Control of road trauma epidemic in Australia.

This lecture discusses initiatives taken by the Road Trauma Committee of the Royal Australasian College of Surgeons to reduce fatality and injury on Australian roads. In 1970 the Road Trauma Committee and the communications media initiated a national campaign in support of legislation for the compulsory wearing of seat belts. Public ignorance and Parliamentary inertia were countered. Victoria became the first State in the Western world to introduce this legislation. All other Australian States followed. Significant and marked reductions in fatality and injury were achieved and have been maintained. Recognising alcohol as the single most important cause of serious road crashes and injuries in Australia, the committee advocated legislation for compulsory blood alcohol tests on all adult road crash casualties. In 1973-74 legislation was enacted in South Australia and Victoria and in 1976 in Queensland. Results show that more than one-quarter of driver casualties have alcohol concentrations above the legal limit of 0.05 g%. Half of these exceed 0.15 g%. On the other hand less than 3% of the general driving population exceed the legal limit. Further advocacy led in 1976 to the enactment of random roadside breath-test legislation in Victoria. The majority of Australian convicted drinking drivers have alcohol-related social problems. A quarter incur reconvictions. The conventional penal approach has failed. At present the Road Trauma Committee is campaigning for compulsory medical assessment of convicted drinking drivers. Reissue of a driving licence would be dependent upon evidence of re-education and/or rehabilitation. Pilot re-education programmes have been shown to lessen recidivism markedly. Prevention of drink-driving behaviour is the major strategy. The tactics entail deterence, improved secondary-school and driver education, and the implementation of a national policy for control of alcohol abuse.