Alcohol-Related Road Traffic Accidents in the English-Speaking Caribbean: A Call to Action

By Francis, Tara; Fremaux, Brian et al. | International Public Health Journal, January 1, 2017 | Go to article overview

Alcohol-Related Road Traffic Accidents in the English-Speaking Caribbean: A Call to Action


Francis, Tara, Fremaux, Brian, George, Nequella, Atkins, Lydia, Ejiofor, Ezinwanneamaka M., International Public Health Journal


Introduction

The UN General Assembly has declared 2011-2020 as the "Decade of Action for Road Safety". This is significant as road traffic accidents (RTAs) are a leading cause of morbidity and mortality in both developing and developed countries (1-4). Annually over 1.3 million people worldwide die as a result of RTAs, and approximately 20-50 million sustain severe injuries, the majority of which require longterm treatment (5). However, low and middle-income countries LMICs are disproportionately affected (6) where it is estimated that 94% of road traffic-related deaths occur. Though these countries have just over half of the world's registered vehicles. The burden of is higher among the youth and young adults as well as middle-aged individuals who, combined, constitute the economically most productive age groups of society (1, 3, 6, 7). Consequently, RTA rates remains one of the most important health and social policy issues that spans all countries across all continents (5).

Understanding the risk factors associated with RTAs is as important as understanding the population at risk, for the development of policies to reduce the growing burden. Traffic incidences are multifactorial events that are caused by human factors, technical issues and environmental conditions (8), but the majority is attributed to human or driver-related factors (7). A large proportion of RTAs are associated with driving under the influence (DUI) of either alcohol or drugs (2, 9-12). Thus, while increased death rates in LMICs, like the Caribbean, are driven, at least in part, by rapid motorization, the lack of concomitant road safety strategy implementation and safe road infrastructure development is also largely responsible (13).

RTAs and their consequences, increased mortality and disabilities, can be reduced through preventive programs that tackle the multifactorial natures of RTAs. Such an approach would seek to address this public health concern, through a mechanism of public policies on road accident prevention and stricter enforcement of the regulations resulting from these policies. This approach recognizes that the impact of RTAs is both at the individual and the population level.

While RTAs are an issue throughout the Caribbean, this paper examined policy options aimed at reducing alcohol and illicit drug related RTAs in the Caribbean region. The specific expected outcomes are (1) improved data quality to quantify the true burden of alcohol and illicit drug related RTAs; (2) focused campaigns promoting safe driving habits; (3) increased public and governmental awareness of the realities of alcohol and illicit drug related RTAs and (4) decreased alcohol and illicit drug RTAs.

Background

As early as 1962 the World Health Organization (WHO), through Resolution WHA27.59, challenged member states to address the urgent problem (14). However, six and a half decades later RTAs remains a major public health concerns for countries around the globe. It is estimated that in the absence of increased efforts and new strategies and policies, the total number of road traffic deaths is expected to reach 1.9 million by the year 2020. Currently, the majority of such deaths are among vulnerable road users - pedestrians, pedal cyclists, and motorcyclists. In addition, the youth and young adults are disproportionately burdened.

It is well documented that traffic accidents are caused by numerous factors that range from faulty vehicles and poor road design to driver-related, which includes alcohol-impaired driving, speeding, and driver distraction (7, 11, 15, 16). However, alcoholimpaired driving is responsible for the greater proportion of RTAs. Global Burden of Disease (GBD) estimates for 2010 indicated that almost 200,000 road traffic accident fatalities were the direct result of alcohol (17). DUI of alcohol and illicit drug use presents unique challenges for public health and government officials (6). Studies have documented that the relative risk of being involved in a RTA significantly increases at a blood alcohol content (BAC) level as low as 0. …

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