Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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How depressing
- Paul Kinnersley (10 May 2002)
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UK roads are the safest in the world.
- Alwyn Davies (10 May 2002)
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The war on the world's roads.
- Sergio Stagnaro (10 May 2002)
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Lies, Damned Lies and Statistics
- Brian H Worboys (10 May 2002)
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Priorities of War
- Bernard C Abrams (10 May 2002)
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Education against road traffic-induced injuries: a neglected subject
- Carlos K. B. Ferrari, Av. Dr. Arnaldo, 715 (2ºandar) - Cerqueira César, 01246-904, São Paulo (SP), Brazil (10 May 2002)
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The public health community should LEAD the way
- David G Hammond (11 May 2002)
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Treating the disease, not the symptoms
- Ben Lovejoy (11 May 2002)
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Shared-use paths are BAD!
- Guy Chapman (11 May 2002)
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Re: UK roads are the safest in the world.
- Guy Chapman (11 May 2002)
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Deterrence of walking and cycling is an issue too
- Paul F Docherty (11 May 2002)
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Worth of Speed Cameras Queried
- Bogush J Mann (12 May 2002)
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rail Road Speed Limits
- Bogush J Mann (12 May 2002)
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People machine divorce.
- Niharika Varma (12 May 2002)
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Speed cameras
- David Potterton (12 May 2002)
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BEYOND YOUR BRIEF, BMJ!
- Tristram J Torrance (13 May 2002)
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More on war on the roads
- Bogush J Mann (13 May 2002)
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Training
- Lyn M Holman (13 May 2002)
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Comment on road safety for all
- Alan R (13 May 2002)
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Imprisoned in our own bodies
- Mel Bartley (14 May 2002)
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Unnecessary and unethical?
- Giles N Cattermole (14 May 2002)
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We must all change
- Kuan J Lee (14 May 2002)
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Catch a train instead?
- nj brooker (14 May 2002)
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Fair Dos
- Mike Sales (14 May 2002)
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You can do better than that!
- Anthony Papagiannis (14 May 2002)
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Air Bags
- Bruce C McG Williamson, none (14 May 2002)
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Anti-Road-Deaths Device?
- James P Moore-Smith (14 May 2002)
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Re: Deterrence of walking and cycling is an issue too
- Emilie van de Graaff (14 May 2002)
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Re: Unnecessary and unethical?
- Irvine S.L. Loudon (14 May 2002)
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Re: More on war on the roads
- john Nottingham (14 May 2002)
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Protection
- clancy mcquigg (14 May 2002)
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We can never win the war on roads
- Rajesh Moholkar, LU5 0FB (14 May 2002)
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Shock tactics and consent
- Roderick Mackenzie (15 May 2002)
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Don't listen to the cyclists
- Donald Kent (15 May 2002)
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Cycling, Road Safety and the Medical Profession
- Dawn M Luxton (16 May 2002)
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War on the roads
- J Gordon Avery, Penny Avery (16 May 2002)
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The BMJ's legitimate double standards
- Richard Smith (16 May 2002)
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Purleez
- Bogush J Mann (16 May 2002)
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The neglected epidemic: new efforts.
- Renato Seligman (17 May 2002)
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Go Dutch!
- Richard M Keatinge (21 May 2002)
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Pedestrians – get off your knees
- John T Dwyer (21 May 2002)
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Re: UK roads are the safest in the world.
- Anthony J Cartmell (21 May 2002)
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Transport Research Laboratory report 323
- Bogush J Mann (23 May 2002)
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Re: Pedestrians – get off your knees
- Sophie A Evans, M15 6BG (29 October 2002)
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Re: BEYOND YOUR BRIEF, BMJ!
- Norman Armstrong (30 October 2002)
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Paul Kinnersley, Research Fellow Sydnye, NSW 2006
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to read that cycle helmets are thought to be the most effective measure for reducing injuries is very depressing. As a cycling doctor (withhelmet) the real problem is simply the risk of getting knocked off one's bike. the helmet only helps with what happens next! As for pedestrians wearing helmets, I presumed this was a joke entry but it is joiint second in terms of viewed effectiveness. It seems the car still rules amongst BMJ readers. |
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Alwyn Davies, Retired
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Dear Sirs, The British Medical Journal has an editorial entitled "War on the roads". Deaths on British roads are around 3400 per annum. More are killed in accidents in their own homes, over 4000 per annum. (RoSPA) The BMJ should be aware that, according to Dr Mark Porter, the Radio Times writer and others, the medical profession accidentally kill up to 54,000 stone dead in the UK every year. Can this be true? If so, why is this not publicised as much as the comparatively tiny number killed by excess speed for the conditions. Article here. http://www.guide-information.org.uk/guide/dr_legal.htm Once again the driver gets all the blame and pedestrians are never, ever to blame. Police figures in the Transport Research Laboratory publication TRL 323 say that 84% of pedestrian accidents are caused by the pedestrian. Whilst we keep ignoring the true causes of accidents, both on the road and within the medical profession, and keep up this relentless campaign to demonise the driver, we are never going to have safer communities. Yours faithfully,
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Sergio Stagnaro, Specialist in Blood, Gastrointestinal and Metabolic Diseases. Researcher in Biophysical Semeiotics. Via Erasmo Piaggio 23/8, 16037 Riva Trigoso (Genoa) Italy
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Sirs, as state Ian Roberts et al. (BMJ 2002;324:1107-1108, 11 May), in such a war, interests of the people, including pedestrians and cyclists, i.e. especially ordinary people, are pitted against the powers that stands to profit from increasing global motorisation. These victims as well as “potential” victims, cannot protect themselves against road traffic injuries, i.e., morbidity and mortality, which show the statistically well documented existence of socioeconomic gradients in both morbidity and mortality due to injury. Apart from different repair according to the different social class gradient, the efficacious protection and the therapy of injuries complications are certainly not the same in every case: very important people, if diseased, fly abroad (for instance to the USA) to obtain a sudden treatment, i.e. without wating lists as happen in every “underdeveloped” countries, like mine, where it seems impossible, apparently, according to VIP, to enjoy suitable medical care. Certainly, the war on the road will not end by the help of manufacturers, official safety agency or actual politicians, on the one hand, neither from the work, already remarkable, of better training doctors. In fact, the burden of disease, due to traffic crashes, by 2002 will reach the third place, moving from the present ninth place. In my opinion, such distressing sight must be enlightened by our western culture destiny (occasum, earth of decline), by “mind ecology” teaching, and finally by the fact that money, not Love, is moving both the world and all others stars. Diagnosis is not therapy, surely, but it is fundamental to it. |
