Castle. The event was part of the Irish EU presidency and was hosted by the RSA. There was a stellar list of speakers from around Europe and beyond; number crunchers, medicos and road safety types for the main part. Nerd heaven, if you like that sort of thing. Europe has been doing extremely well in improving road safety in recent years. Ireland’s performance has drawn a lot of praise but we are not unique. Road deaths in Europe are down by 43% in the decade from 2001 to 2011. Last year’s figures in Europe, as in Ireland, were the lowest since records began. The discussion now centres around what we can do next. There is a consensus that we need to look not only at the headline numbers of deaths but also at the crashes that are causing serious injuries. Hence we come to the problem of definitions. Some countries count it as a road death if a person dies within 24 hours of a crash. Others take a 30-day definition and others a longer time period. If I’m unfortunate enough to be involved in a crash that results in my death a week later, then up until recently I’m a fatality in Ireland but only a serious injury in Spain. A further complication is that most countries, Ireland included, use police reports as the primary data source for counting their road injuries. That is useful but inherently flawed; Gardai cannot be expected to know the outcome for a victim months down the line after a crash. Agreeing on what constitutes a serious injury is even more complicated. For some countries it simply means an injury that required an overnight stay in hospital. For others it is an injury that results in a life-long impairment or disability. Until we can agree on what we are talking about we cannot draw any reasonable conclusions from each other’s data. That can be really powerful as a tool to examine what policy interventions are working, what cost-benefit ratios are and where resources should be spent. The European Commission, with lots of help from across the Continent, is looking to have a common methodology agreed. There is an international system for categorising bodily injuries known as the ‘Abbreviated Injury Scale’. This looks at the nature of the injury and where it is on the body to categorise the outcome, and is extremely helpful for researchers. The complexities discussed at the conference soon left this poor fool groping in the dark but I get the concept. The AIS Scale generates a ‘score’ for severe injuries that will be the same no matter what country it happens in. Fine, so together we need to do two things. Firstly to look at Hospital Discharge Data as well as police reports, and secondly to count injuries in the same way. It all seems rather academic in character and far removed from the day to day reality but it does connect to the real world. This point was brought home forcibly by the astonishingly powerful speech given by Siobhan O’Brien. You may recognise her from some of the RSA’s road safety advertising. Wheel-chair bound because of an acquired brain injury suffered in a crash in 2001, she gave one of the most extraordinary and moving speeches that I have ever seen. She powerfully demonstrated that we not dealing with numbers but with real lives. Her words will stay with me for a long time, and hopefully her story and others like her will keep governments across Europe determined to keep working to reduce road crashes.