Intended for healthcare professionals

  1. Research
  2. The carnage wrought by...
  3. The carnage wrought by major economic change: ecological study of traffic related mortality and the reunification of GermanyCommentary: Road deaths in European countries
Papers

The carnage wrought by major economic change: ecological study of traffic related mortality and the reunification of GermanyCommentary: Road deaths in European countries

BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7199.1647 (Published 19 June 1999) Cite this as: BMJ 1999;318:1647

All rapid responses

Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.

From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.

The word limit for letters selected from posted responses remains 300 words.

Carnage confounded

Winston et al showed a surprising and dramatic increase in death
rates of car occupants following the reunification of Germany. The
authors conclude that sudden economic
change, the increased availability of cars and numbers of inexperienced
drivers were major contributing factors. There are however, other
possible explanations for the rise in deaths among car occupants. Hence,
more data is needed before public health policy recommendations can be
made.

Some of the other factors which may have changed around reunification
include: increases in some or all of drink driving, joy-riding, speed
limits and number of
occupants per car; or reduced use of seat belts, more inefficient policing
and poorer emergency responses due to breakdown in public services.

Further information is needed on trends in these factors at
population level and more detailed information about the characteristics
of individual accidents leading to death
(e.g. location, blood alcohol levels, age of driver, type of car,
conditions of road and road signs and use of seat belt). Also, details
about the geographical location of accidents may show ‘black spots’ which
warrant further investigation.

We know that many young people are dying on East German roads but we
do not know who they are. Are they the drivers of cars or simply
passengers? The accidents may be a
result of West Germans or other nationals driving powerful Western cars on
unfamiliar roads.

The study highlights the problem which occurred and is a useful tool
for sparking further investigation. It faces the problem of all
ecological studies in drawing conclusions from non-specific data. Only by
combining the information put forward in this study with more focused
information can sensible suggestions for public health measures be made
for developing countries as the author suggests.

Liza Hirst, Neil Jennings, Ruth Ting, James Wilson
Stage 3 MBBS
University of Newcastle-upon-Tyne

Competing interests: No competing interests

22 July 1999
Ruth Ting
3rd Year Medical Student
Newcatle University Medical School
Back to top