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Brian H Worboys, Finance Manager Magistrates' Association WP1T 6PP
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Sir, Your article "War on the Roads" is right to highlight the toll of death and injury through road accidents as a public health issue, but omits to mention the one measure which would decimate pedestrian and cyclist injuries and that is the separation of traffic from those categories of road user. Virtually no pedestrians or cyclists are injured or killed on motorways, which are the safest part of the road system, yet the government has set its face against new motorways and has drastically cut back on bypasses, preferring to use the presence of pedestrians and cyclists in towns and villages as a means of slowing traffic. On the statistical front too, chaos reigns. We are told that seventy five percent of accidents are due to speed; twenty percent due to fatigue; ten percent due to alcohol; ten percent due to drugs; etc. etc.. It doesn't take much intelligence to add up all the claims and realise that the total well exceeds one hundred percent. The conclusion is that the statistics are unreliable and that every focus group is picking out uncorraberated statistics which support its own viewpoint without checking to see whether they could possibly be correct. By all means let us have a debate. But let it be a rational one driven by reasoned logic, not by spin and black propoganda. |
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Bernard C Abrams, consultant Cheltenham GL 51 0 AF
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Ian Roberts hints in "War on the roads" that there might be some information manipulation at work in terms of the cost-benefit equation of road transport. Perhaps he is guilty of something similar? The following table gives annual global deaths from various causes, sourced from the World Health Organisation. road traffic accidents 1.2 million tuberculosis 1.5 million neonatal death 2.2 million diarrhoea 2.2 million bronchitis 2.3 million AIDS 2.3 million pneumonia 3.5 million stroke 5.1 million coronary heart disease 7.4 million A worrying picture, and without any reference to cancer. Added to this, over 5000 patients die each year from infections caught in hospitals (UK alone) that they did not have on admission, compared to only 3400 UK road deaths. There is a curious sense of life saving priorities at work. In terms of lives saved compared to money spent, there are clearly better things for medics to attend to than to heed yet another bout of politically correct road bashing. Yours faithfully Bernard Abrams |
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Carlos K. B. Ferrari, PhD student Department of Nutrition, Faculty of Public Health University of São Paulo (USP), Av. Dr. Arnaldo, 715 (2ºandar) - Cerqueira César, 01246-904, São Paulo (SP), Brazil
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The discussion of traffic accidents by BMJ is very opportune, especially in developing countries, as is our case. In Brazil, the mortality by road traffic accidents in 1997 was 30.3 deaths/100.000 habitants, causing 35.756 deaths and representing the leading cause of death under the 40 years of age (1). Unfortunately, few initiatives by government and society has been done. Since 1999, as head professor of Epidemiology and Public Health for Physical Therapy students in a private university center of Sao Paulo, we had included the theme with presentation of seminars and discussion of causes, problems, legislation and possible preventive measures for traffic accidents. During the classes, all of us agree that drivers are used to abuse of vehicle velocity and alcohol intake. By this fact, our classes also included seminars regarding alcoholism, one of the most important Public Health issue in Brazil. After taking the classes, many students begun to perceive the seriousness of the traffic accidents and the need for changing risk behaviours in streets and roads. Many of them pointed out the stronger importance that should be the inclusion, since the elementary school, of the Discipline "Education for Transit". And I had, since my six years of teaching many students which had suffered disabilities associated with road traffic accidents. Besides the implementation of the new "National Transit Code" since the end of 1990's, the poor government structure is very far to provide adequate transit fiscalization and punishment of irresponsible drivers, management of streets and roads, and preventive public education for transit. Then, how far millions of brazilians will continue to live dangerously? 1. Ministério da Saúde. Sistema de informações sobre mortalidade. Brasília (DF), 2000. Available at http://www.datasus.gov.br. |
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David G Hammond, unemployed n/a
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Yet another study of previous studies concluding that accidents are inevitable and secondary safety measures are the answer. How about some original research into accident causes? My wife is a NHS worker, working shifts. The constantly changing shift pattern gives no time for acclimatisation, and it's not unknown for a 10pm - 6am shift to be followed by a 2pm to 10 pm one. She often arrives home totally shattered and in no state to have been driving. The NHS is in a perfect position to do a study on how shift patterns affect casualty rates among staff on the trip home. Health and Safety legislation says they should carry out a risk assessment of all work related issues. With access to ambulance driver/paramedic shift/casualty rate figures they could even compare trained drivers with untrained ones. Given the results the NHS could formulate a shift pattern that would reduce the risks to their staff and the public on the roads, and might even benefit their patients (I wouldn't want to be in the hands of a doctor who was as tired as my wife often is!) Or is it just simpler to blame vehicle manufacturers and drivers? |
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Ben Lovejoy, - London EC2A 2JX
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In considering road fatalities as a disease, I think there are three fundamental requirements. First, we must ensure that we view the disease in perspective. While I would definitely like to see the death-toll further reduced, road accidents are fairly low down the list of accidental deaths in the UK. Compare, for example, the 3400 road deaths to the 5000 people who die of MRSA contracted whilst in hospital. More dramatic examples would be breast cancer and lung cancer. It is important that we prioritise resources so as to save the greatest number of lives. Second, when tackling a disease, we need to tackle the illness itself, not just treat the symptoms. The 'Speed Kills' campaign addresses the symptoms: once a crash occurs, then the impact speed will affect the severity of the injuries. However, the root cause of the vast majority of crashes - as any Police accident investigator will confirm - is poor observation, anticipation and judgement. If we can improve those things, we will prevent crashes happening in the first place. Third, we must ensure proper diagnosis. We wouldn't dream of allowing a paramedic, nurse or doctor to diagnose or treat a patient unless they were properly qualified. And yet all kinds of totally unqualified people can be found expounding their own personal theories on what needs to be done to address the problem of road fatalities. Local councillors, MPs, pressure groups and - dare I say it - medical personnel are not qualified to diagnose the problem. The people who are - the police who investigate road accidents - are finding that their views increasingly go unheard. Let's by all means tackle this important problem, but let's do so intelligently. Ben Lovejoy |
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Guy Chapman, - Henley-on-Thames RG9 1UP
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Many councils seem to think that cyclists are safer on shared-use paths, but this trades the risk of collision from same-direction motor vehicles (a rare type of collision) for the risks of pavement cycling, cycling against traffic flow, crossing junctions out of the flow of traffic and so on. Estimates vary, but seem to suggest that pavement cycle paths increase the chances of collision by between 200% and 350% - not a very impressive result for a safety measure. To see the flaw in shared-use paths you need only consider what happens when the path reaches a side turning. The cyclist must look behind, for cars turning left, down the turning, and ahead for cars turning right. Cars turning are less likely to have seen the cyclist (evidence is conclusive: cyclists are most visible when riding somewhat away from the kerb), and cars arriving at the junction will be watching the traffic lanes, not the footpaths. |
