Royal Australian College of Surgeons see the lifesaving merit of Vision Zero

12 February 2020

I rise today to speak on the issue of road safety and the role that medical practitioners have played in raising awareness and working with decision-makers to help lower the road toll.

It is now 50 years since the first compulsory seatbelt legislation was introduced in South Australia. South Australia was a leader in mandating the fitting of seatbelts in cars during the late 1960s. In 1969, vehicle standards mandated that seatbelts had to be fitted for all front-seating positions, and fitted on all seating positions from January 1971. However, it was Victoria which took the crucial next step and made it compulsory for people to actually wear them. Within two years, by 1972, every Australian state had introduced mandatory front seatbelt laws. Countless lives have been saved in that time, and I want to commend the role played by the specialist surgeons from the Royal Australian College of Surgeons who lobbied for the introduction of seatbelts in the first case. That college also lobbied for compulsory blood alcohol testing for all injured occupants following a vehicle crash. This demonstrated the serious nature of the drink-driving epidemic, which led to random breath testing by 1976, which was also the first year for mandatory-child-restraint legislation. The 1980s saw the introduction of mandatory bicycle helmets and zero blood alcohol for all learner and P-plate drivers. More recently, RACS fellows have been working on legislation for mandatory rollover protection for quad bikes.

Surgeons have to face daily the carnage of wasted lives and horrendous injury. For every person killed in a vehicle accident there are often three more with serious injuries. Dr John Crozier, chair of the RACS Trauma Committee, has been a vocal advocate for improving transport safety, and his is a voice that we very much need to hear. What are surgeons such as Dr Crozier telling us that they would like to see happen now? They have called for Vision Zero. Vision Zero means no deaths or serious injuries at all on our roads. They have advocated for life-saving technologies that exist today to be fitted on all new vehicles. RACS fellow Dr Rob Atkinson has called for the introduction of mandatory autonomous emergency braking in new cars, which would save an estimated 1,200 lives and prevent 54,000 hospitalised injuries by 2033. Just think about that for a moment: 54,000 fewer hospitalised injuries by 2033. At present, incredibly, only half the new cars in Australia have this feature as standard.

It may also be time to consider whether we need the zero tolerance approach to drinking and driving. At the moment, allowing for a blood alcohol limit of 0.05 can cause some people to think, subjectively, that they are under the limit when they are not. If states moved to a zero blood alcohol level there would be no room for confusion. The message would be that if you drive you cannot drink anything at all—zero tolerance. And the increasing use of cannabis in the community, as well as medicinal cannabis, has also greatly increased the risk to road users. People who drive under the influence of cannabinoids have double the crash risk of other road users—double! Legislation on recreational cannabis in the US has also led to significant accident increases in the USA, with Colorado, Washington and Oregon incredibly prominent.

In Queensland, RACS fellow Dr Matthew Hope has also provided early data on the injuries associated with the electric scooters that now plague the streets of many of our cities. The haphazard introduction of these scooters without adequate safety training has been associated with 30 ambulance attendances and 134 emergency department presentations in the Brisbane CBD area alone over just two months.

RACS also supports the introduction of a minimum unit price for all alcohol sales across Australia in order to help stem alcohol fuelled violence. The NT has the highest rate of single-bone forearm fractures in the world, and these injuries typically occur in domestic violence cases where women are defending themselves from an attacker by putting their forearm up to protect themselves. The advocacy of RACS fellows has helped transform the NT into a national leader in action on alcohol fuelled violence. 

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