Annals of Health Law
MAKING A POSITIVE IMPACT
rising tide of road deaths was perceived by government and the public to be
unacceptable.17 Dr. John Birrell, Victorian Police Surgeon (1957-1977),
made this point historically in the context of Victoria18 while the modern-day
“Make Roads Safe” campaign is purposely designed to overcome inaction.19
With the realization that the increasing number of deaths was no longer
acceptable came the systematic development of public safety measures and
their implementation.20 These measures, some of which were, and still are
today, highly contentious in the eyes of the public because of the perceived
infringement of civil liberties, include speed control, mandatory seat belt use,
and laws designed to prevent driving under the influence of alcohol.21 In
addition to these measures focused on behavioral aspects of driving,
improvements in road infrastructure and vehicle safety were also
implemented.22 In each case, underpinning these innovations in safety were
new or revised legislative and/or regulatory instruments23 or, in the case of
infrastructure, highway safety codes.24
This holistic and systematic approach to road safety sets the basis for
current thinking around the state of the scientific art on road trauma
prevention, where the crash prevention and injury mitigation focus is on the
pre-crash, crash, and post-crash phases. This systematic approach to
understanding crash risk factors was first articulated by William J Haddon in
1968,25 where he described what has become known as the “Haddon Matrix.”
17. See KOPITS & CROPPER, supra note 8, at 11; see WHO, WORLD REPORT ON ROAD
TRAFFIC INJURY PREVENTION 39-40 (Margie Peden et al. eds., 2004), available at
[hereinafter WHO WORLD REPOR T].
18. See BIRRELL, supra note 12.
19. See COMM’N FOR GLOBAL ROAD SAFETY, MAKE ROADS SAFE: A DECADE OF ACTION
FOR ROAD Safety (2009), available at http://www.makeroadssafe.org/publications/
20. See Murray May et al., Progressing Road Safety Through Deep Change and
Transformational Leadership, 19 J. OF TRANS. GEO. 1423, 1423–30 (2011); see, e.g., WHO
WORLD REPORT, supra note 17 (providing a systematic examination of the effectiveness of
road safety interventions, and an outline of the role of leadership in their delivery).
21. See BIRRELL, supra note 12; see also PETER VULCAN, THE ROAD TOLL IN VICTORIA –
AN OBJECTIVE ANALYSIS (1993); see also Parts III and V of this article, infra.
22. See VULCAN, supra note 21; WHO WORLD REPORT, supra note 17, at 113-26.
23. Brian O’Neill, Preventing Passenger Vehicle Occupant Injuries by Vehicle Design—
A Historical Perspective from IIHS, 10 TRAFFIC INJURY PREVENTION 113, 114 (2009).
24. See, e.g., 23 U.S. C. §§ 101–610 (2011).
25. William Haddon Jr., The Changing Approach to the Epidemiology, Prevention, and
Amelioration of Trauma: The Transition to Approaches Etiologically Rather Than
Descriptively Based, 58 AM. J. PUB. HEALTH NATIONS HEALTH 1431 (1968), available at
Haddon “defined three phases of the time sequence of a crash event – pre-crash, crash and
post-crash – as well as the epidemiological triad of human, machine, and environment that can