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Guy Chapman, IT professional Henley on Thames, RG9 1UP
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Fascinating stuff, but what about car/cyclist collisions? Over two thirds are caused by the driver. The suggested solution? Make cyclists wear helmets. Great. Whatever happend to prevention being better than cure? |
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Paul F Docherty, GP Scott Road Medical Centre, Scott Road, Selby, North Yorkshire YO8 4BL
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Roberts, Mohan and Abassi are absoulutely right in their editorial on road deaths and injuries. But the impact of motor traffic on the Public Health goes far beyond the deaths and injuries on the roads. An often neglected area is the effect of deterring healthy sustainable modes of transport. This often leads to the situation where pedestrians, children and cyclists sensibly avoid dangerous stretches of road. Responsible authorities then turn down requests for slower speed limits, increased enforcement of road traffic laws or road engineering improvements on the basis that the road is not causing sufficient casualties. Thus the dangerous road becomes the ‘safe’ road – but only by clearing all the vulnerable road users out of the way. The long-term effects on the health of the population through the loss of the opportunity for active lifestyles are obvious. Children also have lost the freedom to play and get about independently at a young age. All these effects need to be added to the road casualty figures. We should look to countries that have been relatively successful in this area in trying to tackle this problem. In particular, countries such as the Netherlands seem to have promoted a culture where drivers do not automatically assume that might is right. This is backed up by the law, which gives precedence to vulnerable road users. We also need to be aware of organised opposition to attempts to improve road casualties from extreme groups with a vested interest in opposing, in particular, speed reduction. They may be completely unrepresentative of the community but they are starting to achieve some spectacular successes – notably the bizarre decision by the government to massively reduce the area-wide effectiveness of speed cameras by making them highly visible. Paul Docherty, GP, Selby, North Yorkshire |
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Bogush J Mann, IT NG5 1HN England
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Perhaps an epidemiological study of the spread of speed cameras and growth of speeding fines might not go amiss: A WORCESTERSHIRE MP has questioned the use of speed cameras throughout the county. Bill Wiggin, MP for Leominster, has highlighted recent statistics revealing that although money raised from cameras has doubled since 1996, driver casualties have risen by 11,000..................... ......."The number of motorists caught across Worcestershire has risen by 13 per cent.......... ............"But, at the same time, there are signs that road safety has worsened in many areas - the number of driver casualties from road accidents has increased.......... ....................Throughout Great Britain there has been a seven per cent increase in the number of accidents between 1996 and 2000 and the number of fixed penalties has increased by 116.3 per cent during the same period. Throughout England and Wales, there has been a 127.2 per cent increase in the number of motorists prosecuted for speeding offences detected by camera in the same time. From: http://www.thisisworcestershire.co.uk/worcestershire/worcester/news/WEN_NEWS_LATEST20.html |
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Bogush J Mann, IT NG5 1HN England
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"Most of the "victims" will never own a car"?! Sorry, but the point is? I am quite prepared to accept that all the dead ones won't, but what weight does that add to the research? And how many "victims" of doctors will ever own a hospital, or even a stethescope? I eagerly await the companion report on the socioeconomic gradients in morbidity due to hospitals. Or even rail-roads. How can we end the war on the rail-roads? How about a study on the impact of increasing speeds to 200mph? Or the impact of forward facing seats? Or lack of seat belts? Or lack of segregation in stations and at level crossings? Or safe speeds in the same locations? And if we're really concerned about "victims": how about a study on inebriated and/or drugged pedestrians? Pedestrians, who, though medically not blind, seem incapable of seeing traffic? Oh, yes, and what about motorist victims of the above? |
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Niharika Varma, Student. Leicester High School, Leicester, LE2 2PP
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There is no point in moving to motorised public transport as buses can kill, bus drivers can get sleepy and have a drink. If there are traffic calming and by implication traffic slowing measures , even bus drivers will have to wake up even EARLIER and then get sleepy while driving !!! The answer is to reduce the traffic on the roads by staggering the times people have to get to work, provide lighting on all roads and motorways at night and using high tech solutions to enable public carriers to use air space than road space - thus reducing the possiblity of collisions between people and machine. |
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David Potterton, Medical journalist
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I would like to thank the BMJ for airing the whole subject of road deaths and endeavouring to put this tragic loss of life into perspective. There is no doubt that standards of driving have deteriorated in recent years. The reason that we have speed cameras is that the majority of drivers do not seem to know (or do not want to know) what the figures 30, 40 or 70 mean. Therefore, most drivers are daily committing illegal acts on the roads (except when they see a speed camera). How many deaths are there in the vicinty of speed cameras? |
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Tristram J Torrance, Office Manager 226, Banbury Road, Oxford OX2 7BY
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It is depressing to observe the BMJ getting caught up in the battle of Political Correctness over road deaths. This is a highly fashionable subject among those who love to tell others how to live their lives, offering as it does, the power to administer an immediate dose of guilt to the recipient of such advice, as long as they commit the cardinal sin of owning a motor car. 3,500 deaths a year is about a tenth of the number of people in this country who die as a result of medical practationers' mis-diagnosis, according to a recent article in a national newspaper. Now there, surely, is a subject that really deserves debate in your editorial, a subject of direct concern to the medical profession and one that the profession could really do something about. An interesting fact is that many of the pressure groups which describe themselves as "road safety campaigners" or similar are founded and run by people who have suffered the terrible tragedy of losing family members in road accidents. The law of this country would rightly forbid the victim of any crime from being in any way involved in the trial of the suspect. Why is it then that these people, whose personal involvement is only too painfully obvious, are allowed to set themselves up as authorities on road safety and then to inflict their ill thought out ideas of social engineering on millions of people who just want to get on with their lives? And why does the BMJ, in it's own editorials, seem so keen to jump on this politically correct bandwagon? |
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Bogush J Mann, IT NG51HN England
