(See Chapter 8, “Healthcare Environment and Infection Control” for potential injuries of all types including occupational and Best Practices in preventing, mitigating, and controlling them)


The US transportation system is a hodgepodge of multiple policy inputs at the local, state, and national level. Many times decisions are made because of politics rather than essential needs. The infrastructure is in serious disrepair throughout the country. Roads, railroads, bridges, dams, etc. and the buried pipes used for transportation of water, sewage, natural gas, oil, etc. are frequently out of date and need replacement. The transportation system is essential to society because it is used to move people and goods in an efficient manner and therefore may have a profound effect on the health, safety, and quality of life of all people.

The use of red light cameras for traffic violations is very controversial. There are questions about the technology and whether or not this is a system to reduce accidents or bring in new revenue for the political entity. Because of confusion on the part of drivers, it may lead to additional rear-end collisions.

Motor vehicles account for over 33,000 deaths and 2.6 million drivers and passengers being treated in emergency rooms annually. Most of the deaths in those aged 1-34 occur as the result of motor vehicle crashes, with 16- to 19-year-olds involved in the most crashes. Alcohol is a factor in almost one third of motor vehicle deaths and in 47% of pedestrian deaths from motor vehicles. (See endnote 13.)

Best Practices for Preventing Injuries in Transportation

  • • Gather and analyze data on mechanical problems, roadway problems, weather-related problems, environmental problems, and behavioral problems, for a given area to determine the primary causes of injuries from transportation sources.
  • • Use current research to determine the best approach to improve the mechanical parts of the automobile.
  • • Develop programs unique to certain age groups such as teenagers and first-time drivers, middle-age, and older people.
  • • Develop and enforce restraint laws including seatbelt laws for all people within a vehicle and also for pets.
  • • Develop and enforce laws for infant carriers, child car seats, and booster seats, and insist that the children be seated in the back.
  • • Develop special programs to evaluate and reduce motorcycle crashes and injuries.
  • • Develop and enforce a helmet law for motorcycles.
  • • Develop and enforce a helmet law for bicycles, scooters, and skateboards.
  • • Enforce all motor vehicle laws that apply to bicycles. Individuals who run stop signs or red lights should receive the same ticket as those using an automobile.
  • • Develop and enforce mandatory ignition interlocks for all people convicted of drunk driving.
  • • Develop and enforce a graduated driver license law for teenagers based on age and experience.
  • • Discourage teenagers from driving other teenagers, which frequently leads to unintended injuries in car accidents.
  • • Require vision tests for renewal of driver’s licenses for older drivers.
  • • Require all drivers who receive speeding or reckless driving tickets to take special driver education courses.
  • • Enforce all laws related to drunk driving and minimum age legal driving.
  • • Develop special programs for individuals who have received warnings or tickets for aggressive, inattentive, or sleepy driving.
  • • Develop and enforce distracted driving laws which cover the use of cell phones and texting while driving. All drivers must be banned from texting while driving.
  • • Develop and enforce alcohol impaired driving laws which include the use of car breathalyzers for ignition for individuals convicted of driving while intoxicated.
  • • Enforce and strengthen driver education requirements, periodic testing, and licensing systems.
  • • Analyze community design in high accident areas to determine how to make engineering changes to promote vehicle movement while promoting pedestrian and bicycle safety measures.
  • • Provide sidewalks where feasible.
  • • Provide safe roadway crossings for pedestrians with flashing yellow lights or other lights.
  • • Reduce vehicle speed in residential areas.
  • • Promote public transportation to reduce the number of vehicles on the roadways.
  • • Provide safe routes to schools and recreational sources for pedestrians and bicycles.
  • • In new construction in the community, provide for various pedestrian and bicycle routes as part of the planning measure.
  • • Improve air quality for pedestrians by: retrofitting diesel engines; mitigating traffic congestion; and utilizing stricter emission regulations for railroads, ships, buses, semitrailers, and other sources of transportation.
  • • Develop and provide educational programs in injury control for all school levels. (See endnotes 14, 15.)
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