Death and injury from motor vehicle crashes in Israel: epidemiology, prevention and control.

Death and motor vehicle crash (MVC) rates per 1000 vehicles and kilometres travelled in Israel (1977) exceed those of all western countries, despite low numbers of young and intoxicated drivers. Increased casualties have resulted from expansion of driver and vehicle populations offsetting a decline in crash risk. Time data indicate casualty crash trends reflect trends in traffic volume, and that night time case fatality rates (CFR) are high. Place data indicate that more than three quarters of all crashes occur in cities, mostly involving pedestrians, but the majority of deaths result from higher speed inter-urban crashes, mostly of 2-vehicle type, and not as intersections. The rates for deaths per 100 crashes are 4- and 8-fold higher in inter-urban than urban crashes for occupants and pedestrians, respectively. Vehicle data indicate high MVC risk from careless driving, probably speeding in taxis, and point to the need for occupant protection standards in light weight trucks and pick up vans. Human data indicate that 92% of drivers in MVCs are male. The risk of involvement is high for drivers aged 18 and drops at aged 55. Pedestrian accidents resulted in 48.1% of all dead, and included large numbers of young and elderly. Reduction in inter-urban private motor vehicle travel and in speeds at which crashes occur are suggested as swift and effective measures to reduce death and injury. Low cost strategies include air bags and other occupant protection standards and more seat belts. Prevention of pedestrian accidents requires a variety of measures to reduce vehicle-pedestrian conflicts.