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David Potterton, Medical journalist, would like to thank the BMJ for airing the whole subject of road deaths and endeavouring to put this tragic loss of life into perspective because he believes that there is no doubt that standards of driving have deteriorated in recent years. He feels that the reason that we have speed cameras is that the majority of drivers do not seem to know (or do not want to know) what the figures 30, 40 or 70 mean. Could this be down to the fact that there is absolutely no consistency or logic in the signing. There used to be guidelines governing the imposition of speed limits. In fact there still are. Unfortunately the authorities seem to have a lot more difficulty in reading the 30, 40, 50, 60 or 70 figures alongside the guideline road categories than motorists have reading the arbitrary and arbitrary and artificially low limit signs. At least the motorists have an excuse. It's a bit hard to read a sign buried in a hedge. Even harder to read a sign that has been removed making a former 40, 50 or 60 road suddenly a 30. And you can hardly blame them for struggling to recognise a pattern when they drive from a 50 or 60 stretch of fairly fast road into a 40 or 50 urbanised but still fast road. Through a very fast and safe section of rural 30! Perhaps it's the motorists fault for missing the camera which should have alerted him to the change in limit? Therefore, he says, most drivers are daily committing illegal acts on the roads (except when they see a speed camera). Not immoral acts. Not unsafe acts. Just illegal acts! How many deaths are there in the vicinty of speed cameras, he asks? How many deaths per billion miles driven I respond? And when you take out the ones caused by psycopaths and sociopaths, and suicidal and drunk pedestrians and cyclists, oh, yes, and overworked doctors? |
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Lyn M Holman, Part time Computing Officer IT Services, University of Reading, RG6 6AF
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As someone who always cycles to work and also uses her bike to do some shopping, go the the Library, etc. and who has been hit by a car who pulled out from a side turning (he did not see me although it was daylight and good visibility - fortunately only my rear wheel was damaged!) I believe there should be more campaigns to make car drivers aware of cyclists. I am sure all cyclists can quote incidents where a driver has overtaken them only to immediately pull in and stop: or alternatively, those drivers who pull out because in both cases they believe, mistakenly, that a cyclist is 'slow' so they have plenty of time. There is also a common belief that cyclists contravene the laws of physics and have to ability to stop instantly whatever their speed! The other major problem is turning right, particularly at roundabouts: again most drivers will quite happily carry on if they see a cyclist indicating a right turn although the same driver will stop if there is a car also waiting to turn right. |
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Alan R, Retired University Lecturer
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Proper training of all categories of road user is to my mind almost the only real way forward in reducing road accidents in general. It is especially important to educate the more vulnerable road user in self preservation, one has a duty to look after oneself and not rely on artificial obstructionism of the powered road user, though he or she does of course have a duty to be alert and mindful of the need for care. No amount of restrictive law will ever prevent a true idiot causing havoc. To this end I do not approve at all of so-called "traffic calming" which in my experience is anything but. Many drivers are plain irritated by queues created by engineered road blockage and are not then liable to be driving calmly and well. Road bumps are another item that should be removed, apart from vehicular damage and possibly damage to sensitive passengers, they must delay emergency services. Driver attention is often diverted in avoiding obstructions rather than observing what really needs to be observed. There is already far too much visual, noisy, needless clutter on the roads as it is. Separate cycle lanes are a good idea if they are genuinely separated as for example the reuse of disused railway track but they are not if the lanes severely cut road widths on busy streets or if cyclists are used as rolling road blocks. Compulsory helmet wearing is fine for children but it is really up to the responsible adult to kit children out properly and for the adult to make his own decisions. As I wrote above, one has a duty to oneself to look out for and avoid hazards, not expect others to legislate all risk out of life, an obvious impossibility. |
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Mel Bartley, Professor of Medical Sociology UCL, 1-19 Torrington Place, London WC1E 6BT
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The toll of child deaths and injuries in traffic accidents is dismaying. But even more dangerous are the chronic diseases we are building up in the population by physical inactivity. To the cost of obesity and its associated ills may be added the costs to the health service and above all to individuals of general unfitness, body dysmorphia and what one newspaper last week describted as 'women's constant battle with food'. Very little prominence has been given, either in the popular or the medical press, to reports by some of the (admittedly few) people who have given up their motor cars. Although the articles I read were not about health, it was striking that all of them mentioned improvements in fitness and loss of weight. The motor car increasingly imprisons us in our own bodies, and from an early age. It is important that people realise that huge road building schemes remained more or less as curiosities, not much used, until governments started to smash up the public transport systems in the 1950s and early 1960s. We see the car as a 'liberation', and in some ways I suppose it may be (I do not have one). But it was not chosen spontaneously by the population, the car economy has been foisted upon us. |
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Giles N Cattermole, SpR A&E UHW, Cardiff CF14 4XW
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Sir, I was somewhat surprised by the front cover of this week's BMJ (War on the roads). The BMJ rightly expects that any clinical photos submitted are accompanied by written consent. Can we therefore assume that the unfortunate young man on the cover had given consent? Or that his family had? And if so, why was this not mentioned? Or as I suspect, if no consent was in fact obtained to publish a rather tasteless photograph for a front cover, will the BMJ be apologising to his family? Sincerely,
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Kuan J Lee, Student University of Sheffield
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Thank you for your articles on this vital issue. I do not think it is beyond your remit as a medical journal to investigate such an important cause of death. I do think it is disingenuous of some correspondents to compare victims of say strokes or MRSA infection with those of RTAs. It is because RTA victims are often young and healthy that makes it such a disaster. That the deaths are often caused by nothing more trivial than impatience (of the victim or otherwise) compounds the sense of waste. I don't know the way to eliminate deaths on the roads, but I know that two conditions must exist: 1. We must all perceive killing with a vehicle as being as profoundly unacceptable as killing with a gun is today. "Accidents" with handguns engender a feeling of disbelief and outrage. So should it be with traffic "accidents". 2. To become safer, we must accept, as a society, some new curbs on our freedoms. All of us now wear seat-belts, even though the vast majority will never need them, to protect the incompetent or unfortunate. We must learn to accept lower speeds (or some other restriction) for the same reason. I hope that with your articles, some of us have started to think about it. |
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nj brooker, sho paediatrics abergavenny
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I too am hugely concerned by the numbers of road traffic victims. Britain's appalling track record in terms of the coverage, safety, punctuality and affordability of our antiquated, disabled and hopelessly inadequate public transport system ensures that these sad statistics, (much-loved family and friends), are going to continue. I drive 35 miles home down the M4, one in every five days after an on -call of 24 plus hours. I would welcome an alternative mode of transport but the one on offer would take two hours at triple the price. We should, however, take on board some of the sensible measures from the Antipodes. Cycling helmets are compulsory for everyone (including children); heavy fines are imposed for those without and consequently the numbers of severe head injuries to cyclists have fallen. Random breath testing in Booze buses is also a common sight, especially at the weekends - a good deterrent and boosts the income of the local cabbies. Far healthier all round. |
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Mike Sales
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If the construction and use regulations for cars were changed so that a driver would be sure to be as damaged as anyone he hit, I believe that the rate of death for drivers would would not increase, but that more vulnerable road users would be much safer. When seat belt wearing was made compulsory the rate of death went up for pedestrians and even more for cyclists. |
