Road & Traffic Safety

Globally, an estimated 3,400 people, including more than 500 children, are killed each day in motor vehicle crashes involving cars, buses, motorcycles, bicycles, trucks, and pedestrians. Annually, about 1.3 million people are killed and an additional 20–50 million are injured in motor vehicle crashes. Although only 54% of the world’s vehicles are in developing countries, 90% of the world’s crash deaths occur in these countries. Nearly half of people who die on the world’s roads each year are pedestrians, cyclists, and motorcyclists, also called “vulnerable road users.”

According to US Department of State data, motor vehicle crashes are the leading cause of nonnatural death among US citizens who die in a foreign country (see Chapter 3, Injury & Trauma). From 2015 through 2016, 484 US citizens living or traveling internationally died as a result of a motor vehicle crash. Most crash deaths (63%) occurred in drivers and passengers of passenger vehicles (cars, trucks, or sport utility vehicles), followed by 18% in motorcycle drivers and passengers; 10% of traffic-related fatalities involved pedestrians.

Table 8-1 shows the top 29 countries visited by US citizens, based on the Survey of International Air Travelers from the Department of Commerce. For each country, the estimated “motor vehicle crash death rate per 100,000 population” is listed as an indicator for the risk of motor vehicle crash death, along with the number of US citizens who died in each country from a crash death from 2015 through 2016.

Motor vehicle crashes are common among foreign travelers for a number of reasons. In many developing countries, unsafe vehicles (vehicles sold in 80% of all countries worldwide fail to meet basic safety standards promoted by the United Nations World Forum for Harmonization of Vehicle Regulations) and an inadequate transportation environment contribute to the crash injury problem. Motor vehicles share the road with vulnerable road users. The mix of traffic including cars, buses, taxis, rickshaws, large trucks, and even animals increases the risk for crashes and injuries. Speed is another risk factor for vehicular crashes, injuries, and deaths. Just 47 countries, comprising 13% of the world’s population, have laws that meet best practices on urban speed (≤50 km [31 mi] per hour). When driving, a lack of familiarity with the roads, driving on the opposite side of the road, the influence of alcohol, poorly made or inadequately maintained vehicles, travel fatigue, poor road surfaces without shoulders, unprotected curves and cliffs, and poor visibility due to lack of adequate lighting can also contribute to a crash.

When a crash occurs, the use of protective equipment significantly decreases the risk of injury and death. Seat belts, car seats, booster seats for children, and helmets (bike and motorcycle), are all proven ways to reduce crash-related injury and death, but this equipment may be scarce. In addition, timely and effective emergency and hospital care may be unavailable in some locations or not acceptable by US standards. Trauma centers capable of providing optimal care for serious injuries are uncommon outside urban areas in many international destinations.

Strategies to reduce the risk of motor vehicle crash injury are shown in Table 8-2. The Department of State has useful safety information for international travelers, including road safety and security alerts, international driving permits, travel insurance (www.travel.state.gov and https://travel.state.gov/content/travel/en/international-travel/before-you...), and the Smart Traveler Enrollment Program (https://step.state.gov/step). The Association for International Road Travel (www.asirt.org) also has useful safety information for international travelers, including road safety checklists and country-specific driving risks.