Intended for healthcare professionals

Rapid response to:


Unsafe driving behaviour and four wheel drive vehicles: observational study

BMJ 2006; 333 doi: (Published 06 July 2006) Cite this as: BMJ 2006;333:71

Rapid Response:

Risk taking behaviors of SUV drivers

Over 30 million people have died in traffic crashes since the very
first pedestrian death in 1898 and show little improvement in traffic
safety in first half decade in 21st century. (1) A recent world forum for
the harmonization of vehicle regulations revealed that when a Sports
Utility Vehicle (SUV) strikes a car in frontal impact, there are four
driver fatalities in the car for every driver fatality in the SUV. The
problem is even worse in side crashes. When SUVs strike passenger cars on
the side, there are 22 passenger car driver fatalities for every SUV
driver fatality. (2)

A recent British Medical Journal (BMJ) editorial has noted that two
independent trends motorized countries are likely to reverse some of the
improvements that have been made in road safety. The first trend is the
aging of the population and its impact on traffic injuries and fatalities
in the world. The second trend is increasing SUVs and its impact on
overall traffic safety in globe. (3). In 2000 Road crashes killed over 40,
000 people in the European Union and more than 1.3 million road crashes
involved personal injury.(4)

In North America popularity of SUVs, Pick up trucks and even heavier
trucks including the military tank like Hummer is soaring. Important
reason for the popularity of SUVs is that people view them as providing
better protection to their occupants in crashes. (5) This in reverse
influence SUV and large pick up truck drivers to engage in risk taking
behaviors such as non compliance of seat belts, speeding and driving while
using cell phones (6) and similarly one previous study has shown that
drivers responded to the increased safety that seat belts provided by
driving speeding excessively (7). Rollover risk depends particularly
steeply on driver behavior, particularly speed choice and number of SUVs
roll over crashes and fatalities are significantly higher in North
American roads due to speeding related behavior of SUV drivers.

The National Highway and Traffic Safety Administration (NHTSA)
estimates that shoulder and lap belt use in automobiles reduces the risk
of death by 45% and the risk of severe injury by 50%, while their use in
light trucks lowers the risk of death by 60% and severe injury by 65% (8).
In comparison, air bags reduce the risk of death by only 12%. Seat belt
use has also been shown to decrease medical costs associated with motor
vehicle crash-related injuries. Over 26 billion dollars in costs could be
saved each year if seat belt use were universal (9).

Motor vehicle crashes contribute significantly to the burden of
injury and deaths worldwide and risky driving behaviors, such as drink
driving, speeding, driving and cell phone use and non-use of seatbelts are
considered responsible for a significant proportion of this global burden
(10). Evidence based guidence to develop policies which seriously
addresses the driver risk taking behavior, is necessary to achieve further
prevent loss of lives on the road. Since motor vehicle crash-related
injuries are a major cause of death, disability, and years of potential
life loss the prevention of motor vehicle crash-related injuries would
seem to be a particularly important priority for policy makers, health
care industry, and insurance companies, in an effort to maximize the
efficiency of dollars spent in health care.


(1) Desapriya E., Pike I., Raina P., Severity of alcohol-related
motor vehicle crashes in British Columbia: case - control study.Int J Inj
Contr Saf Promot. 2006; 13(2):89-94

(2) World Forum for the Harmonization of Vehicles Regulations-
(accessed 29th June 2006)

(3) Simms, C., O'Neill, D., Sports utility vehicles and older
pedestrians BMJ 2005; 331: 787-788

(4) European Commission European Transport Policy for 2010: time to
decide. White paper COM (2001), 370, 2001.

(5) White, M. The "arms race" on American roads: the effect of sport
utility vehicles and pickup trucks on traffic safety. J Law Economics
2004;47:333 -355.

(6) Walker, L., Williams, J., Jamrozik, K., Unsafe driving behavior
and four wheel drive vehicles: observational study. BMJ 2006; 0:

(7) Peltzman, S., The effects of automobile safety regulation . J
Pol. Econ 1975;83 ;677

(8) Halman, S.I., Chipman M., Parkin P.C., et al. Are seat belt
restraints as effective in school age children as in adults? A prospective
crash study. BMJ 2002; 11; 324(7346):1123.

(9). Blincoe, L., Zaloshnja E., Miller T. R., et al. The economic
impact of motor vehicle crashes, 2000. Washington, DC: U.S. Department of
Transportation, NHTSA, 2002.

(10). World Health Organization-Facts about injuries: Road traffic
injuries, World Health Organization, Geneva 2003.

Competing interests:
None declared

Competing interests: No competing interests

01 July 2006
Ediriweera Desapriya
Research Associate
Dr. I. Pike
Department of Pediatrics, Centre for Community Child Health Research 4480 Oak Street V6H 3V4