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Anthony Papagiannis, Respiratory physician 542 49 Thessaloniki, Greece
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I was disappointed to read that a mere 3400 people die from road traffic accidents every year in the UK. This is unacceptably low from a country with a population of 60 million, when Greece achieves half that number with only one sixth of the available potential victims. I would like to offer a collection of rules for drivers so that--to paraphrase Richard Asher--those who wish to break them may do so with impunity (and with my blessing), and those who want to increase the above quota may enlarge their repertoire and refine their technique [1], at their own (and everybody else’s) peril. 1. Your car is not just a means of locomotion, but an extension of your Ego. Use it accordingly. 2. Driving is a race, and every road is a circuit. Poor condition of the roads simply increases the challenge. 3. Every other car on the road is an antagonist. You must try to beat as many as possible. 4. Pedestrians should be treated as moving targets. By missing them you lose points. 5. Speed limits are previous records to be broken at particular segments of the race. 6. Priorities at road intersections are governed by the ‘first come, first served’ rule. 7. None of the above rules is affected by the presence of traffic lights or other signs. Yours sincerely Anthony Papagiannis MD, MRCP(UK), DipPallMed Respiratory Physician Thessaloniki, Greece 1. Asher R. The Seven Sins of Medicine. In: Jones FA, ed. Richard Asher Talking Sense. Edinburgh: Churchill Livingstone, 1972, p.70 |
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Bruce C McG Williamson, retired LE13 0NT, none
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When airbags first arrived, they were met by scepticism. Now, I would not buy a vehicle without them. But the exclusive 'OR' (actually EOR/XOR) debate about air-bags VERSUS seat-belts, does not give all the story, when the logic is 'AND'. At the roadside rescue when a seatbelt is worn AND the bags deploy, facial and sternal injuries seem very much less common. This implies potential avoidance of future disfigurement and mediastinal injury. The acute airway management at the roadside is also less problematic. One's own experience is too small to be significant, but the overall data is surely there to be analysed. Yours faithfully, B.Williamson
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James P Moore-Smith, GP Registrar Orchard House Surgery, Newmarket, Suffolk, CB8 8NU
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What about automated, on board, radio link to each new vehicle made, by order of law, that prevents the car from exceeding a certain speed in certain areas? If you drive in a 30mph area, the on-board radio linked computer senses the car is in that speed restriction and prevents the car from exceeding 30mph. Occasionally acceleration is the best thing to do in a collision situation with another vehicle. A sudden demand on the accelerator would give acceleration in the short term. Also stop all private vehicles coming into cities such as London and provide many, many buses / minibuses so that waiting time is reduced to a bare minimum |
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Emilie van de Graaff, Travel Plan Coordinator Worcestershire County Council WR5 2XG
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Hear hear to Paul F Docherty's response on the issue of deterring walking and cycling. As well as being deterred by dangerous roads, pedestrians and cyclists will be deterred from this potentially healthy undertaking if they are made to wear helmets. This has already been demonstrated in Australia and other countries where the introduction of compulsory helmets for cyclists has seen people give up cycling. Let's face it, you're probably just as likely (if not more so) to get a head injury while driving, so why not make all drivers where helmets? The issue of mandatory helmets being a deterrent has already been discussed by the BMA in an article for the BBC last June. ("Another independent expert, John Franklin, has analysed the data in Australia and found that while head injuries have fallen by eleven percent - there are 15 percent fewer cyclists on the roads, suggesting the risk has actually increased. It's an argument accepted by Vivienne Nathanson, head of Health Policy at the British Medical Association.") |
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Irvine S.L. Loudon, Medical Historian The Mill House, Wantage, Oxon OX12 9EH
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Seeing the appalling mortality from road accidents and the constant traffic jams of today, it is easy to become nostalgic and yearn for a return to horses and carriages when travel was slower but safer and traffic jams unknown. In fact such nostalgia would be wholly misplaced. By the early 1900s, there were more than 100,000 public passenger vehicles and cabs, around half a million trade vehicles and about half a million private carriages in Britain. In London and other large cities traffic was grinding to a halt because of constant traffic jams, stabling could not keep pace with the increasing number of horses, and it has been estimated that the towns of England had to deal with 10 million tons of horse manure a year – most of which was collected at night and dumped in the poorest areas of towns. Moreover, horses and carriages were noisier, not quieter than cars, so that straw was placed on roads outside hospitals and the homes of the sick to muffle the rattle of iron wheels. But what about safety? In England and Wales in 1905 there were 2.424 road deaths from horses and vehicle - a rate of approximately 70 per million population. This is very close to the rate of mortality from road traffic accidents today. Of course the comparison is far from exact. We have no data on serious injuries in the early 1900s and many who died at the time from injuries would almost certainly have been saved today. But if we express road-transport mortality in terms of road deaths per 1,000 vehicles on the roads, there is no doubt that horses and carriages were a greater danger to the public in 1900 than motor vehicles in 2000.(1) For all these reasons the introduction of motor cars (slowly from about 1890 but very rapidly from about 1905), was seen as the answer to the horrendous problems of horse-driven transport. There would be no traffic jams because cars and lorries took up less road space than carriages and horse-drawn wagons. Cars would be faster but safer because they did not bolt or swerve unpredictably, were easier to control, and better able to brake in an emergency; and cars produced no manure. Further, for people like doctors the capital and the running costs of a car were much less than for horse-drawn transport. Moreover, cars enabled the general practitioner to visit far more patients a day with much less exhaustion. For almost everyone, cars were seen as the answer to their prayers. No one in 1900 could have imagined the problems of road transport we have today. Irvine Loudon 1. Irvine Loudon, ‘Doctors and their transport, 1750-1914.’, Medical History, vol.45, 2001, 185-206 |
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john Nottingham, consultant histopathologist Northampton General Hospital, Northampton NN1 5BD, UK
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It is depressing to see so many of your readers, especially the non- medical ones, trying to blame the BMJ, and other road safety pressure groups, for highlighting the considerable numbers of road casualties both in this country and world wide. This is a serious public health problem and therefore a legitimate topic for a medical journal. It impacts on the running of the NHS in general and my workload in particular. Barely a week goes by without I or one of my colleagues carry out an autopsy on a road crash victim. What many of your correspondents seem to forget is that many of the traffic calming devices and speed cameras would be unnecessary if drivers could be trusted to behave in a responsible and restrained manner. A short trip along any motorway or major road would soon dispel any lingering doubts that the majority of drivers are quite capable of breaking the law if left to their own devices. Even in my small village it is common to see cars travelling at well over 30 mph on a road not much wider than two normal vehicles. Given that the road frequently has horses, tractors and cyclists on it, the potential for disaster is obvious. Indeed just a few weeks ago my wife was nearly hit by a car when it mounted a pavement and some walls in the village are regularly hit by cars, despite being well back form the road. Unfortunately motorists are just a microcosm of our increasingly selfish society in which yobbish behaviour has become the norm rather that the exception. It is regrettable that in a week when so much time has been devoted to improving rail safety in response to a train crash, so many road traffic victims will continue to die or be injured unnecessarily. Competing interests-lifelong cyclist and car driver |
