Memorandum by the British Medical Association
ROAD TRAFFIC SPEEDS
The BMA is a voluntary professional association
of doctors, and their trade union, which promotes the science
of medicine and maintains the honour and interests of the medical
profession. With over 123,000 members, it represents around 80
per cent of the medical profession in the UK. The BMA is also
a scientific and educational body and a publishing house.
The BMA has for some time taken an interest
in the impact of road transport on health and has produced a number
of policy publications including Road Transport and Health in
The BMA considers that measures should be taken
to reduce motor vehicle speeds in urban areas.
Most pedestrians and cycle casualties occur as a result of an
urban traffic accident. The critical factor is the speed of motor
vehicles, since a cyclist or a pedestrian hit by a vehicle travelling
at more than 30 mph is likely to sustain severe injuries, whereas
at speeds under 20 mph casualties are likely to be slight. For
this reason, effective measures to reduce the speed of motor vehicles
are essential in protecting vulnerable road users. These include
rigorous police enforcement of existing speed limits
and physical changes to road design and layout to slow down motor
vehicles in urban areas. Traffic-calming measures include road-humps
and speed tables, road narrowing, kerb extensions and mini-roundabouts.
Careful consideration should be given to the needs of cyclists
when designing these features, for example in providing alternatives
to physical obstacles such as ramps and humps in the roads and
in considering road space for cycling when reducing the width
of a carriageway. It would be unfortunate if measures to enhance
the safety of cyclists (and pedestrians) by reducing the speed
of motor vehicles within designated zones had the effect of discouraging
cyclists from these very areas. Safer cycling conditions would
also be provided if cycle networks were introduced in urban areas.
Publicity and education campaigns could raise
drivers' awareness of more vulnerable road users such as cyclists.
Such awareness should in turn lead to a reduction in road casualties101.
As well as improving road safety education in schools, the BMA
recommends that the DLTR could improve the education of drivers
by including hazard perception and awareness of cycling with the
introduction of a practical cycling section in the Driving Test100.
Cycling should be actively promoted as an effective
means of improving public health. Regular cycling, like other
forms of exercise, improves the health of individuals by improving
strength and endurance and contributing to lower blood pressure
and weight. On a population basis, regular exercise such as cycling
is associated with lower rates of mortality, especially from coronary
heart disease. The issue of children's exercise is crucial not
only because of its link with their health and fitness in later
life, but also because habits such as taking part in and enjoying
physical activity are most easily acquired in childhood and may
be difficult to acquire later.101
Health derived national motor reduction targets
should be established by a Traffic Reduction Unit. The percentage
of children travelling to school by foot and by bike set against
casualty rates (especially 10-14 year olds) could be used as an
indicator of progress.100 All relevant government departments
should support initiatives such as the establishment of traffic
free zones, safe walk to school routes, and cycling lanes.101
We recommend that the DTLR provides increased funding for local
authority 20 mph schemes, to approve a minimum of 500 additional
20 mph zones by the end of 2002, and to set targets for further
increase thereafter. Furthermore, we suggest the DTLR investigate
the cost effectiveness for uniform in-car speed limiters in terms
of environmental and health benefits.100
In order to monitor progress in reducing road
traffic accidents, the Health sector should adopt a primary role
in the collection of high quality data on injuries and their consequences.
Future research strategies into injury prevention should include
details of cost effectiveness.
Accuracy and availability of accident information and statistics
should be improved. Many accidents go unreported, even those involving
serious injury. This under reporting could have implications for
assessing what costs traffic injuries have to the NHS99. In our
policy report, Injury Prevention,103 we recommend the establishment
of a comprehensive injury surveillance system that should include
data from surveys of exposure to known avoidable hazards, eg child
pedestrian exposure to non-traffic calmed roads. We acknowledge
that there is strong evidence of effect on traffic calming on
injuries to child pedestrians.
Injury prevention is not cheap. The initial
costs can be high, but savings are possible in the long run through
prevention of injuries and resulting care and rehabilitation costs.103
Reducing traffic speeds make roads more safe, resulting in a reduction
in road traffic injuries. A decrease in the amount of these injuries
would reduce the burden on the NHS to treat them. Moreover, by
making roads safer, the public are more likely to cycle and walk
therefore realising the health benefits of doing so.
I hope these comments are of assistance and
I look forward to reading the report of the Committee in due course.
M J Lowe
100 British Medical Association, Road Transport and
Health, London: BMA, 1997. Back
British Medical Association, Cycling towards health and safety,
London: BMA, 1992. Back
British Medical Association, Growing up in Britain: ensuring
a healthy future for our children, London: BMA, 1999. Back
British Medical Association, Injury Prevention, London: BMA,