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Sweden is setting a goal of zero auto fatalities and disabling injuries  added 4/27/01

http://www.icbc.com/Library/recovery/Volume7/Number3/TheZeroVision/

The Zero Vision

Already a leader in automotive safety, Sweden is shifting the paradigm of road transportation from a tacit acceptance of casualties to a goal of zero fatalities and disabling injuries. Claes Tingvall, national director of road safety, lays out the ethical and scientific basis for turning this revolutionary vision into reality.

THE ROAD TRANSPORT system is the least forgiving of all of the human-machine systems in daily use in the developed world. In Sweden, fatalities or long-term injuries are sustained by approximately 5% of the population. In some countries, this figure exceeds 20%.

In Sweden, the low tolerance for error in the road transport system generates 600 fatalities and 80,000 injuries annually, of which 4,000 are disabling. Every day, year after year, an average of two people are killed and about 10 permanently injured. Roadway injuries cut average life expectancy by at least six months and cause an average of 2.5 years of deteriorated health per person. With thousands of children lost and thousands of orphans created -- with lives altered by pain, reduced mobility, or reduced mental capacity -- this reality should be recognized for what it is: a public-health crisis.

A proposal is now before the Swedish parliament that sets a national goal of zero roadway fatalities and injuries. This can be interpreted more as an ethical attitude than simply an explicit operational goal.

When socioeconomic realities are added to this ethical imperative, the goal can be stated as "saving the maximum number of people using the resources available." How fully and quickly this goal will be realized depends ultimately on political will.

Inevitable casualties

Unlike other modern human-machine systems -- such as aviation, power generation, and health care -- the road transport system is based on people complying with current standards, laws, regulations, and guidelines, and on their having a degree of common sense, being cautious, and always making the right decisions. Expecting right decisions assumes that all the information in the system is clear and easily comprehended, and that the right decisions will inevitably be made.

Not surprisingly, this kind of system does not always work. The most serious problem is that a single wrong decision or mistake may have life-or-death effects on a number of people. In contrast, more mature and quality-assured human-machine systems have a greater built-in tolerance for human error. And, when human errors do lead to an accident, the forces that act on the human body are tolerable and survivable.

The safety problem in road transport is a product of three factors: (1) the number of errors made; (2) the scope and nature of the violence people are exposed to as a result of these errors, and each individual's tolerance to the violence, given the protection provided; and (3) the quality and availability of emergency services, care, and rehabilitation. The interaction of these factors, in effect, inevitably results in a predetermined number of killed or injured road users.

The solution to the road transport problem therefore requires three safety nets: (1) controlling or eliminating possible errors (crash prevention); (2) controlling or eliminating the kinetic energy released and directed at the human body in the form of violent action (injury prevention); and (3) ensuring that high-quality emergency services, care, and rehabilitation are always available.

When road users fall through all of these safety nets, they either die or, in the overwhelming majority of cases, are severely and permanently disabled. The responsibility for creating and maintaining these safety nets rests with the central government, government agencies, other organizations, and market forces, all of which together design the system and regulate and monitor the behaviour of road users.

This collective responsibility does not, however, release users of the system from their responsibilities. The users must observe traffic regulations -- regulations that are meant not to advise but to define the behavioural limits required to protect themselves and their fellow users.

From an individual perspective, the essential responsibility of all road users is to know who they are and to refrain from placing themselves in situations where they lose control of themselves. Dr. Jekyll has the ultimate responsibility for ensuring that no Mr. Hyde emerges.

But a safe system requires more than road users' compliance with current rules. The moral responsibility must transcend the rules and extend to the health of all road users in all situations -- even those not anticipated or defined by the legislative and governing bodies. This imperative places powerful demands on the designers of the system.

Dreaming the future

The theoretical basis for the zero vision lies in the knowledge that people and organizations can generate the energy needed for action and innovation by formulating desirable future scenarios. Without a vision of a better future, no innovation will take place.

In other words, if we wish to change the road-safety situation, we must stop defining casualties as a negative but largely accepted side effect of a system that is essential to our society's continuing prosperity. If, instead, we define a radical and better scenario, the right action and innovation will result. This does not, of course, eliminate the need to formulate intellectually viable and practical strategies.

Studies of young people involved in roadway crashes show that many lack the ability to define their dreams for the future. Instead, they define the purpose of their existence as maximizing immediate feelings of pleasure. Similar attitudes are found among drug users and criminals. No vision of future change means no ability to make change.

This absence of dreams may be contrasted to the U.S. decision in the beginning of the 1960s to put a man on the moon in 10 years. At the time, the costs and technical requirements were unknown. And yet the dream was achieved.

Similarly, there are gaps in our knowledge of what it will cost to achieve the zero vision for road transport. But we have the advantage of knowing more than the moon seekers about the possible technology. Unfortunately, we do not yet have the same degree of commitment at the highest political level to invest the money and human resources required. We hope that will come.

Science into action

The scientific basis of the zero vision differs from the usual approach to safety in human-machine systems: designing a system to minimize the number of events that cause injury. Instead, the zero vision is based on the notion of "allowing" these incidents to occur, but at a level of violence that does not threaten life or long-term health.

The first step is to define and quantify an unacceptable loss of health. A reasonable starting point for such a marker is not death or long-term invalidity but, rather, an injury that has not healed after, say, three weeks. The lower the degree of unacceptable loss of health, the more time and other resources are required to achieve the zero vision -- and vice versa.

The loss of health is not spread randomly over all injury-causing events but corresponds to a rising degree of external violence. Therefore, the second step in the zero strategy is to identify and define the limit for external violence that generates an unacceptable loss of health. Factors determining violence include vehicle and impact speed, and vehicle weight and configuration.

The relationship between these two basic measurements -- external violence and loss of health -- is already known for many parts of the body, types of injury, categories of road users, and age groups. This makes it possible to create a "violence-tolerance" equation (i.e., hazard to health). Similarly, the number of actual incidents that occur at different levels of violence is also relatively well known. This yields a second equation: "violence-exposure."

Putting these two equations together (see chart, below) reveals the essential road-safety problem: losses of health occur in events where the violence involved is greater than the tolerance to violence. The zero vision can become a reality by reducing one side of this dual equation while increasing the other -- in other words, reducing the exposure to violence while also increasing the tolerance to violence. A few examples might clarify how this works.