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clancy mcquigg, Firefighter/Emergency Medical Tech owl-vfd 22192
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some thoughts on this problem from one who picks up the pieces of the injured. 1. Cars are inherently dangerous, and all drivers will get in accidents- from their own actions or the actions of others. 2. Seat belts save lives. The most frequent cause of death is unbelted, drunk drivers driving too fast. 3.The next most frequent cause of death is belted, drunk and speeding drivers. I have never run a fatal accident involved a belted passenger/driver of a sober driver not speeding except for t-bone collisions caused by a red- light runner. They exist, but they are rare. 4. The most unforgiveable cause of death is unrestrained children, most of whom are survived by the driver. Unrestrained children involved in auto accidents is the leading cause of unnatural (ie, not disease related) death in children between 2 and 16. 5. child safety seats are a must for those under 8. 6. Pedestrians and drivers do stupid things. Pedestrians and cars cannot mix safely at speeds over 30 kph. 7. Bicycle riders will have accidents just like vehicle drivers. the only protection they have is a helmet. wear one. Adults who refuse to wear seat belts, to restrain their children or wear helmets when riding a bicycle are not victims, they are stupid. For them, the roads present a Darwinian sieve. |
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Rajesh Moholkar, SHO Psychiatry Orchard Unit, Calnwood road, Luton, LU5 0FB
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Dear editor, Ian Roberts et al have brought out this subject of road accidents and the cost we pay towards them. It not only causes deaths and physical suffering, but is also responsible for told or untold mental misery. In my opinion, there is one and perhaps mandetory way of reducing road accidents and that is to improve public transoprt. Most accidents are caused by cars and tend to happen in areas where the traffic tends to be busy. It goes without saying that improved public transport will lead to less number of vehicles on the road and possibly less accidents. The problem is that if there are less cars on the roads, the government will loose substantially in terms of revenue it generates from road tax, petrol, etc. Hence there is little incentive to improve the public transport. It is inevitable that with the increasing numbers of privately owned vehicles, without any corrosponding improvement in the roads, the number of accidents will keep rising. References 1.War on roads. Ian Roberts et al. BMJ2002; 234:1107-1108. |
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Roderick Mackenzie, SpR A&E Royal London Hospital N1
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Editor, I am delighted that the BMJ has chosen to devote a theme issue to the burden of road traffic related injury. I have provided specialist pre- hospital medical support to ambulance services for many years and have often been faced by scenes like the one you featured on your front cover. The picture does not shock me (as no doubt you hoped it might shock others). However, I am shocked that the BMJ, as the journal of the BMA, appears to have demonstrated a blatant disregard for patient confidentiality, good medical practice and the principles of responsible medical journalism. The GMC guidelines on the use of illustrative clinical records for non-medical purposes are quite clear.1 Many hospitals have stricter guidance. If a patient dies without giving consent for the non-therapeutic use of images, they should be retained until a relative can be sensitively approached. If the images cannot identify the patient then they can be used for medical education and research – provided that, as a matter of courtesy, a close relative agrees in writing. Where no close relative is available, the images must not be used. Illustrative clinical records of deceased patients must also be effectively anonymised. Where this cannot be done, they should not be employed for educational or research purposes. The patient featured on your front cover is clearly deceased and clearly identifiable by his nationality, the nature of the incident and the characteristic features of the vehicles. The BMJs own guidance for authors states ‘If there is any chance that a patient may be identified from a case report, illustration, or paper we ask for the written consent of the patient for publication’ 2 The BMJ has previously complained to the to the ‘press and broadcasting regulatory bodies’ regarding the use of illustrative clinical records without consent on the basis that the media had invaded the privacy of the patient, undermined the doctor-patient relationship, and made it less likely that patients will consent to have material about them published in medical journals. 3 All patients have ethical and legal rights in respect of images taken of them and it is the duty of the profession to protect these rights at all times. Can you confirm that you have the necessary consent in this case ? Would you have printed a picture of a young man from the UK on the front cover even with consent ? References 1.Making and using visual and audio recordings of patients. General Medical Council September 1997. 2.see http://bmj.com/advice/6.html (accessed on 11 May 2002). 3.Informed consent: edging forwards (and backwards). Editorial. BMJ 1998;316:949-951. |
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Donald Kent, Travel Plans Newcastle City Council Civic Centre, NE1 8PD
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The current cyclists are a hardcore who are prepared to put up with the current appalling conditions. Their number (including me) are so small that they are insignificant in almost any terms you care to mention. Ranged against is the mighty monster of the car culture industry which is now deeply embedded in the nations soul - including most "environmentalists" and almost every transport planner and health professional. (Its like People smoking 60 a day advising you to give up.) The people we can move onto bikes are at best 10-15% up from the current 1 0r 2% of trips. It is their needs we should be concentrating on. What they want is segregation and show it by using segregated tracks for leisure purposes. Current segregation is just appalling. The Sustrans and local authority network, good as it is, is littered with gates and consists mainly of ash coated paths which vanish as soon as a more profitable use for the land is found. We need to set aside a core route of cycle paths that join up with each other and dont involve loads of road crossings and sections on road. Once we have built up a good mass we can then start to think about roads. We must ask the people who may not the people who are. |
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Dawn M Luxton, ex nurse 14 Methley Terr, Leeds, LS7 3NL
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As an ex nurse with casualty experience, I sufferd 2 R.T.A.s last year, the first being hit by 'drunk driver',the second resulting in minor head injury. On both occasions I was asked 'Was I wearing a helmet?. Is this a standard question for motorists too? On neither occasion was I asked whether 'protective' measures had been taken e.g. flourescent clothing, adequate lights etc. Health education was integral part of my nurse training. Passing judegment on my patiants was not. Road death tolls are a serious problem. But so is the attitiude of many within the NHS who treat those adults who are not drunk, do not drive, take reasonable safety precautions and have at least one aspect of a healthy lifestyle. We are called cyclists. |
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J Gordon Avery, Retired Public Health Physician The Beeches 56 Kenilworth Rd Leamington Spa Warks CV32 6JW, Penny Avery
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We have read the series on War on the roads (BMJ 11 May 2000) with great interest. The series has rightly given prominence to the plight of the vulnerable road user and the need to return the streets to the people in poorer countries (1). It has given less prominence, however, to similar needs in developed countries The United Kingdom has for many years had one of the best records in the world for reducing road traffic accidents. The one glaring anomaly has been in pedestrian accidents. We have made steady progress in reducing child pedestrian fatalities and injuries since the early 1970’s but we are still placed only 15th out of 29 countries listed in the most recent edition of Road Accidents Great Britain 2000 The reason for our poor position has little to do with the education of road users and designing soft impact areas into cars. It does have a great deal to do with the design of the urban environment. Whilst some good progress has been made most notably with the development of “Home Zones” (2) we still fall a long way behind our European neighbours in making our urban environment safe for children. Some twenty years ago we described the enlightened approach that was being taken by the Scandinavians and the Dutch in creating urban environments which were friendly to vulnerable road users. (3) The Dutch had their woonerfs or living streets whilst the Scandinavians had their mini village complexes with walk/cycleways, green belts, play spaces, crèches and shops all within easy pleasant motor vehicle free access to the residential areas. In contrast in the United Kingdom we have continued to build tightly packed housing estates with fast moving vehicles and potential walk/cycleways blocked off for security reasons. We have “No Ball Games” signs on the sparse green areas and playgrounds sited “out of sight out of mind”. No wonder our children spend most of their time watching TV. When they come out to play they face a very hostile environment. If we are to make further progress in reducing the high pedestrian death and injury rates we need a major change in attitude from our politicians, planners and developers. We need to give top priority to the vulnerable road users and severely restrict the motorist in all urban areas. We need to redesign and rebuild all our socially and economically deprived areas in order to address the gross inequalities that exist at present. This may prove to be more cost beneficial than all the other efforts put together. It is only with some enlightened planning and development and less emphasis on vested interests that we will see our urban areas regenerated. This might then help to change our unenviable position in the middle rankings of countries that have tried to tackle the child pedestrian accident problem. 1 Tiwari G Returning streets to the people. BMJ 2002 324 1164 2 Biddulph M Home Zones: a planning and design handbook. London. The Policy Press 2001 3 Avery JG & Avery PJ Scandinavian and Dutch lessons in childhood road traffic accident prevention. BMJ 1982 285 621-6 |
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Richard Smith, Editor BMJ
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Both Dr Mackenzie and Dr Cattermole argue that the BMJ has double standards when it comes to publishing pictures of patients. They ask if we have written consent from the dead man depicted on the cover of our "War on the roads issue?" We do have double standards, but we believe that they are legitimate--and our ethics committee agrees. The written consent applies to information about patients that emerges from the doctor-patient relationship. Patients expect that relationship to be confidential, and information about them should be disclosed only with their consent. Pictures that are taken outside of that relationship are wholly different, and the same rules do not apply. News photographers do have codes about consent, but they are not nearly as strict as those covering the doctor-patient relationship--and nor should they be. Our ethics committee agrees that with such photographs it is legitimate for the BMJ to apply the same rules as the rest of the press. Richard Smith,
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Bogush J Mann, IT NG5 1HN
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A lot of talk here about "vulnerable" victims, "reclaiming" the CAR- riageways for "people" (those tin boxes contain several) and there being no point in training and educating children. These same people probably tell their kids to go out into the street to play to show those motorists who the CAR-riageway belongs, spend a fortune sending them to the best public schools to be trained abnd educated, and drag them along to anti-bypass protests. Developed countries, unlike the UK, have vastly superior motorway and trunk road networks, make it illegal to jaywalk, and teach their kids not to put their hands in the fire, play with sharp implements, or play on the CAR-riageway. And that's why they have low child casualty rates. And it's also why they can afford the LUXURY of home zones and letting their kids play in them. Whilst this country insists on on forcing cars which account for over 80% of all passenger miles (including planes and ferries) and most of it's freight through the middle of towns and villages, and it's kids to believe that cars MUST stop for them, children will continue to be innocent and vulnerable "victims". But not of motorists. But of self styled "safety" experts, politicians who can't drive, "Doctors" who seem to have lost the capacity for research and logical thought, and their parents. Ask your children what the stopping distance from 30 is: not one will know. Do you? |
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Renato Seligman, Professor of the Department of Internal Medicine - Universidade Federal do Rio Grande do Sul Hospital de Clinicas de Porto Alegre 90035-002
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Editor- There are alternatives and hope to control the high burden of traffic injuries in developing countries. It is much possible to increase the number of vehicles and simultaneously decrease the number of injuries with enforcement of traffic safety regulations. We have interesting numbers in Rio Grande do Sul state, Brazil (Table), after the implement of the new National Traffic Code. It establishes heavy fines for exceeding the speed limit and accounts cumulative points obtained for each transgression, which can lead to temporary suspension of the Drivers License. Furthermore, there were installed speed cameras on roads and important avenues, even though with warning signs where cameras are positioned. These actions, allied to a more severe control for seat belt use, lead to a significant decrease in injuries and deaths in this state comparing 1997 to 2000 rates (RRR = 0.31 95%CI (0.21,0.41) for deaths/vehicles and RRR = 0.31 95%CI (0.23 to 0.38) for injuries/vehicles). Table: Deaths and Injuries related to Traffic Accidents in Rio Grande do Sul, Brazil, from 1997 to 2000. Year Deaths Injuries Nº vehicles Population 1997 1,144 18,884 2,619,719 9,634,688 1998 952 15,317 2,730,490 9,634,688 1999 902 15,038 2,972,383 9,634,688 2000 887 14,712 2,974,883 10,179,801 Detran-RS – Coordenadoria de Estatística (www.detran-rs.gov.br) Data from state roads, federal roads and capital of the state. Prof. Renato Seligman
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Richard M Keatinge, doctor Anglesey, UK
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In Holland, more people cycle more safely than in the UK. We could easily import one reason for this; after any road trauma in Holland, the better-protected party is held legally responsible. This extra, legal risk to drivers is likely to make them much more careful of less-dangerous road users. Gerald Wilde (BMJ 2002;324:1149-1152 (11 May); http://bmj.com/cgi/content/full/324/7346/1149 admirably demonstrates the reality of risk compensation. Risk compensation can work for us. Here is that unusual thing; a simple, if partial, solution to a complex and intractable problem. Let's go Dutch. Let the law protect the weaker party. Let's make our roads safer to use. |
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John T Dwyer, Freelance writer Bookham, Surrey
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It’s galling to read so many complaints about political correctness in a journal like the BMJ. But the complaints do at least illustrate the extent of driver unreason. Normally you can write off Anti-PCs as people who can’t bear the idea that more enlightened times have put their abnoxious attititudes beyond the pale. The Anti PCs may insult people whose skins, or accents, or origins, or sex, are different from their own but the physical harm they do is limited unless, as occasionally happens, they provoke others to commit violence against them. Here, as elsewhere, they blame the victim. But this time the victim is not merely reviled. The victim is injured or dead. And they shouldn’t be. It is not good enough to argue, as Bernard C Abrams does, that TB or coronary heart disease kills more people. Far more children are killed by cars than by predatory paedophiles but we don’t accept the latter risk as ‘tolerable’ on that account. If you analyse the assumptions drivers have to make before they assert that road safety campaigners are being unreasonable, you have to conclude that drivers believe not just that their business is inherently more important than that of anyone on foot, but that their business is inherently more important even than the lives of anyone on foot. There is no other explanation for their attitudes. Scratch a driver and you find someone who really believes he or she has the right to kill people who happen to be in the wrong place at the wrong time. How else do you explain the way a man told me over lunch about a neighbour’s recent experience? He had turned too fast round a corner and run into two young girls on a crossing. One was killed, the other badly injured. “Poor chap,” said the man, “He didn’t stand a chance!” I’ll bet his neighbour received a fine. I’ll bet the girls' parents wished they could have got away so lightly. This is a British problem. Walk around Vancouver, or Detroit, or even parts of southern Portugal, and most drivers will stop to let you cross the road they are turning into. This provision remains in our highway code but has been steadily watered down by officials anxious to please drivers. Drivers in these other places see absolutely no reason to treat people on foot as any different from themselves. It’s a British problem because, as a legacy of the days when the gentry drove round in carriages, generations of school children have been indoctrinated to defer to drivers. If they so much as hear a car, they are taught to wait until it goes by. The lesson is that the police and others who indoctrinate children this way are not teaching pedestrians, they are teaching tomorrow’s drivers. When these children pass their tests they expect a level of abjection that no civilised society would tolerate. This is a BMJ matter, because people who don’t accept a duty of care to other road users, who drive without regard for the safety of others are unwell, whatever the medical term. If they exhibited the same behaviour in any other context than a conflict between driver and pedestrian or cyclist they would be sectioned as sociopaths. It is a BMJ matter because, once the illness is recognised, which may be beginning to happen, one wonders how the NHS will cope with their treatment. Yours sincerely, John Dwyer |
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Anthony J Cartmell, Software engineer
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The Transport Research Laboratory report 323 "A new system for recording contributory factors in road accidents" looked at different ways to collect and interpret road crash data, using eight volunteer police forces. It was not a study of the causes of crashes. Although this report is widely quoted by members of the Association of British Drivers, it is of no use to this debate. Those looking for evidence that speeding causes crashes might like to read TRL report 421 "The effects of drivers' speed on the frequency of road accidents", PR058 "Speed, speed limits and accidents", CT084.1 "Speed and road accidents update (94-98)", and LR88 "The relation between a driver's speed and his accident rate". |
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Bogush J Mann, IT NG51HN
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Anthony J Cartmell writes (something disturbingly familiar): > The Transport Research Laboratory report 323 "A new system for recording contributory factors in road accidents" looked at different ways to collect and interpret road crash data, using eight volunteer police forces. It was not a study of the causes of crashes . Although this report is widely quoted by members of the Association of British Drivers, it is of no use to this debate. Yes, only eight (major metropolitan?) police forces. Then the Transport Research Laboratory did say that: > Knowledge about the factors which ** contribute to the occurrence ** of road accidents can make a vital contribution to devising methods for improving road safety.....also held the more subjective contributory factors which were recorded by police officers.......a number of forces have ceased to collect these factors and the systems used by the remainder have diverged. > A new system has been developed at TRL......report summarises the development of the new system, describes the trial ** and presents analyses of the data collected to demonstrate the type of results that can be achieved ** So "not a study of the causes of crashes" at all then. But you could probably tell that from the title: "A new system for recording contributory factors in road accidents" Unlike the following, also widely circulated on reclaim the streets type web sites: > Those looking for evidence that speeding causes crashes might like to read TRL report 421 "The effects of drivers' speed on the frequency of road accidents" But then, of course, this was done using nine, or was it ten police forces. Though only on some (specific types) of their roads, rather than all of them as in TRL 323, if memory serves. |
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Sophie A Evans, clerical assistant Manchester Metropolitan University, M15 6BG
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I have been reading all of these responses with great interest. As a cyclist who cycles to work during rush hour every day, I effectively risk my life each day. This is not out of choice. My deciding to use my bike is a choice. I do not accept that, as a necessary and unavoidable consequence of that choice, I am generally "asking" to be knocked off my bike. Every day I encounter buses who seem to think it funny to overtake and then pull in in front of me with no warning at all; drivers who ignore my signals and overtake me as I'm about to turn right; pedestrians who seem not to see me at all, despite the so-called "high visibility" jacket. In fact, quite often when you're on a bike, you get the feeling that you must be nothing more than a figment of your own imagination because other road users seem to think you don't count, somehow. Given a choice, I would rather not have to share the "CAR-riageway" with double-decker buses. But in most cases I am not given that choice because the available space is being taken up by double-decker buses or cars, which are obviously far more important (because these people pay good money etc etc ad nauseam...). Given a choice, I would like to be able to take a route to work that was safe, well-designed and well marked. But for most of the journey, I am not given that choice. When will drivers realise that, for the best part of last century, they had everything their way? As a result, we now have a rail system that is falling apart at the seams, a massively inadequate system of paths for cyclists and pedestrians, ever- increasing asthma rates and cities which, for hours and hours each day are utterly gridlocked. Oh yes, and "road rage", which seems to be the most appalling attempt to justify impatience and violent behaviour yet. If I attack a pedestrian who has walked into the cycle path and knocked me off my bike does calling it "cycle rage" explain me beating that pedestrian to a pulp? Shooting him/her? We are constantly being told by the car lobby that environmentalists are merely people who want to spoil drivers' fun. When will drivers realise that if what they entitle "fun" actually means reducing someone else's standard of living, or doing them physical harm, then they should really be looking at other ways of having fun. |
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Norman Armstrong, Development worker (mental health) Common Wheel Glasgow G20 9BD
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Mr Torrance's response to the question of road deaths is painfully stupid. The concern the BMJ has and we working in the field of health, both mental and physical, is nothing to do with PC. Cars are in our view the most detrimental aspect of modern consumer society, not only killing vast numbers of people, maiming even greater numbers, but contributing to the general psychosis of a system where roads replace community. There is nothing "fashionable" about opposing the car as Torrance claims. Indeed the car is the ultimate fashion icon of western capitalist civilisation. Torrance's suggestion that those most personally affected by car-related suffering be excluded from the debate is execrable. He claims to speak in favour of those who 'just want to get on with their lives', yet his selfishness blinds him to the fact that all car-victims wanted to do is get on with their lives, a contingency which their death renders somewhat difficult. And now Torrance would even deny them a right to protest against this killing machine. Such fascist thinking has no place in rational debate. Norman Armstrong Competing interests: None declared |
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